Non-infectious vaginitis
Inflammation of the vagina is not always due to infection. It may occasionally be caused by allergy or chemicals.
Antiseptics and deodorants used in douches can irritate and inflame the vagina. As already mentioned, douching is unnecessary (unless advised by your doctor) and can be harmful. I have seen severe chemical vaginitis in women who douched with undiluted antiseptics in an attempt to get rid of a discharge. Rarely, women have had allergic reactions to intravaginal treatments or spermicides, and even more rarely to the rubber of diaphragms or condoms (or their lubricants).
Allergic or chemical vaginitis causes redness and swelling of the vaginal lining and usually copious watery discharge that is not irritating. If the vulval skin is also inflamed by the allergy, it may be itchy or sore. Sex is usually painful.
The diagnosis may at first be difficult if allergy isn’t suspected. Often women don’t think to mention that they’ve been using something in the vagina or that their partner is using a new brand of condom, and doctors sometimes don’t think to ask about these things. If the vagina is inflamed but swabs show no evidence of infection, allergy or chemical irritations the most likely cause. The treatment is to find and eliminate the allergen or chemical irritant.
Atrophic vaginitis
The vaginal lining (and vulval skin) becomes thin and weak (atrophic) when oestrogen is deficient, such as after the menopause. The atrophic vagina and vulva are prone to infection and other inflammation. Itching, discharge and painful sex ate common symptoms. Atrophic vaginitis can be treated and its recurrence prevented by the use of pessaries or creams containing oestrogen, or by HRT.
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