What is vaginitis?

Updated: Dec 04, 2018
  • Author: Hetal B Gor, MD, FACOG; Chief Editor: Michel E Rivlin, MD  more...
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Vaginitis (inflammation of the vagina) is the most common gynecologic condition encountered in the office. It is a diagnosis based on the presence of symptoms of abnormal discharge, vulvovaginal discomfort, or both. Cervicitis may also cause a discharge and sometimes occurs with vaginitis. 

Discharge flows from the vagina daily as the body’s way of maintaining a normal healthy environment. Normal discharge is usually clear or milky with no malodor. A change in the amount, color, or smell; irritation; or itching or burning could be due to an imbalance of healthy bacteria in the vagina, leading to vaginitis.

The most common causes of vaginitis in symptomatic women are bacterial vaginosis (40-45%), vaginal candidiasis (20-25%), and trichomoniasis (15-20%); yet 7-72% of women with vaginitis may remain undiagnosed.

The workup for patients with vaginitis depends on the risk factors for infection and the age of the patient. Accurate diagnosis may be elusive, and care must be taken to distinguish vaginitis from other infectious and noninfectious causes of symptoms. All women presenting with abnormal vaginal discharge should have a careful pelvic examination. Condition-specific tests (ie, colposcopy and cervical biopsies) are indicated for suspected cervical cancer.

Studies that may be performed in cases of suspected vaginitis include saline wet mount, the so-called whiff test, pH testing, culture, nucleic acid amplification testing, and a number of other second-line tests (see Presentation, DDx, and Workup).

Treatment of vaginitis varies by cause and is directed at the relevant pathogen. Inpatient care usually is not indicated, unless serious pelvic infections arise or evidence of systemic infection in an immunocompromised host is present (see Treatment).

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