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Vaginitis

Vaginitis

Also indexed as: Atrophic Vaginitis, Bacterial Vaginosis, Gardnerella Infection, Hormone-Related Vaginitis, Irritant Vaginitis, Trichomoniasis, Vulvovaginitis

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Soothe the discomfort of vaginitis and get back to enjoying life. First, uncover the cause. Then control the irritating symptoms. According to research or other evidence, the following self-care steps may be helpful:

What you need to know

  • Give yogurt a go
  • Help prevent recurrences of bacterial or candidal vaginitis by eating 5 ounces (113 grams) a day of yogurt containing live Lactobacillus acidophilus, a friendly bacteria
  • Try topical acidophilus
  • To relieve symptoms, apply a daily topical preparation or a suppository containing live Lactobacillus acidophilus for up to two weeks; for prevention in those with recurrent infections, apply weekly
  • Steer clear of irritants
  • Reduce vaginal irritation by minimizing friction and reducing your exposure to perfumes, spermicides, and other chemicals
  • Get a checkup
  • Visit your healthcare provider to find out if your vaginitis is caused by a treatable medical condition

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full vaginitis article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About vaginitis

Vaginitis is inflammation of the vagina.

Vaginitis is responsible for an estimated 10% of all visits by women to their healthcare practitioners. The three general causes of vaginitis are hormonal imbalance, irritation, and infection. Hormone-related vaginitis includes the atrophic vaginitis generally found in postmenopausal or postpartum women and, occasionally, in young girls before puberty. Irritant vaginitis can result from allergies or irritating substances. Infectious vaginitis is most common in reproductive-age women and is generally caused by one of three types of infections: bacterial vaginosis (BV), candidiasis (yeast infection), or trichomoniasis. A healthcare professional should be consulted for the diagnosis and treatment of any vaginal infection.

Although it is a type of vaginitis, yeast infection is not discussed on this page. For specific information on yeast infections (i.e., vaginitis caused by Candida albicans), see the yeast infections article.

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Product ratings for vaginitis

Science Ratings Nutritional Supplements Herbs
3Stars

Lactobacillus acidophilus (vaginal application)

 
2Stars

Lactobacillus rhamnosus G R-1 and Lactobacillus reuteri RC-14 (orally)

Neem

1Star

Soy

Vitamin A

Vitamin E

Barberry

Echinacea

Goldenseal

Tea tree

3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
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What are the symptoms?

Hormone-related vaginitis is marked by dryness, irritation, thinning of the vaginal mucous membranes and painful intercourse. Irritant vaginitis is characterized by itching and soreness. Infectious vaginitis also itches and typically includes vaginal discharge that varies in color, consistency, and odor, depending upon the infectious organism. Discharge may range from scant to thick and white and may or may not be accompanied by a strong odor. Symptoms are often worse immediately after intercourse or the menstrual period.

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Dietary changes that may be helpful

Food allergies are believed to be a contributory factor in some cases of recurrent irritant vaginitis.

In a controlled trial, women with recurrent BV or vaginal candidiasis ate 5 ounces (150 grams) of yogurt containing live Lactobacillus acidophilus daily.1 They had more than a 50% reduction in recurrences, while women who consumed pasteurized yogurt that did not contain the bacteria had only a slight reduction.

In another study, women who ingested 45 grams of soy flour per day showed an improvement in the estrogen effect on their vaginal tissue.2 That observation suggests that supplementing with soy may be helpful for preventing or reversing atrophic vaginitis.

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Lifestyle changes that may be helpful

For irritant vaginitis, minimizing friction and reducing exposure to perfumes, chemicals, irritating lubricants, and spermicides can be beneficial.

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Other therapies

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Vitamins that may be helpful

Lactobacillus acidophilus is a strain of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help maintain the vaginal microflora by preventing overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic. These friendly bacteria also compete with other organisms for the utilization of glucose. The production of lactic acid and hydrogen peroxide by lactobacilli also helps to maintain the acidic pH needed for healthy vaginal flora to thrive. Most of the research has used yogurt containing live cultures of Lactobacillus acidophilus or the topical application of such yogurt or Lactobacillus acidophilus into the vagina. The effective amount of acidophilus depends on the strain used, as well as on the concentration of viable organisms.

Vaginal application of a proprietary Lactobacillus acidophilus preparation may help bacterial vaginitis. In one trial, 80% of women with bacterial vaginitis who used the preparation were either cured or experienced marked improvement in symptoms.3 In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (for example, Gyne-Lotrimin), or placebo weekly for 21 months.4 Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis—a result almost as good as that achieved with clotrimazole. In a preliminary trial, women with vaginal Trichomonas infection received vaginal Lactobacillus acidophilus suppositories for one year.5 Over 90% of them were reported to be cured of their clinical symptoms in that time.

Two specific strains of lactobacillus (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) have been found to be effective against bacterial vaginosis when taken orally. In a double-blind study, supplementation with a capsule containing 10 billion of each of these organisms twice a day for 30 days increased the cure rate from antibiotic therapy to 88%, compared with a 40% cure rate in the group receiving antibiotics alone.6

Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis. Vitamin E as a suppository in the vagina or vitamin E oil can be used once or twice per day for 3 to 14 days to soothe the mucous membranes of the vagina and vulva. Some doctors recommend vaginal administration of vitamin A to improve the integrity of the vaginal tissue and to enhance the function of local immune cells. Vitamin A can be administered vaginally by inserting a vitamin A capsule or using a prepared vitamin A suppository. Vitamin A used this way can be irritating to local tissue, so it should not be used more than once per day for up to seven consecutive days.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

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Herbs that may be helpful

In a double-blind, placebo-controlled trial, a cream containing neem seed extract, saponins of Sapindus mukerossi (reetha), and quinine hydrochloride (5 ml applied vaginally once at bedtime) eliminated all symptoms in 10 of 14 women with chlamydia compared with none of four women given placebo cream.7 Neither cream was effective in women with trichomoniasis or candidal vaginitis.

Topically applied tea tree oil has been studied and used successfully as a topical treatment for Trichomonas,  Candida albicans, and other vaginal infections.8 Tea tree oil must be diluted when used as a vaginal douche, and should only be used for this purpose under the supervision of a healthcare practitioner. Some physicians suggest using tea tree oil by mixing the full-strength oil with vitamin E oil in the proportion of 1/3 tea tree oil to 2/3 vitamin E oil. A tampon is saturated with this mixture or the mixture is put in a capsule to be inserted in the vagina each day for a maximum of six weeks.

Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.9 In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

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References
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