• Dr Stella E. Okereke-Nwokeji



  1. Yeast infections, a common cause of vulvovaginitis, will affect around 75 percent of women in their lifetime.

  2. Vulvovaginitis in children may be caused by low estrogen levels.

  3. Vulvovaginitis typically improves after one week of treatment.

Vulvovaginitis is an inflammation or infection of the vulva and vagina. It’s a common condition that affects women and girls of all ages, and it has a variety of causes. Other names for this condition are vulvitis and vaginitis.

Bacterial vulvovaginitis will affect nearly 30 percent of women during their lifetime, according to the Centers for Disease Control and Prevention. Yeast infections are even more prevalent, affecting an estimated 3 out of 4 women during their lifetime.

What causes vulvovaginitis?

Many triggers can cause an infection in the vagina and vulval areas. The most common cause is bacteria. The following can also cause vulvoganitis:

  • yeast

  • viruses

  • parasites

  • environmental factors

  • sexually transmitted infections

  • exposure to allergens

  • chemical irritants


Certain bacteria can multiply and can cause vulvovaginitis. These bacteria include Streptococcus, Gardnerella, and Staphylococcus. A bacterial infection can cause a grayish-white discharge that smells fishy.


One of the most common causes of vulvovaginitis is Candida albicans. This yeast infection can cause genital itching and a thick, white vaginal discharge that is similar to cottage cheese. A yeast infection often follows the use of antibiotics. Antibiotics can kill the antifungal bacteria that normally live in the vagina. This can lead to a yeast infection.


Viruses that can cause vulvovaginitis are typically sexually transmitted. These include herpes and human papillomavirus (HPV).


Pinworms, scabies, and lice can cause inflammation of the vulva and vagina.

Environmental factors

Poor hygiene and allergens can cause this condition. Tight clothing can rub against the skin and create irritation. Irritated skin is more susceptible to vulvovaginitis than normal skin. Irritation can also delay recovery.

Sexually transmitted infections

The sexually transmitted infection (STI) trichomonas vaginitis can also cause vulvovaginitis. This causes genital discomfort, itching, and heavy discharge. The discharge can be yellow, green, or gray. It often has a strong odor. Chlamydia, gonorrhea, and herpes can also cause vaginitis. These infections in a child might indicate abuse.


Some chemicals can cause vulvovaginitis. These often appear in the form of

soaps, feminine sprays, perfume, and vaginal contraceptives. Common chemicals that can cause an allergic reaction include:

  • parabens

  • sodium sulfate

  • triclosan

  • dioxane

If any of these ingredients are in your soaps or laundry detergent, you may want to switch to a hypoallergenic or fragrance-free brand. This can keep your infection from recurring.

Vulvovaginitis in children

Vulvovaginitis is the most common gynecological condition in prepubescent girls. Doctors believe this is due to low estrogen levels.

When puberty begins, the vagina becomes more acidic and the infections usually stop. Prior to puberty, the infection can be treated with daily bathing, steroids, and low-dose, topical antibiotics. The child should also be advised on proper bathroom hygiene. Wearing loose-fitting cotton underwear can keep the infection from occurring again.

What are the symptoms of vulvovaginitis?

The symptoms of vulvovaginitis vary and depend on their cause. In general, symptoms can include:

  • irritation of the genital area

  • itching

  • inflammation around the labia and perineal areas

  • an increased, strong-smelling vaginal discharge

  • discomfort while urinating

How is vulvovaginitis diagnosed?

A doctor will diagnose vulvovaginitis by discussing your symptoms and possibly collecting a sample of vaginal discharge to test.

In most cases, the doctor will need to perform a pelvic examination. A wet prep may be necessary to correctly identify the cause of your inflammation. This involves collecting some vaginal discharge for microscopic evaluation. The doctor can then identify the organism, which makes treatment quicker and more successful.

In rare cases, it may be necessary to biopsy the vulva to identify the organism. This means the doctor will take a small sample of tissue for further examination. A biopsy is usually only necessary if traditional methods are unsuccessful or there are suspicious areas.

How is vulvovaginitis treated?

The correct treatment for vulvovaginitis depends on the type of infection and the organism causing the problems. It’s possible to treat some types of vulvovaginitis on your own. However, you should speak with a healthcare provider before initiating any treatment.

Home remedies

If you have had a yeast infection in the past, you may be able to treat vulvovaginitis using over-the-counter products available at any pharmacy. Vaginal creams, suppositories, topical ointments, and oral pills are available to treat vulvovaginitis. Crushed garlic and coconut oil, both known for their antibacterial properties, may also work as home remedies.

A pharmacist may be able to advise you on the best product for your symptoms and how to apply the product. Consult your doctor if the inflammation or discharge isn’t better after a week of home treatment.

You may be able to relieve some of the symptoms of your vulvovaginitis by sitting in a sitz bath, a warm, shallow bath in which the water only covers your hip area. Adding tea tree oil or a trace amount of vinegar or sea salt to the bath may help kill some of the bacteria, if that is what is causing your symptoms. Be careful not to sit in the bath too long, and use a towel to dry the affected area completely after your bath is complete.

Prescribed medications

After your doctor identifies the type of organism causing your vulvovaginitis, they will prescribe medication.

This could include:

  • oral antibiotics

  • antibiotic creams applied directly to the skin

  • antifungal creams applied directly to the skin

  • antibacterial creams applied directly to the skin

  • oral antihistamines, if an allergic reaction is a possibility

  • estrogen creams

  • oral antifungal pills

Your doctor may also recommend a personal hygiene routine to help heal the infection and prevent it from recurring. This could include taking sitz baths and wiping properly after using the toilet.

Other suggestions include wearing loose clothing and cotton underwear to allow the circulation of air and to reduce moisture. Removing underwear at bedtime may also help.

Proper cleansing is important and may help prevent irritation. This is especially true if the infection is bacterial. Avoid using bubble baths, perfumed soaps, and washing powders as much as possible. Opt for sitz baths instead. You may also find sensitive-skin versions of these products less irritating.

A cold compress is useful to relieve pain on swollen or tender areas.

Sexual health

It’s important to alert your sexual partners if your vulvovaginitis is the result of an STI. All sexual partners should receive treatment for the condition, even if they’re not currently showing symptoms.

What is the outlook for vulvovaginitis?

Most cases of vulvovaginitis will heal quickly when properly treated. Return to your doctor if you don’t see an improvement within one week. You may find that alternative treatments are more effective.

Yeast infections and bacterial infections are not transmitted sexually. For this reason, it is not necessary to abstain from sex during treatment if your vulvovaginitis is caused by yeast or bacteria. But if you have an STI or virus, you should wait until you and your partner have completed treatment and have no more symptoms before resuming sex.

If yeast is causing your vulvovaginitis, you may find that the infection returns. Over-the-counter products can usually treat these infections.