Vaginitis is an inflammation of the areas vagina that can be uncomfortable, painful, and embarrassing. It can be caused by irritation of the vagina leading to infection, or by a change of the balance of vaginal bacteria due to a number of factors. Treatment usually involves medication. Prevention can involve changes in hygiene habits, or even clothing.

In this excerpt from the book Real Cause, Real Cure by Jacob Teitelbaum, MD and Bill Gottlieb, CHC the authors discuss what causes vaginitis and the simple changes that can help prevent this condition.


Real Causes

  • Digestive Difficulties. Eating a high-sugar diet can change the body’s acid-alkaline balance, allowing an overgrowth of the yeast Candida albicans.
  • Prescription Medications. Overuse of antibiotics can encourage the growth of candida.
  • Hormonal Imbalances. Low estrogen is the cause of the dry, irritated vaginal tissue of atrophic vaginitis.

Ten percent of all visits by women to health care practitioners are for vaginitis, an infection or irritation of the vagina. But this common problem is also commonly misunderstood. In a telling study, only 26 percent of women who thought they had a yeast infection—one type of vaginitis—actually had one.

Here’s a simple, straightforward guide to the most common types of vaginitis. First, I’ll describe each type of vaginitis, and then present preventive and curative regimens for each.

Bacterial vaginosis (BV). Forty to 45 percent of the time, vaginitis is BV—not an infection, but an overgrowth of the anaerobic (non-oxygen-requiring) bacteria that usually coexist peacefully in the vagina with aerobic (oxygen-requiring) bacteria. Typical symptoms include a thin, grayish discharge; slight irritation; burning during urination; and a fishlike odor.

The problem is triggered when the normally acidic pH of the vagina (3.8 to 4.2) becomes more alkaline (4.5 or higher), allowing the anaerobic bacteria to thrive. Common causes of increased alkalinity include menstruation (levels of hormones at menstruation make the vagina less acidic, and menstrual blood is alkaline); intercourse (ejaculate has an alkaline pH); douching; using heavily scented soaps and laundry detergents; and scented fabric softeners.

Yeast (fungal) infection. Twenty to 25 percent of the time, vaginitis is a yeast infection— and 95 percent of the yeast organisms that do the infecting are Candida albicans. The most common symptom is itching. Other possible symptoms include a thick, white, cottage cheese–like discharge; burning; painful urination; painful sex; and a swollen vulva (the external part of the vagina) that has pinpoint red lesions, like a baby with diaper rash. It usually doesn’t have a fishy odor, like BV.

Common causes include antibiotics (which kill friendly bacteria that keep yeast in check); unprotected intercourse (usually with a new or recent partner who has a yeast infection you don’t know about); douching; excessive stress; a high intake of sugar and other refined carbohydrates (yeast feeds on sugar); diabetes; and a weakened immune system from chemotherapy or high doses of anti-inflammatory steroids.

•Trichomoniasis. This is a sexually transmitted disease (STD) caused by the trichomonad protozoa, an amoeba-like creature. In 20 to 50 percent of cases, there are no symptoms. When there are symptoms, they can include large amounts of a frothy, green-yellow discharge; pain with urination; itching; and bleeding after intercourse.

•Atrophic vaginitis. This is a common postmenopausal problem: drier, thinner, more easily irritated vaginal tissue, caused by a decrease in estrogen.

Real Cure Regimens

Yes, you can treat some types of vaginitis (BV, yeast infections, and atrophic vaginitis) yourself if they’re a recurrence and you’re absolutely sure you know what kind of infection or irritation you have.

But you should always see a doctor for vaginitis if it’s your first episode; you’re not sure what kind of infection or irritation it is; the symptoms are persistent; you have recurrences; you’re pregnant; you have an underlying serious health condition, such as diabetes, cancer, or AIDS; or your sexual partner is also experiencing symptoms.

Bacterial Vaginosis (BV)

If you’ve never had vaginitis or BV, you need to see your doctor and receive an accurate diagnosis. If your doctor diagnoses BV, you’ll receive the antibiotic metronidazole (Flagyl), taken twice a day for seven days.

But you should also take a probiotic, a supplement or suppository with friendly lactobacillus bacteria. This additional treatment doesn’t kill the bacteria. Instead, it helps restore normal vaginal pH—and helps defeat BV—in several ways. They increase the cure rate of an antibiotic—in one study, from 50 to 87 percent. On their own, they reestablish normal bacterial balance and acidic pH, knocking out the BV. And they prevent recurrence of BV when taken daily.

