Candida albicans, which causes yeast infections, is one of the most common causes of vulvovaginitis in women of all ages. Yeast infections typically cause genital itching and a thick, white vaginal discharg, and other symptoms.
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 calledtrichomonas vaginitis 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 cause 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.
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 for Diagnosing Vulvovaginitis
Vaginal symptoms are best diagnosed by a health care provider. If you have been diagnosed with a yeast infection in the past you may try treatment with over the counter products. However, if your symptoms do not completely disappear in about a week, make sure to contact your health care provider. Many other infections have similar symptoms. The health care provider will perform a pelvic examination. This may show 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.
Treatment of Vulvovaginitis
The cause of the infection determines the appropriate treatment. It may include oral or topical antibiotics and/or antifungal creams, antibacterial creams, or similar medications. A cream containing cortisone may also be used to relieve some of the irritation. If an allergic reaction is involved, an antihistamine may also be prescribed. For women who have irritation and inflammation caused by low levels of estrogen (postmenopausal), a topical estrogen cream might be prescribed.
Note: If a sexually transmitted disease is diagnosed, it is very important that your partner(s) receive treatment also, even if there are no symptoms. Many organisms don't produce noticeable symptoms. Failure of the partner(s) to accept treatment can cause continual reinfection, which may eventually (if not taken care of) lead to more extensive problems, possibly limiting fertility and affecting overall health.
Expectations (prognosis)
Complications
Discomfort that does not go away
Skin infection (from scratching)
Complications due to the cause of the condition (such as gonorrhea and candida infection)
Calling your health care provider
Call your health care provider if vulvovaginitis symptoms are present or if known vulvovaginitis does not respond to treatment.
Prevention
Children should be taught how to properly clean the genital area while bathing or showering. Proper wiping after using the toilet will also help (girls should always wipe from the front to the back to avoid introducing bacteria from the rectum to the vaginal area).
Hands should be washed thoroughly before and after using the bathroom.
