Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Bacterial vaginosis (BV) is the most common cause of vaginitis, accounting
for 50% of cases. Bacterial vaginosis is caused by a change or imbalance in the
types of the bacteria normally found in the
vagina and causes an overgrowth of organisms such as Gardnerella vaginalis.
Risk factors include pregnancy,
intrauterine device (IUD) use, and frequent
douching. It is associated with sexual activity, and possibly a new sexual
partner or multiple sexual partners. Women who have never had sexual intercourse
are rarely affected.
You do not get bacterial vaginosis from toilet seats, bedding, or swimming pools.
In the United States, as many as 16% of pregnant women have bacterial
vaginosis. This varies
by race and ethnicity from 6% in Asians and 9% in whites to 16% in Hispanics and
23% in African Americans.
Vaginal yeast infections are caused by a fungus, mainly by Candida
albicans. This is also called candidiasis, genital
candidiasis, or vulvovaginal
candidiasis (VVC). Yeast infection can spread to other parts of the body
including skin, mucous membranes, heart valves, esophagus, and other
areas. It can cause life-threatening systemic infections mostly in people with
weakened immune defenses (such as women who are pregnant and people who are
have diabetes, or are taking steroids).
Nearly 75% of all adult women have had at least one genital yeast infection
in their lifetime. Vaginal yeast infection is not considered a sexually
transmitted disease, but 12% to 15% of men will develop symptoms such as itching
and penile rash
following sexual contact with an infected partner.
Yeast infections are caused by an overgrowth of normally growing fungi in
the vagina that creates unpleasant symptoms. The yeast are kept under control by
normally growing bacteria in the body. If the natural balance of microorganisms
is disrupted, the yeast grow out of control. It is not clear how fungal
infections originate, but they are not thought to be sexually transmitted. Your
own natural bacteria allow this type of infection when an imbalance occurs,
possibly caused by any of these events:
Use of antibiotics: Antibiotics destroy protective
bacteria in the vagina. These bacteria normally stop the candidal organisms from
overgrowing. Yeast infection may occur after taking a course of antibiotics for
another condition such as strep throat.
Diabetes: Both diabetes and pregnancy make the vagina
better suited for fungal growth. These conditions lower the glycogen store in
certain vaginal cells. They may also raise the sugar content (and the pH) of the
vagina and increase the risk of yeast infection.
Birth control pills: Changes in the vaginal
environment occur with increased hormonal levels from estrogen-containing
control pills. This change creates an environment for the fungus to grow and
Hormonal changes such as ovulation, menopause, or
Wearing underwear that is tight or non-cotton: This
can increase temperature, moisture, and local irritation.
Scratches in the vagina
(during insertion of a tampon or other objects)
Trichomoniasis is a sexually transmitted disease (also called trich, pronounced "trick") caused by the parasite Trichomonas vaginalis. Trichomoniasis is primarily an infection of the urinary and
genital tract. For women, the vagina is the most common site of infection. For
men, the urethra is most
Other causes of vaginal inflammation may be allergies to spermicides, vaginal
hygiene products, and detergents and fabric softeners. Another type of sexually
transmitted disease may be present. Older women may experience atrophic
vaginitis (a thinning of the vaginal walls with menopause). Foreign objects such
as a forgotten tampon or another foreign object may cause vaginal irritation.