Vaginitis is a common condition that can have different symptoms depending on the cause of the inflammation. Patients most often go to a gynaecologist with symptoms of bacterial vaginosis. The second most common genital tract infection is thrush, also known as candidiasis. Less common are trichomoniasis, which is caused by the vaginal parasite Trichomonas vaginalis, and atrophic vaginitis, which is associated with a decrease in oestrogen levels and mainly occurs in women after the menopause. In any case, it is important to consult a doctor who can recommend appropriate treatment, including antibiotics, antifungal vaginal or oral medications, as well as changes in daily hygiene and diet to restore health and comfort.

Bacterial vaginosis, also known as bacterial vaginosis, is the most common type of intimate infection in women of childbearing age (30–40%). It is a vaginal infection caused by an overgrowth of anaerobic bacteria that normally colonise the vaginal vestibule along with lactobacilli. An imbalance of the bacterial flora can lead to symptoms such as unpleasant odour, grey-white vaginal discharge and discomfort. Risk factors include poor personal hygiene, frequent changes of sexual partners and the use of antibiotics, which can disrupt the natural vaginal flora. Treatment usually consists of antibiotic therapy, and probiotics are also recommended to prevent recurrence. It is important to consult a doctor if symptoms occur, as untreated bacterial vaginosis can lead to more serious health complications.

How is vaginitis treated?

The treatment of this condition depends on the cause, so it is important to carry out appropriate tests, such as a vaginal swab, before starting treatment. Depending on the results, the doctor may recommend an antibiotic for vaginitis or an antifungal medication, which can be administered orally or vaginally. In some cases, it may also be necessary to treat the sexual partner to prevent the infection from recurring. It is important not to ignore the symptoms and to consult a doctor who, based on a gynaecological examination, the characteristics of the vaginal discharge and possibly a microscopic examination, will make the correct diagnosis and recommend appropriate treatment and, if necessary, issue an e-prescription. It is also important to maintain good intimate hygiene and avoid factors that can disrupt the natural bacterial flora of the vagina.

Which doctor should I see for bacterial vaginosis?

General practitioners and family doctors, despite their extensive medical knowledge, often do not have access to specialised diagnostic equipment in their practices. This means that if more detailed tests are needed, such as for diagnosing vaginosis, they can refer patients to specialists who have the appropriate equipment. If bacterial vaginosis is suspected, it is advisable to consult a gynaecologist. 

A gynaecologist is a specialist with the relevant knowledge and experience in the diagnosis and treatment of infections and inflammation of the reproductive system. During the appointment, the doctor will perform a physical examination and may also order a vaginal swab to determine the type of pathogens causing the infection and to select an effective treatment based on this. It is important not to delay a visit to a specialist, as an untreated infection can lead to more serious health complications.

Prescription medication for vaginitis

Medication for bacterial vaginitis mainly includes prescription drugs (metronidazole, clindamycin). Medication for fungal vaginitis includes isoconazole or antifungal antibiotics such as natamycin.

Vaginitis ointment

Treatment of bacterial infections:

Hexatiab activ gel is an example of a product containing ingredients such as silicone resin and Fomblin®, which form a protective barrier, as well as hyaluronic acid and tocopherol to support tissue regeneration.

GINEintima VagiActive contains chlorhexidine, which is known for its antibacterial properties.

Infecvagin is a specialised intimate hygiene gel that contains polyaminopropyl biguanide, an antiseptic ingredient.

Multi-Gyn ActiGel contains the patented 2QR complex derived from aloe vera. It forms a protective layer on the surface of the vaginal epithelium, which limits the adhesion of pathogenic bacteria.

Iladiamed is a medicine for vaginitis containing octenidine and phenoxyethanol, and has a disinfecting and anaesthetic effect. It has a bactericidal, fungicidal and virucidal effect.

Prescription drugs

Dalacin cream - the active ingredient clindamycin binds to the 50S subunit of the bacterial ribosome, which leads to the inhibition of the synthesis of proteins essential for bacterial life.

Treatment of fungal infections:

Albivag Gel, which contains boric acid, is often used to treat fungal infections because it inhibits the growth of yeasts. It also helps restore the vaginal pH to normal levels.

Clotidal, Canesten or Clotrimazol GSK are ointments for vaginal inflammation containing clotrimazole, which has an antifungal effect on yeasts and dermatophytes.

Gynoxin® OPTIMA vaginal cream contains fenticonazole nitrate, which is effective against genital candidiasis.

Trivagin is a combination product that combines antibacterial, antifungal and probiotic effects.

Prescription drugs

Pimafucin - the active ingredient is natamycin. It works by binding to ergosterol, a component of the fungal cell membrane, which leads to its damage and consequently to cell death.

Pimafucort - the active ingredients of the drug are neomycin sulphate, hydrocortisone and natamycin. Thanks to this combination, the preparation is used in the treatment of complex infections where antibacterial, antifungal and anti-inflammatory effects are required.

Izovag - the active ingredient is isoconazole nitrate, which works by inhibiting the biosynthesis of ergosterol, a key component of the fungal cell membrane.

Gynazol - the active ingredient is butoconazole, which inhibits the conversion of lanosterol to ergosterol, which is an essential building block of the fungal cell membrane.

It is important to remember that the choice of the right product should be consulted with a doctor or pharmacist to ensure effective and safe treatment. You should also pay attention to potential interactions with other medications used and follow the recommendations regarding dosage and duration of therapy. 

What antibiotic for vaginitis?

In the case of bacterial vaginosis, treatment usually involves the use of chemotherapeutics (metronidazole) and antibiotics (clindamycin).

Metronidazole is administered orally or vaginally. It acts on the DNA of the microorganisms, causing the chain to break and the bacteria to die.

Clindamycin is available as oral tablets, globules and a vaginal cream. It works by inhibiting the synthesis of proteins essential for bacterial life. It is the main antibiotic used for bacterial vaginosis.

It is important to strictly follow the doctor's instructions and not to stop the treatment on your own, even if the symptoms disappear after a few days. Stopping the medication too quickly can lead to a relapse of the disease.

After the end of the antibiotic therapy, it is crucial to restore the normal bacterial microflora of the vagina. A carefully selected treatment with probiotics, applied vaginally or orally, supports the restoration of the natural protective barrier and the maintenance of an acidic pH, which is important for the prevention of future infections. 

Over-the-counter medication for bacterial vaginosis

There are over-the-counter medications for bacterial vaginosis that can help relieve symptoms. These products work in different ways to restore the natural bacterial flora and maintain the vaginal pH, which is crucial for preventing infections.

Albothyl vaginal suppositories contain polycresulen, which is known for its antibacterial properties. It effectively fights both gram-positive and gram-negative bacteria, as well as anaerobic bacteria. Its unique ability to coagulate selectively allows it to target dead and pathologically altered cells.

Tantum Rosa is a medicine intended for irrigation. The benzidamine it contains has a local anaesthetic, antiseptic and anti-oedema effect.

Lakcid Intima and Lactovaginal are vaginal probiotics that help restore and maintain the normal vaginal microflora, thus preventing the proliferation of pathogens.

Vagical globules are a homeopathic medicine based on calendula, which has antifungal and antibacterial properties, as well as anti-inflammatory properties that support the healing process.

All these products are intended to improve and support the fight against intimate infections. Although these are over-the-counter preparations, it is recommended that their use be consulted with a doctor, especially in the case of pregnancy, breastfeeding or the presence of allergies.