Vaginitis – what is the cause and how to treat it

2nd September, 2022 • 13 min read

It’s a special kind of discomfort if you have a sore vaginal opening or the outer lips and clitoris area (vulva) are swollen, inflamed or irritated. Wearing your normal clothes can make it feel worse. And forget about concentrating on work, exercise, playing with the kids - or even thinking about sex. It can also be very worrying having these symptoms when you don’t know what’s causing them.

“Medically known as vaginitis, this is one of those annoying health issues that many of us get from time to time,” says

Dr Ann Nainan
, doctor and Healthily expert. “It’s hard to know exactly how many women are affected because vaginitis isn’t a diagnosis in itself - it just describes symptoms that can have different causes, including infections and reactions to things like shower gel. But research suggests the majority of women get an infection that causes soreness, swelling, itching or burning at some point in their life. The good news is in most cases it can be easily treated - and there are self-care steps you can take to help prevent it, too.”

Read on for all you need to know about vaginitis, including the common symptoms and causes, and, most importantly, what you can do about them.

What is vaginitis in women?

Vaginitis means your vagina is sore, itchy and uncomfortable. Depending on the cause, you may also have other symptoms, including a change in the way your vagina smells and

unusual vaginal discharge
.

The symptoms can affect your vaginal opening, outer lips (labia majora), inner lips (labia minora) and clitoris. For this reason, the condition is sometimes called vulvovaginitis.

Who gets vaginitis?

Vaginitis is one of the most common reasons for women to see a doctor or women’s health specialist (gynaecologist).

Anyone with a vagina can have vaginitis, at any age, but things that can raise your risk include:

What are the main vaginitis symptoms?

Vaginitis symptoms vary depending on the underlying cause but you’ll probably have 1 or more of these:

  • soreness, itching or burning in or around your vagina
  • a change in your
    vaginal discharge
    – including the smell, colour, amount and thickness
  • a
    strong or unusual smell from your vagina
    – especially after sex
  • pain or discomfort when you pee or have sex
  • vaginal dryness
  • cracked or swollen skin around your vagina
  • light vaginal bleeding or spotting between your periods

Vaginitis symptoms can be really uncomfortable, and may make you feel self-conscious and embarrassed, especially if they don’t go away or keep coming back (recurrent vaginitis).

If you’re concerned about your symptoms but not sure whether you need to see a doctor, you can try our

Smart Symptom Checker
to help you work out what your next steps should be. But it’s best to see a doctor if you have symptoms of vaginitis for the first time, so they can try to find out what’s causing it.

Find useful information on other areas of vaginal health with our

complete Guide
.

What causes vaginitis?

Vaginitis can be caused by several different things. Here are the most common causes, along with the symptoms to look out for.

Infections

There are lots of different infections that can cause a sore, swollen vulva.

Thrush (candidiasis)
is a common yeast infection that can happen if a normally harmless fungus overgrows in your vagina. It’s one of the most common causes of vaginitis, and research suggests about 75% of women will get thrush at least once in their life. Look out for itching and irritation inside and around your vagina, and possibly a thick, lumpy and white vaginal discharge.

Bacterial vaginosis (BV)
is another common vaginal infection that can cause vaginitis. It happens when there’s a change in the balance in the bacteria that normally live in your vagina. The most common symptom is vaginal discharge with a strong fishy smell.

Sexually transmitted Infections (STIs)

There are 3 STIs that can often cause soreness, swelling and itching around your vagina:

  • trichomoniasis
    is caused by a tiny parasite and is usually spread by having sex without a condom (unprotected sex). As well as being sore, you may get a thick or frothy smelly discharge
  • chlamydia
    is one of the most common STIs and is also spread through unprotected sex. If you get symptoms, they can include unusual discharge, pain when peeing, bleeding after sex and between periods, and tummy pain
  • genital herpes
    is caused by the herpes simplex virus - the same common virus that causes
    cold sores
    . It can be passed on through anal, vaginal or oral sex and lead to small blisters or sores in, on and around your vagina, vulva or bottom, burning or itching around your genital area, unusual vaginal discharge and pain when peeing

Skin conditions

Skin conditions that cause irritation, such as

eczema
and
lichen planus
, can affect any part of your body – including your genitals. Symptoms include dry, itchy and sore patches of skin on your vulva, which you may also have on other parts of your body.

Allergies

Chemicals used in lots of common products can cause a reaction if you’re allergic to them. Common culprits include perfumed soaps and body washes, laundry detergent, tampons and sanitary pads, scented toilet paper, condoms and contraceptive foams.

Using intimate products

Sometimes, things you put inside your vagina - like tampons - can cause irritation. And products such as vaginal washes, douches (washes designed to be used inside your vagina) and wipes can disrupt your vagina’s bacterial balance, leading to an increased risk of vaginitis from infections like thrush and BV. Your vagina is designed to clean itself – that’s what normal vaginal discharge does.

Changing hormone levels

Falling levels of the hormone oestrogen can cause the lining and tissues of your vagina and vulva to become drier, thinner and less elastic. This often happens during and after menopause and it can also happen while you’re breastfeeding. It can lead to soreness, itching, burning and other symptoms of

vaginal dryness
.

How to treat vaginitis

There are lots of effective treatments, and what’s right for you depends on what’s causing your symptoms. In some cases, self-care steps and things you can get from a pharmacy may be enough to help. If the cause of your symptoms isn’t clear, the pharmacist may suggest speaking to a doctor first.

