Vaginitis is inflammation of the vagina (soreness and swelling).

Many women with vaginitis also get:

• an abnormal vaginal discharge
• irritation or itching
• pain while urinating or having sex
• light bleeding or spotting

A strong, unpleasant smell, particularly after sex, can also be a sign.

Some women with vaginitis may experience few other symptoms or none at all.

Causes of vaginitis

Vaginitis may be caused by any of the following infections or irritants:

• thrush – a fungal infection that commonly affects the vagina
• bacterial vaginosis – a bacterial infection of the vagina
• trichomoniasis – a sexually transmitted infection (STI) caused by a tiny parasite
• chemical irritation – for example, from perfumed bubble bath, soap or fabric conditioner, or from spermicide (a chemical that kills sperm, sometimes found on condoms)
• washing inside your vagina
• chlamydia – an STI caused by bacteria
• genital herpes – an STI caused by the herpes simplex virus

Vaginal itching, dryness or discomfort (particularly during sex) can also sometimes be caused by a fall in oestrogen levels after the menopause. This is called vaginal atrophy or atrophic vaginitis, and is due to the thinning of the vagina's lining.

When to see your GP

See your GP if you have any unusual vaginal symptoms, particularly if:

• you haven't had a vaginal infection before
• you've had vaginal infections in the past, but this time your symptoms are different
• you've had a number of sexual partners or you have a new sexual partner
• you've finished a course of medication for vaginal thrush, but your symptoms are persisting, or you have an unpleasant vaginal odour

There's no need to see your GP if you've been diagnosed with thrush in the past and your symptoms are the same. If you're sure you have thrush and you've treated it successfully in the past with over-the-counter medication, you can treat it yourself again.

Read more about over-the-counter thrush medications.

Treating vaginitis

Treatment for vaginitis depends on what's causing it. Fungal infections are usually treated with antifungal medicines, and bacterial infections are usually treated with antibiotics.

Read more about:

• treating vaginal thrush
• treating bacterial vaginosis
• treating trichomoniasis

If your vaginitis is caused by thinning of the lining of the vagina after the menopause (atrophic vaginitis), hormone replacement therapy (HRT) may be recommended. HRT replaces the female hormones, oestrogen and progesterone.

Creams, pessaries or vaginal tablets that contain oestrogen are also available. Unlike HRT, they only restore oestrogen to your vagina rather than to your whole body, reducing the risk of side effects.

Read more about the side effects of HRT.

Self care

Things you can do at home to help improve your vaginitis include:

• keeping your genital area clean and dry – take a warm bath rather than a hot one and use plain, unperfumed soap to clean your genital area (the vagina cleans itself with natural secretions); dry yourself thoroughly
• avoiding douching (spraying water inside your vagina) – it may make your vaginitis symptoms worse, by removing the healthy bacteria that line the vagina and help keep it free from infection
• not using feminine hygiene products – such as sprays, deodorants or powders
• using pads rather than tampons if you have an infection
• wearing loose-fitting cotton underwear – don't wear underwear at night while you sleep

You should also practice safe sex by using condoms to avoid getting or spreading STIs.

Read more about contraception.

If you're prone to vaginitis, particularly after sex, always apply a lubricant before having sex. There are several types – some are water-based and some are silicone-based. You may need to try a few before you find one that's suitable. Ask you GP or pharmacist if you need further advice.