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Vaginitis in Teens

What is vaginitis in teens?

Vaginitis is any inflammation or infection of the vagina. It's a common problem in girls and women of all ages. It develops when the walls of the vagina become inflamed because of an infection or irritant.

Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your provider as you talk about your care.

What causes vaginitis in a teen?

Bacteria, yeast, viruses, and chemicals can cause vaginitis. The most common types are:

  • Yeast infection. This is caused by one of the many species of fungus known as candida. These normally live in the vagina in small numbers. Candida may also be in the mouth and digestive tract in both boys and girls. Infection happens when something upsets the normal balance. For example, antibiotics can kill bacteria that normally balance the amount of yeast in the vagina. Too much yeast grows, causing an infection. Another cause can be pregnancy, which changes hormone levels. Diabetes can also be a cause because of too much sugar in the urine.

  • Bacterial vaginosis. This infection is caused when certain types of normal vaginal bacteria grow out of control and cause inflammation.

  • Trichomoniasis (trich). This is a sexually transmitted infection (STI) caused by a parasite. This parasite passes between partners during sexual contact. Most boys don’t have symptoms with trichomoniasis. So the infection is often not diagnosed until a girl has vaginitis symptoms.

  • Viral vaginitis. Viruses are a common cause of vaginitis. Most are spread through sexual contact. The herpes simplex virus (HSV) can cause viral vaginitis. The human papillomavirus (HPV) can also cause viral vaginitis. Both of these are spread through sexual contact.

  • Noninfectious vaginitis. This is vaginal irritation without an infection. It’s most often caused by an allergic reaction or irritation. Chemicals in vaginal sprays, douches, or spermicides can cause it. It may also be caused by perfumed soaps, detergents, or fabric softeners. Even chemicals in clothing can cause symptoms.

Which teens are at risk for vaginitis?

A girl is more at risk for vaginitis if she:

  • Has recently taken antibiotics

  • Is pregnant

  • Has diabetes that is not well-controlled

  • Has HIV

  • Is using an immunosuppressant medicine

  • Is using high-estrogen contraceptives

  • Is having corticosteroid therapy, which weakens the immune system

What are the symptoms of vaginitis in a teen?

Symptoms can occur a bit differently in each girl.

The symptoms of a yeast infection can include:

  • A thick, white, odorless vaginal discharge that is like cottage cheese

  • Itching and redness of the vulva and vagina

  • Pain when peeing (urination) or during sex

The symptoms of bacterial vaginosis can include:

  • A thin, white fluid from the vagina

  • A thick, gray or green fluid from the vagina

  • Fishy smell to the fluid

The symptoms of trichomoniasis can include:

  • Frothy, greenish-yellow fluid from the vagina that smells musty

  • Itching or burning in and around the vagina and vulva

  • Swelling or redness at the opening of the vagina

  • Light bleeding, especially after sex

  • Burning feeling when peeing

  • Pain in the lower belly (abdomen)

  • Pain during sex

  • No symptoms, in some cases

The symptoms of viral vaginitis can include:

  • Pain in the genital area from sores, if the cause is HSV

  • Painless warts on the vagina, rectum, vulva, or groin, if the cause is HPV. But a girl may have the virus without visible warts.

The symptoms of noninfectious vaginitis can include:

  • Vaginal itching or burning feeling

  • Fluid from the vagina

  • Pelvic pain, especially during sex

The symptoms of vaginitis can be like other health conditions. Make sure you see your healthcare provider for a diagnosis.

How is vaginitis diagnosed in a teen?

The healthcare provider will ask about your teen’s symptoms and health history. They will give your teen a physical exam. The physical exam may include a pelvic exam. The healthcare provider may also check vaginal fluid under a microscope.

How is vaginitis treated in a teen?

Treatment will depend on your teen’s symptoms, age, and general health. It will also depend on the cause and how severe the condition is.                                         

Yeast infection

Treatment may include:

  • Antifungal vaginal creams and suppositories

  • Vaginal tablets

  • Antifungal medicines that are taken by mouth (oral)

Bacterial vaginosis

Treatment is with antibiotics.

Trichomoniasis

Treatment is done with oral antibiotics. All sexual partners need to be treated. This is to prevent the infection from occurring again.

Viral vaginitis

Treatment depends on the cause:

  • This virus can be treated with antiviral medicine. These include acyclovir, valacyclovir, and famciclovir. These medicines don’t kill the virus. But they can decrease the pain and shorten the length of the outbreak.

  • Most HPV infections go away within 6 to 12 months. Some infections last and can lead to cancer of the vulva, vagina, or anus.

Noninfectious vaginitis

Treatment is done by finding out what caused the reaction or irritation, and removing it from use.

Talk with your teen’s healthcare provider about the risks, benefits, and possible side effects of all medicines.

What are possible complications of vaginitis in a teen?

HPV is the main cause of cervical cancer in women. 

How can I help prevent vaginitis in my teen?

An HPV vaccine can prevent infection by the types of HPV that cause most cervical cancers. The vaccine also helps prevent genital warts as well as some cancers of the vulva, vagina, and anus. The vaccine is given to children and young adults ages 9 to 26, ideally before they become sexually active. Ask your healthcare provider for more information.

When should I call my teen’s healthcare provider?

Call the healthcare provider if your teen has:

  • Symptoms that don’t get better, or get worse

  • New symptoms

Key points about vaginitis in teens

  • Vaginitis is any inflammation or infection of the vagina. It's a common problem in girls and women of all ages. It develops when the walls of the vagina become inflamed because of an infection or irritant. 

  • Bacteria, yeast, viruses, and chemicals can cause vaginitis.

  • The symptoms of vaginitis can include pain, itching, burning, sores, fluid from the vagina, and other problems.

  • Treatment may include medicines. The type of medicine depends on the cause.

  • An HPV vaccine can prevent infection by the types of HPV that cause most cervical cancers.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you for your child.

  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.

  • Ask if your child’s condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if your child does not take the medicine or have the test or procedure.

  • If you r child has a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Medical Reviewers:

  • Donna Freeborn PhD CNM FNP
  • Irina Burd MD PhD
  • Stacey Wojcik MBA BSN RN