What are treatment options for vulvovaginitis?

Dr. Kevin W. Windom, MD
OBGYN (Obstetrician & Gynecologist)

There are numerous treatments for vaginal infections. The most important thing is to diagnose the culprit of this infection. Once the etiology of the infection is diagnosed, then adequate treatment can be made using antifungal creams for yeast infections, antibacterial creams for bacterial infections, antiviral medications for viruses such as herpes, and there are numerous other medications that can be used to help decrease the symptoms while the bacteria, fungus, or virus are being killed.

There are a number of treatments available to vulvovaginitis which each depend on the cause of the infection:

Bacterial vulvovaginitis
Doctors typically prescribe oral or topical antibacterial medications such as metronidazole or clindamycin. It is particularly important for pregnant women to receive treatment as soon as possible to reduce the risk of pregnancy complications such as low birth weight or premature birth. In situations where a woman runs a greater risk of bacterial infection, such as caesarian delivery, IUD insertion, or a hysterectomy, doctors usually advise women to get treated for bacterial vulvovaginitis prior to the procedure if possible.

Estrogen deficient vulvovaginitis
Women who experience mild symptoms will be advised to use several lubricants or moisturizers as needed. However, if a woman experiences more severe symptoms that interfere with her daily life, a doctor may recommend hormone therapy. This treatment can come in the form of an estrogen pill, cream or a vaginal ring that secretes estrogen. Sometimes, doctors prescribe a combination hormonal therapy patch, which includes both estrogen and progestin. Most doctors also recommend an increase in sexual activity as well, which can help kick start your natural lubrication system and improve your vagina's elasticity.

Nonspecific vulvovaginitis
The most common treatments of bacterial or fungal infections include prescribed oral medication or topical medication. Examples of topical medication include antibacterial drugs, creams, ointments or cortisone creams. If the infection was caused by an allergic reaction to foreign matter, antihistamines may help reduce allergy symptoms.

Trichomonal vulvovaginitis
The most effective treatment option for trichomonal vulvovaginitis is to take prescription medication. This medication can come in a one-dose pill, namely of metronidazole or tinidazole. After taking the pill, doctors usually recommend abstaining from sex until symptoms are completely gone, as well as avoiding alcohol use, as that may aggravate side effects of the medication. Any sexual partners should be treated at the same time, to reduce the risk of re-infection. After treatment begins, symptoms of trichomonal vulvovaginitis are usually gone within a week.

No matter the treatment, it is also crucial to practice healthier genital hygiene habits during treatment and afterwards. These habits may include wiping from front to back when using the bathroom, washing hands more frequently, or taking a special type of bath called a sitz bath. A sitz bath involves soaking the hips and buttocks in warm water for at least 15 minutes, and is typically used as a cleanser treatment for hemorrhoids and vaginal or other genital infections. A tablespoon of baking soda added to the warm water may be soothing and cleansing.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.