Vaginitis is an inflammation of the vagina which is associated with multiple complications such as urinary tract infections, preterm labor and pelvic inflammatory disease. It has been described as a remarkably common medical problem which needs special care by health care providers. It includes a spectrum of conditions that cause vaginal or vulvar symptoms like itching, burning, irritation and discharge and bad odor.
Vaginitis influences women’s quality of life by inducing vulvovaginal discomfort, sexual dysfunction and anxiety. Moreover, it may negatively affect outcomes of pregnancy, pelvic inflammatory disease (PID), sexually transmitted disease (STD) and reproductive health.
The majority of women with vaginal complaints use over- the counter (OTC) drugs and self-treat inappropriately. Therefore, it is essential to diagnose the vaginitis properly, possible underlying mechanisms, and initiate an appropriate therapeutic method. In practice, vaginal complaints are usually treated empirically based on the patient’s complaints. However, studies have revealed weak association between symptoms and the final diagnosis of vaginitis.
Definite diagnosis of vaginitis needs a thorough examination, cultures, pH determination and wet mount microscopy. Management of this condition induces health care costs .Estimations by World health organization (WHO) revealed that more than 340 million new cases with sexually transmitted diseases happen each year and 75-85% occurs in developing countries. It can be explained by the relationship between STDs and vaginitis. For example, BV is associated with the prevalence and incidence of multiple STIs including chlamydia, gonorrhea, herpes, HIV and trichomoniasis. Various factors are known to be associated with infectious vaginitis such as parity, poor socioeconomic status, poor menstrual hygiene and illiteracy.
Vaginitis can be divided into two main groups, including infectious and non-infectious vaginitis (Figure 1). Non-infectious vaginitis can be categorized as: Atrophic vaginitis, allergic vaginitis, foreign body, chemical irritation, desquamative vaginitis and lichen planus. On the other hand, infectious vaginitis includes Bacterial vaginosis, Vulvovaginal candidiasis and Trichomoniasis. The majority of infectious causes of vaginitis are Candida albicans, BV and trichomoniasis. The mentioned infections are usually treated with appropriate medications properly.
Assessment of Vaginal Discharge
To prevent vaginitis, there are certain measures to follow.
- Do not use feminine hygiene sprays or scented tampons.
- Do not douche. It is better to let the vagina cleanse itself.
- Use plain warm water to clean the vulva. Soaps and detergents can change the normal balance of organisms inside the vagina.
- Thoroughly clean diaphragms, cervical caps, and spermicide applicators after each use.
- Use condoms during sex.