Also indexed as:
Atrophic Vaginitis, Bacterial Vaginosis, Gardnerella Infection,
Hormone-Related Vaginitis, Irritant Vaginitis, Trichomoniasis,
Vaginitis, inflammation of the vagina, is responsible for an estimated
10% of all visits by women to their healthcare practitioners. The three
general causes of vaginitis are hormonal imbalance, irritation, and
vaginitis includes the atrophic vaginitis generally found in
postmenopausal or postpartum women and, occasionally, in young girls
before puberty. Irritant vaginitis can result from allergies or
irritating substances. Infectious vaginitis is most common in
reproductive-age women and is generally caused by one of three types of
infections: bacterial vaginosis (BV), candidiasis (), or trichomoniasis. A healthcare
professional should be consulted for the diagnosis and treatment of any
Although it is a type of vaginitis, yeast infection is not discussed
on this page. For specific information on yeast infections (i.e.,
vaginitis caused by Candida albicans), see the
Checklist for Vaginitis
What are the symptoms of vaginitis?
Hormone-related vaginitis is marked by dryness, irritation, thinning of
the vaginal mucous membranes and painful intercourse. Irritant vaginitis
is characterized by itching and soreness. Infectious vaginitis also
itches and typically includes vaginal discharge that varies in color,
consistency, and odor, depending upon the infectious organism. Discharge
may range from scant to thick and white and may or may not be
accompanied by a strong odor. Symptoms are often worse immediately after
intercourse or the menstrual period.
Conventional treatment options:
Conventional treatments vary with the cause of the vaginitis.
Hormone-related vaginitis is commonly treated with estrogen replacement
therapy, including conjugated estrogens (Premarin®) and ethinyl
estradiol. Irritant vaginitis can be treated either by removal of the
offending irritant or with an antihistamine agent, such as
diphenhydramine (Benadryl®). Bacterial vaginosis and trichomoniasis are
each commonly treated with metronidazole (Flagyl®).
Dietary changes that may be helpful:
are believed to
be a contributory factor in some cases of recurrent irritant vaginitis.
In a controlled trial, women with recurrent BV or vaginal candidiasis
ate 5 ounces (150 grams) of
daily.1 They had more than a 50% reduction in recurrences,
while women who consumed pasteurized yogurt that did not contain the
bacteria had only a slight reduction.
In another study, women who ingested 45 grams of
per day showed an
improvement in the estrogen effect on their vaginal tissue.2
That observation suggests that supplementing with soy may be helpful for
preventing or reversing atrophic vaginitis.
Lifestyle changes that may be helpful: For
irritant vaginitis, minimizing friction and reducing exposure to
perfumes, chemicals, irritating lubricants, and spermicides can be
Nutritional supplements that may be helpful:
is a strain of friendly bacteria that
is an integral part of normal vaginal flora. Lactobacilli help maintain
the vaginal microflora by preventing overgrowth of unfriendly bacteria
and Candida. Lactobacilli produce lactic acid, which acts like a natural
antibiotic. These friendly bacteria also compete with other organisms
for the utilization of glucose. The production of lactic acid and
hydrogen peroxide by lactobacilli also helps to maintain the acidic pH
needed for healthy vaginal flora to thrive. Most of the research has
containing live cultures
of Lactobacillus acidophilus or the topical application of such
yogurt or Lactobacillus acidophilus into the vagina. The
effective amount of acidophilus depends on the strain used, as well as
on the concentration of viable organisms.
Vaginal application of a proprietary Lactobacillus acidophilus
preparation may help nonspecific vaginitis. In one trial, 80% of women
with nonspecific vaginitis who used the preparation were either cured or
experienced marked improvement in symptoms.3 In another
trial, women who were predisposed to vaginal Candida
because they were
HIV-positive received either Lactobacillus acidophilus vaginal
(e.g., Gyne-Lotrimin®), or placebo weekly for 21 months.4
Compared to those receiving placebo, women receiving Lactobacillus
acidophilus suppositories had only half the risk of experiencing an
episode of Candida vaginitis—a result almost as good as that achieved
with clotrimazole. In a preliminary trial, women with vaginal
Trichomonas infection received vaginal Lactobacillus
acidophilus suppositories for one year.5 Over 90% of
them were reported to be cured of their clinical symptoms in that time.
Some doctors recommend vitamin E (taken orally, topically, or
vaginally) for certain types of vaginitis. Vitamin E as a suppository in
the vagina or vitamin E oil can be used once or twice per day for 3 to
14 days to soothe the mucous membranes of the vagina and vulva. Some
doctors recommend vaginal administration of
to improve the
integrity of the vaginal tissue and to enhance the function of local
immune cells. Vitamin A can be administered vaginally by inserting a
vitamin A capsule or using a prepared vitamin A suppository. Vitamin A
used this way can be irritating to local tissue, so it should not be
used more than once per day for up to seven consecutive days.
1. Shalev E, Battino S, Weiner E, et al. Ingestion of
yogurt containing Lactobacillus acidophilus compared with pasteurized
yogurt as prophylaxis for recurrent Candidal vaginitis and bacterial
vaginosis. Arch Fam Med 1996;5:593–6.
2. Wilcox G, Wahlqvist M, Burger H, et al. Oestrogenic
effects of plant foods in postmenopausal women. BMJ
3. Karkut G. Effect of lactobacillus immunotherapy on
genital infections in women. Geburtshilfe Frauenheilkd
1984;44:311–4 [in German].
4. Williams A, Yu C, Tashima K, et al. Weekly treatment
for prophylaxis of Candida vaginitis. Presentation. 7th Conference on
Retroviruses and Opportunistic infections. Foundation for Retrovirology
and Human Health in collaboration with the (US) National Institute of
Allergy and Infectious Diseases and the Centers for Disease Control and
Prevention. January 30–February 2, 2000.
5. Litschgi MS, Da Rugna D, Mladenovic D, Grcic R.
Effectiveness of a lactobacillus vaccine on Trichomonas
infections in women. Preliminary results. Fortschr Med
1980;98:1624–7 [in German.]
6. Pena E. Melaleuca alternifolia oil: Its use for
trichomonal vaginitis and other vaginal infections. Obstet Gynecol
7. Melchart D, Linde K, Worku F, et al. Immunomodulation
with Echinacea—a systematic review of controlled clinical trials.