Vaginitis – Diagnosis and Treatment
Diagnosis
A healthcare professional usually starts by asking about past vaginal or sexually transmitted infections. Next, the doctor does a pelvic exam.
During the exam, the doctor uses a speculum to view the inside of the vagina. The doctor looks for symptoms like swelling, unusual discharge, redness, or irritation.
The doctor often takes a sample of vaginal or cervical fluid for lab tests. The sample goes under a microscope to check for yeast, bacteria, clue cells, or signs of trichomonas vaginalis.
Doctors may also do a whiff test or measure the vaginal pH. If the vaginal pH is higher than 4.5, it often points to bacterial vaginosis or trich.
- Common tests include:
- Microscopy: Doctors look for candida albicans, clue cells, and trichomonads.
- Gram Stain: This test finds organisms like gardnerella vaginalis.
- pH Testing: A high pH with a fishy odor may mean BV.
- Amsel Criteria: Doctors use this to help diagnose bacterial vaginosis.
Doctors check for other symptoms like itching, burning, pain with sex (dyspareunia), abnormal discharge, or vaginal dryness.
- Modern clinics may use nucleic acid amplification tests or antigen tests for more accurate results.
Treatment
Doctors choose treatment based on the cause of the symptoms. They select specific medicines or steps depending on the type of vaginitis and each person’s situation, such as age, pregnancy, or other health conditions like diabetes.
Common Treatment Options:
| Cause | Medicine Type |
|---|---|
| Bacterial Vaginosis | Antibiotics |
| Yeast Infection | Antifungal creams/tablets |
| Trichomoniasis (STI) | Antibiotics (antiprotozoal) |
| Menopause-Related Atrophy | Hormone therapy |
| Noninfectious Vaginitis | Lifestyle change (no medicine needed) |
Important Points
At-Home Care Steps
You can use over-the-counter antifungal medicine for yeast infections to manage mild symptoms. These come as creams or vaginal suppositories in several treatment lengths.
Follow the full treatment course even if symptoms improve before you finish.
A cold washcloth or ice pack on the affected area may help relieve itching or burning. Wearing loose, cotton underwear keeps the area dry and reduces irritation.
Avoid douching and fragrant sprays, as they may cause contact dermatitis or make discomfort worse. Good hygiene, including washing with mild soap and water, can also help.
Getting Ready for Your Visit
Steps to Take Before Your Appointment
To prepare for your medical visit, consider these steps:
Write down all your symptoms. Note how long you have noticed any issues such as unusual discharge, discomfort, or itching.
List your recent sexual activity, including the number of partners and if you have started seeing a new partner. This helps your doctor understand possible causes.
Make a record of all the medicines, vitamins, and supplements you use, including their dosages.
- Prepare questions to ask your healthcare provider. Some useful ones are:
- How can I prevent these symptoms in the future?
- Should my sexual partner be tested or treated?
- Are over-the-counter treatments safe or effective for my case?
- What signs mean I need to contact you again?
- What should I do if symptoms come back?
Do not use tampons, douche, or have sex for at least 24 hours before your appointment. This helps your doctor get a clear and accurate sample for testing.
Tip: Organizing your information in a simple chart or list can make your appointment go smoother and faster.
What Your Healthcare Provider Might Ask
Be ready to answer questions such as:
- Do you notice any strong or unusual vaginal odor?
- When do your symptoms occur? Are they linked to your menstrual cycle?
- Have you tried treating the symptoms with any products from the store?
- Are you currently pregnant?
- Have you recently changed soap, used bubble bath, or tried new hygiene sprays?
- Do you use douches or other feminine hygiene products?
Share honest details about your sexual activity and any unprotected sex. This helps your healthcare provider recommend safe and suitable care. Ask for clarification or share any concerns during your visit.
