Vulvovaginitis, vulvitis, and vaginitis are general terms that refer to the inflammation of the vagina and/or vulva (the external genital organs of a woman).These conditions can be caused by bacterial, fungal, or parasitic infections. Also, vulvovaginitis can be caused by low estrogen levels (called "atrophic vaginitis") or any type of allergic or irritation response from things such as spermicidal products, condoms, soaps, and bubble bath.
In general, vulvovaginitis causes vaginal discharge, irritation, and itching. One of the most common reasons why women visit their doctor is because of a change in vaginal discharge. It is completely normal for a woman to have a vaginal discharge, the amount and consistency of which varies during the course of the menstrual cycle. Each of the three most common types of vulvovaginitis will be described separately.
Bacterial vaginosis is the most common cause of vaginitis during the childbearing years. Forty percent to 50% of vaginitis cases are caused by bacterial vaginosis. The occurrence of bacterial vaginosis is difficult to determine but studies have proposed that 10% to 41% of women have had it at least once. The occurrence of bacterial vaginosis in the United States is highest among African-American women and women who have had multiple sexual partners and lowest among Asian women and women with no history of sexual contact with men. Bacterial vaginosis is not considered a sexually transmitted disease although it can be acquired by sexual intercourse.
Bacterial vaginosis is not caused by a particular organism but is a change in the balance of normal vaginal bacteria. Ninety percent of the bacteria found in a healthy vagina belong to the Lactobacillus family. For unknown reasons, there is a shift in the bacterial population that results in overgrowth of other bacteria. Patients suffering from bacterial vaginosis have very high numbers of bacteria such as Gardnerella vaginalis, Mycoplasmahominis, Bacteroides species, and Mobiluncus species. These bacteria can be found at numbers 100 to 1000 times greater than found in the healthy vagina. In contrast, Lactobacillus bacteria are in very low numbers or completely absent from the vagina of women with bacterial vaginosis.
Belinda Rowland PhD, The Gale Group Inc., Gale, Detroit,