Vulvovaginitis: what it is, causes, types, symptoms and treatment


What is vulvovaginitis?

Vulvovaginitis, also known to specialists as Lower Runny Syndrome, is an inflammation of the vulva and vagina at the same time. It is a common disease and affects women of all ages. It is usually caused by an infection by viruses, fungi or bacteria. However, it can occur due to poor personal hygiene and hormonal changes.

Types of vulvovaginitis

The disease is classified as infectious and non-infectious. Are they:


Bacterial vaginosis

Caused by bacteria, especially Gardnerella vaginalis , it is not considered a sexually transmitted disease (STD), as some of these bacteria can be found regularly in humans. However, contagion can occur through intimate contact or sexual intercourse.

Vaginal candidiasis

It usually occurs in women of childbearing age, caused by the fungus Candida albicans, which resides on the skin or in the intestine, and can spread to the vagina. Pregnant and diabetic women are more likely to have this type.


Genital infection arises due to the protozoan Trichomonas vaginalis , disseminated through sexual intercourse or intimate contact with secretions of an infected person, which can be a woman / man and woman / woman. The protozoan causes damage to the vaginal tissue, progressing to the formation of microscopic ulcers that favor the contamination of other STDs.


Atrophic vaginitis

Atrophic vaginitis or vaginal atrophy is characterized by drying and inflammation of the vaginal walls due to the lack of production of estrogen – the hormone responsible for controlling ovulation and the development of female characteristics.

The disorder is more frequent after menopause , but it can appear during breastfeeding or at any other time when there is a decrease in the production of estrogen in the woman’s body.

Cytolytic vaginosis

Because they have symptoms similar to vaginal candidiasis , they are easily confused. This type of vulvovaginitis is the most common in the 2nd phase of the menstrual cycle. It is related to the increase in the number of Lactobacillus Sp (bacteria responsible for maintaining the acidic pH of the vagina) in the lower genital tract, cervix and vagina.

Non-specific vulvovaginitis

This type is recurrent in girls who have not started puberty. Experts believe that this is due to the low level of estrogen. At the beginning of puberty, the vagina is set to become more acidic, and infections stop.

Infantile vulvovaginitis

Among the diseases that most affect children and adolescents, vulvovaginitis is the main reason for gynecological consultations, totaling about 87% of the cases analyzed. Girls between 2 and 7 years of age are the ones who suffer most from the problem.

Typically, nonspecific vulvovaginitis is the cause of vaginal discharge in children, with 70% of the occurrences. The event and presentation of the pathology will depend on the level of estrogen, menstruation, sexual activity and use of contraceptive methods.

The prepubertal girl tends to have infections due to the anatomical physiology of the genital tract and lack of personal hygiene. At this stage, the vulva is vulnerable, as it does not have the full lips fully developed or hair. The vulvar skin is thin, making it more vulnerable to physical aggression. In addition, the vulva is very close to the anus, increasing the risk of contamination.

The evaluation of the problem will be done through an inspection on the outside of the vagina. Depending on the circumstances, a more detailed view of the vaginal canal will be necessary.

The taboos that have to do with the female genitalia make the diagnosis difficult. Therefore, it is necessary that there is a collaboration between the gynecologist and the child’s parents, so that the problem is solved in a more pleasant way. Thus, the girl will be less anxious and embarrassed at the time of the exam.



The overgrowth of some bacteria, such as Gardnerella and Staphylococcuses , causes vulvovaginitis. Half of women who have this type of infection have no symptoms.


The use of antibiotics can be pointed out as one of the causes of yeast infection, since they even kill the bacteria that preserve the balance of the vaginal flora.


Infection in the intimate region can also be caused by a virus, such as herpes simplex and human papilloma ( HPV ).


Common worms, scabies and lice are parasites that can cause vulvovaginitis.

External (environmental) Factors

Some factors, such as poor hygiene, allergies and tight clothing, cause skin irritation, contributing to the onset of the disease or delaying its recovery.


Sexually transmitted diseases (STDs), including trichomoniasis , chlamydia and gonorrhea , can also cause infection in the female intimate region. If they occur in children, it may be an indication of sexual abuse. However, the disease can be passed on to girls without sexual contact.


The use of substances that cause allergies or intimate hygiene products that contain perfumes, such as soaps, bubble baths, absorbents, creams and latex from condoms, favor the appearance of vulvovaginitis.

Risk factors

Some factors favor the appearance of vulvovaginitis:

Hormonal changes

Very low or high levels of estrogen affect the vaginal canal. If the pH is below or above what is considered ideal, there is an imbalance, allowing the appearance of infections, allergies and fetid odors. As a result, during the woman’s fertile period , hormonal changes produce an abnormal watery, mucous or milky white discharge. The amount and aspects of secretion depend on the phases of the menstrual cycle.

After menopause, the inner lining of the vagina and the tissues of the vulva decrease in thickness, natural fluidity is also reduced as a result of the lack of estrogen. Because of this, the intimate region can become contaminated and injuries occur more frequently.

