Vaginitis: Causes and prevention measures

Vaginitis is an inflammation of the vagina and affects a large percentage of women of reproductive age. This inflammation is usually accompanied by a burning sensation, stinging and irritation, and in more severe cases, pain. The symptoms may be internal to the vagina or may extend to the vulva (vulvovaginitis).

Inside the vagina live various species of microbes and fungi, which create the so-called vaginal microbiome and play an important role in the maintenance of vaginal health. Some of their vital tasks are to maintain an acidic environment (low pH) in order to prevent infections, and to produce small amounts of secretions, which keep the vagina clean. When the delicate balance of microbial populations is disturbed, a condition called dysbiosis, the area becomes vulnerable to the establishment of pathogenic bacteria and fungi.

Infectious Vaginitis

The cause of infectious types of vaginitis is either the growth of bacteria or fungi at abnormal levels or a sexually transmitted infection.

Bacterial vaginosis is one of the most common causes of vaginal inflammation and it is caused by the overgrowth of aerobic or anaerobic bacteria, such as various species of streptococcus, staphylococcus, or Gardnerella vaginalis. It is not considered a sexually transmitted disease. Symptoms of bacterial vaginosis include white, gray, or green vaginal discharge, itching, burning, and a fishy odor. In many cases, bacterial vaginosis has no symptoms while in other cases it can be cured on its own. Depending on the severity of the infection, medication may be needed.

Candida infection (candidiasis) is caused due to the overgrowth of fungi of the genus Candida. The most common species is Candida albicans which can normally be found in very small concentrations in the vagina. The main symptom is intense itching in combination with thick, odorless, white discharge. Most Candida infections subside quickly after taking antifungal medications. Women with diabetes, a weakened immune system, taking antibiotics, and during pregnancy are more prone to develop infections by Candida.

Chlamydia is a member of the family Chlamydiaceae and constitutes the most common sexually transmitted disease (STD) in women aged 18 to 35. The infection can be treated with the appropriate antibiotics.

Gonorrhea is caused by the bacterium N. gonorrhea and it is also a common sexually transmitted infection, which can coexist with chlamydial infection.

Trichomoniasis is caused by a parasite invisible to the naked eye called Trichomonas vaginalis. About 70% of infected women and men have no symptoms. If a woman has symptoms, she may experience severe discomfort in her vagina and yellow-green discharge with an intense smell. Trichomoniasis is treated with the administration of appropriate drugs. Men with trichomoniasis may experience discharge, redness, and discomfort.

Viral vaginitis is an inflammation caused by viruses, such as the herpes simplex virus (HSV) or the human papillomavirus (HPV). They are sexually transmitted and cause ulcers or warts on the genitals, which are often painful.

Non-Infectious Vaginitis

Non-infectious causes of vaginitis include decreased estrogen levels or exposure to irritating chemicals.

Atrophic vaginitis: At various stages of a woman's life, such as during pregnancy or breastfeeding, estrogen levels fluctuate. Decreased estrogen occurs normally during menopause - the stage at which a woman stops menstruating - and continues after menopause when estrogen levels remain consistently low. Estrogens help in the maintenance of healthy vaginal walls and are involved in the natural lubrication of the vagina. As the hormones decrease, the vaginal mucosa becomes drier and thinner. Symptoms of atrophic vaginitis usually develop slowly over time and include pain during sexual intercourse, vaginal dryness, and burning during urination. Depending on the severity of the condition, taking a low dose of estrogen in various forms (cream, oral, etc.) can relieve the symptoms.

Non-infectious vaginitis: Caused by an allergic reaction to a soap or another product used for vaginal washings. In addition, non-infectious vaginitis can be caused by detergents, fabric softeners, vaginal sprays, and soaps that contain fragrance.

Prevention of vaginitis

The genital area should be kept clean and dry. It is recommended to avoid vaginal sprays and scented soaps.

It is also important to avoid vaginal washes, as they can cause irritation, or they can hide and spread an underlying infection. They also remove friendly bacteria of the vagina (e.g. lactobacilli), which promote natural cleansing, which leads to the imbalance of the vaginal microbiome.

Finally, avoiding clothes that retain heat and moisture is a very important measure in order to prevent vaginitis. Nylon underwear, skinny jeans, sports shorts, leggings, and tights without cotton panels can lead to fungal infection.

Using a condom is the best way to prevent the transmission of infections between partners.

It is important for every woman to have a complete gynecological examination at least once a year.

The FemoScan® Comprehensive of Diagnostiki Athinon enables the examination of the vaginal microbiome and its deviations from the normal one, in order to take the appropriate therapeutic measures in time (antibiotics, antifungals, antiseptics, probiotics).

The vaginal microbiome (vaginal flora) is tested with the FemoScan® Comprehensive & FemoScan® Screen by molecular tests (RT-PCR) allowing the accurate, fast, and objective identification of all microorganisms and lactobacilli that participate in the occurrence of vaginitis resulting in etiological and effective treatment of the disease.