In the United States, vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year.
Vaginal infections are caused by microorganisms, but women can take precautions, such as wearing loose, absorbent underwear, to reduce their risk of getting infections.
Infections usually cause a discharge with itching, redness, and sometimes burning and soreness.
Doctors examine a sample of fluids from the vagina or cervix to check for microorganisms that can cause infections.
Treatment depends on the cause.
Vaginal infections include
Vaginal infections can cause vaginal discharge Vaginal Discharge A discharge from the vagina may occur normally or may result from inflammation of the vagina (vaginitis), often due to an infection. The genital area (vulva)—the area around the opening of the... read more , discomfort, and vaginal odor. However, these symptoms do not necessarily indicate an infection. Instead, they may result from other conditions that affect the vagina. For example, chemicals or other materials (such as hygiene products, bubble bath, laundry detergents, contraceptive foams and jellies, and synthetic underwear) can irritate the vagina and cause a discharge and discomfort. The inflammation that results is called noninfectious (inflammatory) vaginitis.
A vaginal discharge may be caused by a disorder that affects other reproductive organs, rather than the vagina. For example, a discharge can result from certain sexually transmitted infections such as chlamydial infection Chlamydial and Other Nongonococcal Infections Chlamydial infections include sexually transmitted infections of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect... read more or gonorrhea Gonorrhea Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover... read more . The bacteria that cause these diseases can spread from the vagina to the cervix (the lower, narrow part of the uterus that opens into the vagina) and the uterus, causing pelvic inflammatory disease Pelvic Inflammatory Disease (PID) Pelvic inflammatory disease is an infection of the upper female reproductive organs (the cervix, uterus, fallopian tubes, and ovaries). Pelvic inflammatory disease is usually transmitted during... read more . Genital herpes Herpes Simplex Virus (HSV) Infections Herpes simplex virus infection causes recurring episodes of small, painful, fluid-filled blisters on the skin, mouth, lips (cold sores), eyes, or genitals. This very contagious viral infection... read more , which can cause blisters on the vulva (the area around the opening of the vagina), in the vagina, and on the cervix, can also cause a vaginal discharge.
Internal Female Genital Organs
Causes of Vaginal Infections
Vaginal infections may be caused by bacteria, yeast, and other microorganisms.
Certain conditions make infection more likely:
Reduced acidity (increased pH) in the vagina: When acidity in the vagina is reduced, the number of protective bacteria (lactobacilli) that normally live in the vagina decreases, and the number of bacteria that can cause infection increases, sometimes resulting in bacterial vaginosis Causes Bacterial vaginosis is a vaginal infection that occurs when the balance of bacteria in the vagina is altered. Women who have a sexually transmitted infection, who have several sex partners,... read more .
Poor hygiene: When the genital area is not kept clean, the number of bacteria increases, making bacterial infections more likely.
Tight, nonabsorbent underwear: This type of underwear may trap moisture, which encourages the growth of bacteria and yeast.
Tissue damage: If tissues in the pelvis are damaged, the body’s natural defenses are weakened. Damage can result from tumors, surgery, radiation therapy, or structural abnormalities such as birth defects or fistulas. Fistulas are abnormal connections between organs, which may, for example, allow the intestine’s contents (which include bacteria) to enter the vagina.
Irritation: Irritation of vaginal tissues can lead to cracks or sores, which provide access to the bloodstream for bacteria and yeast.
Some specific causes of vaginal infections are more common among certain age groups.
In children, vaginal infections are usually caused by bacteria from the anus. These bacteria may be moved to the vagina when girls, particularly those aged 2 to 6 years, wipe from back to front or do not adequately clean the genital area after bowel movements. Fingering the genital area, particularly if girls do not wash their hands after bowel movements, may also move these bacteria to the vagina. Fingering is often a response to itching.
Putting an object (such as a toy or toilet tissue) in the vagina is another common cause of vaginal infections in children.
Sexual abuse Sexual abuse Child maltreatment includes all types of abuse and neglect of a child under the age of 18 by a parent, caregiver, or another person in a custodial role (for example, clergy, coach, or teacher)... read more is another possible cause. Sexually transmitted infections Overview of Sexually Transmitted Infections (STIs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted infections may be caused... read more , including those that cause vaginal infections, can be spread during sexual abuse.
Pinworms Pinworm Infection Pinworm infection is caused by the intestinal roundworm Enterobius vermicularis and usually affects children, but adult members of their households and caregivers, institutionalized people... read more may also cause vaginal infections.
Did You Know...
Women of childbearing age
Hormonal changes shortly before and during menstrual periods or during pregnancy can reduce acidity in the vagina, as can frequent douching, use of spermicides, and semen. Reduced acidity encourages the growth of bacteria that cause disease.
Leaving tampons in too long can lead to infection, possibly because tampons provide a warm, moist environment where bacteria can thrive and because they can irritate the vagina.
Did You Know...
After menopause, estrogen levels decrease. As a result, tissues in the vagina become thinner, drier, and more fragile. Cracks or sores may form, providing access for bacteria or yeast. Also, acidity in the vagina decreases, increasing the risk of infection.
Women who have urinary incontinence Urinary Incontinence in Adults Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women... read more or are confined to bed may have difficulty keeping the genital area clean. Irritation from urine and stool can lead to infection.
