Learn About Vulvovaginitis

What is the definition of Vulvovaginitis?

Vulvovaginitis or vaginitis is swelling or infection of the vulva and vagina.

Vaginitis is a common problem that can affect women and girls of all ages.

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What are the alternative names for Vulvovaginitis?

Vaginitis; Vaginal inflammation; Inflammation of the vagina; Nonspecific vaginitis

What are the causes of Vulvovaginitis?

INFECTIONS

Yeast infections are one of the most common causes of vulvovaginitis in women.

  • Yeast infections are most often due to the fungus Candida albicans.
  • Candida and the many other germs that normally live in the vagina keep each other in balance. However, sometimes the number of candida increases. This leads to a yeast infection.
  • Yeast infections often cause genital itching, a thick white vaginal discharge, rash, and other symptoms.

The vagina normally contains both healthy bacteria and unhealthy bacteria. Bacterial vaginosis (BV) occurs when more unhealthy bacteria than healthy bacteria grow. BV may cause a thin, gray vaginal discharge, pelvic pain, and a fishy odor.

A less common type of vaginitis is spread by sexual contact. It is called trichomoniasis. Symptoms in women include genital itching, vaginal odor, and a heavy vaginal discharge that may be yellow-gray or green in color. Women may also experience vaginal spotting after intercourse.

OTHER CAUSES

Chemicals can cause itchy rashes in the genital area.

  • Spermicides and vaginal sponges, which are over-the-counter birth control methods
  • Feminine sprays and perfumes
  • Bubble baths and soaps
  • Body lotions

Low estrogen levels in women after menopause can cause vaginal dryness and thinning of the skin of the vagina and vulva. These factors may lead to or worsen genital itching and burning.

Other causes include:

  • Tight-fitting or nonabsorbent clothing, which leads to heat rashes.
  • Skin conditions.
  • Objects such as a lost tampon can also cause irritation, itching, and strong-smelling discharge.

Sometimes, the exact cause cannot be found. This is called nonspecific vulvovaginitis.

  • It occurs in all age groups. However, it is most common in young girls before puberty, particularly girls with poor genital hygiene.
  • It causes a foul-smelling, brownish-green discharge and irritation of the labia and vaginal opening.
  • This condition is often linked with excess growth of bacteria that are typically found in the stool. These bacteria are sometimes spread from the rectum to the vaginal area by wiping from back to front after using the toilet.

Irritated tissue is more likely to become infected than healthy tissue. Many germs that cause infection thrive in a warm, damp, and dark environment. This can also lead to a longer recovery.

Sexual abuse should be considered in young girls with unusual infections and repeated episodes of unexplained vulvovaginitis.

What are the symptoms of Vulvovaginitis?

Symptoms include:

  • Irritation and itching of the genital area
  • Inflammation (irritation, redness, and swelling) of the genital area
  • Vaginal discharge
  • Foul vaginal odor
  • Discomfort or burning when urinating
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What are the current treatments for Vulvovaginitis?

Creams or suppositories are used to treat yeast infections in the vagina. You can buy most of them over-the-counter. Follow the directions that came with the medicine you are using.

There are many treatments for vaginal dryness. Before treating your symptoms on your own, see a provider who can find the cause of the problem.

If you have BV or trichomoniasis, your provider may prescribe:

  • Antibiotic pills that you swallow
  • Antibiotic creams that you insert into your vagina

Other medicines that may help include:

  • Cortisone cream
  • Antihistamine pills to help with itching

Be sure to use the medicine exactly as prescribed and follow the instructions on the label.

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What is the outlook (prognosis) for Vulvovaginitis?

Proper treatment of an infection is effective in most cases.

When should I contact a medical professional for Vulvovaginitis?

Call your provider if:

  • You have symptoms of vulvovaginitis
  • You do not get relief from the treatment you receive for vulvovaginitis
How do I prevent Vulvovaginitis?

Keep your genital area clean and dry when you have vaginitis.

  • Avoid soap. Just rinse with water to clean yourself.
  • Soak in a warm, not hot, bath to help your symptoms. Dry thoroughly afterward.

Avoid douching. Many women feel cleaner when they douche, but it may actually make symptoms worse because it removes healthy bacteria that line the vagina. These bacteria help protect against infection.

Other tips are:

  • Avoid using hygiene sprays, fragrances, or powders in the genital area.
  • Use pads instead of tampons while you have an infection.
  • If you have diabetes, keep your blood sugar level in good control.

Allow more air to reach your genital area. You can do this by:

  • Wearing loose-fitting clothes and not wearing panty hose.
  • Wearing cotton underwear (instead of synthetic fabrics) or underwear that has a cotton lining in the crotch. Cotton allows normal evaporation of moisture so that moisture buildup is reduced.
  • Not wearing underwear at night when you sleep.

Girls and women should also:

  • Know how to properly clean their genital area while bathing or showering.
  • Wipe properly after using the toilet. Always wipe from front to back.
  • Wash thoroughly before and after using the toilet.

Always practice safe sex. Use condoms to avoid catching or spreading infections.

Female perineal anatomy
What are the latest Vulvovaginitis Clinical Trials?
Prospective Studies of Vaginal Yeast and Microbiome Related to Vulvovaginal Candidiasis in Canadian Females
Summary: Vulvovaginal candidiasis (VVC; colloquially referred to as a 'yeast infection') is a prevalent mucosal infection caused by Candida spp. that affects75% of women at least once in their life. VVC usually responds well to treatment, yet a small but significant fraction of women experience recurrent yeast infections even with weekly treatment. A further complication in understanding the causes of recu...
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Evaluation of Performance and Safety of the CE Marked Medical Device Class IIb Celegyn® in Vulvovaginal Atrophy (VVA): a Randomised, Double-blind, Parallel Groups, Multicentric, Placebo-Controlled, Prospective Clinical Study
Summary: The aim of this study is primarily to investigate the performance of Celegyn®, a hyaluronic acid-based vaginal cream (CE marked 0546 medical device), enriched with plant-based ingredients, in comparison with placebo, in promoting vaginal health in adult woman reporting symptoms of vulvovaginal atrophy - VVA (or atrophic vulvovaginitis)
What are the Latest Advances for Vulvovaginitis?
Treatment of Recurrent Vulvovaginal Candidiasis With Ibrexafungerp.
Summary: Treatment of Recurrent Vulvovaginal Candidiasis With Ibrexafungerp.
Vaginal bleeding in prepubertal females: a case of Shigella vaginitis and review of literature.
Summary: Vaginal bleeding in prepubertal females: a case of Shigella vaginitis and review of literature.
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Effectiveness of redcore lotion in patients with vulvovaginal candidiasis: a systematic review and Meta-analysis.
Summary: Effectiveness of redcore lotion in patients with vulvovaginal candidiasis: a systematic review and Meta-analysis.
Who are the sources who wrote this article ?

Published Date: June 03, 2020
Published By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Abdallah M, Augenbraun MH, McCormack WM. Vulvovaginitis and cervicitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 108.

Braverman PK. Urethritis, vulvovaginitis, and cervicitis. In: Long SS, Prober CG, Fischer M, eds. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 51.

Gardella C, Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23.

Oquendo Del Toro HM, Hoefgen HR. Vulvovaginitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 564.