Vaginitis

Vaginitis is inflammation of the vagina — causing itching, burning, discharge, pain during sex, and sometimes odour. It is one of the commonest reasons women see a gynaecologist. Most causes are straightforward to identify and treat.

Main causes

• Yeast infection (candida) — thick, white "curd-like" discharge; intense itching; no bad smell.
• Bacterial vaginosis — thin, greyish discharge; fishy smell; not usually itchy.
• Trichomoniasis — an STI; frothy yellow-green discharge; irritation; partner also needs treatment.
• Atrophic vaginitis — around menopause; vaginal dryness, thinning; painful sex.
• Contact/allergic vaginitis — from soaps, intimate washes, perfumed products, spermicide.
• Foreign body — rare; e.g. a forgotten tampon.
• Mixed infections — common.

When to see a Health Expert

• First episode.
• Symptoms not clearing in a few days.
• Recurrent episodes (more than 4 a year).
• Bleeding, pelvic pain, fever.
• Pregnancy or breastfeeding.
• Sexually active with new partner — test for STIs.
• Symptoms in a girl before puberty or an elderly woman — specific evaluation.

Avoid self-treatment with random OTC products

Self-diagnosing and using over-the-counter creams delays correct diagnosis — bacterial vaginosis, STIs and atrophic vaginitis need different treatments than yeast. Unregulated ayurvedic vaginal suppositories, pastes, and "purifying" products have caused real harm including chemical burns and resistant infections.

Self-care alongside treatment

• Wash with water only on the vulva; do not douche inside the vagina.
• Cotton, loose underwear; change promptly when damp.
• Unscented sanitary products.
• Treat partners if an STI is diagnosed.
• Manage diabetes and avoid unnecessary antibiotics — both trigger yeast.
• For menopausal atrophy, vaginal moisturisers and local oestrogen are effective.