Vaginitis

Diagnosis

To diagnose vaginitis, your healthcare provider uses several methods to determine the cause of your symptoms.

• Medical history review: Your provider will discuss your history of vaginal or sexually transmitted infections and any symptoms you are currently experiencing.

• Pelvic exam: During the exam, a speculum may be used to view the inside of the vagina and check for signs of inflammation or unusual discharge.

• Sample collection for lab testing: A small sample of vaginal or cervical discharge may be collected to identify the specific type of infection causing vaginitis.

• pH testing: A pH test stick or paper may be applied to the vaginal wall. An elevated pH level can suggest bacterial vaginosis or trichomoniasis, though this test alone is not sufficient for diagnosis.

Treatment

Treatment for vaginitis depends on the underlying cause. Each type of vaginitis has a specific approach to manage symptoms and clear the infection.

• Bacterial vaginosis: Common treatments include metronidazole tablets taken by mouth, metronidazole gel applied to the vagina, or clindamycin in cream, oral tablet, or vaginal capsule form. Tinidazole and secnidazole are other oral options. Bacterial vaginosis may recur even after successful treatment.

• Yeast infections: Over-the-counter antifungal creams or suppositories such as miconazole, clotrimazole, butoconazole, or tioconazole are typically effective. Prescription oral medications like fluconazole may also be used. While over-the-counter treatments are convenient, using them without a diagnosis could delay proper care if the infection is not caused by yeast.

• Trichomoniasis: This sexually transmitted infection is treated with oral medications such as metronidazole or tinidazole.

• Genitourinary syndrome of menopause (vaginal atrophy): Estrogen therapy in the form of creams, tablets, or rings can relieve symptoms. This treatment requires a prescription and consideration of any potential risks or complications.

• Noninfectious vaginitis: Identifying and avoiding the source of irritation is key. Common irritants include soaps, laundry detergents, sanitary products, or new hygiene items.

Proper diagnosis ensures that treatment is effective and prevents recurring or worsening symptoms.