What are the symptoms of vaginitis?

Gynecological disorders are relatively common among women. Common types of gynecological inflammation include vaginitis, uterine fibroids, uterine tumors, ovarian tumors, and cervicitis. Among these, vaginitis is particularly prevalent. Its causes are often linked to bacterial or viral infections.

What Are the Symptoms of Vaginitis?

The primary symptoms of vaginitis are pruritus (itching) of the external genitalia and abnormal vaginal discharge.

Symptoms—and the characteristics of vaginal discharge—vary depending on the causative pathogen. For example:

• Trichomonas vaginitis presents with thin, purulent, frothy vaginal discharge that has a foul odor.
• Candidal vaginitis (vulvovaginal candidiasis) features thick, white, curd-like (resembling tofu residue) discharge with a sour, yeasty odor.
• Bacterial vaginosis manifests as thin, grayish-white, homogenous discharge with a characteristic fishy odor.

Therefore, definitive diagnosis of the specific type of vaginitis requires clinical evaluation and laboratory testing of vaginal secretions at a healthcare facility. Targeted treatment based on the confirmed diagnosis is essential for effective resolution of the condition.

Common Types of Acute Vaginitis Include:

Trichomonas Vaginitis

Symptoms include pruritus of the vulva, intermittent burning or pain, dyspareunia (painful intercourse), and thin, purulent, yellow-green, frothy vaginal discharge with an unpleasant odor. When associated with urethral infection, patients may experience urinary frequency and dysuria. Cervical examination may reveal punctate hemorrhages, producing the classic “strawberry cervix.”

Treatment: Since Trichomonas vaginalis can concurrently infect the urethra, paraurethral glands, and Bartholin’s glands, systemic antimicrobial therapy is required. First-line treatment consists of oral metronidazole or tinidazole. Sexual partners must be treated simultaneously. Patients and their partners should abstain from unprotected sexual intercourse until both have completed treatment and are symptom-free, due to the high transmission rate. Follow-up screening is recommended within three months.

Vulvovaginal Candidiasis (VVC)

Also commonly referred to as “yeast vaginitis,” this condition typically presents with intense vulvar pruritus and burning, dyspareunia, and dysuria. Discharge is characteristically thick, white, and curd-like (resembling cottage cheese or tofu residue). On gynecologic examination, findings may include erythema, edema, and excoriations of the vulva; in severe cases, fissures and epidermal desquamation may be observed. The vaginal mucosa appears erythematous and edematous, with adherent white plaques on the inner labia minora and vaginal walls. In acute cases, superficial erosions or ulcers may also be present.

Treatment: Antifungal therapy—either oral or topical—is effective. Oral and topical azole antifungals demonstrate comparable efficacy, and azoles are generally more effective than nystatin. Routine treatment of asymptomatic sexual partners is not recommended.

Bacterial Vaginosis (BV)

Symptoms are often mild and may include slight vulvar pruritus. Characteristic discharge is thin, grayish-white, homogenous, and adherent to the vaginal wall, with a distinct fishy odor.

Treatment: Therapy targets anaerobic bacteria using agents such as metronidazole, tinidazole, or clindamycin—administered either orally or topically, or via combined regimens. Routine treatment of sexual partners is not indicated.

We hope the above information is helpful. Wishing you good health and happiness!