Self-care and pharmacy treatments

If vaginitis is caused by thrush:

  • your pharmacist may recommend an antifungal medicine, such as a cream to apply to your vagina, a tablet to take or a suppository to put inside your vagina
  • you should see your doctor if you have
    thrush symptoms
    for the first time, if you’re pregnant or breastfeeding, if your symptoms don’t get better with pharmacy treatments or if they keep coming back

If vaginitis is caused by a skin condition or a reaction to a product, like soap or scented sanitary towels:

  • wash with non-perfumed, soap-free products – or just plain water
  • avoid scented panty liners, toilet paper and lubricants
  • try unscented moisturising creams called emollients. They can help soothe dry, sore or itchy skin on your vulva, as well protecting it from irritants and helping to prevent flare-ups
  • soothe itching, swelling and pain with a cold compress or ice pack wrapped in a flannel

If vaginitis is caused by low oestrogen levels:

  • your pharmacist may recommend a vaginal moisturiser or lubricant to help soothe dryness and soreness
  • if you want support with other menopausal symptoms, talk to your doctor - they can prescribe a few treatments to help

If vaginitis is caused by genital herpes:

  • you can try rubbing petroleum jelly, such as Vaseline, or an anaesthetic (painkilling) cream onto your blisters to help reduce pain when you pee
  • pouring warm water over your genitals when you pee can also help
  • you’ll need medication from a doctor to help clear it up more quickly, especially if this is the first time you’ve had it - treatment works best if you start it as soon as possible so don’t put off getting help

When to see a doctor

If you’re not sure what’s causing your vaginitis, or it’s the first time you’ve had symptoms, it’s best to see your doctor. They can help you work out what’s causing it, so you can get the right treatment. You should also see your doctor about vaginitis symptoms if:

  • they aren’t getting better or keep coming back
  • the symptoms have changed
  • you notice a change in the colour, thickness, smell of your vaginal discharge
  • you have a rash or blisters as well
  • symptoms started after sex with a new partner, or you think you might have an STI
  • it hurts during or after sex
  • you have vaginal bleeding in between your periods or after sex
  • you have symptoms of a
    urinary tract infection (UTI)
  • you’re pregnant
  • you’re struggling with other menopause symptoms

Your doctor will ask questions about your symptoms, and may want to examine you and do some tests. This may include looking at the skin of your vulva and inside your vagina, and taking a swab from your vagina to check for infections. See a doctor urgently if you have a high temperature (fever) or

lower tummy (pelvic) pain
.

Preparing for your appointment

Being prepared for the appointment with your doctor can help you feel more confident about talking to them - and help you get the right diagnosis. Try not to feel embarrassed talking about vaginitis. Doctors have seen and heard it all before, and are there to help you get the treatment you need.

Before your appointment:

  • keep a diary of your symptoms, including when and how often you get them
  • think about any recent changes you’ve made – such as having a new sexual partner or using a different laundry detergent
  • make a list of any medications you’re taking, as well as vitamins and supplements
  • write down any questions or concerns you have – for example, “What can I do to prevent vaginitis?”, or “What can I do if my symptoms come back?”

Treatment from your doctor

Your doctor will recommend next steps depending on the cause of your vaginitis. If symptoms are caused by:

  • thrush – they may prescribe antifungal cream, tablets or suppositories. If the treatment doesn’t work or you have recurrent thrush, your doctor can do some tests to confirm your diagnosis and suggest a different way of treating it, such as a longer course of medication
  • BV – the usual treatment is a short course of antibiotic tablets or an antibiotic gel to put inside your vagina. It’s common for BV to come back after treatment (usually within 3 months). If you keep getting it, your doctor may refer you to a sexual health clinic
  • trichomoniasis – your doctor will prescribe an antibiotic tablet or gel. If your symptoms continue after treatment, you may need a test to see if it’s gone away or other tests to see if you also have another STI
  • chlamydia – antibiotics cure more than 95% of cases if they’re taken the right way
  • genital herpes – you may be given antiviral tablets, especially if this is the first time you’ve had it. Any future outbreaks tend to be milder so you won’t necessarily always need to take medication
  • a skin condition or allergic reaction and self-care steps haven’t helped – they may suggest a steroid cream or ointment
  • menopausal hormone changes – your doctor may suggest local oestrogen treatments. These are creams, tablets, rings or pessaries you can put inside your vagina to help ease vaginal dryness. Read more about
    treatments for vaginal dryness

Self-care tips to help prevent vaginitis

Once you’ve treated the cause of your vaginitis, the good news is there are things you can do to reduce your chances of getting it again. These include:

  • not washing inside your vagina – douching can disrupt your vagina’s healthy bacterial balance. Using mild, unperfumed soap for the rest of your body can also minimise the chances of irritating your genital area. Read more about
    how to clean your vagina
  • avoiding using anything fragranced around your vagina
  • always wiping from front to back after using the toilet – this helps to prevent bacteria being spread from your bottom to your vulva
  • choosing breathable, cotton underwear – cotton stops moisture building up and allows more airflow. Avoid synthetic or nylon materials, which can make you sweat more
  • not wearing underwear while sleeping
  • wearing loose-fitting clothes as much as possible. Think about wearing trousers instead of leggings or tights, for example - or wear skirts with bare legs when it’s warm enough
  • practising safe sex - always use a condom to protect against STIs with any new sexual partners

Check out these

other need-to-knows to help keep your vagina healthy
.

Your health questions answered

Can I have sex if I have vaginitis?

“'Vaginitis is inflammation in your vagina and this can have lots of different causes. Any inflammation in your vagina or the surrounding areas might make sex uncomfortable – and sex might make your symptoms worse. STIs are also common causes of vaginitis so if you don’t know why you have vaginitis and think you could have an STI, see a doctor so they can check the cause. If you do have an STI, it’s important that you and your partner(s) are treated before you have sex, to avoid reinfection. (Read about how to prevent STIs.)”
Dr Ann Nainan

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.