Understanding Vaginal Inflammation
Vaginitis causes vaginal discharge, itching, and discomfort. Several conditions cause similar symptoms - including infections and hormonal changes. Accurate diagnosis ensures the right treatment.
Vaginitis is inflammation of the vagina causing discharge, itching, and irritation. The term covers several conditions with different causes: bacterial vaginosis (BV), thrush (candidiasis), trichomoniasis (an STI), and atrophic vaginitis. These have different treatments, so accurate diagnosis is important. Many women self-treat incorrectly, which can worsen symptoms or delay proper care.
We examine discharge characteristics and may use vaginal pH testing, microscopy, and swabs for culture or PCR. Different types of vaginitis have distinct features. BV has thin grey discharge with fishy odour; thrush has thick white 'cottage cheese' discharge with itching; trichomoniasis causes frothy yellow-green discharge. Accurate diagnosis guides treatment.
Treatment depends on the cause: BV requires antibiotics (metronidazole or clindamycin); thrush needs antifungals (fluconazole or topical treatments); trichomoniasis requires metronidazole (and partner treatment); atrophic vaginitis responds to vaginal oestrogen. Using the wrong treatment doesn't help and can worsen symptoms. If over-the-counter treatments haven't worked, seek professional assessment.
Without testing, it's hard to distinguish reliably. BV typically has grey, fishy-smelling discharge without much itching. Thrush causes thick white discharge with intense itching. Trichomoniasis may cause frothy, yellow-green, smelly discharge with irritation. Many women misdiagnose themselves. Professional assessment with testing provides certainty.
Trichomoniasis is sexually transmitted and requires partner treatment. BV is not considered an STI but is associated with sexual activity - partner treatment isn't routinely recommended. Thrush isn't sexually transmitted though can sometimes be passed between partners. We'll advise on partner treatment based on your diagnosis.
Recurrent vaginitis is common and frustrating. Causes include: incomplete treatment, incorrect diagnosis, resistant organisms, reinfection, underlying factors (diabetes, immune issues), disruption of vaginal flora by products or antibiotics. Persistent cases need thorough evaluation. Preventive strategies may help reduce recurrence.
If OTC treatment fails, possibilities include: you don't have thrush (something else causing symptoms), resistant Candida strain, or recurrent thrush needing different management. Don't keep using OTC products repeatedly - seek professional diagnosis. We can identify the actual cause and provide appropriate treatment.
Book a confidential consultation or STI test at our South Kensington clinic. Walk-in appointments available.
At STI Clinic, our GPs and nurses are highly trained in sexual health and general medicine. We are committed to delivering confidential, non-judgemental care in a safe and supportive environment.
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