Vulvovaginitis is inflammation of the vulva and vagina. It is a common condition that affects females of all ages and has a variety of causes.
This page covers vulvovaginitis in adults and girls who have gone through puberty. Childhood vulvovaginitis is a different condition. See vulvovaginitis in girls.
- Vulvovaginitis occurs when the normal balance of yeast and bacteria in your vulva and vagina is disturbed.
- This may be caused by factors such as infection, irritation, hormonal changes or antibiotics.
- It may cause soreness, itchiness, redness and burning.
- See your doctor if you are bothered by unusual vaginal symptoms, particularly if you have never had them before or they are different from symptoms you normally get.
- Your doctor will advise treatment depending on what is causing your symptoms.
What causes vulvovaginitis?
There are 3 common infections that cause vulvovaginitis:
- Thrush – caused when there is too much of a fungus called candida. You always have some candida in your vagina but an overgrowth of it causes vaginal thrush.
- Bacterial vaginosis – caused when there is an imbalance of the different types of bacteria that normally live in your vagina. See bacterial vaginosis.
- Trichomoniasis – caused by a tiny parasite called trichomonas vaginalis that you can get through having sex with someone who is infected. See trichomoniasis.
You can also get vulvovaginitis from:
- a change in hormones, usually during childbirth or after menopause
- irritation caused by lubricants, soaps, tight clothing, etc
- having diabetes, which can make you more likely to get some forms of vulvovaginitis.
What are the symptoms of vulvovaginitis?
Symptoms are usually noticed in the area in or around your vagina and include:
- redness and inflammation
- burning sensation
- pain when peeing
- abnormal vaginal discharge and smell.
Abnormal discharge can give your doctor clues as to what is causing your vulvovaginitis:
- Discharge from vaginal thrush is typically white and clumpy, similar to cottage cheese. It has no smell. Itching is also a common complaint.
- Discharge from bacterial vaginosis is heavier than usual but thin, has a strong fishy-smell and is grey or green in colour.
- Discharge from trichomoniasis also has an unpleasant fishy smell but is yellow-green and sometimes frothy.
When should I seek medical advice?
See your doctor if you are bothered by unusual vaginal symptoms, particularly if you have:
- vaginal itching or unpleasant smelling discharge
- never had a vaginal infection before
- had vaginal infections before, but the symptoms of this infection are different
- a new or more than one sexual partner
- finished a course of treatment for vaginal thrush, but your symptoms haven’t cleared.
You don’t need to see your doctor if you have been diagnosed with vaginal thrush before and your symptoms are the same as last time.
If you're sure you have thrush and you've treated it successfully in the past with over-the-counter medication, you can treat it yourself again. Read more about treatment of vaginal thrush.
What happens at the GP appointment?
Your doctor will ask you questions about your symptoms and medical history. They may also ask questions about things in your life that might have triggered your symptoms, such as new sexual relationships, detergents or soaps, etc.
Your doctor may ask for a sample of the discharge so it can be sent to the lab for testing to find out what type of infection you have.
How is vulvovaginitis treated?
Treatment will depend on the cause.
- Vaginal thrush is treated with antifungal medication – see treatment of vaginal thrush.
- Both bacterial vaginosis and trichomoniasis can be treated with an antibiotic medication called metronidazole.
- If irritation is the cause, the source of it needs to be identified and removed, for example, a soap or detergent. Your doctor may recommend a topical cream to soothe itching or burning.
How can I prevent vulvovaginitis?
You may be able to reduce your chances of getting vulvovaginitis by:
- wearing loose-fitting breathable clothing that doesn’t hold moisture in
- not using perfumed soaps or sprays on or near your vagina
- avoiding washing inside your vagina
- using a condom during sex.
|Dr Jeremy Tuohy is an Obstetrician and Gynaecologist with a special interest in Maternal and Fetal Medicine. Jeremy has been a lecturer at the University of Otago, Clinical leader of Ultrasound and Maternal and Fetal Medicine at Capital and Coast DHB, and has practiced as a private obstetrician. He is currently completing his PhD in Obstetric Medicine at the Liggins Institute, University of Auckland.|