What Is Vaginitis? Causes, Symptoms and Treatment

12 min read
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Vaginal itching, irritation, unusual discharge or changes in odour can be uncomfortable, especially when you're unsure what's causing them. These symptoms are often associated with vaginitis, a general term for inflammation of the vagina.

Vaginitis can have several causes, including infections, irritation from products and hormonal changes. Bacterial vaginosis (BV), a common imbalance in vaginal bacteria, is often discussed alongside vaginitis even though it doesn't always cause inflammation.

Most causes are treatable, but the right treatment depends on what's behind your symptoms. Understanding the possible causes can help you recognise changes and know when to seek medical advice.

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What is vaginitis?

Vaginitis refers to inflammation of the vagina, which can cause irritation, itching, discomfort or changes in vaginal discharge. Sometimes the surrounding vulva, the external genital area, is also affected.

The vagina naturally contains a community of microorganisms, often called the vaginal microbiome. Lactobacillus bacteria commonly help maintain an acidic environment that supports vaginal health. Changes in this environment can sometimes allow other microorganisms to become more prominent.

However, not all vaginal irritation or inflammation is caused by an imbalance in bacteria. Infections, hormonal changes, allergic reactions and sensitivity to certain products can also contribute.

Vaginal discharge naturally changes throughout the menstrual cycle, so not every change indicates a problem. What's more useful is recognising changes from what's normal for your body, particularly when accompanied by discomfort, itching or an unusual odour.

What causes vaginitis?

There isn't one single cause of vaginitis. Several factors can contribute to vaginal inflammation, irritation or changes in the vaginal microbiome.

Common causes and contributing factors include:

  • Infections: Yeast infections and sexually transmitted infections such as trichomoniasis can cause vaginal inflammation.
  • Changes in vaginal bacteria: Bacterial vaginosis occurs when the usual balance of vaginal bacteria changes.
  • Antibiotics: Some antibiotics can affect the bacteria that normally live in the vagina, increasing the likelihood of yeast overgrowth.
  • Hormonal changes: Lower oestrogen levels during menopause, breastfeeding or certain medical treatments can contribute to vaginal dryness and irritation.
  • Products and irritants: Fragranced washes, detergents, spermicides and some lubricants may irritate sensitive tissue.
  • Vaginal douching: Internal washing can disrupt the vaginal environment and is associated with an increased risk of BV.

Sexual activity can also influence the vaginal environment, although having vaginitis doesn't necessarily mean you have a sexually transmitted infection (STI).

What are the symptoms of vaginitis?

Symptoms vary depending on the underlying cause. Some people experience noticeable discomfort, while others have only subtle changes or no symptoms at all.

Possible symptoms include:

  • Vaginal or vulval itching, irritation or burning
  • Changes in vaginal discharge, including its colour, consistency or amount
  • An unusual or stronger vaginal odour
  • Redness, swelling or tenderness around the vulva
  • Discomfort or pain during sex
  • Stinging or burning when urinating
  • Vaginal dryness or discomfort

These symptoms can overlap with other conditions, including urinary tract infections, sexually transmitted infections and vulval skin conditions. The appearance of discharge or the presence of an odour isn't enough to reliably identify the cause.

Common types and causes of vaginitis

Bacterial vaginosis (BV)

Bacterial vaginosis occurs when the balance of bacteria in the vagina changes, with certain bacteria becoming more prominent and Lactobacillus bacteria often becoming less dominant.

BV doesn't always cause inflammation and many people have no symptoms. When symptoms occur, they may include:

  • Thin, white or greyish discharge
  • A noticeable fishy odour, sometimes more apparent after sex
  • Mild vaginal or vulval irritation

BV is not traditionally classified as an STI, although it is associated with sexual activity and can occur in people who aren't sexually active. Treatment usually involves prescribed antibiotics.

Yeast infections (vaginal thrush)

Vaginal thrush, also called vulvovaginal candidiasis, is usually caused by an overgrowth of Candida yeast. Candida can live naturally in the vagina without causing problems, but an overgrowth may lead to symptoms.

Common symptoms include:

  • Itching or burning around the vagina and vulva
  • Redness, swelling or tenderness
  • Thick, white discharge that may resemble cottage cheese
  • Discomfort during sex or when urinating

Thrush is more likely in some circumstances, including after antibiotic use, during pregnancy and in people with certain health conditions such as diabetes.

