Vaginitis is inflammation of the vagina.

It is a common form of gynecological disorder found in women. Almost all women experience it at least in one phase of their life.

There are different kinds of vaginitis, each with their own causes and symptoms.

The common causes of vaginitis are hormonal imbalances, infection, irritation and lack of personal hygiene. Vaginitis can also result from reduced estrogen levels after menopause.

Infectious vaginitis is most common in reproductive period of women and the common types of infectious vaginitis are bacterial vaginosis, candidiasis or trichomoniasis.

The commonly seen symptoms are abnormal white discharge, itching, irritation with or without foul smell.

The vagina creates an own environment and maintains balance between the normal bacteria found there and hormonal changes in the woman body.

Sometimes, bacterial vaginitis is initially harmless but it assists the production of dangerous germs like Chlamydia through the uterus into the ovaries and fallopian tubes. An advanced stage of this type can lead to infertility.

Candida infections

Candida infections are the most common fungal infections occurring in patients with HIV infection. Candida infections are generally easy to control and usually involve the mucosal surfaces. This condition generally occurs when there is too much of fungi grown in the vagina. The discharge is usually thick, white and appears like cottage cheese.

In women with HIV infection, vaginal yeast infections are seen as an early sign of immunodeficiency.

Vaginal Candida infections may be treated with topical nystatin or clotrimazole troches; the frequency of administration should match the severity of the disease.

Trichomoniasis

Trichomoniasis is one of the major causes of symptomatic vaginitis. While the organism can survive for a few hours in moist environments and could be acquired by direct contact, person to person venereal transmission accounts for virtually all cases of trichomoniasis. Its prevalence is greatest among those with sexual partners and those with other sexually transmitted diseases.

This infection caused in women is usually symptomatic and often manifest by a yellow colored vaginal discharge, itching, dysuria or urinary frequency and dyspareunia (difficulty in sex). These manifestations however do not clearly distinguish trichomoniasis from other causes of infectious vaginitis.

Conventional method of treatment

Metronidazole is the main stay of treatment and may be given as either a single 2 g dose or 250 mg thrice for 7 days. It is important that all sexual partners be treated concurrently to prevent reinfection, especially from asymptomatic males.

Metronidazole should be avoided in the first trimester of pregnancy and if possible later in pregnancy.

Alternative therapies during pregnancy are not readily available, although use of 100 mg clotrimazole vaginal suppositories nightly for 2 weeks may cure some infections during pregnancy.

Successful treatment of these resistant infections has been achieved with metronidazole given in higher oral doses, in parenteral doses, or in concurrent oral and vaginal doses.

Bacterial vaginosis

Vaginal discharge not associated with yeast or cervical infection is usually due to bacterial vaginosis. This syndrome is characterized by vaginal malodor and a slightly to moderately increased white discharge that is homogenous, low in viscosity and smoothly coats the vaginal mucosa. It is unclear whether bacterial vaginosis is a sexually transmitted infection. The syndrome is associated with STD risk factors, such as multiple sexual partners and recent intercourse with a new partner, but no single sexually transmitted pathogen has been clearly implicated the cause.

Antibiotic treatment of male partners does not seem to influence the rate of recurrence among affected women. Formerly considered a benign condition, bacterial vaginosis has been implicated as a risk factor for acute salpingitis, premature labor and related neonatal and perinatal complications.

Conventional method of treatment

The standard regimen for bacterial vaginosis has been metronidazole (500 mg orally, twice daily for 7 days). Clindamycin (300 mg orally, twice daily for 7 days) is also effective.

Recent data suggest that intravaginal treatment with 2% clindamycin cream (5g each night for 7 nights) or 0.75% metronidazole gel (5 g twice daily for 5 days) is comparable to oral therapy in efficacy but produces fewer adverse reactions. Intravaginal clindamycin cream is likely to become the treatment of choice for pregnant women with bacterial vaginosis.

Oral amoxicillin formerly was considered as a therapeutic option, but is much less effective than metronidazole and clindamycin therapies.

Treatment of male partners of women with bacterial vaginosis does not seem to prevent recurrence in these women and therefore is not indicated.

Prevention of vaginitis

• Avoid douches because they can kill good bacteria and or cause irritation.

• Practicing safe sex can help protect against sexually transmitted disease.

• Avoid wearing tight panties. Switch to loose fitting panties.

• Pregnant women should see their Doctor immediately if they are experiencing symptom.

• Maintain personal hygiene to prevent recurrence of infection.

• Avoid stimulants like coffee, tobacco and alcohol.

• Drink 6 – 8 glasses of water daily.

• Avoid refined foods such as white breads, pastas and sugar. sour and indigestible foods should be avoided.

• Eat fruits and vegetables rich in antioxidants. Have foods rich in B vitamins and calcium.

• Have yogurt.

Herbal cure pack for bacterial vaginosis

• Shatavari – 2 teaspoons twice daily with milk

• Female support – 2 capsules twice daily with plain water after meals

• Chanderprabha vati – 2 tablets twice daily with plain water before meals