Women of all ages
At any age, conditions that increase the risk of getting a vaginal infection include
A fistula (abnormal connection) between the intestine and genital tract, which allows bacteria from the intestine to enter the genital tract
Pelvic radiation or tumors, which break down tissue and thus impair the body's normal defenses against infection
Conditions other than infections cause up to 30% of cases of vaginitis. For example, vaginitis may result from hypersensitivity to or irritation from hygiene sprays or perfumes, menstrual pads, laundry soaps, bleaches, fabric softeners, fabric dyes, synthetic fibers, bathwater additives, toilet tissue, or, occasionally, spermicides, vaginal lubricants or creams, latex condoms, or contraceptive rings or diaphragms.
Symptoms of Vaginal Infections
Typically, vaginal infections cause a vaginal discharge. This discharge differs from a normal one because it is usually accompanied by itching, redness, and sometimes burning or soreness in the genital area. A discharge may have a fishy odor. The appearance and amount of the discharge tend to vary depending on the cause. However, different disorders sometimes cause similar discharges.
Itching may interfere with sleep. Some infections can make sexual intercourse painful and make urination painful and more frequent.
Rarely, the folds of skin around the vaginal and urethral openings become stuck together.
However, sometimes symptoms are mild or do not occur.
Diagnosis of Vaginal Infections
A doctor's evaluation
Examination and testing of sample of the discharge and/or fluid from the cervix
Girls or women who have a vaginal discharge with itching or who have other vaginal symptoms, such as redness, burning, soreness, or pain during sexual intercourse, should see a doctor.
To determine the cause, the doctor asks questions about the discharge (if present), about possible causes of the symptoms, and about hygiene. The doctor may ask a woman the following:
Have lotions or creams (including home remedies) been used to try to relieve the symptoms?
When did the discharge begin?
Was the discharge accompanied by itching, burning, pain, or a sore in the genital area?
When do symptoms occur in relation to the menstrual period?
Does the discharge come and go, or is it always present?
Has an abnormal discharge occurred before, and if so, how did it respond to treatment?
What kind of birth control has been and is being used?
Is pain felt during sexual intercourse?
Has she had previous vaginal infections?
Does her sex partner have symptoms?
The doctor also asks about the possibility of sexually transmitted infections Overview of Sexually Transmitted Infections (STIs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted infections may be caused... read more . For example, a woman may be asked whether she is sexually active and, if so, whether she has more than one partner. This information helps the doctor determine whether other people require treatment.
Physical examination and testing
A pelvic examination Gynecologic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more is done. While examining the vagina, the doctor takes a sample of the discharge (if present) with a cotton-tipped swab. The sample is examined under a microscope. With information from this examination, the doctor can usually determine whether the cause is bacterial vaginosis, Trichomonas vaginitis, or a yeast infection.
Usually, the doctor also uses a swab to take a sample of fluid from the cervix. The sample is tested for sexually transmitted infections.
To determine whether there are other infections in the pelvis, the doctor checks the uterus and ovaries by inserting the index and middle fingers of one gloved hand into the vagina and pressing on the outside of the lower abdomen with the other hand. If this maneuver causes substantial pain or if a fever is present, other infections may be present.
Evaluation of children
If children have Trichomonas vaginitis, doctors evaluate them to determine whether sexual abuse Sexual abuse Child maltreatment includes all types of abuse and neglect of a child under the age of 18 by a parent, caregiver, or another person in a custodial role (for example, clergy, coach, or teacher)... read more could be the cause.
Prevention of Vaginal Infections
Prevention includes the following:
Keeping the genital area clean and dry to help prevent infections (washing every day with a mild, nonscented soap, such as glycerin soap, and rinsing and drying thoroughly are recommended)
Wiping from front to back after urinating or defecating to prevent bacteria from the anus from being moved to the vagina
Teaching young girls good hygiene
Wearing loose, absorbent clothing, such as cotton or cotton-lined underpants, to allow air to circulate and to help keep the genital area dry
Practicing safe sex and limiting the number of sex partners
Douching frequently and using medicated douches are discouraged. Douching can remove normal, protective bacteria from the vagina and reduce the acidity of the vagina, making infections, including pelvic inflammatory disease, more likely.
Treatment of Vaginal Infections
Use of water or ice to relieve symptoms
If needed, drugs to relieve itching
Measures used for prevention, such as keeping the genital area clean and dry, also help treat infections. Strong or scented soaps and unnecessary topical products (such as feminine hygiene sprays) should be avoided.
Occasionally placing ice packs on the genital area, applying cool compresses, or sitting in a cool sitz bath (with or without baking soda or Epsom salts) may reduce soreness and itching. A sitz bath is taken in the sitting position with the water covering only the genital and rectal area. Flushing the genital area with lukewarm water squeezed from a water bottle may also relieve soreness and itching.
If these measures do not relieve symptoms, drugs may be needed. Antihistamines taken by mouth help relieve itching. They also cause drowsiness and may be useful if symptoms interfere with sleep.
Specific treatment depends on the cause. For example, infections (such as bacterial vaginosis Bacterial Vaginosis (BV) Bacterial vaginosis is a vaginal infection that occurs when the balance of bacteria in the vagina is altered. Women who have a sexually transmitted infection, who have several sex partners,... read more , Trichomonas vaginitis Trichomonas Vaginitis Trichomonas vaginitis is a vaginal infection due to the protozoa Trichomonas vaginalis. Trichomonas vaginitis is usually sexually transmitted. It can cause a green or yellow... read more , and yeast infections Vaginal Yeast Infection (Candidiasis) The vagina is infected by a yeast called Candida, usually Candida albicans, resulting in a yeast infection called candidiasis. Being pregnant or having diabetes or a weakened immune... read more ) are treated with antimicrobial drugs. Foreign bodies are removed.