Vaginal thrush is generally treated with antifungal medication. Because its symptoms overlap with other conditions, it's best to seek medical advice if it's your first suspected infection, symptoms are unusual or treatment hasn't worked.

Trichomoniasis

Trichomoniasis is a sexually transmitted infection caused by a parasite called Trichomonas vaginalis.

Many people with trichomoniasis have no noticeable symptoms. When symptoms occur, they may include:

  • Unusual vaginal discharge, sometimes yellowish or greenish
  • A stronger or unpleasant vaginal odour
  • Vaginal or vulval itching and irritation
  • Discomfort during sex or urination

Trichomoniasis requires prescribed antibiotics, and sexual partners generally need treatment to prevent reinfection. Testing is important because symptoms alone cannot confirm the infection.

Non-infectious vaginitis and irritation

Not all vaginal or vulval irritation is caused by an infection. Some people react to products or substances that come into contact with sensitive genital tissue.

Possible irritants include:

  • Fragranced soaps, body washes or intimate deodorants
  • Detergents and fabric softeners
  • Certain lubricants, spermicides or condoms
  • Menstrual products or their ingredients
  • Friction, moisture or prolonged contact with irritating substances

Skin conditions such as eczema or contact dermatitis can also affect the vulva and may be mistaken for a vaginal infection.

Hormonal changes and vaginal dryness

Lower oestrogen levels can affect vaginal moisture, elasticity and the tissues of the vagina and vulva. This is particularly common during perimenopause and after menopause, but can also occur during breastfeeding or following certain medical treatments.

These changes may contribute to dryness, itching, burning and discomfort during sex. When associated with menopause, they may be part of a condition called genitourinary syndrome of menopause (GSM).

Unlike bacterial or yeast infections, hormonal vaginal dryness doesn't necessarily require antimicrobial treatment. Depending on the cause and severity, management may include vaginal moisturisers, lubricants or prescription vaginal oestrogen.

How is vaginitis diagnosed?

Because several conditions can cause similar symptoms, identifying the cause is important before choosing treatment.

A GP or sexual health clinician may ask about your symptoms, menstrual cycle, medications, sexual history and any products you've recently started using.

Depending on your circumstances, assessment may include:

  • An examination of the vulva or vagina
  • A vaginal swab to check for yeast, bacteria or sexually transmitted infections
  • Testing vaginal pH or examining a discharge sample
  • Additional tests if another condition is suspected

Not everyone needs every test. Your clinician can explain which investigations are appropriate for your symptoms.

How is vaginitis treated?

Treatment depends on the underlying cause. Although symptoms can look similar, the treatments for thrush, BV, sexually transmitted infections and non-infectious irritation are different.

  • Bacterial vaginosis: Usually treated with prescribed antibiotics, taken orally or applied vaginally.
  • Vaginal thrush: Usually treated with antifungal creams, pessaries or oral medication, depending on individual circumstances.
  • Trichomoniasis: Requires prescribed antibiotics and appropriate treatment of sexual partners.
  • Product-related irritation: May improve when the irritating product is identified and discontinued, although persistent symptoms should be assessed.
  • Hormonal vaginal dryness: May be managed with moisturisers, lubricants or prescribed hormonal treatment, depending on the cause.

Repeatedly treating suspected thrush without confirming the cause can delay appropriate care if something else is responsible. If symptoms keep returning or aren't responding to treatment, seek medical advice rather than continuing to try different products.

How to support vaginal health and comfort

You don't need a complicated intimate hygiene routine to look after your vaginal health. In fact, using fewer products is often better, particularly if you're prone to irritation.

Avoid internal cleansing

The vagina is self-cleaning and doesn't need douching, internal washes or deodorants. Gently washing the external vulva with water is sufficient for many people. If you use a cleanser, choose a mild, fragrance-free product and avoid washing inside the vagina.

Read more about why vaginal douching isn't recommended.

Choose products that suit your skin

If you notice irritation after using a particular menstrual product, cleanser or lubricant, consider whether an ingredient or friction could be contributing. Fragrance-free products may be better tolerated by sensitive skin, but individual reactions can still occur.

Follow the manufacturer's cleaning and hygiene instructions for menstrual cups, discs and other reusable products.

Reduce friction and manage dryness

If vaginal dryness or friction is contributing to discomfort, an appropriate lubricant or moisturiser may help.

