Vaginitis 1

Ayurvedic & Unani Tibbia College and
Hospital
Ajmal Khan Road, Karol Bagh, New Delhi – 110005.
PROJECT ON VAGINITIS
SUBMITTED BY: SUBMITTED TO:

ASADULLAH(96506) Dr. AYSHA RAZA (M.D) HOD
BUMS final year Department of Gynae & Obs
Vaginitis
Vaginitis is an infection or inflammation of the vagina that
can result in discharge, itching and pain.
Types of Vaginitis:
There are many types of vaginitis. The most common

kinds are:
➢ Bacterial vaginosis (BV). A healthy vagina has

a balance of many different kinds of bacteria, yeast,
and other microbes. But sometimes, the balance
gets upset, and one microbe grows too much. BV
happens when there's too much of one
bacteria,usually Gardnerella vaginalis bacteria.
signs and symptoms:

 Non irritating,grayish white discharge with a
strong fishy smell.
 The vaginal mucosa and cervical epithelium will appear
normal. There will be no cervical motion tenderness or pelvic
pain on palpation.
Amsel’s Diagnostic Criteria for BV (must have three of
the four criteria).The criteria are -
 thin, white, homogeneous vaginal discharge,
 pH greater than 4.5, a positive amine whiff test,
 presence of clue cells on microscopic examination.
➢ Candida or "yeast" infection. Candida yeast is

a type of fungus. Small amounts of this fungus live
in your mouth, digestive system, and vagina. This is
perfectly normal and healthy.
Signs and symptoms :
genital burning, pruritis, dyspareunia, dysuria and a thick,

white, curd(cottage cheese)-like discharge.
The pH will be less than 4.5, and the amine “whiff” test will be
negative.
Chlamydia: This is the most common sexually

transmitted infection (STI), especially among
people ages 15-24 years who have multiple sex
partners.
➢ Trichomoniasis. This infection is caused by a

parasite spread during sex. It causes a yellow
green, frothy discharge. It raises your risk of
other STIs.
signs and symptoms :

 green-to-yellow, frothy vaginal discharge.
 vaginal pruritic and irritation, dysuria and dyspareunia.
 A physical exam will reveal vaginal mucosa erythema and
strawberry cervix.
 pH will be greater than 4.5. An amine test can be positive
Causes
The cause depends on what type of vaginitis you have:
 Bacterial vaginosis. This most common type of vaginitis
results from a change of the bacteria found in your vagina,
upsetting the balance. What causes the imbalance is unknown.
It's possible to have bacterial vaginosis without symptoms.
This type of vaginitis seems to be linked to but not caused by

sex — especially if you have multiple sex partners or a new sex
partner — but it also occurs in women who aren't sexually
active.
 Yeast infections. These occur when there's an overgrowth of a

fungal organism — usually Candida albicans — in your vagina. C.
albicans also causes infections in other moist areas of your body,
such as in your mouth (thrush), skin folds and nail beds. The
fungus can also cause diaper rash.
 Trichomoniasis. This common sexually transmitted infection is
caused by a microscopic, one-celled parasite called Trichomonas
vaginalis. This organism spreads during sex with someone who
has the infection.
In men, the organism usually infects the urinary tract, but often it
causes no symptoms. In women, trichomoniasis typically infects
the vagina, and might cause symptoms. It also increases
women's risk of getting other sexually transmitted infections.
 Noninfectious vaginitis: Vaginal sprays, douches,

perfumed soaps, scented detergents and spermicidal
products can cause an allergic reaction or irritate vulvar and
vaginal tissues. Foreign objects, such as toilet paper or
forgotten tampons, in the vagina also can irritate vaginal
tissues.
 Genitourinary syndrome of menopause (vaginal
atrophy). Reduced estrogen levels after menopause or surgical
removal of your ovaries can cause the vaginal lining to thin,
sometimes resulting in vaginal irritation, burning and dryness.
Risk factors:
Factors that increase the risk of developing vaginitis include:
 Hormonal changes, such as those associated with pregnancy,