Sexual intercourse

Vulvovaginitis is more common in women who have already started sexual activity, since physical proximity facilitates contact with bacteria.

Having an STD

The bacteria that cause Candidiasis, Trichomoniasis and Chlamydia can also trigger vulvovaginitis.

Prolonged use of medications

The continued use of antibiotics can eliminate the bacteria that keep the vaginal flora stable.


The most common symptoms of vulvovaginitis are:

  • Irritation and redness in the intimate region;
  • Pain when urinating;
  • Continuous itching;
  • Swelling in the vulva and vagina;
  • Abnormal vaginal discharge;
  • Pain during sexual intercourse;
  • Vaginal dryness;
  • Bleeding from the vagina.

How is the diagnosis made?

The reports of symptoms presented by the woman alone are a strong indication of vulvovaginitis, which facilitates the diagnosis of the gynecologist . However, in some cases it is necessary to collect secretion . With the analyzed material, it is possible to discover the type of vulvovaginitis and, thus, determine the most appropriate treatment.

For a more accurate diagnosis, vulvoscopy can be used, which is nothing more than an enlarged image exam of the vulva.

Is vulvovaginitis curable?

Vulvovaginitis can be cured in one to two weeks if you have an appropriate treatment.

In the case of vaginal candidiasis, the woman can transmit to her partner through sexual intercourse. However, as he does not have symptoms, he can cause the woman to become infected again after treatment. So it is important that your partner is treated as well.

What is the treatment?


The treatment to be applied is subject to the cause and type of vulvovaginitis, and may be topical or oral – in some cases, both are used. Among the possibilities are antibiotics, ointments and specific creams.

Home treatment

It is also possible to perform home treatments, which can relieve symptoms and speed up the procedure recommended by the doctor. They have anti-bacterial, anti-inflammatory and diuretic action, which help to improve infection in the genital region.

It is worth mentioning that the effectiveness is not proven and can be harmful to health. Consultation with the specialist is essential.

Tip 1


  • 1.5 liters of water;
  • 2 tablespoons soup and full of dried parsley;
  • 2 dry thyme;
  • 2 dry rosemary.

Preparation mode

In a saucepan, bring the water to a boil. As soon as the water boils, add all the ingredients and cook for 20 to 30 minutes. Then strain and let cool. Wash the intimate area with the mixture twice a day until the symptoms disappear.

Tip 2


  • 1 cup (tea) of water;
  • 1 peeled cucumber;
  • 1 lemon juice.

Preparation mode

Beat all items in a blender and drink afterwards.

Tip 3


  • 1 liter of water;
  • 2 tablespoons of chopped chard leaves;
  • Honey to taste.

Preparation mode

In a saucepan, boil the chard leaves with water. Strain and sweeten with honey according to your preference. Drink a cup (tea) 3 times a day.

Medicines for vulvovaginitis

Among the medications prescribed by gynecologists are:

  • Ciprofloxacin Hydrochloride ;
  • Benzidamine Hydrochloride ( Flogo-Rosa );
  • Clindamycin Hydrochloride ( Clindamin C );
  • Dexamethasone Phosphate + Nystatin + Neomycin Sulfate + Tirothricin ( Gynax N );
  • Itraconazole ;
  • Metronidazole + Nystatin + Lysozyme + Benzalkonium Chloride ( Colpistatin );
  • Fenticonazole nitrate ( Fentizole );
  • Miconazole nitrate ( Anfugitarin );
  • Promestriene ( Colpotrofine );
  • Tinidazole ( Pletil );
  • Tinidazole + Miconazole Nitrate ( Anfugine , Crevagin );
  • Tioconazole + Tinidazole + Secnidazole ( Gynopac );
  • Thyrotricin ( Lacto-Vagin ).

Living together

During the treatment, it is recommended to wear cotton underwear and loose clothing that help to air the genital area, which contributes to reducing the worsening of the infection.

Another measure is to wash the vagina with a product suitable for intimate hygiene, taking care to dry well after showering. If the patient has trichomoniasis, which is an STD, sexual intercourse should be avoided.


The disorder usually has no complications. However, in pregnant women, bacterial vaginosis and trichomoniasis are related to premature births and low birth weight babies. Women who have these diseases are still subject to contracting HIV and other sexually transmitted diseases (STDs).

How to prevent vulvovaginitis?

Some daily habits are able to hinder the onset of the disease. Avoid:

  • Vaginal shower (which removes the protective layer from the vaginal mucosa);
  • Tight clothes;
  • Underwear made of synthetic fabrics;
  • Sex without a condom;
  • Perfumed soap and with high pH;
  • Daily absorbents;
  • Unnecessary use of antibiotics.

Another practice that helps is to clean the vagina in a back-to-back motion after urinating, as it prevents the proliferation of fungi and bacteria from the anus to the vagina. Maintaining a balanced diet and sleeping without panties are also a form of prevention.

Vulvovaginitis is a disease that can develop for several reasons, including STDs. That is why it is important to have adequate personal hygiene and seek medical help.