Personal lubricants provide temporary glide during sex, intimate activity or insertion of products such as menstrual cups, discs and pelvic floor devices. Water-based lubricants are a versatile option, while silicone-based lubricants may provide longer-lasting glide. Check compatibility with condoms and silicone devices before use.

Vaginal and intimate moisturisers are designed to help manage dryness and may be used more regularly, depending on the product instructions. Check whether a moisturiser is intended for external or internal use.

Lubricants and moisturisers can help with dryness and friction, but they don't treat BV, thrush or other infections. If you have unexplained itching, burning, unusual discharge or odour, seek advice about the cause before relying on these products for relief.

Choose comfortable clothing

Breathable underwear and comfortable clothing may help reduce moisture and friction around the vulva. If damp clothing causes irritation, changing after swimming or exercise may improve comfort.

Pay attention to changes in discharge

Vaginal discharge varies naturally across the menstrual cycle, including changes in consistency and amount around ovulation. Learning what's typical for your body can help you recognise changes that may need attention.

Our guide to what's normal for vaginal discharge explains these changes in more detail.

When should you see a doctor?

Arrange an appointment with a GP or sexual health clinic if you experience:

  • New or persistent vaginal itching, burning or irritation
  • Unusual discharge or a noticeable change in odour
  • Symptoms that return frequently or don't improve with treatment
  • Pain during sex or urination
  • Bleeding between periods or after sex
  • Possible exposure to a sexually transmitted infection
  • Vaginal symptoms during pregnancy

Seek urgent medical assessment if you have significant pelvic or lower abdominal pain, fever, vomiting or feel seriously unwell. These symptoms may indicate a condition that needs more immediate treatment, such as pelvic inflammatory disease. If that link doesn't match your published PID article URL, update it before publishing.

Frequently asked questions about vaginitis

Is vaginitis the same as thrush?

No. Vaginitis is a broad term for vaginal inflammation, while thrush is a particular yeast infection that can cause vaginitis. Other possible causes of vaginal symptoms include bacterial vaginosis, sexually transmitted infections, irritation and hormonal changes.

Is vaginitis a sexually transmitted infection?

Not necessarily. Some causes, such as trichomoniasis, are sexually transmitted, while thrush is generally not considered an STI. BV is associated with sexual activity but isn't traditionally classified as an STI. Testing can help identify the cause.

Can vaginitis cause an unusual smell?

Yes. Changes in vaginal odour can occur with conditions such as BV and trichomoniasis. However, natural vaginal odour varies, and smell alone can't identify an infection. A new or persistent unpleasant odour, particularly with other symptoms, is worth discussing with a clinician.

Can menstrual cups or discs cause vaginitis?

Menstrual cups and discs aren't established common causes of infectious vaginitis when used and cleaned appropriately. However, any product that contacts sensitive tissue may occasionally cause irritation or friction. Follow cleaning and wear-time instructions, avoid using a product that causes discomfort and seek medical advice if symptoms persist.

Can I use lubricant if I have vaginitis?

Lubricants may reduce friction associated with vaginal dryness, but they don't treat infections or inflammation. Some formulas may also sting or worsen irritation. If you have active symptoms, it's best to identify the cause first and avoid products that aggravate discomfort.

Do probiotics help prevent or treat vaginitis?

Research into probiotics and vaginal health is ongoing, but there isn't enough consistent evidence to recommend probiotics as a replacement for established treatments for BV or thrush. If you experience recurrent symptoms, a healthcare professional can help investigate the cause and discuss appropriate treatment options.

Can menopause cause symptoms similar to vaginitis?

Yes. Falling oestrogen levels during perimenopause and menopause can contribute to vaginal dryness, burning, itching and discomfort during sex. These symptoms can resemble an infection, but they may require different treatment, including vaginal moisturisers or prescription vaginal oestrogen.

Understanding what's normal for your body

Vaginal discharge, moisture and comfort can change throughout your life. While occasional changes are normal, persistent itching, unusual discharge, odour or discomfort shouldn't be something you simply have to put up with.

Knowing the possible causes of vaginitis can help you recognise when something has changed and seek treatment suited to your symptoms.

At Period Shop, we're here to help you better understand your body and find products that suit your needs. Explore our guides to vaginal discharge and pain during sex, or browse our lubricants and intimate moisturisers for options that may help with dryness and friction.

Sources and further reading

This article is for general education and is not a substitute for individual medical advice, diagnosis or treatment.