Vaginal infections - common

About common vaginal infections

Certain types of bacteria live naturally inside your vagina. They produce acid to help fight off other bacteria, viruses and fungi that don't normally live in your vagina.

Vaginal infections are common. For example, around 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 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 (this may be unusual in colour and smell unpleasant)
  • irritation and soreness of the vulva (the skin around the outside of your vagina)
  • vaginal itching
  • pain during sex
  • bleeding between periods or after sex
  • abdominal (tummy) pains
  • lumps, redness, swelling, blisters or ulcers on the vulva or anus
  • pain when passing urine

It's important that you see your GP if you have any of these symptoms.

Causes of common vaginal infections

Certain types of bacteria and fungi live naturally inside your vagina. When you have a vaginal infection, some bacteria or fungi grow more than usual, while others, that keep your vagina healthy, grow less. Many factors such as hormonal changes, stress, or even using soap to clean your genital area are thought to upset the levels of bacteria and fungi in your vagina.

A foreign object, 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).

Types of common vaginal infections

The main types of common vaginal infection are described below. For more detailed information about individual types of vaginal infections, see Related topics.

Thrush

Around half of women have Candida albicans growing harmlessly in their vagina. A change in your vaginal environment can mean the yeast grows more than usual, causing thrush (vaginal candidiasis).

Common triggers for thrush include:

  • pregnancy
  • antibiotics
  • diabetes

Other factors linked to thrush include using perfumed soaps or feminine hygiene sprays, taking the combined contraceptive pill and wearing tight underwear or clothes.

Bacterial vaginosis (BV)

Bacterial vaginosis (BV) is caused when bacteria living naturally inside your vagina grow more than usual (for example, Gardnerella vaginalis). It’s the most common cause of vaginal discharge in women of childbearing age. The vaginal discharge is usually thin and grey with a fishy smell. Sometimes the fishy odour only occurs after sex, when vaginal secretions are mixed with semen.

Possible triggers of BV include:

  • perfumed soaps, feminine hygiene sprays or vaginal douching
  • having an intra-uterine system (IUS or coil)
  • antibiotics

BV is not a STI, although there may be a link with having a new sexual partner or a high number of sexual partners. If left untreated, BV may increase your risk of:

  • pelvic inflammatory disease (PID) after giving birth or having an abortion
  • miscarriage
  • premature labour
  • having a 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, sometimes 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:

  • becoming infected with viruses including Human immunodeficiency virus (HIV) and Human papilloma virus (HPV)
  • premature labour or having a low birth-weight baby

Chlamydia

Chlamydia is the most common STI in the UK. It is caused by a bacterium called Chlamydia trachomatis.

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 your womb (uterus), ovaries and fallopian tubes and cause PID. Up to three women in 10 with untreated chlamydia will get PID. PID can damage the fallopian tubes and can increase the risk of:

  • ectopic pregnancy
  • infertility
  • chronic pelvic pain

Gonorrhoea

Gonorrhoea is caused by a bacterium called 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 when passing urine
  • bleeding between periods
  • pelvic or abdominal pain
  • pain during sex

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 sexual contact. Once infected, HSV stays in your body for the rest of your life.

Symptoms of genital herpes include:

  • painful blisters
  • pain when passing urine
  • discharge
  • fever
  • tiredness

Genital warts

Genital warts are the most common sexually transmitted viral infection in the UK, and are especially common in people under 25.

Genital warts are caused by 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 your 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.

Diagnosis of common vaginal infections

If you have any symptoms, visit your GP or your local 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 your vagina. These samples may be tested or examined under a microscope in the clinic, as well as being sent to a laboratory for testing.

Treatment of common vaginal infections

Some treatments are available from your pharmacist as well as on prescription from your doctor. Always read the patient information leaflet that comes with your medicine.

Thrush

Most infections respond to antifungal treatments such as clotrimazole cream or pessaries (a medicine you put directly into your vagina), or fluconazole tablets, which are available from your pharmacist without prescription. The infection clears up completely in most women. If you’re pregnant, see your GP before taking any medicines to treat thrush.

If your symptoms don't improve within seven to 14 days or symptoms come back, see your GP. He or she may prescribe a different antifungal medicine. Male partners don’t need treatment unless they have a rash or a sore penis.

BV

Antibiotic treatment clears BV infection in most women. Antibiotics are usually given in tablet form although sometimes, especially in pregnancy, your GP will prescribe a gel or cream. Male sexual partners don't need treatment.

Trichomoniasis

If you have trichomoniasis, your GP may refer you to a sexual health clinic.