“Lactobacilli were beneficial for the treatment of patients with BV,” concluded researchers from the University of Wisconsin in a review of 25 studies on probiotics and BV. The probiotic product used in many BV studies is an over-the-counter product called RepHresh Pro-B. Its manufacturer also makes a vaginal gel that helps restore proper vaginal acid/alkaline balance.

You can preserve the acidity of the vagina by avoiding the products and habits that destroy it. Here are recommendations from Cherie A. Lefevre, MD, director of the Vulvar and Vaginal Disorders Specialty Center at the St. Louis University School of Medicine…

  • Wear all-white cotton underwear with a white crotch, not nylon with a cotton crotch. Thong-type underwear is not recommended on a daily basis. Sleeping without underwear is advised.
  • Avoid full pantyhose. If you wear them, cut out the diamond crotch (be sure to leave about ¼ to ½ inch of fabric from the seam to prevent running), or wear thigh-high hose.
  • Use a detergent free of dyes, enzymes, and perfumes.
  • Don’t use a fabric softener in the washer or dryer. White vinegar can be used in the washer as a natural softener
  • Limit stain-removing products. Bleach or stain removers are not recommended for your underwear.
  • Avoid bath soaps, lotions, gels, etc., that contain perfume. This includes many baby products and feminine hygiene products marked “gentle” or “mild.” Use these soaps in a bar form: Dove-Hypoallergenic; all-natural olive oil soap; Neutrogena; Basis; or Pears.
  • Avoid all bubble baths, bath salts, and scented oils. Instead, use a baking soda soak— soaking in lukewarm (not hot) bath water with four to five tablespoons of baking soda to help soothe vulvar itching and burning. Soak one to three times a day, for five to 10 minutes, when you have vulvar symptoms.
  • Use white unscented toilet paper.
  • Avoid all feminine hygiene sprays, perfumes, and adult or baby wipes.
  • Avoid deodorized pads and tampons. Tampons should be used when the blood flow is heavy enough to soak one tampon in four hours or less. Use only pads that have a cotton liner that comes in contact with your skin (no dry-weave pads).
  • Do not douche.
  • Keep dry by choosing cotton fabrics, not wearing pads daily, and keeping an extra pair of underwear handy and changing once during the day.

Yeast (Fungal) Infection

You can tell if you don’t have a yeast infection with the over-the-counter Vagisil Screening Kit. If the results are alkaline, you don’t have a yeast infection and may have BV. However, it takes a visit to the doctor to confirm.

Many yeast infections resolve on their own, without treatment. To speed healing, cut out sugar and other refined carbohydrates and alcohol.

The safest, easiest, and most reliable treatment for a yeast infection is using an over-the-counter antifungal, such as miconazole (Monistat) or clotrimazole (Mycelex). As with BV, taking probiotics may help a yeast infection resolve. Taking a probiotic regularly can decrease recurrences. Other ways to help prevent recurrences are to avoid antibiotics and to reduce or eliminate sugar.

You could also try supplementing your diet with sea buckthorn berry extract. A study from Finland shows it can improve the moisture of vaginal mucous membranes, reducing susceptibility to infection. I recommend the product Omega-7, from Terry Naturally. Follow the dosage recommendations on the label.


If diagnosed, trichomoniasis is treated with metronidazole (Flagyl): a two-gram, one-day dose. Your sexual partner also needs to receive Flagyl.

Atrophic Vaginitis

Bioidentical vaginal estrogen creams are very effective, and I generally recommend them for this problem. However, these creams may not be appropriate for women with breast cancer or a clotting disorder. (See Menopause Problems on page 290 for a complete discussion of bioidentical hormones for women.)

A wonderful natural alternative, recommended by Dr. Lefevre: vegetable-based oils, such as sunflower oil, canola oil, and olive oil, and solid vegetable shortenings, with a small amount applied twice a day, inside the vagina. The oils are completely safe for vulvar and vaginal tissues. “I have seen women who have suffered for five or more years with atrophic vaginitis and painful intercourse achieve complete relief within six weeks of starting this regimen,” she told us. My late wife and live wife did and do this, without much muss or fuss, following the exact instructions here: applying a small amount inside the vagina twice a day. As long as you use a small amount, it’s very straightforward—and very effective, just as the doc says. (And you quickly learn what a “small amount” is from direct experience.) Also, the Vulvar and Vaginal Disorders Center gives exactly this written advice, without any extra guidelines, so it’s a good guess that the advice is working for their many patients without need for more detail.

Another excellent option to use as a lubricant during intercourse: coconut oil that is liquid at room temperature. Nature’s Way makes an excellent product called Always Liquid Premium Coconut Oil. It is nonirritating and pleasant to use.

For more ways to fix root causes of common health problems, purchase Real Cause, Real Cure from

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