Dr. Chemen Neal, an OB/GYN with IU Health Coleman Center for Women at University Hospital talks about what patients fear and what they need to know about one of the most common diagnoses among women.

Vaginitis – The very word can cause raised eyebrows and whispers among girlfriends. Patients are reluctant to discuss their condition for fear of embarrassment.

Yet it is a common condition – most women will have vaginitis at least once in their lives.

So what is it? 

Vaginitis is a name for abnormal vaginal symptoms such as swelling, itching, or burning that can be caused by several different germs. The most common causes of vaginitis are bacterial vaginosis (BV), a yeast infection, and trichomonas (a sexually transmitted disease). Other symptoms can include a discolored discharge, pain during intercourse or urination, or strong fishy odor. 

“Studies show 70 percent of women report having a yeast infection at least once in their lifetime and 20 percent of women with vaginitis will be diagnosed with a yeast infection; 40 percent will be diagnosed with bacterial vaginosis; and another 15 percent will be diagnosed with trichomoniasis,” said Dr. Chemen Neal, an OB/GYN with IU Health Coleman Center for Women at University Hospital.

Vaginitis is diagnosed by taking a small cotton swab sample from the vagina and testing it under a microscope. Typical treatment can include a topical antifungal cream and/or antibiotics.

What’s tricky is that many women go undiagnosed for fear of having “the difficult conversation” with their partner, family members, or medical provider.

“I have women who have had it for five years and call the doctor every month for medication. They take medication but symptoms come back, and I have women who won’t get married and won’t have sex because they feel embarrassed,” said Dr. Neal, one of the only physicians in the state who specializes in chronic vaginitis and vulvar diseases. “Unfortunately, we don’t understand what is the initiating event – the imbalance. We know the problem is the good bacteria in the vagina are gone (they produce acid that keeps bad bacteria away and maintain the PH balance). Something happens that makes the good bacteria go away and results in vaginitis.”

Here are some things doctors do know:

• Douching can increase the risk of vaginitis by wiping out the normal bacteria in the vagina.
• There is some research that indicates people with impaired immune systems – such as patients with HIV, organ transplants, and diabetes – have an increase in yeast infections.
• Menopausal women with low estrogen are also susceptible to vaginitis.
• Eleven percent of people with trichomoniasis are women 40 or over.
• Bacterial vaginosis is less common in women who use condoms during sexual intercourse and is more common among women with multiple sexual partners.

“If you think you are having abnormal vaginal symptoms you should see your gynecologist,” said Neal. “Symptoms can be confusing but women should also know that they aren’t always something benign. Some forms of vaginitis can lead to more serious issues such as pre-term and low weight births in pregnant women, and increased transmission of HIV and other sexually-transmitted diseases.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at T.J. Banes or on Twitter @tjbanes.