Vaginitis

Vaginitis is inflammation of the vagina that can cause itching, discomfort and discharge.

Symptoms of vaginitis

Symptoms include:

• an abnormal vaginal discharge
• vaginal irritation or itching
• pain when peeing or having sex
• light bleeding or spotting

A strong, unpleasant smell, particularly after sex, can be a sign of bacterial vaginosis or trichomoniasis, which can sometimes cause vaginitis (see below).

When to get medical advice

See your GP or go to a sexual health clinic if you have any unusual vaginal symptoms, particularly if:

• you have vaginal itching or an unpleasant smelling vaginal discharge
• you haven't had a vaginal infection before
• you've had vaginal infections in the past, but this time your symptoms are different
• you've had a number of sexual partners or you have a new sexual partner – you may have a sexually transmitted infection (STI)
• you've finished a course of medication for vaginal thrush, but your symptoms are persisting

There's no need to see your GP if you've been diagnosed with thrush in the past and your symptoms are the same.

If you're sure you have thrush and you've treated it successfully in the past with over-the-counter medication, you can treat it yourself again.

Read more about over-the-counter thrush medicines.

Causes of vaginitis

Vaginitis can be caused by any of the following infections or irritants:

• thrush – a common yeast infection that affects most women at some point
• bacterial vaginosis – a bacterial infection where the balance of bacteria inside the vagina is disrupted 
• trichomoniasis – an STI caused by a tiny parasite 
• chemical irritation – for example, from perfumed soap, bubble bath, or fabric conditioner, or from spermicide (a chemical that kills sperm, sometimes used on condoms) and some sanitary products
• washing inside your vagina 
• chlamydia – an STI caused by bacteria
• gonorrhoea – an STI caused by bacteria 
• genital herpes – an STI caused by the herpes simplex virus

Vaginal dryness, itching or discomfort (particularly during sex) can also sometimes be caused by a decrease in oestrogen levels after the menopause. This is known as vaginal atrophy or atrophic vaginitis, and is due to the thinning of the vagina's lining.

Treating vaginitis

Treatment for vaginitis depends on what's causing it.

Yeast infections, such as vaginal thrush, are usually treated with antifungal medicines, and bacterial infections are usually treated with antibiotics.

Read more about treating:

• vaginal thrush
• bacterial vaginosis
• trichomoniasis

Vaginal atrophy

Hormone replacement therapy (HRT) may be recommended if you have vaginitis that's caused by vaginal atrophy (thinning of the lining of the vagina after the menopause). HRT replaces the female hormones, oestrogen and progesterone.

Creams, pessaries or vaginal tablets that contain oestrogen are also available. Unlike HRT, they only restore oestrogen to your vagina rather than to your whole body, reducing the risk of side effects.

Read more about the side effects of HRT.

Self care

To help improve your vaginitis you should:

• keep your genital area clean and dry – take a warm bath rather than a hot one and use unperfumed soap to clean your genital area (the vagina cleans itself with natural secretions); dry yourself thoroughly
• avoid douching (spraying water inside your vagina) – it may make your vaginitis symptoms worse by removing the healthy bacteria that line the vagina and help keep it free from infection
• not use feminine hygiene products – such as sprays, deodorants or powders
• use pads rather than tampons if you're using intravaginal creams or pessaries to treat an infection – tampons may 'soak up' the treatment meaning there's less available in the vagina 
• wear loose-fitting cotton underwear – this may be beneficial if you have external soreness, but it won't prevent getting vaginitis in the future

Having sex 

You should also practice safe sex by using condoms to avoid getting or spreading STIs. Read more about contraception.

If you have mild to moderate vaginitis, using a lubricant can help relieve pain and discomfort while having sex. Lubricants provide short-term symptom relief and can improve vaginal dryness during sex, but there's no evidence to show they're an effective long-term treatment.

Several types of lubricant are available – some are water-based and some are silicone-based. You may need to try a few before finding one that's suitable. Ask your GP or pharmacist if you need further advice.