Vulvovaginitis Health Article

Definition

Vulvovaginitis is inflammation or infection of the vulva and vagina.

Alternative Names

Vaginitis; Vaginal inflammation; Inflammation of the vagina

Causes, incidence, and risk factors

Vulvovaginitis can affect women of all ages and is extremely common. It can be caused by bacteria, yeasts, viruses, and other parasites. Some sexually transmitted diseases can also cause vulvovaginitis, as can various chemicals found in bubble baths, soaps, and perfumes. Environmental factors such as poor hygiene and allergens may also cause this condition.

Candida albicans, which causes yeast infections, is one of the most common causes of vulvovaginitis in women of all ages. Antibiotic use can lead to yeast infections by killing the normal antifungal bacteria that live in the vagina. Yeast infections typically cause genital itching and a thick, white vaginal discharge.

Another cause of vulvovaginitis is bacterial vaginosis, an overgrowth of certain types of bacteria in the vagina. Bacterial vaginosis may cause a thin, grey vaginal discharge and a fishy odor.

A sexually transmitted disease called Trichomonas vaginalis infection is another common cause. This infection leads to genital itching, a vaginal odor, and a heavy vaginal discharge, which may be yellow-grey or green in color.

Bubble baths, soaps, vaginal contraceptives, feminine sprays, and perfumes can cause irritating itchy rashes in the genital area, while tight fitting or nonabsorbent clothing sometimes cause heat rashes.

Irritated tissue is more susceptible to infection than normal tissue, and many infection-causing organisms thrive in environments that are warm, damp, and dark. Not only can these factors contribute to the cause of vulvovaginitis, they frequently prolong the recovery period.

A lack of estrogen in postmenopausal women can result in vaginal dryness and thinning of vaginal and vulvar skin, which may also lead to or worsen genital itching and burning.

Nonspecific vulvovaginitis (where no causative organism or irritant can be identified) can be seen in all age groups, but it occurs most commonly in young girls before puberty. Once puberty begins, the vagina becomes more acidic, which tends to help prevent infections.

Nonspecific vulvovaginitis can occur in girls with poor genital hygiene and is characterized by a foul-smelling, brownish-green discharge and irritation of the labia and vaginal opening. This condition is often associated with an overgrowth of a type of bacteria that is typically found in the stool. These bacteria are sometimes spread from the rectum to the vaginal area by wiping from back to front after using the bathroom.

Sexual abuse should be considered in children with unusual infections and recurrent episodes of unexplained vulvovaginitis. Neisseria gonorrhoeae, the organism that causes gonorrhea, produces gonococcal vulvovaginitis in young girls. Since gonococcal vaginitis is considered a sexually transmitted disease, young girls with culture-proved gonococcal vaginitis should be evaluated for sexual abuse.

Symptoms

• Irritation and itching of the genital area
• Inflammation (irritation, redness, and swelling) of the labia majora, labia minora, or perineal area
• Vaginal discharge
• Foul vaginal odor
• Discomfort or burning when urinating

Signs and tests

A pelvic examination may reveal red, tender vulvar or vaginal skin. Any lesions or sores should be inspected. A wet prep (microscopic evaluation of vaginal discharge) is usually done to identify a vaginal infection or overgrowth of yeast or bacteria. In some cases, a culture of the vaginal discharge may identify the organism causing the infection.

Trying to diagnose the condition by symptoms alone is very inaccurate in determining the cause of vulvovaginitis. Furthermore, self-diagnosis and treatment with over-the-counter medications (such as yeast infection creams) is unwise and may lead to incorrect and ineffective use of these products. For this reason, vulvovaginitis should be diagnosed by a health care provider.