birth control pills or menopause
 Sexual activity
 Having a sexually transmitted infection
 Medications, such as antibiotics and steroids
 Use of spermicides for birth control
 Uncontrolled diabetes
 Use of hygiene products such as bubble bath, vaginal spray or
vaginal deodorant
 Douching
 Wearing damp or tight-fitting clothing
 Using an intrauterine device (IUD) for birth control
Diagnosis:
 History taking
 Physical examination
 Laboratory test- Swab test, Vaginal pH test, Wet-mount ,KOH
prep(to detect fungi),Whiff test(suggestive of BV)
TREATMENT:
 For Bacterial Vaginosis:
Metronidazole 500 mg orally twice a day for 7 days

or
Metronidazole gel 0.75%, one full applicator (5 g) intravaginally,
once a day for 5 days
or
Clindamycin cream 2%, one full applicator (5 g) intravaginally at
bedtime for 7 days
 For Trichomoniasis:
Metronidazole 2 gm by mouth once or tinidazole 2 gm by mouth
once.
Alternative Regimen
Metronidazole 500 mg by mouth two times per day for 7 days.
 For Candidiasis:
Uncomplicated:
A single dose by mouth of fluconazole 150 mg by mouth is also
effective. No follow-up is needed if the symptoms resolve.
Complicated Disease:
Recurrent candidiasis: 7 to 14 days of topical therapy or a 100-
mg, 150-mg, or 200-mg oral dose of fluconazole every third day
for a total of 3 doses [day 1, 4, and 7) can be used. Oral
fluconazole (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6
months is the first line maintenance regimen.
 Genitourinary syndrome of menopause (vaginal atrophy)-
Estrogen - in the form of vaginal creams, tablets or rings — can

treat this condition.
 Noninfectious vaginitis-
To treat this type of vaginitis, you need to pinpoint the source of

the irritation and avoid it.
Complications:
 PID
 Preterm labor
 PROM
 Low birth weight infant
 Postpartum endometritis
Prevention:
Good hygiene might prevent some types of vaginitis from

recurring and relieve some symptoms:
 Avoid baths, hot tubs and whirlpool spas.

 Avoid irritants. These include scented tampons, pads,
douches and scented soaps. Rinse soap from your outer
genital area after a shower and dry the area well to prevent
irritation. Don't use harsh soaps, such as those with
deodorant or antibacterial action, or bubble bath.
 Wipe from front to back after using the toilet. Doing so
avoids spreading fecal bacteria to your vagina.
Other things that might help prevent vaginitis include:
 Avoid douching. Your vagina doesn't require cleansing

other than regular showering. Repetitive douching disrupts
the good organisms that live in the vagina and can
increase your risk of vaginal infection. Douching won't
clear up a vaginal infection.
 Practice safer sex. Using a condom and limiting the
number of sex partners can help.
 Wear cotton underwear. Also wear pantyhose with a
cotton crotch. Consider not wearing underwear to bed.
Yeast thrives in moist environments.

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Ayurvedic & Unani Tibbia College and

SUBMITTED BY: SUBMITTED TO:

There are many types of vaginitis. The most common

➢ Bacterial vaginosis (BV). A healthy vagina has

signs and symptoms:

➢ Candida or "yeast" infection. Candida yeast is

Signs and symptoms :

genital burning, pruritis, dyspareunia, dysuria and a thick,

Chlamydia: This is the most common sexually

➢ Trichomoniasis. This infection is caused by a

signs and symptoms :

This type of vaginitis seems to be linked to but not caused by

 Yeast infections. These occur when there's an overgrowth of a

 Noninfectious vaginitis: Vaginal sprays, douches,

 Hormonal changes, such as those associated with pregnancy,

 For Bacterial Vaginosis:

Metronidazole 500 mg orally twice a day for 7 days

 Genitourinary syndrome of menopause (vaginal atrophy)-

Estrogen - in the form of vaginal creams, tablets or rings — can

To treat this type of vaginitis, you need to pinpoint the source of

Good hygiene might prevent some types of vaginitis from

 Avoid baths, hot tubs and whirlpool spas.

Other things that might help prevent vaginitis include:

 Avoid douching. Your vagina doesn't require cleansing

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