Vaginitis

Vaginitis

is inflammation of vagina, which can be caused by infection or other factors. Women of any age, especially at childbearing age and sexually active females are more vulnerable to this condition.

Vaginal Discharge

  • Normal vaginal discharge is an odourless secretion which is clear or white in colour, and paste-like or egg white-like in texture
  • Volume may slightly increase during ovulation, before period, when sexually excited, during pregnancy, using contraceptives or intrauterine devices
  • Abnormal vaginal discharge is usually yellowish or greenish which is yogurt-like or frothy with an unpleasant smell and may even contain blood; causes include infection, inflammation, cervical polyps or genital tumours. Patients should seek medical advice promptly

Bacterial Vaginosis

Causes: Commonly seen in women of child bearing age due to an imbalance of normal healthy flora (bacteria) in the vagina. Using intrauterine device, practising vaginal lavage or having multiple sexual partners are risk factors for bacterial vaginitis
Signs and Symptoms: Increased vaginal discharge or with abnormal odour; some may have no signs or symptoms
Treatment: Take antibiotics; avoid vaginal lavage; practise safer sex

Candidiasis (Moniliasis)

The most common type of vaginal infection is caused by Candida, a type of yeast (fungus). Many women have recurrent infection which may be due to small amount of yeast colonised inside the vagina.

Causes: When the pH value of the vagina changes or there is hormonal change inside the body, e.g. during pregnancy, having diabetes or weakened immune system, taking antibiotics, having long-term use of steroids or immunosuppressants, the vaginal environment would be favourable for candida to multiply, causing vaginal infection
Signs and Symptoms: Cheese-like or bean curd like vaginal discharge, very itchy around genital area
Treatment: Use vaginal suppositories, topical cream; for recurrent infections, oral medication may be considered; control diabetes

Sexually Transmitted Vaginitis

Causes: Unprotected sex (not using condoms) or having multiple sexual partners; trichomoniasis, gonorrhoea, chlamydia, genital herpes and warts are common causes
Signs and Symptoms: Itchiness of vagina, increased vaginal discharge, pelvic or lower abdominal pain, difficulty in passing urine or abnormal bleeding; some may have no signs or symptoms
Treatment: Drug treatment; partners also require assessment and treatment; maintain personal hygiene and practise safer sex. If suspect of having sexually transmitted infections, with or without symptoms, should seek medical consultation promptly

*Some patients may have no symptoms; if not properly treated, the reproductive organs can be affected, resulting in oviduct obstruction, subfertility, ectopic pregnancy, habitual abortion or even pelvic infection.

Atrophic (Senile) Vaginitis

Causes: Non-infectious; usually occurs after menopause due to decreased female hormone or vaginal discharge leading to thinning of vaginal mucosa
Signs and Symptoms: Itchiness and burning sensation inside the vagina, painful sexual intercourse or post-coital bleeding (bleeding after sex)
Treatment: Use of lubricant; take hormonal replacement therapy

Points to Note for Prevention of Vaginitis

  • Adopt a healthy lifestyle and maintain personal hygiene
  • Wear cotton underpants and avoid wearing tight pants
  • Take a shower instead of a bath
  • Avoid allergens or using genital cleansers or fragrances
  • Wipe the genital area or anus from front to back; avoid vaginal lavage
  • Clean the genitals before sexual intercourse and empty the bladder afterwards
  • Maintain a single sexual partner, practise safer sex using condom

*Vaginal infection is not always caused by sexually transmitted infections; seek medical advice promptly if in doubt. Ensure the sexual partner is also treated if necessary.

(Content revised 08/2015)