Vaginitis: Causes, Types, Symptoms, Treatment & Frequently Asked Questions

What is vaginitis, and what are its most common types?

Vaginitis is one of the most common conditions affecting women of all ages and involves inflammation of the vaginal mucosa. It is often accompanied by inflammation of the vulva (vulvovaginitis). It is caused by an imbalance in the normal vaginal flora (loss of protective lactobacilli) or by the introduction of exogenous pathogenic microorganisms.

The main types of vaginitis are classified according to their cause:

• Fungal Vaginitis (Candidiasis): It is usually caused by the fungus Candida albicans. It is one of the most common forms and is associated with an overgrowth of fungi that are normally present in small numbers in the vagina.
• Bacterial Vaginosis (BV): This condition is caused by the uncontrolled proliferation of anaerobic bacteria (such as Gardnerella vaginalis) at the expense of beneficial lactobacilli.
• Trichomoniasis: This is a sexually transmitted infection (STI) caused by the protozoan Trichomonas vaginalis.
• Atrophic Vaginitis: It occurs mainly after menopause due to a decrease in blood vessels and estrogen levels, causing dryness, thinning of the vaginal wall, and inflammation.
• Non-Infectious / Irritant Vaginitis: Caused by an allergic reaction or irritation from chemicals (perfumes, soaps, scented panty liners, latex condoms).

What factors increase the risk of developing vaginitis?

The balance of the vaginal ecosystem is delicate and can be disrupted by:

• Use of broad-spectrum antibiotics (which destroy lactobacilli).
• Hormonal fluctuations (pregnancy, menstruation, menopause, use of birth control).
• Diabetes mellitus (especially when it is not well controlled).
• Poor hygiene habits (vaginal douching, use of harsh or scented soaps).
• Wearing synthetic or very tight underwear and clothing that traps moisture.
• Sex without a condom or frequently changing partners.
• A weakened immune system or severe stress.

What are the typical symptoms of vaginitis?

Although symptoms vary depending on the cause of the infection, the most common signs include:

• Changes in Vaginal Discharge (Fluids):

1. In the case of a fungal infection: White, thick discharge resembling “curdled milk” or mizithra, without a strong odor.
2. Bacterial vaginosis: Thin, grayish or white discharge with a characteristic strong, unpleasant odor (“fishy”), especially after sexual intercourse.
3. In Trichomonas infection: Foamy, yellowish or greenish, foul-smelling discharge.

• Intense Itching & Burning: Particularly intense in the vulva and at the entrance to the vagina.
• Redness & Swelling: In the area of the internal and external genitalia.
• Dyspareunia: Pain or discomfort during sexual intercourse.
• Dysuria: A burning sensation or pain during urination when urine comes into contact with the irritated vulva.

Frequently Asked Questions & Answers About Vaginitis

How is vaginitis accurately diagnosed?

The diagnosis should not be based solely on clinical presentation or empirical treatment. It is made by:

• Clinical & Gynecological/Sexual Health Examination: Assessment of the mucosa and secretions.
• Microbiological Culture of Vaginal Fluid: Sample collection to identify the specific pathogen (fungi, bacteria, Trichomonas, Mycoplasma, Ureaplasma) and perform an antibiogram/mycogram.
• Vaginal Fluid pH Measurement & Molecular Testing (PCR): For extremely precise and persistent cases.

How is vaginitis treated?

Treatment is targeted and depends on the cause:

• Fungal: Antifungal medications (suppositories, creams, or oral tablets, such as fluconazole).
• Bacterial: Antibiotic treatment (metronidazole, clindamycin) in the form of a vaginal gel, suppositories, or tablets.
• Trichomoniasis: Specific oral antiparasitic/antibiotic treatment, with simultaneous treatment of the sexual partner.
• Atrophic: Topical application of estrogen, moisturizing vaginal gels, or hyaluronic acid.

Does the partner need to receive treatment as well?

In trichomoniasis, treatment of the sexual partner is mandatory, as this is an STD. In bacterial and fungal vaginitis, treatment of the sexual partner is recommended when he exhibits symptoms (e.g., balanitis, redness, itching) or in cases of recurrent infections.

What can I do to prevent relapses?

• Avoid vaginal douches and scented soaps; clean the area only externally using a special mild cleanser with a neutral or protective pH.
• Wear comfortable cotton underwear and avoid tight synthetic pants.
• Change out of your wet swimsuit or sweaty workout clothes right away.
• Always wipe from front to back after using the restroom.
• Use a condom consistently, especially with new partners.
• Support your vaginal flora by taking probiotics ( Lactobacillus strains) as directed by your doctor, especially while taking antibiotics.

Responsible Care at Dermtherapy

Vaginitis is a completely treatable condition, provided that its exact cause is diagnosed in a timely manner. Self-medication or incorrect treatment can lead to recurrences, microbial resistance, and chronic discomfort. At the Dermtherapy dermatology and venereology clinic in Galatsi, dermatologist and venereologist Alexandros Soumalevris offers reliable laboratory diagnosis, personalized treatment protocols, and responsible scientific guidance.