What Is Vulvovaginitis?

Vulvovaginitis is inflammation or infection of the vulva and vagina (the tissues closest to the vaginal opening) and is a common issue among people with vaginas. It usually shows up as irritation around the vulva and/or vagina as well as unusual vaginal discharge (some discharge is normal). The condition may also cause pain while urinating or during sex. 

Chances are that you or someone you know has had vulvovaginitis. Approximately one-third of people with vaginas will experience at least one form of vaginitis at some point in their lives. Though many try to treat vulvovaginitis on their own, treatments vary by what is causing the inflammation, which can’t always be known without testing.

This article will give a general overview of vulvovaginitis, including common causes, symptoms, and treatment. 

Types and Causes

There is more than one type of vulvovaginitis, which can be caused by several factors, including:

• Bacteria or fungi
• Chemicals in hygiene products 
• Inadequate personal hygiene
• Clothing 
• Health of sexual partners
• Hormones 

Infections That Cause Vulvovaginitis

Yeast infections are the most common cause of vulvovaginitis. Yeast infections often occur when a fungus that normally lives in the vagina, Candida albicans, grows out of control and the community of fungal organisms in the lower reproductive tract shifts out of balance. 

Another infection that causes vulvovaginitis is bacterial vaginosis (BV). The vagina is normally full of healthy and unhealthy bacteria. Bacterial vaginosis occurs when there are more unhealthy than healthy bacteria growing. As with yeast infections, the imbalance triggers the infection.

Trichomoniasis (sometimes called “trich”), the most common sexually transmittable disease that’s curable, may also cause vulvovaginitis. Parasites cause this infection, and the vulva and vagina are two of the most commonly infected sites.

Additional Causes

Chemicals: Vulvovaginitis can be caused by chemicals, such as those in feminine sprays and perfumes, soaps and bubble baths, and spermicides and vaginal sponges. While poor genital hygiene can lead to vulvovaginitis, the vagina does a good job at keeping itself clean without any hygiene products.

Tight-fitting clothes: Wearing tight-fitting or nonabsorbent bottoms and underwear can foster excess moisture, which can allow harmful bacteria to grow. Changing out of wet clothes, such as swimsuit bottoms, can help prevent the growth of harmful bacteria.

Health of sexual partners: Partners can pass on organisms during intercourse that offset the bacterial balance of the vaginal area.    

Hormonal changes: Low estrogen levels, such as after menopause (when periods have stopped for 12 months), can also cause vulvovaginitis. Low estrogen levels can lead to dryness and thinning of the skin of the vagina and vulva, which may in turn cause itching and burning. Children often get vulvovaginitis because the skin around the vagina is thin and can be easily irritated.

Vulvovaginitis Symptoms

Symptoms of vulvovaginitis depend on the cause. There are some common symptoms to watch out for when irritation is caused by one of the three most common causes of vulvovaginitis: yeast infections, bacterial vaginosis, and trichomoniasis. 

Symptoms of yeast infections include:

• Vaginal itching
• Pain or burning when urinating
• Changes in vaginal discharge
• Pain during sex

Many people who have bacterial vaginosis don’t have symptoms. If they are noticed, they are similar to those of yeast infections but also include:

• A thin white or gray vaginal discharge
• Pain, itching, or burning in the vagina
• A strong fish-like odor, especially after sex
• Burning when urinating
• Itching around the outside of the vagina

Symptoms of trichomoniasis share those of yeast infections and bacterial vaginosis. Symptoms that are unique to trichomoniasis include:

• A frothy, musty-smelling, greenish-yellow discharge
• Discomfort in the lower abs (not explained by gastrointestinal issues or post-workout soreness)
• Pain during sex

Diagnosis

Some cases of vulvovaginitis will resolve on their own. While there are at-home tests for yeast infections and bacterial vaginosis available, they aren’t reliable because they can’t always pinpoint what is causing the vaginal inflammation and acidity.

If your symptoms persist, you likely will need to see your healthcare provider for a diagnosis. It’s important to determine what the underlying cause is to optimally treat the infection.

To diagnosis vulvovaginitis, your healthcare provider will do a physical (pelvic) exam to check for infection and take a sample of vaginal secretions for lab tests.

In the lab, samples may be looked at under a microscope or tested for certain genetic material. If yeast is present, then you'll be diagnosed with a yeast infection. If certain bacteria are present, bacterial vaginosis is diagnosed.

Diagnosis of trichomoniasis often includes lab tests, but the condition can also be tested for at home through urine samples and self-collected vaginal swabs.

Treatment

Because vulvovaginitis can be caused by an underlying condition, it’s best to seek treatment from a healthcare provider. Through examination, they can help you determine what’s causing the irritation and recommend the appropriate treatment accordingly.

In general, vulvovaginitis that is caused by an infection is treated with either prescription antibiotics or antifungals.

Vulvovaginitis can occur more than once, so prevention is also considered part of treatment. Good genital hygiene (but not overdoing it with perfumes and soaps) is one way to give the vagina a healthy balance of bacteria.

A Word From Verywell

Having an itchy vagina and pain when you urinate or have sex can be quite disruptive to everyday life. And the fact that there are several causes of vulvovaginitis, let alone the potential embarrassment of seeking healthcare advice, can make figuring out how to make it go away that much harder.

Fortunately, vulvovaginitis is treatable. While it can seem easier to try an over-the-counter treatment for vulvovaginitis, it really is best to speak to your healthcare provider, who can point you to the right treatment based on the cause. It’s normal to feel shy talking about vaginal health, but seeking help is the best way to clear up any medical problems fast.