As any woman knows, when something causes the vaginal area to feel inflamed, everyday actions like peeing or sitting can be irritating at best and painful at worst. That inflammation, which can develop from very different causes, is called vaginitis.

“Different types of vaginitis may share symptoms of vaginal itching, discomfort, and often associated vaginal discharge,” says Yale Medicine pathologist Angelique Levi, MD.

The symptoms of vaginitis might be limited to the vagina, but they can also affect the external parts surrounding it, called the vulva.

Inside a healthy vagina, a community of bacterial and fungal microbes carry out vital tasks, like keeping the area acidic enough to ward off infections. But sometimes, the area can turn into a breeding ground for “bad” bacteria or fungus. Another form of vaginitis can be the result of hormonal changes. As a woman’s estrogen levels fluctuate throughout her life, lower levels can lead to vaginal irritation and inflammation.

Given the complex origins of vaginitis, it’s important to seek medical care at the earliest signs of swelling and discomfort.

At Yale Medicine, our specialists take time to identify the specific cause of vaginitis so that the most targeted treatment approach can be found. 

Your doctor will take down a detailed medical history, conduct an exam, and send a sample of vaginal discharge for lab testing to get an accurate diagnosis. Treatments options vary depending on the cause of the infection or irritation. Antibiotics, as well as anti-fungal creams and pills, can quickly resolve some forms of vaginitis. In other cases, hormone pills may be needed. Your doctor may also recommend modifying vaginal hygiene habits so that potential irritants like fragrances, douching, or deodorants are taken out of the picture. 

Pathologists can diagnose the causes of vaginitis, both non-infectious and infectious, by visually examining a Pap Test slide under the microscope. 

At Yale Medicine, we offer the newest technology to diagnose infectious vaginitis using molecular techniques, both by DNA probe (BD Affirm) and a PCR amplified molecular panel (BD MAX). Clinical providers receive special kits with collection swabs provided by pathologists to sample vaginal mucosa. In the laboratory, a molecular vaginitis panel is performed to simultaneously detect and differentiate the three most common infectious causes of vaginitis noted above. Overall, the advantages of molecular testing are fast results, as well as enhanced sensitivity and specificity for the commonest causes of infectious vaginitis with superior detection of co-infections. Species specific identification, in some cases, may improve potential treatment choices and shorten treatment length. 

In pregnant women, symptomatic infectious vaginitis/vaginosis has been associated with premature deliveries and low birth weight babies. With the growing evidence linking vaginitis to pregnancy complications, accurate and timely diagnosis and treatment are more critical than ever. “With the molecular vaginitis panel, we can confidently detect the relevant infectious organism or organisms in less than one day, which allows for accurate diagnosis, specific treatment, and prompt symptom relief for our patients,” says Dr. Levi.