Certain types of bacteria live naturally inside the vagina. They produce acid, which helps to fight off other bacteria, as well as viruses and fungi that don't normally live in the vagina. Anything that lowers the acidity of the vagina can cause a vaginal infection.
Vaginal infections are common. For example, half to three-quarters of women will have thrush in their lives.
Symptoms of common vaginal infections
It's normal and healthy for a woman of childbearing age to have a vaginal discharge. The amount and colour of the discharge can change during your menstrual cycle, sexual excitement and pregnancy.
Symptoms of a vaginal infection include:
- unusual vaginal discharge (may be unusual in colour and smell unpleasant)
- irritation and soreness of the vulva (the skin around the outside of the vagina) vaginal itching
- pain during sex
- bleeding after sex
- abdominal pains
- redness, swelling, lumps, blisters, or ulceration of the vulva or anus pain when passing urine
Causes of common vaginal infections
Certain types of bacteria live naturally inside the vagina. Many factors such as hormonal changes, stress, or even using soap to clean the genital area can unbalance the acid levels in your vagina. This can cause bacteria living naturally inside the vagina to grow more than usual and cause a vaginal infection.
A foreign body, such as a forgotten tampon, can also encourage bacteria to grow and cause an infection. Rarely, it can produce a life-threatening complication known as 'toxic shock syndrome'.
Vaginal infections can also be caused through unprotected sexual intercourse or skin-to-skin contact. These are known as sexually transmitted infections (STIs).
Diagnosis of common vaginal infections
If you have any symptoms, visit your GP, your local GUM (genito-urinary medicine) or sexual health clinic. Your GP may refer you to a sexual health clinic for specialist treatment.
There are different ways to test for a vaginal infection.
- You may be asked to provide a sample of urine.
- A doctor or nurse may look inside your vagina, using a speculum (which is also used for smear tests) and take a swab (similar to a small round cotton bud). The swab picks up a sample of cells from the vagina.
The samples are usually sent to a laboratory for testing.
Types of common vaginal infections
The main types of common vaginal infection are mentioned here briefly. For more detailed information about individual types of vaginal infections, see Related topics.
Thrush
Almost all women have Candida albicans growing harmlessly in the vagina. A change in the vaginal environment can mean the yeast grows more than usual, causing thrush (vaginal candidiasis).
Possible triggers of thrush include:
- pregnancy
- antibiotics
- diabetes
- perfumed soaps or feminine hygiene sprays
- the contraceptive pill
- tight underwear
Bacterial vaginosis (BV)
Bacterial vaginosis is caused when bacteria living naturally inside the vagina grow more than usual (for example, Gardnerella vaginalis). It is the most common cause of vaginal discharge in women of childbearing age. The vaginal discharge is usually thin and grey with a fishy smell.
Possible triggers of BV include:
- perfumed soaps or feminine hygiene sprays
- intra-uterine system (IUS or coil)
BV is not a sexually transmitted disease, although there may be a link with having a new sexual partner or a high lifetime number of sexual partners. If left untreated, BV may increase your risk of:
- pelvic inflammatory disease (PID)
- transmission of viruses
- miscarriage
- premature labour
- low birth-weight baby
Trichomoniasis
Trichomoniasis is caused by a parasite called Trichomonas vaginalis. This is usually transmitted during unprotected sexual intercourse.
Symptoms of trichomoniasis include a heavy, frothy, yellow-green, fishy-smelling vaginal discharge. However, half of women with trichomoniasis don't have any symptoms.
If left untreated, trichomoniasis infection may increase your risk of:
- transmission of viruses
- premature labour
- low birth-weight baby
Chlamydia
Chlamydia is the most common STI in the UK. It is caused by the bacterium Chlamydia trachomatis, which destroys the cells of the lining of the cervix and other tissues.
Many people have chlamydia without knowing it. Seven in 10 women and half of men with chlamydia don't have any symptoms.
In women, chlamydia infection can spread to the womb (uterus), ovaries and fallopian tubes and cause PID. Between one and four women in 10 with untreated chlamydia will get PID. PID can damage the fallopian tubes and can increase the risk of:
- ectopic pregnancy
- infertility
Gonorrhoea
Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae, which is passed on during unprotected sexual intercourse.
Symptoms of gonorrhoea usually appear within two weeks of infection, and may include:
- vaginal discharge
- pain passing urine
- bleeding between periods
- pelvic or abdominal pain
However, half of women with gonorrhoea don't have any symptoms.
Genital herpes
Genital herpes infection is caused by the herpes simplex virus (HSV) being passed on during unprotected sexual contact. Once infected, HSV stays in your body for the rest of your life.
Symptoms of genital herpes include:
- painful blisters
- pain passing urine
- discharge
- fever
- tiredness
Genital warts
Genital warts are the most common sexually transmitted viral infection in the UK, particularly in men in their early 20s and 16 to 19-year-old women.
Genital warts are caused by the human papilloma virus (HPV), which makes cells grow unusually. You can catch genital warts by having sex and/or skin-to-skin contact with someone who has them.
Genital warts appear as small round lumps on or around the vulva, upper thighs, cervix, vagina or anus. It can take several months or even years after infection for the warts to appear. However, many people with the virus don't develop warts and you may not know you have the infection.
Treatment of common vaginal infections
Some treatments are available from your pharmacist as well as on prescription from your GP. Always read the patient information leaflet that comes with your medicine.
Thrush
Most infections respond to antifungal treatments such as imidazole cream or pessaries (eg Canesten), or fluconazole (Diflucan) tablets, which are available from your pharmacist without prescription. The infection clears up completely in most women. If you are pregnant, see your GP before taking any medicines to treat thrush.
If your symptoms don't improve in seven to 14 days or the symptoms come back, see your GP. He or she may prescribe different antifungal medicines. There isn't any evidence to suggest treating a male partner helps, unless he has a rash or a sore penis.
Bacterial vaginosis (BV)
Antibiotic treatment clears BV infection in most women. Antibiotics are usually given in tablet form although sometimes a gel or cream may be prescribed. Male sexual partners don't need treatment.
Trichomoniasis
If you have trichomoniasis, your GP will refer you to a sexual health clinic.
Trichomoniasis can sometimes get better without treatment, but antibiotics are usually prescribed. Antibiotics can be taken as a course of tablets for five to seven days or as a one-off large dose. Sexual partners need to be treated as symptoms are less common in men, and your partner may be unaware he is infected.
Chlamydia and gonorrhoea
Both chlamydia and gonorrhoea infections are treated with antibiotics.
Antibiotics may be given as a one-off dose, or for chlamydia you may be given a week-long course. Sexual partners need to be treated as symptoms are less common in men, and your partner may be unaware he is infected.
Genital warts
Treatment depends on where the warts are, what they look like and how many you have. It may consist of using creams or liquids, surgery, cryotherapy or laser treatment.
Some women find that the warts go after one treatment whereas others find it takes several treatments.
Genital herpes
Genital herpes can be treated very successfully although there's no cure. You may be prescribed anti-viral tablets, which stop the herpes from multiplying. You need to take them for at least five days or longer.
You may also need to use a local anaesthetic ointment on your vulva to help with the pain.
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