Inflammatory vaginitis is vaginal inflammation without evidence of the usual infectious causes of vaginitis.
Etiology may be autoimmune. Vaginal epithelial cells slough superficially, and streptococci overgrow.
The major risk factor is
Genital atrophy predisposes to inflammatory vaginitis and increases risk of recurrence.
Treatment is with clindamycin vaginal cream 5 g every evening for 1 wk. After treatment with clindamycin, women are evaluated for genital atrophy. Genital atrophy, if present, can be treated with topical estrogens (eg, 0.01% estradiol vaginal cream 2 to 4 g once/day for 1 to 2 wk, followed by 1 to 2 g once/day for 1 to 2 wk, then 1 g 1 to 3 times weekly; estradiol hemihydrate vaginal tablets 10 mcg twice/wk; estradiol rings q 3 mo). Topical therapy is usually preferred because of concerns about the safety of oral hormonal therapy; topical therapy may have fewer systemic effects.