Treatments for Vaginitis

Vaginitis is a condition where there is inflammation in the vagina. It is usually accompanied by a condition of the vulva known as vulvovaginitis. It develops from an infection caused by bacteria, yeast, or the parasite Trichomonas vaginalis. However, it may also result from a chemical or physical irritation of the vagina. A number of the infections that cause vaginitis are sexually transmitted but not all are considered to be sexually transmitted diseases (STDs).

What causes vaginitis?

Here are some of the causes of vaginitis:

• Yeast infection - is a common cause of vaginitis. A good example is a Candida infection. This fungal infection cannot be sexually transmitted.

• Trichomoniasis - is another cause of vaginitis. The infection is caused by a parasite that can be sexually transmitted.

• Bacterial vaginosis - is probably the most common of all the causes of vaginitis. It is a result of the imbalance between the good and bad bacteria in the vagina. It has not yet been confirmed whether the infection is sexually transmitted but some studies have shown that women can get the infection even without sexual contact. Other bacterial causes of vaginitis include STDs such as gonorrhea and chlamydia.

Other chemical or physical causes of vaginitis include:

• low levels of estrogen in women during menopause
• perfumes, scented soaps, or douches
• spermicides
• fecal bacteria from the anus, especially in young girls who have poor hygiene

Diagnosis

A successful vaginitis diagnosis mostly depends on the signs and symptoms that are experienced by the affected women. The diagnosis is carried out by a pelvic examination that involves getting a sample of vaginal discharge. The sample can either be examined under a microscope for a clear visualization of the Trichomonas parasite or in a laboratory for specialized tests to identify the infectious organisms.

Bacterial Vaginosis Treatment

Antibiotics can be used to successfully treat bacterial vaginosis.

Metronidazole 

Metronidazole is the most preferred treatment for bacterial vaginosis and it comes in the form of:

• Gels - application of gel in your vagina once daily for at least five days.
• Tablets - for 5-7 days, tablets should be taken orally for two times a day.
• Vaginal suppositories - can be inserted into the vagina once a day before bedtime.

If symptoms of bacterial vaginosis are present during pregnancy, metronidazole tablets are taken for five days or as prescribed by a physician. They are mostly preferred as they are the most effective antibiotic in such a case.

A metronidazole gel application is highly recommended in women who are breastfeeding as the drug can affect the breast milk. In case of a reaction due to metronidazole, a cream containing clindamycin can be used as an alternative treatment. It can be applied once a day to the affected area for one week.

To reduce the risks of having recurring symptoms, it is advisable to continuously take the antibiotic's prescribed dosage until the end of the treatment even if you start feeling better.

The Sides Effects of Metronidazole

Some of the side effects associated with metronidazole are vomiting, nausea, and a mild metallic taste in the mouth. Metronidazole should not be taken on an empty stomach. The best time to take this drug is after meals. If you experience side effects such as vomiting, you can consult your doctor for any alternative drug if your vomiting still persists.

Taking drinks with alcoholic content while under metronidazole medication can lead to more serious side effects, so it is best to keep away from them for at least two days after finishing your dose.

Further Treatment

The first course of treatment may not be effective in some cases of BV. When this happens, the doctor will be forced to prescribe an alternative antibiotic. However, the doctor will first check if you correctly took a full dose of the initial treatment.

If your BV seems to be as a result of the type of contraceptive you are using, the doctor may recommend getting rid of it and switching to another type of contraceptive.  

Restoring the Normal Vaginal pH

pH correction treatments is another way of getting rid of BV. It can simply be done through the application of a medicated gel inside the vagina. The medicated gel works by restoring the acid balance inside the vagina. Various vaginal pH treatments are accessible in pharmacies.

Referral to a Medical Specialist

In case your BV recurs within a short period of time, your doctor will consider referring you to a genitourinary medical specialist for more treatment options. In cases of pregnancy, midwives or obstetricians are referred to discuss further treatment options.

Things to Avoid When Undergoing Treatment

There are a number of things one is supposed to avoid during a BV treatment. For instance, you should avoid douching, having bubble baths, and using scented soaps to clean your vagina.

Risk Factors Associated with Vaginitis 

Each type of vaginitis has different risk factors depending on the possible cause.

• Weak immune system - the immune system becomes suppressed due to either taking immune-suppressing medications or due to cancer. The use of antibiotics can also lead to a yeast infection. Taking oral contraceptives, diabetes, and pregnancy can increase a woman's chances of developing a yeast vaginitis.

• Having multiple sexual partners and unprotected sex - can lead to vaginitis among other sexually transmitted diseases.

Smoking cigarettes, using IUDs as contraceptives, and also having oral sex with multiple sex partners are some of the risk factors that are linked to bacterial vaginosis.

What are the symptoms of vaginitis?

• vaginal itching, pain, and burning sensations
• unusual vaginal discharge
• foul-smelling odor in the vagina
• pain during sexual intercourse or during urination

However, studies also suggest that it is possible to have vaginitis without experiencing some of these symptoms.

Medications to Treat Vaginitis

• Bacterial vaginosis - can be managed using different antibiotics such as Zithromax (azithromycin), Suprax (Cefixime), Flagyl (metronidazole), and Cleocin (Clindamycin).

• Yeast infection - antifungal medications are used in this kind of vaginal infection. Some of the antifungals are Gynazole (butoconazole), Mycostatin (nystatin), Monistat (miconazole), Terazol (terconazole) and Diflucan (fluconazole).

• Trichomoniasis - in the case of a trichomonas infection, metronidazole is the most efficient antibiotic treatment.

The vaginal area is rather sensitive and home remedies are usually not suitable for treatment unless recommended. However, some women prefer to use home remedies to control the symptoms. It is preferable to allow air to circulate around the vagina by wearing loose cotton undergarments and the removal of undergarments at night.

During menopause, estrogen levels tend to get lower due to the thinning of the vaginal walls, which leads to irritation. However, this condition can be treated with hormonal therapy that can either be applied directly to the vagina or orally.

Can vaginitis be prevented?

If vaginitis has been caused by STDs, it can be prevented simply by abstaining from having multiple sex partners and also practicing safe sex. It is not easy to prevent all infections leading to vaginitis but if hygiene practices are followed, vaginitis might be avoided.

What is the prognosis for vaginitis?

If vaginitis is detected early and properly treated, it cannot cause long-term problems. If left untreated, a vaginal infection may spread and cause pelvic inflammatory disease (PID). This condition can lead to a serious impaired fertility. Even after successful treatment, vaginitis can reoccur and another treatment course may be required.

In cases where sexually transmitted diseases occur in babies or pregnant mothers, they should be treated as soon as possible to avoid any further complications from arising.

Issues to Consider During Treatment

HIV patients are no exemptions when it comes to vaginitis. Even if they are immunocompromised, they should be treated with the same treatments as other patients. Pregnancy should not be the cause of delay of treatment. However, a test for pregnancy should be done and properly documented before any treatment is administered.

In a case of child abuse or sexual assault, legal action should be taken into consideration and should also be properly documented.