(See also Overview of Vaginitis.)
Etiology of inflammatory vaginitis may be autoimmune.
Vaginal epithelial cells slough superficially, and streptococci overgrow.
The major risk factor for inflammatory vaginitis is
Genital atrophy predisposes to inflammatory vaginitis and increases risk of recurrence.
Because symptoms of inflammatory vaginitis overlap with those of other forms of vaginitis, testing (eg, vaginal fluid pH measurement, microscopy, whiff test) is necessary.
Inflammatory vaginitis is diagnosed if
Treatment of inflammatory vaginitis is with clindamycin vaginal cream 5 g every evening for 2 weeks. 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 a day for 1 to 2 weeks, followed by 1 to 2 g once a day for 1 to 2 weeks, then 1 g 1 to 3 times weekly; estradiol hemihydrate vaginal tablets 10 mcg twice a week; estradiol rings every 3 months). Topical therapy is usually preferred because of concerns about the safety of oral hormonal therapy; topical therapy may have fewer systemic effects.