Vulvovaginitis in adult women

There are 3 common infections that cause vulvovaginitis:

• Thrush – caused when there is too much of a yeast called candida. You always have some candida in your vagina but an overgrowth of it causes vaginal thrush.
• Bacterial vaginosis – caused when there is an imbalance of the different types of bacteria that normally live in your vagina. See bacterial vaginosis.
• Trichomoniasis – caused by a tiny parasite called trichomonas vaginalis that you can get through having sex with someone who is infected. See trichomoniasis.

You can also get vulvovaginitis from: 

• Other sexually transmitted infections (STIs). So if you're sexually active, it's a good idea to get a sexual health screen to make sure any infections can be treated.
• A change in hormones, usually during childbirth, after menopause or with some types of contraception.
• Irritation caused by lubricants, soaps, tight clothing, hair removal etc.
• Having diabetes, which can make you more likely to get some forms of vulvovaginitis.
• Leaving a tampon in for too long.

Symptoms are usually noticed in the area in or around your vagina and include: 

• redness and inflammation
• itchiness
• vaginal dryness
• a burning sensation
• pain when peeing
• abnormal vaginal discharge and smell. 

Read more about vaginal discharge.

See your healthcare provider if you are bothered by unusual vaginal symptoms. This is especially important if you have:

• vaginal itching or an unpleasant smelling discharge
• never had a vaginal infection before
• had vaginal infections before, but the symptoms of this infection are different
• a new or more than one sexual partner
• vaginal dryness, which may cause pain during sex
• finished a course of treatment for vaginal thrush, but your symptoms haven’t cleared up.

You don’t need to see your healthcare provider if you have been diagnosed with vaginal thrush before and your symptoms are the same as last time. However, if you find that the treatment isn’t working, or you are having repeated episodes of thrush (more than twice in 6 months), you do need to see your healthcare provider.

Read more about treatment of vaginal thrush. Many of the conditions discussed here can present in a similar way and it's not always easy to tell without seeing a doctor or nurse practitioner. 

Your healthcare provider will ask you questions about your symptoms and medical history. They may also ask questions about things in your life that might have triggered your symptoms, such as new sexual relationships, detergents or soaps, etc. 

Your healthcare provider may want to do an examination to look at the skin around your vagina, and may get you to take swabs from inside your vagina. These can be sent to the lab for testing to find out if you have an infection. Some of the causes of vulvovaginitis can only be diagnosed with an examination and swab results, so if you are concerned it's best to see your healthcare provider. 

Treatment will depend on the cause. 

• Vaginal thrush is treated with antifungal medication – see treatment of vaginal thrush.
• Both bacterial vaginosis and trichomoniasis can be treated with an antibiotic medication called metronidazole.
• If irritation is the cause, the source of it needs to be identified and removed, for example, a soap or detergent. Your doctor may recommend a cream you can put on the area to soothe itching or burning.

You may be able to reduce your chances of getting vulvovaginitis by:

• wearing loose-fitting breathable clothing that doesn’t hold moisture in
• washing your vulval area gently with water only (not using perfumed soaps or sprays on or near your vagina)
• avoiding washing inside your vagina
• using a condom during sex
• changing your tampons/pads regularly when you have your period.

Vulvovaginal health in premenopausal women(external link) BPAC, NZ, 2011 
Vulvovaginal health in postmenopausal women(external link) BPAC, NZ, 2014