Trichomoniasis can sometimes get better without treatment, but your doctor will usually prescribe antibiotics. You can take antibiotics as a course of tablets for five to seven days or as a one-off large dose. Sexual partners need to be treated too as symptoms are less common in men and they may not know they are infected.

Chlamydia and gonorrhoea

Both chlamydia and gonorrhoea infections are treated with antibiotics.

You will be given antibiotics as a one-off dose, or for chlamydia a week-long course. Sexual partners need to be treated too as symptoms are less common in men and your partner may not know he is infected.

Genital warts

Treatment depends on where the warts are, what they look like and how many you have. You may be given creams or liquids, surgery, cryotherapy (a freezing procedure) or laser treatment.

Some women find that the warts go after one treatment, whereas others need several treatments.

Genital herpes

Your GP may prescribe antiviral tablets, which stop the herpes from multiplying but don’t cure the infection. You need to take them for at least five days.

You may also need to use a local anaesthetic ointment on your vulva to help with the pain.

For STIs like chlamydia, gonorrhoea and trichomoniasis, you will be tested again a couple of weeks after you have finished your treatment to ensure that the infection has gone completely.

If you're diagnosed with an STI, it's important to contact your previous partners who may be at risk, to prevent them from spreading the infection to others. Sexual health clinics can send anonymous notifications on your behalf if you're willing to provide details.

Prevention of common vaginal infections

Chlamydia, gonorrhoea, trichomoniasis, genital warts and herpes are passed on by skin-to-skin contact, such as during sexual intercourse. A condom provides good protection against many STIs, but genital warts and herpes may still be passed on by contact with skin that is not covered with a condom.

You can reduce your risk of having thrush or BV by:

  • not wearing tight-fitting, nylon underwear and tights
  • not using perfumed soaps or feminine hygiene sprays
  • not using vaginal douches – they disturb the natural protective acidity in your vagina

How long will it take for a vaginal infection to clear up and is it likely to come back again?

Answer

The time it takes for a vaginal infection to go will vary. Common vaginal infections are often treated with a course of antibiotics. Some infections do come back. You can help to prevent this by taking your medicine as advised and finishing the course of treatment.

Explanation

It's important that you finish your course of treatment even if your symptoms have improved and always read the patient information leaflet that comes with your medicine.

The time it takes for the infection to clear up depends on the type of vaginal infection you have. If you still have symptoms after you’ve finished your course of treatment, or you get a repeat infection, talk to your GP.

Is there anything I can do to feel more comfortable when I have a vaginal infection?

Answer

There are steps you can take to help ease your symptoms while you're having treatment. These include wearing the right clothes and underwear, not using perfumed bath and shower products and taking painkillers.

Explanation

Some vaginal infections cause symptoms that can be uncomfortable and unpleasant. The following steps may help.

  • Wear loose-fitting, cotton clothes rather than tight clothes, or nylon underwear or tights.
  • Don't use strong detergent to wash underwear.
  • Use plain water to wash – perfumed soaps, bath or shower products, antiseptics or vaginal deodorants can irritate your skin. Don't scrub with a flannel or sponge. Wash your hair over a sink so the shampoo doesn't run down to, and irritate, your genital area.

If you have pain from genital herpes or warts, the following may help.

  • Take an over-the-counter painkiller, such as paracetamol or ibuprofen.
  • Bathe in salt water (add half a cup of household salt to your bath).
  • Apply petroleum jelly (such as Vaseline) or a mild anaesthetic gel to the infected area – you can buy this from your pharmacy.
  • Pass urine while sitting in warm water or pour warm water over your vulva while you're passing urine on the toilet.

Can I use yogurt or complementary therapies to treat a vaginal infection?

Answer

'Live' natural yogurt can help to ease symptoms of thrush and bacterial vaginosis (BV), although research shows that it isn't effective as a treatment for either infection. Studies have shown complementary medicines such as tea tree oil don't work and may cause skin irritation.

Explanation

Both thrush and BV are thought to be caused by a disturbance in the healthy bacteria and yeasts usually found in your vagina. Research has shown that yogurt isn't effective at treating either condition, but it may help to ease the symptoms.

Using yogurt isn't likely to be harmful. So, if you want to use yogurt to ease your symptoms, you can apply it directly to the outside of your vagina. Always use plain, unsweetened, 'live' yogurt. Eating probiotic yoghurts or drinks containing lactobacillus may also help to prevent thrush if you’re prone to it.

Some women find that diluted tea tree oil eases symptoms, but it can cause skin irritation. Douching (washing out your vagina with water or special douching fluid) is not effective at treating vaginal infections and may irritate your vagina or spread infections up to your uterus (womb).