What does vulvovaginitis look like? Everything you need to know about vulvovaginitis

If you’ve experienced pain or redness in or around your vulva (the outer parts of your genitalia) or vagina (the internal passage that connects your vulva to your cervix), then you’re certainly not the only one. Conditions like urinary tract infections (UTIs), yeast infections, and bacterial vaginosis (BV) are pretty well known and frequently affect lots of people. But what you might not know is that sometimes they’re grouped together and called vulvovaginitis. 

Knowing that vulvar and vaginal conditions are incredibly common (and often simple to diagnose) doesn’t take away from the fact that they can be inconvenient and uncomfortable. It can be annoying and worrying if you notice a new itch, pain, or burning sensation, and if it persists, then you should always reach out to your health care provider. 

Flo’s symptom tracker could help you explain what you’re going through to a health care provider, and here, an obstetrician and gynecologist (OB-GYN) and a sex therapist explain what vulvovaginitis is, what causes it, and how you can treat it.

What is vulvovaginitis?

Being diagnosed with vulvovaginitis may sound daunting, but it’s actually just an umbrella term for a variety of common conditions that impact your vulva and vagina. It has been cited as the most common reason women in the United States visit their health care provider for a gynecological diagnosis. 

While you might experience different symptoms depending on what sort of infection you have (more on this below), if your vulva is swollen, tender, or painful, that’s a pretty good indicator that you could have vulvovaginitis.

“Vulvovaginitis is a generic term to describe inflammation, infection, or changes in the vaginal bacteria or vulva skin,” says Dr. Sameena Rahman, OB-GYN. “It typically either means bacterial vaginosis (BV), vulvovaginal candidiasis (yeast infection), trichomoniasis, or vulvar inflammatory skin conditions.” These aren’t the only reasons you might notice a change in your discharge or new pain. In case you’re not familiar with these conditions, they’re explained below. 

Symptoms of vulvovaginitis

Generally, symptoms of vulvovaginitis include: 

• Inflammation or irritation around and inside your vulva
• Dry or cracked skin around your vulva 
• Vaginal dryness 
• Spotting (light bleeding between your periods)
• A change in the color, texture, and smell of your discharge (typically discharge is clear or white, doesn’t have a strong smell, and can range in texture from sticky to slimy)
• Stinging or burning when you pee
• Pain during or after sex

Your vulva is as unique as you are, and one of the easiest ways to spot symptoms is to get familiar with what’s normal for you. Using a mirror to take a close look can help give you a really good idea of what your vulva typically looks like. 

If you notice any sudden changes, that’s when you know it’s time to speak to your health care provider. 

Causes of vulvovaginitis

So, vulvovaginitis describes a number of conditions, right?

As Dr. Rahman explains, any discomfort you have in your vulva or vagina could be caused by different things. Trying to describe the pain you’re experiencing might feel difficult, but try to be as clear as you can and know that your health care provider is there to support you. 

Some of the most common causes of vulvovaginitis are: 

Yeast infections

You’ve probably heard of yeast infections. They’re sometimes called vaginal thrush. They happen when certain factors cause the yeast that normally lives in your body (sometimes called candida) to become imbalanced and to grow more than usual. This can cause pain and itching inside your vulva. 

Bacteria

Just like your gut, your vagina contains bacteria (sometimes called your vaginal flora). It helps to protect your vagina from infection. And just like with your gut, the bacteria in your vagina can be split into “good” and “bad” bacteria. If the “bad” bacteria outgrows the “good,” then it can cause an imbalance in your vaginal pH and lead to conditions like bacterial vaginosis. One of the most common symptoms associated with BV is gray discharge with a strong, fishy smell. 

If bacteria in your poop enters your urethra (the tube that you pee out of), then you may experience a UTI. This can happen during sex or after you’ve used the toilet. Both UTIs and BV are conditions described under the term vulvovaginitis. 

Sexually transmitted infections (STIs)

Chlamydia, gonorrhea, and herpes are some of the most well-known STIs. While some people don’t experience any symptoms, a change in the smell, consistency, and color of your discharge and soreness and itching around your vulva are all associated with gonorrhea, herpes, and chlamydia. If you experience any of these symptoms, then you should reach out to your health care provider. 

Trichomoniasis, or “trich,” is another STI that falls under a vulvovaginitis diagnosis and can sometimes have no symptoms. It’s caused by a parasite (trichomonas vaginalis) and can be spread through unprotected penetrative sex and sharing sex toys. To protect yourself from trich and other STIs, use barrier protection (like condoms) during sex.

Other conditions that affect your vulva and vagina

As you can see, vulvovaginitis describes a pretty wide range of conditions that share fairly similar symptoms. Other conditions that fall under this umbrella term include the following:

• Vaginal atrophy is caused by a sustained drop in your estrogen levels and also falls under the category of vulvovaginitis. It’s when the walls of your vagina become thinner and inflamed, and it may feel dry. This can be linked to the transition toward menopause (as your estrogen levels drop permanently). 
• Vulvodynia describes vulvar pain that lasts three months or longer. It’s often described as a burning, stabbing, stinging, or raw sensation, and health care professionals don’t yet know what causes it. 
• Contact dermatitis is a type of eczema that is triggered when you come into contact with certain chemicals and materials. The skin around your vulva is incredibly sensitive. Something as small as changing your soap, laundry detergent, or pads can cause irritation.

