Vaginitis is a vaginal infection that disrupts the normal vaginal flora. Experts estimate that 40% of all types of vaginitis are caused by candida, a yeast like fungus. When it multiplies in the vaginal tract, the disorder is called vulvovaginitis. Women often refer to it as a "yeast infection." About 75% of women get candida vaginitis at some time in their lives. Vaginal candida does not generally occur in the absence of estrogen, so premenarchal girls and postmenopausal women not on estrogen replacement almost never develop vaginal yeast.
Candida is a yeast like fungus that grows in the vagina. When there is too much, the fungus causes infection. The following increase your chance of getting a yeast infection:
Your health care provider will give you a pelvic examination and swab your vagina to check for candida. You may also have a Pap smear. Some women have chronic yeast infections. If this happens, your health care provider may want to do additional tests.
Physicians usually recommend topical treatments before oral medications. For chronic infections, your health care provider may increase the dosage and length of treatment. If you have vaginitis, you should avoid excessive exertion and sweating, keep the vaginal area as dry as possible, and avoid sex until symptoms clear. Take showers instead of baths, use unscented soap, and always wipe from front to back after bowel movements. Wearing cotton underwear and avoiding pantyhose and tight fitting pants can help prevent infection.
Topical and oral therapies are equally effective.
Topical therapies (these may initially cause burning from inflammation):
Alternative therapies may help treat acute and chronic vaginitis. Always tell your health care provider about the herbs and supplements you are using. The following douches and suppositories should be discussed with your doctor to make sure they are not too irritating.
Use only one of the following douches at one time. Do not douche during menstrual periods. For first time or acute infection try the vinegar douche or boric acid capsules. For chronic vaginitis, use the herbal combination douche. For recurrent vaginitis, use the Betadine douche. Stop douching if you are in pain or your symptoms get worse.
These nutritional tips may help reduce symptoms:
You may address nutritional deficiencies with the following supplements:
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted. Some herbs can interfere with medications so you should talk to your health care provider before beginning an herbal therapy.
Some of the most common remedies for vaginitis are listed below. Usually, the dose is 3 - 5 pellets of a 12X to 30C remedy every 1 - 4 hours until your symptoms get better.
Acupuncture may be helpful in improving immune function.
To prevent recurrence of infection, take showers instead of baths, use unscented soap, and always wipe from front to back after bowel movements. Wearing cotton underwear and avoiding pantyhose and tight fitting pants can help prevent infection. Recurrent signs and symptoms of vaginitis may be an indication of HSV-2. See your healthcare provider if you are suffering from recurrent infections.
Yeast infections occur twice as often during pregnancy.
ACOG. ACOG Practice Bulletin. Clinical management guidelines for obstetricians-gynecologists, Number 72, May 2006: Vaginitis. Obstet Gynecol. 2006;107(5):1195-1206.
Black. Obstetric and Gynecologic Dermatology. 3rd ed. Baltimore, MD: Mosby, An Imprint of Elsevier; 2008.
Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.
Cvetnic Z, Vladimir-Knezevic S. Antimicrobial activity of grapefruit seed and pulp ethanolic extract. Acta Pharm. 2004;54(3):243-50.
Delia A; Morgante G; Rago G; Musacchio MC; Petraglia F; De Leo V. Effectiveness of oral administration of Lactobaccillus paracasei subsp. paracasei F19 in association with vaginal suppositories of Lactobacillus acidofilus in the treatment of vaginosis and in the prevention of recurrent vaginitis. Minerva Ginecol. 2006;58(3):227-31.
Heggers JP, Cottingham J, Gussman J, et al. The effectiveness of processed grapefruit-seed extract as an antibacterial agent: II. Mechanism of action and in vitro toxicity. J Altern Complement Med. 2002;8(3):333-40.
Heitzman ME, Neto CC, Winiarz E, Vaisberg AJ, Hammond GB. Ethnobotany, phytochemistry and pharmacology of Uncaria (Rubiaceae). Phytochemistry. 2005;66(1):5-29.
LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH:LexiComp; 2000: 452-454.
Nanda N; Michel RG; Kurdgelashvili G; Wendel KA. Trichomoniasis and its treatment. Expert Rev Anti Infect Ther. 2006;4(1):125-35.
Reid G, Burton J, Hammond JA, Bruce AW. Nucleic acid-based diagnosis of bacterial vaginosis and improved management using probiotic lactobacilli. J Med Food. 2004;7(2):223-8.
Ross SE, Carter B, Lambert S. Seroprevalence of herpes simplex virus-2 infection among women seeking medical care for signs and symptoms of vaginitis. Herpes. 2009;15(3):46-50.
Scnitzler P, Schon K, Reichling J. Antiviral activity of Australian tea tree oil and eucalyptus oil against herpes simplex virus in cell culture. Pharmazie.2001;56(4):343-7.
Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.
Sufka KJ, Roach JT, Chambliss WG Jr, et al. Anxiolytic properties of botanical extracts in the chick social separation-stress procedure. Psychopharmacology (Berl). 2001;153(2):219-24.
Tempera G; Abbadessa G; Bonfiglio G; Cammarata E; Cianci A; Corsello S; Raimondi A; Ettore G; Nicolosi D; Furneri PM. Topical kanamycin: an effective therapeutic option in aerobic vaginitis. J Chemother. 2006;18(4):409-14.
Van Kessel K; Assefi N; Marrazzo J; Eckert L. Common complementary and alternative therapies for yeast vaginitis and bacterial vaginosis: a systematic review. Obstet Gynecol Surv. 2003;58(5):351-8.
Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.
© 2011 University of Maryland Medical Center (UMMC). All rights reserved.
UMMC is a member of the University of Maryland Medical System,
22 S. Greene Street, Baltimore, MD 21201. TDD: 1-800-735-2258 or 1.866.408.6885