Vaginitis, Vaginosis — How to tell the Difference?
Vaginitis and vaginosis are common infections that can affect women of all ages. This part of the body is delicate, and its chemical balance can be easily disrupted by many everyday factors. The symptoms vary, but most often include irritation, itching, discomfort, and sometimes even pain in the vulva or vagina. Although these infections may seem similar, their treatments differ. It is therefore important to know how to distinguish between them.
YEAST VAGINITIS
Yeast vaginitis is a common condition whose main symptom is itching. It can sometimes be accompanied by odorless vaginal discharge, often white, thick, and clumpy (similar to cottage cheese), as well as redness caused by inflammation of the vaginal tissues. Less commonly, it may cause dysuria (difficulty urinating) or dyspareunia (pain during sexual intercourse). Yeast vaginitis is not a sexually transmitted infection (STI). It is rather caused by a fungus that multiplies in the vagina due to an imbalance of the vaginal flora. In 80 to 92% of cases, Candida albicans is the primary culprit.
CAUSES AND TREATMENT
Yeast vaginitis can be triggered by several causes: certain medications like antibiotics, pregnancy, and it can even be an early sign of gradually developing type 2 diabetes. The condition is more common in immunosuppressed individuals. To relieve the infection, treatment with over-the-counter miconazole or clotrimazole is recommended. However, if your symptoms persist after treatment, it is important to consult a healthcare professional to determine possible causes of your vaginal irritation, which could be due to hypersensitivity reactions, allergic reactions, contact dermatitis, for example.
BACTERIAL VAGINOSIS
Vaginosis is also a common problem, but the main symptom usually appears after sexual intercourse or following menstruation, characterized by the presence of foul-smelling vaginal discharge (fishy odor). Like vaginitis, other symptoms may occur: itching, whitish vaginal discharge, and a burning sensation inside the vagina.
RISK FACTORS
The exact cause is unknown, but certain risk factors have been identified, such as having a new sexual partner or multiple partners, vaginal douching, the use of scented products in the vaginal area, ethnicity (more common in Black women), being overweight, smoking, the use of intrauterine devices (IUDs), and sometimes a decrease in beneficial vaginal bacteria (lactobacilli) or the presence of sexually transmitted infections (STIs).
Between 50 to 75% of women naturally have this bacterium in their vaginal flora without it causing any problems, as they are asymptomatic. Antibiotic treatment is only required when symptoms are present.
HOW TO PREVENT THEM
It is possible to prevent the occurrence of these infections; here are some helpful tips.
- Avoid vaginal douching or scented products
- Use gentle hygiene products (e.g., Dove)
- Avoid tight clothing (such as undershirts or nylon stockings)
- Avoid crossing your legs (which increases heat and moisture)
- Avoid spas and very hot baths
- Limit your number of sexual partners
- Use condoms (if allergic to latex, choose latex-free condoms rather than spermicidal contraceptive creams)
- Maintain a healthy weight
- Avoid smoking
An accurate diagnosis
It can sometimes be difficult to self-diagnose this type of infection. When in doubt, it is best to consult and make an appointment with a specialized nurse practitioner at one of our three clinics (Terrebonne, La Prairie, or Blainville). They will be able to make an accurate diagnosis and guide you toward the appropriate treatment.
Geneviève Boulanger, IPSPL
References
Merck Manual
INESS
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Authors: Jack D Sobel, MDCaroline Mitchell, MD, MPHSection Editors:Robert L Barbieri, MDCarol A Kauffman, MDDeputy Editor:Kristen Eckler, MD, FACOG – Contributor Disclosures //All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Dec 2020. | This topic last updated: Mar 24, 2020.
Authors:Jack D Sobel, MDCaroline Mitchell, MD, MPHSection Editor:Robert L Barbieri, MDDeputy Editor:Kristen Eckler, MD, FACOG – Contributor Disclosures // All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Dec 2020. | This topic last updated: Sep 04, 2020.