These conditions aren’t caused by infections but may leave you feeling sore, itchy, or uncomfortable. Rather than worrying about any changes or trying to diagnose yourself at home, the best thing you can do is keep a log of your symptoms (in the Flo app or elsewhere) and speak to your health care professional.

What is cyclic vulvovaginitis?

You might have been diagnosed with BV or a UTI and treated for the symptoms once. But it’s common for people to experience more than one episode of vulvovaginitis. As the name suggests, cyclic or recurrent vulvovaginitis describes experiencing four or more episodes of the same condition within a year. 

A study of women who had been successfully treated for BV found that 52% had it again at least once more. Similarly,  20% to 30% of young women have recurrent UTIs. It can be really frustrating, but if you’ve been diagnosed with vulvovaginitis in the past and can see that symptoms are coming back, don’t hesitate to reach out to a medical professional for help. 

How vulvovaginitis is diagnosed

Trying to explain changes in your discharge to your health care provider might not sound like a particularly fun conversation. However, the clearer you can be about your symptoms, the easier it’ll be for your medical professional to rule out (or treat) any infections. 

You know your body better than anybody, so trust your gut, tap into your support network, and if it feels right, then bring a friend to your appointment. If you struggle with remembering the timeline of symptoms, write them down and share that with your health care provider first.

Dr. Rahman explains, “The diagnosis is made by taking a thorough history, determining risk factors, examining the vulva and vagina, and taking a vaginal discharge sample to […] evaluate.” 

During your health history, you might be asked about your sex life. If your health care provider conducts a pelvic exam, they’ll gently insert a finger into your vagina while pressing down on your tummy. They may also want to look at the skin around your vulva, take a sample to test your vagina’s pH, and assess what might be causing your discomfort. If at any point you feel uncomfortable, you can ask your health care provider to stop and explain what they’re doing. 

Vulvovaginitis treatment: Can you treat it at home?

Vulvovaginitis treatment depends on the type of condition that you’re diagnosed with. 

While some conditions can be treated at home, it’s really important to get the advice of your health care provider before you start taking any new medication or supplements. 

Treatment can include: 

• Over-the-counter medication: Yeast infections can be treated using over-the-counter medication from a pharmacy. Make sure you speak to your health care provider before seeking out medication and follow the directions on the packaging carefully. A cold compress may help relieve the burning and irritation. If you don’t see a change in your symptoms within a week, then you should go back to your health care provider. 
• Medication from your health care provider: Not all vulvovaginitis conditions can be treated over the counter. To treat trichomoniasis, other STIs, bacterial vaginosis, and vaginal atrophy, you will need to speak to your health care provider about your symptoms and get a prescription based on their guidelines. Make sure to finish the full round of medication to prevent any recurrent vulvovaginitis and follow up with your medical professional.

How can vulvovaginitis impact sex?

Managing any medical condition can affect more areas of your life than your health, and dealing with vulvovaginitis can take a toll on your mental well-being. So if it’s getting you down, know that that’s normal and be kind to yourself. With treatment, it should pass. 

One of the trickier aspects of a health condition like this is that “vulvovaginitis can cause pain or discomfort during sex and intimacy, especially if there is vaginal penetration involved,” says Casey Tanner, sex therapist and Flo medical board member. “If someone is experiencing this sort of pain with all or certain sexual activities, it may impact their sex drive or sense of self-worth.” 

Managing any pain or discomfort you’re feeling while also being open and vulnerable with your health care provider can take some practice. Be gentle with yourself. “Take your time figuring out what works for you and don’t push yourself to do things sexually that you don’t feel emotionally and/or physically ready for,” says Tanner.

How to prevent vulvovaginitis

While you can’t always avoid vulvovaginitis, Dr. Rahman outlines that there are some steps you can take to prevent recurring symptoms.

She recommends: 

• Avoid using scented products like soap and period products around your genital area (they can upset the balance of bacteria in your vagina leading to conditions like bacterial vaginosis).
• Avoid douching (spraying water or other products up your vagina).
• Wipe carefully when using the toilet. Always move from the front to the back to prevent bacteria from your poop from getting too close to the vaginal or urethral opening. 
• Wear cotton underwear and loose clothing. Tight or wet clothing and synthetic fabrics may increase your chances of infection.
• Make sure that you clean all of your sex toys between uses and never switch between anal and vaginal sex during penetration.
• Instead of rubbing, pat dry your vulva after washing to prevent irritation.

What does vulvovaginitis look like? The takeaway

Vulvovaginitis is an umbrella term that describes a number of conditions that affect your vulva and vagina. If you’ve ever experienced itching, soreness, or changes in your vaginal discharge, then you’re not alone. It’s the most common reason that women and girls reach out to their health care provider for a gynecological diagnosis. 

Knowing when to speak to your medical professional can be tough, especially when you’re dealing with pain and discomfort. But keeping a note of your symptoms, researching them using an app like Flo, and speaking about them with a loved one may help you clarify what you want to say to your health care provider. 

You know your body better than anyone, so don’t doubt yourself. If you think something doesn’t feel quite right, don’t be afraid to say something.