Women's Health

Can Vaginitis be Treated Over the Counter?

Can Vaginitis be Treated Over the Counter?

The inflammation of the vagina is what is known as vaginitis. Infection is the leading cause in premenopausal women.  A low estrogen level after menopause mostly results in atrophic vaginitis (vaginal atrophy). You may get vaginitis due to hypersensitivity to an irritating chemical like spermicides, bathing soap, or douching.

Nearly all vaginitis that are infectious are a result of one of the following three infections:

  • Bacterial vaginosis: This is the leading cause of an unpleasant vaginal smell or an abnormal vaginal discharge, and it results when there is a change in the form of bacteria that are found in the vagina normally. In the case of bacterial vaginosis, other bacteria replace the normal lactobacillus bacteria, including G. vaginalis, Mobiluncus, Mycoplasma hominis, and Prevotella. What exactly causes this change is still unclear. Bacterial vaginosis can raise the chances of premature delivery in women who are pregnant.
  • Vaginal yeast infections (candida vaginal infections): These are normally a result of albicans fungus. It is estimated that 75% of women will get this infection at least once in their lifetime. Women have an increased risk for candida vaginal infections if they are pregnant, their bodies are stressed due to poor diet, they douche a lot, they are sick or lack sleep, or if they use birth control pills or antibiotics. Women who have HIV or diabetes have higher chances of getting recurring yeast infections.
  • Trichomonas vaginitis (Trichomoniasis): This is an STD (sexually transmitted disease) that is a result of trichomonas vaginalis, which is a microscopic one-celled organism. In women, this infection results in inflammation of the urethra, vagina, and cervix. Trichomoniasis can increase the chances of preterm delivery or preterm membranes’ rupture in pregnant women.


  • In bacterial vaginosis: An unpleasant vaginal odor with an abnormal vaginal discharge, which is grayish-white in color.
  • In candida vaginitis:
    • Discomfort or pain during sex
    • Soreness or itching of the vagina
    • A thick vaginal discharge that looks like cheese
    • A burning sensation near the opening of the vagina, especially during urination
  • In trichomonas vaginitis:
    • Itching or vaginal pain
    • A foul-smelling vaginal discharge that is yellow-green in color
    • Burning sensation during urination
    • Discomfort in the lower abdomen
    • Inflammation and irritation around the opening of the vagina
    • Vaginal pain during sex

Trichomonas organisms can stay in the vagina for long (years) without showing any symptoms. During menstruation, the symptoms can worsen. 


When you explain your symptoms to your physician, he or she will conduct a gynecological examination and look at your cervix, external genitals, and vagina for abnormal discharge and inflammation.

If there is a discharge that is a grayish-white color coating your vaginal walls, it is probably bacterial vaginosis. The vaginal discharge may have a fishy smell. The doctor will use a pH test strip to measure the discharge acidity. Normally, the pH of vaginal discharge is below 4.6. In the case of bacterial vaginosis, the pH will be higher.

If there is an inflammation in your vagina and a white discharge in the opening of the vagina and in the vagina, you probably have candida vaginitis. A sample of the discharge may be taken for examination under a microscope in a laboratory.

To confirm whether or not you have Trichomoniasis, your doctor will examine your vaginal discharge using a microscope. Individuals with trichomonas infections have higher chances of getting other STIs, so you may be tested for HIV, gonorrhea, syphilis, and chlamydia, as well.


Is bacterial vaginosis transmitted sexually?

The word “vaginosis” means an abnormality of the vagina, so only women can develop bacterial vaginosis. It can, however, be spread if the partners are both female.


Is bacterial vaginosis common?

  • Bacterial vaginosis is the leading vaginal complaint in childbearing-age women
  • It is a common condition
  • According to studies, about 29 percent of women in the US have the condition
  • About 25 percent of women who are pregnant have bacterial vaginosis


Is bacterial vaginosis a yeast infection or an STD?

  • Bacterial vaginosis is neither a yeast infection nor an STD
  • It is not a dangerous condition, although its symptoms can be unpleasant
  • If your discharge is unusual, you should be evaluated to rule out severe infections like gonorrhea and chlamydia
  • The symptoms of bacterial vaginosis may resemble those of Trichomoniasis and vaginal yeast infections


Treatment for vaginitis

The type of vaginitis you have determines the treatment to be used. Some individuals prefer to treat their condition on their own, but it is important to see a doctor for lab tests and examination to identify the form of vaginitis that you have.


Bacterial Vaginosis

Antibiotics are effective in treating bacterial vaginosis.

Currently, there is no proof that probiotics, like those contained in certain yogurts, have the ability to prevent or treat bacterial vaginosis.



Metronidazole is the preferred and leading antibiotic treatment for bacterial vaginosis. It is found in the following three forms:

  • A gel which you apply in the vagina one time everyday for 5 days
  • Tablets which are taken two times a day for 5-7 days
  • One larger-dose tablet you take once only

Mostly, it is recommended to take Metronidazole tablets for 5-7 days, since they are believed to be the most effective. These can also be taken by pregnant women who have symptoms for bacterial vaginosis.

Metronidazole gel is normally recommended for breast-feeding women, since the tablets affect the breast milk.

Sometimes, the doctor may recommend another antibiotic instead of Metronidazole, like clindamycin cream, which is applied inside the vagina one time for 7 days.  If you react to Metronidazole, this cream may be recommended.

It is important to complete whichever course of antibiotics your doctor prescribes, even when you begin feeling better. This minimizes the chances of symptoms recurring or persisting.


Side effects

Metronidazole may result in vomiting, a bit of metallic taste in the mouth, or nausea. It is a good idea to take it after a meal. When you begin to vomit after taking the drug, call your doctor. An alternative treatment may be prescribed.

Alcohol should be avoided after using Metronidazole and for a minimum of 48 hours after completing the antibiotics’ course. Consumption of alcohol when using this medicine may result in side effects that are more severe.


Yeast infections

Normally, a topical cream or a medicine that is put in the vagina is used to treat yeast infections. You should visit a doctor to confirm what is causing your vaginal symptoms, although you can purchase treatments for yeast infections over-the-counter. Other forms of vaginitis cannot be treated by medicines used in the treatment of yeast infections.



Trichomoniasis and other STIs require immediate treatment. A single-dose antibiotic medicine is used to treat Trichomoniasis. To prevent the infection from recurring and spreading to others, the infected woman and her partner should be treated.


Vaginitis resulting from sensitivity or allergy

This can be treated by avoiding the product that is resulting in the symptoms. Your doctor may prescribe a medicated cream to ease symptoms as the reaction clears.


Further treatment

The initial course of treatment is not effective in treating bacterial vaginosis in certain women. If this happens, the doctor will first inquire if you took the medicine as instructed. A different option may then be prescribed.

If an IUD (intrauterine device) is the cause of the bacterial vaginosis, it may be taken out and another form of contraception recommended.



Since Trichomoniasis is a sexually transmitted infection, you can prevent it by:

  • Abstaining from sex
  • Having only one sexual partner who is not affected
  • Using male latex condoms every time you have sex

You can prevent vaginitis by:

  • Ensuring the area near your genitals is always clean and dry
  • Keeping off irritating soaps, douches, vaginal sprays, and bath additives
  • Frequently changing sanitary pads and tampons
  • Putting on cotton underwear that is loose; Do not wear nylon underwear
  • Immediately wear dry clothes after swimming

Final Thoughts

There are multiple types of vaginitis, so it is important to go to a doctor to be treated for the correct form. Treating vaginitis is usually a fairly simple and noninvasive process, so it is easy and important to treat vaginitis in any form.