Vaginitis
Vaginitis has three common causes -- bacterial vaginosis, yeast infection (candidiasis), and trichomoniasis -- each treated differently, per the CDC Sexually Transmitted Infections Treatment Guidelines, 2021.
Symptoms
Discharge, odor, itching, and irritation, with the pattern varying by cause: thin grayish discharge with odor for BV, thick white discharge with itching for yeast, and frothy yellow-green discharge for trichomoniasis.
Causes and risk
BV reflects a shift in normal vaginal bacteria; yeast infections involve Candida overgrowth (often after antibiotics or with diabetes); trichomoniasis is a sexually transmitted parasitic infection.
How it is evaluated
pH testing, the KOH whiff test, and microscopy of a wet-mount sample distinguish the causes; NAAT is preferred for trichomoniasis specifically.
Treatment
Each cause has a specific first-line regimen per the CDC 2021 guidelines. Testing and treatment are generally reserved for symptomatic patients for BV and yeast. Because trichomoniasis reinfection is common, retesting at 3 months is recommended after treatment.
When to seek care
Pelvic pain, fever, or symptoms not improving with treatment can indicate pelvic inflammatory disease or another condition requiring urgent evaluation rather than continued self-treatment.