Vaginitis

To diagnose vaginitis, your health care provider is likely to:

• Review your medical history. This includes your history of vaginal or sexually transmitted infections.
• Perform a pelvic exam. During the pelvic exam, your health care provider might use an instrument (speculum) to look inside your vagina for inflammation and discharge.
• Collect a sample for lab testing. Your health care provider might collect a sample of cervical or vaginal discharge for lab testing to confirm what kind of vaginitis you have.
• Perform pH testing. Your health care provider might test your vaginal pH by applying a pH test stick or pH paper to the wall of your vagina. An elevated pH can indicate either bacteria vaginosis or trichomoniasis. However, pH testing alone is not a reliable diagnostic test.

A variety of organisms and conditions can cause vaginitis, so treatment targets the specific cause:

• Bacterial vaginosis. For this type of vaginitis, your health care provider might prescribe metronidazole tablets (Flagyl) that you take by mouth or metronidazole gel (MetroGel) that you apply to the affected area. Other treatments include clindamycin (Cleocin) cream that you apply to your vagina, clindamycin tablets you take by mouth or capsules you put in your vagina. Tinidazole (Tindamax) or secnidazole (Solosec) are taken by mouth.

  Bacterial vaginosis can recur after treatment.

• Yeast infections. Yeast infections usually are treated with an over-the-counter antifungal cream or suppository, such as miconazole (Monistat 1), clotrimazole (Lotrimin AF, Mycelex, Trivagizole 3), butoconazole (Gynazole-1) or tioconazole (Vagistat-1). Yeast infections might also be treated with a prescription oral antifungal medication, such as fluconazole (Diflucan).

  The advantages of over-the-counter treatment are convenience, cost and not waiting to see your health care provider. However, you might have something other than a yeast infection. Using the wrong medicine might delay an accurate diagnosis and proper treatment.

• Trichomoniasis. Your health care provider may prescribe metronidazole (Flagyl) or tinidazole (Tindamax) tablets.
• Genitourinary syndrome of menopause (vaginal atrophy). Estrogen — in the form of vaginal creams, tablets or rings — can treat this condition. This treatment is available by prescription from your health care provider, after other risk factors and possible complications are reviewed.
• Noninfectious vaginitis. To treat this type of vaginitis, you need to pinpoint the source of the irritation and avoid it. Possible sources include new soap, laundry detergent, sanitary napkins or tampons.

You'll need prescription medication to treat trichomoniasis, bacterial vaginosis and vaginal atrophy. If you know you have a yeast infection, you can take these steps:

• Use a medication specifically for yeast infections that you can get without a prescription. Options include one-day, three-day or seven-day courses of cream or vaginal suppositories. The active ingredient varies, depending on the product: clotrimazole, miconazole (Monistat 1) or tioconazole (Vagistat).

  Some products also come with an external cream to apply to the labia and opening of the vagina. Follow package directions and complete the entire course of treatment, even if you're feeling better right away.

• Apply a cold compress, such as a washcloth, to the labial area to ease discomfort until the antifungal medication takes full effect.

Your family health care provider, gynecologist or another medical practitioner can diagnose and prescribe treatment for vaginitis.