What is Vaginitis?
Vaginitis (sometimes referred to as vulvovaginitis) is the inflammation and/or infection of the vagina (and vulva), the external portion of a woman’s genitals. It can be associated with itching, pain, discharge and odour, often most noticeable after sex. Vaginitis is more common in the reproductive years [1].
What Causes Vaginitis?
Vaginitis is typically a reaction to an environmental change that disrupts the usually friendly bacterial and yeast balance inside your vagina. There is more than one type of vaginitis, and each one has different causative factors.
1. Bacterial vaginosis (BV) is the most common vaginal infection in women aged 15-44 and occurs when the ‘good’ and ‘harmful’ bacteria living in a woman’s vagina are out of balance. Causes of imbalanced bacteria include antibiotics, douching, an intrauterine device (IUD), having unprotected sex with a new partner or many partners [1].
2. Yeast infections (candidiasis) are caused by excess candida growth in the vagina. Candida is the more formal term for yeast. It is a type of fungus and typically lives around us and inside us, including inside the vagina. For example, you might have too much growing there because of antibiotics, pregnancy, diabetes (more likely, if the diabetes is not well-controlled) and corticosteroid medicines [1].
3. Trichomoniasis is another factor which can lead to the development of Vaginitis. Trichomoniasis is a common sexually transmitted disease caused by a parasite [1].
4. Vaginitis can also be caused by contact irritation, if you are sensitive or allergic to products that you use, such as vaginal sprays, douches, spermicides, soap, detergents or fabric softeners. These can cause burning, itching and discharge [1].
5. Hormonal alterations can also promote vaginal irritation. Common examples include breastfeeding, or menopause [1].
What are UTIs?
Urinary tract infections (UTIs) are bacterial infections that can occur anywhere in your urinary tract, which includes your kidneys, bladder, or urethra. They are among the most common bacterial infections worldwide, occurring in both community and healthcare settings. UTIs can range from uncomplicated to complicated, and are usually treated empirically [2, 3].
What causes UTIs?
UTIs are predominantly caused by bacteria. Most commonly, Uropathogenic Escherichia coli (UPEC) is the culprit, but other pathogens that may cause UTIs are Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus spp. These bacteria can travel up the urethra and reproduce in the bladder [2, 4].
The bacteria usually responsible for a UTI emerge from the skin or from the rectum. These germs move into the body via the urethra. If they make their way into the bladder, the UTI is called bacterial cystitis. In some cases, bacteria can migrate from the bladder into the kidneys increasing the likelihood of triggering a serious condition known as pyelonephritis [3].
Other risk factors, such as sexual activity, which can introduce bacteria into the urinary tract – or poor hygienic practices – can also increase susceptibility to the disease. Failure to treat UTIs can lead to pyelonephritis, which can in turn lead to kidney failure and, in some cases, death. The use of indwelling urinary catheters, which can leave the urinary tract open to bacterial infection, is another risk factor for UTIs. In fact, such ‘catheter-associated’ UTIs account for 40% of all cases of nosocomial (or hospital-acquired) infections [4, 5].
Relationship between Vaginitis and UTIs
Vaginitis and urinary tract infections (UTIs) are two distinct conditions that can affect women's health. However, they share some similarities and differences in terms of causes, symptoms, and treatment.
...
Differences
Vaginitis is the inflammation or infection of the vagina and women commonly experience itching, burning, irritation and abnormal vaginal discharge. Urinary tract infection (UTI) is a bacterial infection of the urinary system. It includes infections of the urethra, bladder, kidneys and urinary tract. Symptoms of UTI are those who have problems in urinating, they could feel painful feeling like they are burning when going the bathroom or they have a pressing need to urinate more often than usual [6, 7].
The symptoms of these two afflictions can differ. UTIs may manifest as pelvic and abdominal pain and could allow for more serious kidney manifestations if not treated [7]. Vaginitis can manifest as itching, burning and irritation of the vulva plus a ‘fishy’ vaginal odour [8, 9].
Medically, both conditions need to be treated. Antibiotics are usually used for UTIs, whereas the treatment of Vaginitis depends on the cause and can include antibiotics plus antifungal medication or hormones [7, 9].
Similarities
Despite these differences, the two afflictions are strongly intertwined. Of women found to have bacterial vaginosis (a form of vaginitis), 75% also harboured a UTI; some 46% of women with vaginal candidiasis (yeast infection) also had a UTI, while, of those with trichomoniasis, 13% also had UTIs [10]. Judging by these numbers, it’s possible that women with Vaginitis are also more likely to get a UTI.
Can Vaginitis Cause UTIs?
Specifically, vaginitis – inflammation of the vagina, often caused by infection – is frequently seen alongside UTIs. The types of organisms that cause vaginitis are not at all related to those that give rise to UTIs. However, despite the disparity in organisms, distinct conditions, and activities associated with each, extensive evidence from population-based studies demonstrate that there is a pronounced association between vaginitis and UTIs [10].
Bacterial vaginosis (BV), the most frequent cause of Vaginitis in women between 15 and 44 years old, has been linked to UTIs: one study reported that 75% of women with BV also had a UTI [10]. Another reported that 22.4% of women with BV had a UTI, as opposed to 9.7% of those without [11].
Other types of Vaginitis were also found to be associated with UTIs: 46% of women with vaginal candidiasis and 13% with trichomoniasis also had the same UTI diagnosis [10].
Additionally, this doesn’t mean they are always causally linked, of course, as many UTIs are caused by pathogens that don’t typically cause vaginal infections. But healthy vaginal flora might shield the urethra from invading bacteria [11, 12].