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Vaginitis

Obstetrics and GynaecologyGynaecological Oncology

Vaginitis is a common gynaecological condition, referring to the inflammation of the tissues inside the vagina. It can be caused by bacteria, fungi, viruses, or other microorganisms, leading to discomfort and inflammatory responses in the vaginal area."

Symptoms

Common symptoms of vaginitis include:

Abnormal Discharge: There may be an increase in discharge, with changes in colour, texture, and odour.
Itching and Irritation: The vagina and vulva may feel itchy or irritated.
Pain: This includes pain during intercourse or while urinating.
Redness and Swelling: The external genitalia may become red and swollen.

Factors

Bacterial infections generally cause vaginitis, and the common types include:

Bacterial vaginosis
Candida or yeast infections
Chlamydia
Gonorrhoea
Trichomoniasis
Viral vaginitis
Sensitivity or allergic reactions (non-infectious vaginitis)"

Risks

Risk factors that may lead to vaginitis include:

Sexual Activity: Having multiple sexual partners or a new sexual partner may increase the risk of certain types of vaginitis.
Use of Antibiotics or Steroids: These types of medications can disrupt the normal balance of vaginal flora, making the vagina more susceptible to infections.
Poor Hygiene Practices: Lack of cleanliness can easily lead to bacterial growth in the genital area; excessive cleaning can also disturb the pH balance of the genital area.
Specific Health Conditions, such as Diabetes: Diabetes affects the function of the immune system. Additionally, the higher blood sugar levels in diabetic patients may lead to the overgrowth of yeast (such as Candida), causing vaginal yeast infections.

Diagnosis

Bacterial vaginosis typically presents with a whitish-grey, fishy-smelling watery discharge; Candida or yeast infections are characterized by white, thick, odourless discharge; Trichomoniasis often involves a yellowish discharge with a rotten smell. However, more than relying solely on symptoms or the colour of discharge is required for an accurate diagnosis. Hence, laboratory tests are needed for confirmation.

Here are some diagnostic methods for Vaginitis:

Clinical Assessment: Evaluation based on specific symptoms of different types of vaginitis; examination of the external genitalia, vaginal walls, and cervix for signs of inflammation or discharge.
Microscopic Examination: Examining vaginal discharge under a microscope is a primary method for diagnosing vaginitis.
Culture Tests and Laboratory Analysis: Including pH testing, microscopic examination, bacterial culture, antigen, and nucleic acid testing.

Type of Vaginitis	Diagnosis
Bacterial Vaginosis	Diagnosis can be made if three out of four Amsel criteria are met. - Which include a watery grey-white (or yellow-white) discharge adhering to the vaginal walls, pH>4.5, a solid ammonia-like fishy odour - During the Whiff test with 10% KOH, and an increased presence of clue cells (most reliable indicator).
Candidiasis	Observation of pseudo hyphae, hyphae, or spores in 10% KOH preparation. - With Vaginal pH<4.5 - Vaginal discharge culture
Trichomoniasis	Observation of moving trichomonads and increased inflammatory cells in a saline wet mount - With numerous WBCs (>10 WBCs/HPF), and moving trichomonads visible in a drop of saline. - Red strawberry-like spots on the cervix and upper vagina. - With Vaginal pH >6.0.

Treatments

The treatment methods for vaginitis can be briefly divided into the following points:

Bacterial Vaginosis: Treatment typically involves oral antibiotics and anti-protozoal medication or topical antibiotic creams for vaginal use. The treatment period is usually 7 days.
Candidiasis: Treatment options include the use of topical creams or vaginal pessaries to treat fungal infections, along with oral medication. The duration of treatment varies depending on the severity of the condition.
Trichomoniasis: This can be treated with oral anti-protozoal and antibacterial medication for treating specific infections. It is also necessary to treat sexual partners to prevent reinfection.

FAQ

Vaginitis and urethritis are different infections, but there may be a specific connection between them. Due to the proximity of the vagina and urethra, vaginitis may increase the risk of urethritis. For example, bacterial vaginitis could spread bacteria to the urethra, thus causing a urinary tract infection.

Whether vaginitis can be transmitted to men depends on the type of vaginitis. For instance, vaginitis caused by sexually transmitted pathogens, such as trichomonas, can be contagious to men, potentially leading to urethritis in them. However, vaginitis caused by non-sexually shared factors, such as hormonal changes or bacterial imbalance, is generally not contagious to men.