Understanding Vaginitis

This post brings together the vaginitis series I shared on Instagram - here it is together in one place.

Get a swab first

You cannot treat what you have not diagnosed. Doctors cannot see an infection with their eyes, and neither can you, only a microscope can identify an infection. Sometimes inflammation looks exactly like infection and a swab is the only way to know for certain.

Bacterial infection, yeast, trichomoniasis, they can all cause itching, burning, and discharge. Each has typical signs, but none are 100% reliable. The only thing that is reliable is a lab test.

OTC and medical treatments are not neutral. Antibiotics kill the bad bacteria, but also the good ones, which is why the most common result of treating without knowing is a secondary yeast infection on top of the original problem.

Some infections must be treated medically, trichomoniasis, chlamydia, and other STIs cannot clear without it. The swab tells you when that is the case, the immediate therapeutic treatment, and protects you from unnecessary treatment when it is not.

Before you treat, know what you are treating, because treating the wrong thing can take months to fix.

What is vaginitis, and how does Chinese medicine see it?

Vaginitis is an inflammation or infection of the vagina that can cause itching, burning, discomfort and abnormal discharge. It is one of the most common gynaecological conditions, most women will experience it at least once in their lifetime.

Vaginitis is one of the most common gynaecological conditions, and one of the most undertreated, because many women either ignore the signs or treat without a proper diagnosis. According to the 2023 ISSVD guidelines, treating based on symptoms alone should be avoided where possible. A vaginal swab helps ensure the right treatment.

Red flags: profuse discharge, discharge with or without odour, pain, itch, dryness, burning sensation. The vulva may look normal, or inflamed (vulvitis): red, swollen, or with sores.

Normal vs abnormal: a clear or white discharge is normal and changes throughout your cycle. If you need to clean yourself or change during the day, that might be too much and worth paying attention to. A small stain on your underwear by the end of the day is normal. Your vagina needs discharge just as your mouth needs saliva. Any discharge causing discomfort is not normal.

Common causes: bacterial overgrowth, yeast infection (candidiasis), vaginal atrophy (genitourinary syndrome of menopause), sexually transmitted infections (trichomoniasis, chlamydia, gonorrhoea, herpes, HPV), or irritation from soaps, pads, creams and washing powders.

Skin conditions like dermatitis usually belong to vulvitis, not vaginitis.

Chinese medicine treats vaginitis systemically, not by targeting a pathogen, but by changing the conditions that made it possible. In many cases, such as sexually transmitted infections, western medicine is usually the most direct approach. Chinese medicine works alongside it, supporting the body so the conditions that allowed the infection don't return.

Your body is communicating and it is worth listening.

And use a condom, it's the best way to avoid STIs.

If you would like to check whether this applies to you, you are welcome to book a free 20 minutes introductory call here.

The oral and vaginal connection

Growing research shows that your oral microbiome and your vaginal microbiome possibly share bacterial species and directly influence each other. Science proves again what Chinese medicine has known for thousands of years, our body works systematically. I never treat a specific disease or a specific organ, it's always the pattern and the associated syndromes.

Many of the women I see with vulvar and vaginal conditions also have inflamed gums. Probably not a coincidence.

What you can do: floss after meals. It's simple and it makes a real difference. One option is oil pulling or applying organic cold pressed coconut oil along the gum line, research suggests it has antibacterial properties that target harmful bacteria while protecting the good ones.

A healthy mouth supports a healthy vaginal microbiome. It is all connected.

Food as medicine

Fermented vegetables and fruits, made with just salt and water, no vinegar, are full of live bacteria that can support your gut and through that, your whole body, including your vaginal microbiome.

Basic recipe: fill your jar with vegetables, spices, and/or fruits you like. Add lukewarm water with 1 tablespoon of good quality salt (not table salt) per litre of water. Add leafy greens like celery and dill before closing. Use the cabbage root as a weight and a cabbage leaf to help create vacuum.

A little goes a long way, a small amount with your meal is enough.

In Chinese medicine, fermentation adds two new flavours: sour and salty.

The sour flavour contracts and absorbs fluids. In small doses it can release the flow of what is stuck, including digestive and vaginal fluids. If you crave sour foods, your body may be searching for stress relief: mental stress or muscle tension.

The salty flavour purges and softens. It has a drying effect and can dissolve what Chinese medicine calls masses and phlegm in the body.

Too much can do the opposite, that's why different cultures serve pickles alongside a meal, not as a portion of it, to lightly help the digestive process.

What you add matters: spicy herbs like garlic, ginger, black pepper and chilli stimulate the circulation of qi and blood. Dill is sweet, nourishing and relaxing. Bitter herbs like turmeric, lemon peel and celery are cleansing and clearing, useful in inflamed conditions.

Enjoy your pickles, and remember to hold yourself back from eating the whole jar at once 😉

Less is more

Sterilisation is good for open wounds and surgeries - not for your vulva and vagina.

Over-washing, especially with soap, strips away the natural protective oil and good bacteria your skin needs.

Wash your vulva with water only, and make sure you reach all the hidden areas.

Your vagina cleans itself, no washing needed at all.

Water is enough.

Diet basics: Damp and Heat

In Chinese medicine I don't treat a western disease. I ask many questions that might sound unrelated, until I find the pattern behind the condition. For vaginitis, two Chinese syndromes almost always show up: Damp and Heat.

The first thing we need to do is reduce foods that may create damp and heat, as they can feed an environment where bad germs thrive more easily. Cheese and bread may create Dampness and Heat in the body. Same goes for dairy, sugar, cold and raw foods, and processed carbs. Dairy and wheat are also known in western nutrition as foods that may increase inflammation, so you can look at it from both angles.

In general, foods that may increase the formation of damp in the body are fatty, cold, raw and sweet foods: ice cream, yogurt cheese and milk, too many raw fruits and vegetables, simple processed carbs like breads and pastries, processed and junk food.

What helps instead: cooked and steamed vegetables, warm meals, and whole grains like buckwheat, rice, quinoa, oats and lentils.

In acute inflammation, being stricter until symptoms stop can help. For maintenance, I tell my patients what I've been telling my son since he was a toddler: most of our food should serve our body, and some is for the heart ♥️. Our body can handle a small percentage of the less healthy food. But when you're trying to get rid of a chronic condition, being stricter for a short time can make a real difference.

Questions or experiences to share? Write in the comments or reach out privately. 

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This information is for educational purposes only and is not a substitute for individual medical advice. If you are experiencing persistent symptoms, please consult a qualified healthcare professional before trying any new approach.