We've all had some type of "-itis" in our lifetime—cystitis, sinusitis, mastitis. But one of the more annoying “-itis” conditions is vaginitis. You know what I’m talking about. For some women it’s just feeling aware down there, other women notice a change in vaginal odor or discharge, and for others it's actual pain. When a condition ends in “-itis”, is usually indicates that there is inflammation. The inflammation can be in response to an infection, or it can simply be irritation such as an allergic response without any infection. Vaginitis is a term that describes all of these situations and more.
Atrophic vaginitis I hate to tell all you ladies, but that myth about your vagina drying up with age is true. Atrophic vaginitis is thinning of the vaginal lining that results in a variety of symptoms, the most common being vaginal dryness. I can't tell you how many women compare sexual activity with vaginal dryness to rubbing sand paper on your skin. When should a woman seek treatment for atrophic vaginitis? First of all, the need for treatment is determined by how bothered a woman is. For example, if a 30-year old woman had premature menopause or a 60-year old woman had natural menopause and both have vaginal dryness that is causing enough pain with sexual activity (dyspareunia) that they avoid it, then they should be treated. On the other hand, if a woman has vaginal dryness but is not sexually active or bothered by it, then she doesn’t need any treatment.
In addition to dyspareunia, atrophic vaginitis can also cause an imbalance of the vaginal microbiome (mix or normal bacteria, yeast, and other organisms) that makes many women feel “aware” down there (you really shouldn’t be aware of your vagina). This imbalance can also predispose to things like bladder infections because it can cause a decrease in the number of good bacteria.
A common treatment for atrophic vaginitis is vaginal estrogen. Traditional estrogen replacement such as with a pill or patch can often help, but women who don't want to take systemic estrogen (such as with history of breast cancer) or women who take systemic estrogen but are still dry can benefit from additional vaginal estrogen that is available as cream, suppositories, or a time-release ring. Specific laser treatments for vaginal dryness are also available. Vaginal moisturizers and lubricants (hint: GLISSANT) are also helpful.
Vaginitis due to infection The vaginal microbiome works in such a way that actual vaginal infections are not as common as an imbalance. What I mean by that is when there is an excess of certain bacteria, the vaginal discharge can change in odor or even color but there is no associated pain or fever as with other types of infections. This is referred to as bacterial vaginosis or BV. When the microbiome is significantly altered such as after taking antibiotics or excessive douching, then the “bad” bacteria or yeast have a chance to grow and cause vaginal pain, itching or other symptoms. Rather than take more antibiotics, the microbiome can often be restored by simply waiting for Mother Nature to work (assuming no severe symptoms) or use something to restore the normal acidic vaginal pH like vaginal estrogen or boric acid.
Vaginitis due to inflammation Pain, burning, and/or discharge in the vaginal area isn't always due to infection, it can also be due to an allergic type reaction to things like condoms, lubricants with certain chemicals (not GLISSANT lubricants of course!), or even douching.
Regardless of the cause of vaginitis, you should get the right care for down there...it's a very important place.