Vaginitis: Signs, Symptoms & Diagnosis

Different types of vaginitis have different symptoms. However, there are some common ones that are usually present regardless to the type of vaginitis you may have. These common indicators of vaginitis may include:

• Change in vaginal discharge. There may be a change in the color or odor of your vaginal discharge. There may also be a change in the amount of vaginal discharge.
• Itching and burning. The mucous membranes inside or around your vagina may itch, burn or do both.
• Dyspareunia and dysuria. Dyspareunia is pain during vaginal intercourse. Dysuria is pain during urination. You may experience either or both of these.
• Light bleeding from the vagina. A small amount of vaginal bleeding that is not associated with menstruation may occur.

Each different type of vaginitis has its own unique set of symptoms. However, many may cause no symptoms at all in some women. Other women may notice some, but not all, of the usually symptoms. Individual types of vaginitis and their associated symptoms include:

• Bacterial vaginosis. In addition to vaginal itching or irritation, this type of vaginitis may result in foul-smelling discharge that is grayish white in color. The odor, which is frequently described as fishlike, is often more obvious after vaginal intercourse. It is important to note that approximately half of all women with bacterial vaginosis do not experience any symptoms.
• Yeast infection. The primary signs and symptoms of this condition are itching, or pruritus, and burning inside and around the vagina. However, yeast infection is often also characterized by a thick, white, cottage-cheese-like discharge. Many times the affected area will also become extremely red and irritated.
• Trichomoniasis. This form of vaginitis may cause a greenish yellow discharge that is sometimes frothy in appearance. Soreness and itching of the vulva and vagina and burning during urination are also common, and some women with trichomoniasis may experience abdominal pain. It is important to note that one-third to one-half of all women with trichomoniasis do not experience any symptoms.
• Atrophic vaginitis. In addition to the symptoms that accompany most types of vaginitis, such as itching and burning, spotting or bleeding, and pain during intercourse or urination, atrophic vaginitis may be accompanied by frequent urination, urinary urgency and loss of urination.
• Viral vaginitis. Indicators of viral vaginitis typically depend on the type of virus present. For instance, the herpes simplex virus is accompanied by painful lesions or sores, whereas the human papillomavirus (HPV) may be accompanied by genital warts.

Women should immediately notify their gynecologist if they experience any of these symptoms.

Diagnosing vaginitis

Routine gynecologic examinations can often identify vaginitis that is not accompanied by noticeable symptoms. Therefore, it is important for women to visit their gynecologist annually. Women who experience symptoms of vaginitis should immediately notify their gynecologist unless they have been previously diagnosed with a yeast infection and the current symptoms are identical (in such cases women can often treat themselves with over-the-counter medications).

Diagnosis of vaginitis typically begins with a medical history, followed by a pelvic examination. Women should avoid douching or using deodorant sprays before their medical examination because these products can impede the diagnosis of vaginitis.

If bacterial vaginosis is suspected, the gynecologist will measure the acidity or pH level of your vagina using narrow-range pH paper. The normal vaginal pH of premenopausal women is approximately 4.0 on the 0.0 to 14.0 pH scale, with 7.0 being neutral. A pH of 4.5 or greater may indicate that you have bacterial vaginosis. The gynecologist will also typically take a sample of your cervical or vaginal discharge for analysis under a microscope. The sample will be examined for "clue cells," bacteria-covered cells in your vaginal lining that indicate the presence of bacterial vaginosis. In addition, the gynecologist may add potassium hydrochloride to a vaginal discharge specimen and check its odor. This is called a whiff test.

Women who have had yeast infections in the past often believe that they can diagnose an infection without consulting their gynecologist. However, misdiagnosis of yeast infection is common. Therefore, women should schedule a gynecological appointment unless they are certain that they have a yeast infection, and not another condition that presents similar symptoms.

To diagnose a yeast infection, the gynecologist will examine the vagina for abnormal discharge or inflammation. The doctor will also collect secretions from the vaginal area and view the specimens under a microscope to determine if the infection is present due to a yeast organism. This is called a slide test. This test is generally sufficient for diagnosing yeast infections in first-time sufferers and those with occasional infections. However, cases of recurrent or resistant yeast infections may require further analysis in the form of a vaginal culture, which is used to identify the presence of other forms of vaginitis as well as sexually transmitted diseases.

Trichomoniasis may also be detected by measuring the acidity or pH level of your vagina using pH paper. However, the condition is typically diagnosed by examining a vaginal fluid sample under a microscope for the presence of parasites, called protozoa. This technique, called a wet mount, is accurate only about 50 percent of the time because the protozoa can be difficult to find, and are often mistaken for normal cells. Researchers are developing more reliable tests for diagnosing this condition.

Diagnosis of viral vaginitis typically depends on the type of virus present. For instance, HPV can sometimes be detected along with a Pap smear or through special DNA probe tests that can determine the type of virus. A Pap smear is a screening procedure that detects changes in the cervix.

Vaginitis may have no symptoms at all. When symptoms do occur, they may be mistaken for symptoms of various other conditions. Because of this, it's important to schedule regular pelvic examinations with your gynecologist. Furthermore, if you do notice any symptoms, talk to you gynecologist. If vaginitis is detected, it can be treated, often before it becomes a nuisance.