Aerobic vaginitis: A condition that causes vaginal inflammation

Bacterial vaginosis, a common infection down there, is often blamed for foul smelling vaginal discharge. However, it is not always the reason behind abnormal vaginal discharge. Aerobic vaginitis, which is associated with harmful aerobic bacteria, can also lead to abnormal discharge accompanied by inflammation and discomfort down there. This condition may even cause pain during sex or lead to a burning sensation while peeing. This condition mostly affects women in their reproductive stage. However, it can easily be treated with the help of antibiotics.

What is aerobic vaginitis?

It is a vaginal infectious condition characterised by inflammation and an overgrowth of harmful aerobic bacteria or bacteria that thrive in oxygen, explains obstetrician and gynaecologist Dr Chetna Jain. It involves the presence of bacteria such as:

• Escherichia coli (E. coli)
• Enterococcus faecalis
• Group B Streptococcus (GBS)
• Staphylococcus aureus

“These bacteria damage the vaginal lining and cause severe inflammation, redness, and discomfort,” says the expert. The prevalence of this condition ranges between 7 and 12 percent, according to a study published in journal Research In Microbiology in 2017.

What are the symptoms of aerobic vaginitis?

The symptoms can range from mild to severe and may resemble vaginal infections like bacterial vaginosis or yeast infections. “But aerobic vaginitis is distinct due to its inflammatory nature,” says the expert.

• Abnormal vaginal discharge that can be yellowish, greenish, or brownish in colour. It can be watery or thick, and have unpleasant odour. The vaginal walls may appear inflamed, swollen, and irritated.
• Persistent vaginal itching due to irritation of the vaginal lining.
• Burning or stinging sensation, especially when urinating.
• Due to vaginal dryness and inflammation, sex can be painful or uncomfortable.
• It can irritate the urinary tract, leading to burning or discomfort when urinating.

What causes aerobic vaginitis?

The key causes of this vaginal infection are:

• A decline in beneficial Lactobacilli, which normally maintains vaginal acidity and prevents infections.
• Overwashing or using harsh soaps disrupts the vaginal pH (potential of hydrogen).
• Poor perineal hygiene, especially after using the washroom.
• Unprotected sexual activity can introduce or spread pathogenic bacteria.
• Vaginal douching, using scented tampons, and perfumed products for the intimate area can disturb the natural flora.

Risk factors of aerobic vaginitis

The following are some of the primary risk factors for this condition:

1. Women who have unsafe sex

“Unprotected sex or sex with multiple partners can introduce harmful bacteria into the vaginal area. This increases the likelihood of aerobic vaginitis,” says the expert. Sexual transmission of bacteria, due to unprotected sex, can introduce new pathogens into the vagina, leading to imbalances in the microbiota.

2. Pregnant women

Expecting moms are particularly vulnerable to aerobic vaginitis due to the physiological and hormonal changes that take place during pregnancy. “The increased levels of progesterone can reduce the body’s natural ability to fight bacterial overgrowth, making the vaginal environment more prone to infections like aerobic vaginitis,” says Dr Jain. It increases the risk of negative pregnancy outcomes such as abortion, stillbirth, and premature delivery, as per a study published in the journal Reproductive Health in 2022.

3. Recurrence of bacterial infections

Individuals who have had repeated or chronic infections such as bacterial vaginosis are at a higher risk of developing aerobic vaginitis. “This is due to the changes in the vaginal flora that are caused by recurring infections down there,” says Dr Jain.

How is aerobic vaginitis diagnosed?

Here’s how diagnosis of aerobic vaginitis is done:

1. Clinical examination

The doctor will start by reviewing your medical history, including symptoms, sexual health history, and any potential risk factors. During the pelvic examination, the doctor may observe the vaginal walls for signs of infection, including redness or swelling of the vaginal tissues, thin, yellowish discharge with a foul odour.

2. Laboratory testing

To confirm the diagnosis, laboratory tests are often required. These may include:

• Vaginal swab: The doctor will take a sample of vaginal discharge using a swab. This sample will be sent to the laboratory for further examination under a microscope and culture.
• Microscopic examination: A slide of the discharge may be prepared to check for the presence of abnormal aerobic bacteria.

How to treat aerobic vaginitis?

Treatment for aerobic vaginitis typically involves a combination of medications and lifestyle changes so that the natural balance of the vaginal microbiota gets restored.

1. Antibiotic treatment

“Antibiotics are the primary treatment for this condition. They help reduce the overgrowth of aerobic bacteria that cause the condition,” says the expert. Clindamycin is a common antibiotic used to treat aerobic vaginitis, especially in pregnant women, as per research published in the journal Reproductive Health in 2022.

2. Topical treatments

Topical antimicrobial creams or gels can be used along with oral antibiotics. “Metronidazole gel is often applied directly to the vaginal area to help clear the infection,” says Dr Jain. Such treatments are usually helpful when the infection is localised in the private area.

3. Probiotics

Probiotics, particularly those containing the good bacteria Lactobacillus, can help to restore the natural vaginal flora by introducing beneficial bacteria. Oral probiotics containing strains like Lactobacillus rhamnosus or Lactobacillus reuteri can help to improve the balance of the vaginal microbiome and prevent recurrence of this infection.

4. Correcting hormonal imbalances

In cases where hormonal changes such as during pregnancy are a contributing factor to this condition, managing hormonal imbalances might help. “For pregnant women, hormonal changes might naturally resolve after childbirth, but supportive care such as probiotics can be helpful during pregnancy,” says the expert.

Aerobic vaginitis is a condition that leads to abnormal vaginal discharge, inflammation, and discomfort down there. It is mostly treated with oral and topical antibiotics. Once it gets cleared up, make sure to go to a doctor to avoid recurrent infection.

Note: All medications for aerobic vaginitis must be taken only after consultation with your doctor.