[2] Other causes include allergies to substances such as spermicides or soaps or as a result of low estrogen levels during breast-feeding or after menopause.
[3] Prepubescent girls are often at risk for development of vulvovaginitis because of low amounts of estrogen and an underdeveloped labia minora.
[3] Other causes of symptoms such as inflammation of the cervix, pelvic inflammatory disease, cancer, foreign bodies, and skin conditions should be ruled out.
[4] A woman may have vaginal irritation, itching, or burning or may notice a foul-smelling or abnormal discharge that could appear green or yellow.
[2] The vaginal flora consists of those organisms which generally do not cause symptoms and is dominated mainly by Lactobacillus species.
Physical factors that have been claimed to contribute to the development of infections include the following: constantly wet vulva due to tight clothing, chemicals coming in contact with the vagina via scented tampons, antibiotics, birth control pills, or a diet favoring refined sugar and yeast.
[9] Diagnosis is made with microscopy (mostly by vaginal wet mount) and culture of the discharge after a careful history and physical examination have been completed.
[27] Prevention of bacterial vaginosis includes healthy diets and behaviors as well as minimizing stress as all these factors can affect the pH balance of the vagina.
[11] Prevention of trichomoniasis revolves around avoiding other people's wet towels and hot tubs, and safe-sex procedures, such as condom use.
[9] Some women consume good bacteria[clarification needed] in food with live culture, such as yogurt, sauerkraut and kimchi, or in probiotic supplements either to try to prevent candidiasis, or to reduce the likelihood of developing bacterial vaginitis following antibiotic treatment.
[26] Studies have suggested a possible clinical role for the use of standardized oral or vaginal probiotics in the treatment of bacterial vaginosis, either in addition to[28] or in place of[29] the typical antibiotic regimens.
However, recent articles[30][31] question their efficacy in preventing recurrence compared with other means, or conclude that there is insufficient evidence for or against recommending probiotics for the treatment of bacterial vaginosis.
The female vagina hosts a diverse array of over 50 different microorganisms that interact and coexist in a complex microecological environment.
When the balance among these microorganisms is disrupted, it can lead to mixed infectious vaginitis, with the specific pathogens involved varying based on individual cases and environmental factors.
This condition often results in distressing symptoms like vulvar itching, burning pain, and urethral irritation, and can be complicated by increasing drug resistance and recurrence rates, particularly in patients with ineffective treatment, long-term contraceptive use, or compromised sexual hygiene.
Nonspecific vulvovaginitis may be triggered by fecal contamination, sexual abuse, chronic diseases, foreign bodies, nonestrogenized epithelium, chemical irritants, eczema, seborrhea, or immunodeficiency.
[40] Infectious vulvovaginitis can be caused by group A beta-hemolytic Streptococcus (7-20% of cases), Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, Shigella, Yersinia, or common STI organisms (Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, herpes simplex virus, and human papillomavirus).