Vaginitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Vaginitis is most often caused by bacterial vaginosis; other common infectious causes include trichomoniasis and candidiasis, although noninfectious causes are also possible.
Affects all age groups of women, particularly during their reproductive years.
Common symptoms include discharge, pruritus, and dyspareunia.
It is recommended to screen for sexually transmitted infections (STIs; also known as sexually transmitted diseases [STDs]) in all women with infective vaginitis.
Sexual partners of individuals with Trichomonas vaginalis should be treated and offered screening for other STIs.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Trichomonas vaginitis with copious purulent discharge emanating from the cervical os
Photomicrograph revealing bacteria adhering to vaginal epithelial cells, known as clue cells
Phase contrast wet mount micrograph of a vaginal discharge revealing the presence of Trichomonas vaginalis protozoa
Vaginal smear identifying Candida albicans using a wet mount technique

Citations

Key Articles

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.[Abstract][Full Text]
American College of Obstetricians and Gynecologists. Vaginitis in nonpregnant patients: ACOG practice bulletin, number 215. Obstet Gynecol. 2020 Jan;135(1):e1-e17.[Abstract]

Referenced Articles

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46. Sobel JD, Ferris D, Schwebke J, et al. Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol. 2006 May;194(5):1283-9.[Abstract]
47. Boselli F, Petrella E, Campedelli A, et al. Efficacy and tolerability of fitostimoline (vaginal cream, ovules, and vaginal washing) and of benzydamine hydrochloride (tantum rosa vaginal cream and vaginal washing) in the topical treatment of symptoms of bacterial vaginosis. ISRN Obstet Gynecol. 2012;2012:183403.[Abstract][Full Text]
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49. Weissenbacher ER, Donders G, Unzeitig V, et al. A comparison of dequalinium chloride vaginal tablets (Fluomizin®) and clindamycin vaginal cream in the treatment of bacterial vaginosis: a single-blind, randomized clinical trial of efficacy and safety. Gynecol Obstet Invest. 2012;73(1):8-15.[Abstract][Full Text]
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51. Krychman ML. Vaginal estrogens for the treatment of dyspareunia. J Sex Med. 2011 Mar;8(3):666-74.[Abstract]
52. Chollet JA. Efficacy and safety of ultra-low-dose Vagifem (10 mcg). Patient Prefer Adherence. 2011;5:571-4.[Abstract][Full Text]
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55. Henriksson L, Stjernquist M, Boquist L, et al. A one-year multicenter study of efficacy and safety of a continuous, low-dose, estradiol-releasing vaginal ring (Estring) in postmenopausal women with symptoms and signs of urogenital aging. Am J Obstet Gynecol. 1996 Jan;174(1 Pt 1):85-92.[Abstract]
56. Lethaby A, Ayeleke RO, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2016 Aug 31;(8):CD001500.[Abstract][Full Text]
57. Wolner-Hanssen P, Krieger JN, Stevens CE, et al. Clinical manifestations of vaginal trichomoniasis. JAMA. 1989 Jan 27;261(4):571-6.[Abstract]
58. Petersen EE, Genet M, Caserini M, et al. Efficacy of vitamin C vaginal tablets in the treatment of bacterial vaginosis: a randomised, double blind, placebo controlled clinical trial. Arzneimittelforschung. 2011;61(4):260-5.[Abstract]
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62. Martens MG, Maximos B, Degenhardt T, et al. Phase 3 study evaluating the safety and efficacy of oteseconazole in the treatment of recurrent vulvovaginal candidiasis and acute vulvovaginal candidiasis infections. Am J Obstet Gynecol. 2022 Dec;227(6):880.e1-880.e11.[Abstract][Full Text]
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64. Svare JA, Schmidt H, Hansen BB, et al. Bacterial vaginosis in a cohort of Danish pregnant women: prevalence and relationship with preterm delivery, low birthweight and perinatal infections. BJOG. 2006 Dec;113(12):1419-25.[Abstract]
65. McGregor JA, French JI, Parker R, et al. Prevention of premature birth by screening and treatment for common genital tract infections: results of a prospective controlled evaluation. Am J Obstet Gynecol. 1995 Jul;173(1):157-67.[Abstract]
66. US Preventive Services Task Force. Screening for bacterial vaginosis in pregnancy to prevent preterm delivery: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2008 Feb 5;148(3):214-9.[Abstract][Full Text]
67. Brocklehurst P, Gordon A, Heatley E, et al. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000262.[Abstract][Full Text]
68. St John E, Mares D, Spear GT. Bacterial vaginosis and host immunity. Curr HIV/AIDS Rep. 2007 Feb;4(1):22-8.[Abstract]
69. McClelland RS, Sangaré L, Hassan WM, et al. Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition. J Infect Dis. 2007 Mar 1;195(5):698-702.[Abstract][Full Text]