- ATHENS OFFICE MED4WOMAN ATHENS
- VOLOS OFFICE MED4WOMAN VOLOS
Obstetrician-Gynecologist
PhD, University of Athens Medical School
Obstetrician-gynecologist Panagiotis Polyzos practices at the Institute of Life, the IVF Unit of IASO Maternity Hospital.
Vaginal disorders, commonly known as vaginitis, are today the most common health problem women face and the most common reason a woman visits her gynecologist. The term vaginitis refers to inflammation of the vagina. It usually presents with itching and increased vaginal discharge, which may sometimes have an unpleasant odor.
Although vaginitis may initially seem like a simple condition, it can often be one of the most challenging problems to manage. This is due to the complex physiology of the vagina and the delicate balance required for its proper function.
Under normal conditions, the vagina is naturally inhabited by a large number of microorganisms known as lactobacilli and normal vaginal flora. These microorganisms are beneficial and necessary, as they help maintain the vaginal pH at optimal levels and prevent the growth of harmful (pathogenic) bacteria. In cases of vaginitis, however, pathogenic microorganisms overgrow, disrupting the natural vaginal flora and the pH balance. This imbalance manifests clinically as itching and abnormal vaginal discharge. Any woman experiencing these symptoms should consult her gynecologist for proper diagnosis and treatment.
Inflammations (infections) of the female reproductive organs occur more frequently during the summer and may affect various areas, including the vulva (the external area around the vaginal opening), the vagina (vaginitis), the cervix, the endometrium, and the fallopian tubes.
They are caused by microorganisms such as yeast and trichomonas (the most common causes), chlamydia, mycoplasma and others, by bacteria (aerobic and anaerobic) as well as by viruses, such as those that cause genital herpes (HSV) and genital warts (HPV infection). And of course, we should not forget that certain types of HPV are linked to dysplasia (precancerous changes) and cancer of the cervix and vulva.
Several factors can contribute to the development of vaginitis, including:
In addition to the previously mentioned causes of vaginitis, there are several specific factors that particularly contribute to the development of yeast infections. These include:
Take any possible vaginal infection seriously and see your gynecologist promptly, especially if you notice any of the following symptoms: increased vaginal discharge, burning sensation, itching (mild or intense), redness, swelling, pain during sexual intercourse (dyspareunia), or lower abdominal pain if the inflammation affects the endometrium or fallopian tubes.
The yeast infections (candidiasis) cause intense itching and burning in the vagina and vulva, increased white vaginal discharge with a thick, cottage cheese-like texture, which is odorless and viscous, as well as painful urination or pain during intercourse.
The trichomonas infection is characterized by thin, yellowish-green, foul-smelling discharge, while bacterial infections, such as Haemophilus vaginalis, produce thick, malodorous secretions.
The mycoplasma and chlamydia infections often cause no symptoms, but they can affect fertility, as they may lead to salpingitis (inflammation of the fallopian tubes), which can potentially result in infertility.
With genital herpes small blisters and ulcers (sores) appear on the vulva, whereas genital warts appear as small, wart-like growths on the vulva, vagina, or cervix.
Most types of vaginitis, regardless of the underlying cause, show similar symptoms, which makes it difficult to diagnose them accurately based solely on clinical signs. Although your gynecologist can often suspect vaginitis through a detailed medical history and clinical examination, a definitive diagnosis is usually made through a vaginal culture (vaginal and cervical fluid test). This test is essential to identify the specific microorganism responsible for the infection and to determine the appropriate treatment.
Treatment for vaginitis usually involves a combination of oral antibiotics and vaginal suppositories or creams. However, even after completing therapy, a significant number of patients experience recurrences, which may be due to drug-resistant strains or reinfection. In any case, proper prevention and an early visit to your gynecologist as soon as you notice the first symptoms that may indicate vaginitis are crucial for effective management of the condition.
Vaginal health issues and the occurrence of vaginitis can cause not only physical discomfort but also feelings of insecurity and embarrassment, often affecting a woman’s overall emotional well-being.
Several basic preventive measures can help avoid the development or recurrence of vaginitis, particularly important during summer months and holidays. These include proper hygiene (especially of the genital area), responsible sexual behavior, and self-care, which involves maintaining a strong immune system.
Below are some simple hygiene and protection tips every woman should follow to effectively protect herself:
Special care when swimming in the sea or pool:
The word “vaginitis” covers different conditions with different treatments. A simple guide to the most common ones:
Two or more forms can occur at the same time. If itching is your main problem, you may also find it helpful to read the guide on vaginal itching.
In bacterial vaginosis, no foreign germ “gets in.” Lactobacilli decrease and are replaced by anaerobic bacteria, which form a thin film (biofilm) on the vaginal walls. This biofilm explains why this type of vaginitis often comes back: in large studies, about one in two women has a new episode within a year.
As estrogen levels fall, the vaginal wall becomes thinner, less elastic and more sensitive. Lactobacilli decrease and the pH rises. The result is dryness, burning, pain during sex and often bladder symptoms. Today this condition is described as genitourinary syndrome of menopause.
Symptoms do not go away on their own over the years and usually get worse. Do not hesitate to talk about them. You will find more about the changes of this stage on the page about menopause and perimenopause.
Vaginitis involves the vaginal walls. However, some germs also affect the cervix or travel higher, and then the picture and the treatment change.
That is why, if along with vaginitis symptoms you have abdominal pain, fever or bleeding outside your period, do not rely on vaginal products alone. Contact your gynecologist for an exam and testing for sexually transmitted infections.
It depends on the type. Trichomoniasis is sexually transmitted. Bacterial vaginosis and yeast infections are not considered sexually transmitted diseases.
Some mild episodes clear up, but targeted treatment is usually needed, and it differs for each cause.
For trichomoniasis, always. For yeast infections, only if the partner has symptoms. For bacterial vaginosis, the evidence is changing: a large randomized study published in 2025 showed that treating the regular male partner at the same time, with an oral antibiotic and a cream, reduced recurrences in monogamous couples. If you have repeated episodes, discuss with your doctor whether this fits your case.
Common causes are vaginal douching, recent antibiotics, poorly controlled diabetes and incomplete treatment. Recurrences need a culture and a longer course of treatment.
Bacterial vaginosis and trichomoniasis have been linked to preterm birth, so they are treated with medications that are safe in pregnancy.
It is not forbidden, but it is best to wait until treatment is finished, especially if you are using vaginal products. After swimming, change out of your wet swimsuit right away.
They may help some women with recurrent bacterial vaginosis, as a supplement to treatment and not a replacement. The evidence is still limited, so discuss using them with your doctor.
Normal vaginal pH is acidic, about 3.8 to 4.5, thanks to lactobacilli. A raised pH points to bacterial vaginosis, trichomoniasis or atrophy, while a normal pH with itching is more consistent with a yeast infection. It is measured with a simple strip in the office.
