Summary about Disease
Vulvovaginitis is an inflammation or infection of the vulva (the external female genitalia) and vagina. It can result from a variety of causes, including infections, irritants, or allergies. It's a common condition affecting women of all ages.
Symptoms
Itching or burning sensation in the vulva and vagina
Abnormal vaginal discharge (color, consistency, or odor)
Redness or swelling of the vulva and vagina
Painful urination
Painful sexual intercourse
Vaginal odor
Vaginal spotting or bleeding
Causes
Infections:
Bacterial vaginosis (BV)
Yeast infections (candidiasis)
Trichomoniasis (a sexually transmitted infection - STI)
Chlamydia (an STI)
Gonorrhea (an STI)
Herpes (an STI)
Irritants:
Soaps, detergents, douches, feminine hygiene sprays
Perfumed tampons or pads
Tight-fitting clothing
Spermicides
Latex condoms (allergy)
Allergies:
To latex, spermicides, or other products
Other:
Hormonal changes (e.g., menopause, pregnancy)
Foreign bodies (e.g., forgotten tampon)
Poor hygiene
Medicine Used
The specific medication used depends on the cause of the vulvovaginitis:
Bacterial Vaginosis (BV): Antibiotics such as metronidazole or clindamycin (oral or vaginal).
Yeast Infections: Antifungal medications such as fluconazole (oral), or clotrimazole, miconazole, or terconazole (vaginal creams or suppositories).
Trichomoniasis: Antibiotics such as metronidazole or tinidazole (oral; both partners need treatment).
Chlamydia/Gonorrhea: Antibiotics such as azithromycin or ceftriaxone.
Herpes: Antiviral medications such as acyclovir, valacyclovir, or famciclovir (oral or topical).
Non-infectious vulvovaginitis (due to irritants/allergies): Topical corticosteroids to reduce inflammation; avoidance of the irritant.
Atrophic vaginitis (due to menopause): Topical estrogen cream or estrogen tablets or ring.
Is Communicable
It depends on the cause:
Yes: Trichomoniasis, Chlamydia, Gonorrhea, and Herpes are sexually transmitted and therefore communicable.
No: Bacterial vaginosis and yeast infections are not considered sexually transmitted. However, certain sexual activities may increase the risk of developing these conditions. Vulvovaginitis caused by irritants or allergies is not communicable.
Precautions
Practice good hygiene: Gently wash the vulva with mild, unscented soap and water. Avoid douching.
Wear cotton underwear.
Avoid tight-fitting clothing.
Change tampons or pads frequently.
Use condoms during sexual intercourse.
Avoid irritants: Choose unscented hygiene products.
Wipe from front to back after using the toilet.
If you are prone to yeast infections, consider eating yogurt with live cultures or taking probiotic supplements.
For menopause related Atrophic vaginitis, vaginal moisturizers and lubricants can help.
How long does an outbreak last?
The duration depends on the cause and treatment:
Bacterial Vaginosis/Yeast Infections/Trichomoniasis: With appropriate treatment, symptoms usually improve within a few days to a week.
STIs (Chlamydia, Gonorrhea, Herpes): With appropriate antibiotic/antiviral treatment, the infection can be eradicated or managed, but herpes is a lifelong infection with recurring outbreaks.
Irritant/Allergic Vulvovaginitis: Symptoms usually resolve within a few days to a week after the irritant is removed.
Atrophic vaginitis is a chronic condition that can be managed with long-term treatment.
How is it diagnosed?
Medical History and Physical Exam: The doctor will ask about symptoms, sexual history, and hygiene practices. They will perform a pelvic exam to visually inspect the vulva and vagina.
Vaginal Discharge Sample: A sample of vaginal discharge may be taken and examined under a microscope to identify bacteria, yeast, or other organisms.
pH Testing: The pH of the vaginal discharge may be tested.
STI Testing: If an STI is suspected, tests for chlamydia, gonorrhea, trichomoniasis, and herpes may be performed.
Timeline of Symptoms
The timeline of symptoms can vary greatly depending on the underlying cause:
Rapid Onset (within a few days): Often seen with irritant-induced vulvovaginitis or acute infections like yeast infections.
Gradual Onset (over several weeks): More common with bacterial vaginosis or chronic conditions like atrophic vaginitis.
Cyclical: Some women experience vulvovaginal symptoms that worsen around their menstrual cycle.
Recurrent: Some conditions, like yeast infections or herpes, can recur even after treatment.
Important Considerations
Self-diagnosis and treatment can be harmful. Always consult a healthcare provider for accurate diagnosis and appropriate treatment.
Complete the full course of prescribed medications, even if symptoms improve.
Inform sexual partners if diagnosed with an STI so they can be tested and treated.
Untreated vulvovaginitis can lead to complications, such as pelvic inflammatory disease (PID), infertility, and increased risk of STIs.
Vulvar pain can be a symptom of other conditions, such as vulvodynia, which requires specialized evaluation and treatment.