2026
Vaginitis or vaginosis?
Category (s):
Pregnancy
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Vaginal infections are common in adult women, and especially during pregnancy and after childbirth. The subject is often seen as taboo, yet it deserves to be discussed clearly, because this information can be useful at any age.
Itching or burning of the vulva, with or without unusual vaginal discharge, affects many pregnant women and new mothers. Out of modesty, many still hesitate to talk about it, since these symptoms involve the intimate parts of the body and a dimension linked to sexuality.
Two vaginal infections are very common in pregnant women and new mothers: vulvovaginal candidiasis, commonly called vaginitis, and bacterial vaginosis.
According to health guidelines, screening for these two infections is not done routinely during prenatal care, unlike screening for sexually transmitted infections. When a pregnant woman has obvious symptoms of vaginitis or vaginosis, a culture is not needed in order to treat her.
It is useful to learn to tell these two infections apart, in particular so as not to confuse them with normal physiological vaginal secretions, which are often heavier during pregnancy.
At the root of it, the hormonal changes of pregnancy cause the vaginal pH to shift. pH is the degree of acidity or alkalinity of an environment. Normally, vaginal pH is fairly acidic, which prevents micro-organisms from getting in and multiplying. This acidic environment is a natural physiological protection that keeps the vaginal ecosystem in balance.
During certain normal hormonal changes — the menstrual cycle, pregnancy, the postnatal period, infections and menopause — there is a significant drop in the "lactobacilli" flora of the genital tract.
Lactobacilli are natural probiotics, good bacteria that naturally live in the lining of the mouth, the digestive tract and the female genital tract. They act as the body's natural defences against contaminants from outside. When vaginal pH becomes unbalanced and turns more sugary than acidic, because of the presence of glycogen (a sugar), a woman becomes more prone to vaginal infections such as vaginitis or vaginosis, sometimes repeatedly.
We now know that the placenta, the amniotic fluid and meconium are not sterile inside the uterus. The baby comes into contact with some bacteria as early as intrauterine life: they come from the placenta, but also from the amniotic fluid the baby swallows during gestation. These bacteria then end up in the baby's intestine, in the meconium, and later in the stools.
To date, there is no evidence that the baby can be infected by vaginitis or vaginosis during pregnancy. We do know, however, that the healthier a woman's intestinal and urogenital microbiota, the more her baby benefits in turn. When vaginitis or vaginosis is present, as soon as the amniotic sac breaks the baby can come into direct contact with the yeast or the bacteria present in the mother's vagina. If needed, the baby will be treated should thrush develop later (with an antifungal) or a bacterial infection (with an antibiotic).
Vaginitis affects a great many women at one time or another in their lives. It is a vaginal infection caused by contamination with yeast or fungus. In 80 to 92% of cases, vaginitis is linked to the fungus Candida albicans, which is very present in our environment.
To identify a yeast infection, a sample can be taken from the vaginal wall with a cotton swab, in order to collect a sample of vaginal secretions for analysis.
In the postnatal period, it remains appropriate to watch for a possible yeast infection. The hormonal imbalance lasts for a few weeks after the birth. In addition, taking antibiotics during labour or after the birth also encourages vaginitis in the new mother.
About 20% of affected women have no symptoms. When symptoms are present, they may include:
It is difficult to eliminate a yeast infection completely during pregnancy, since hormones fluctuate throughout gestation. The goal remains to relieve the pregnant woman of her unpleasant symptoms as much as possible.
SOGC recommendations suggest treating vaginitis during pregnancy and postpartum only when symptoms are present, with an antifungal. A health care provider may recommend a cream applied externally along with intravaginal ovules for at least 7 days, as an over-the-counter treatment, entirely safe for the pregnant woman and for the breastfeeding new mother. A 3-dose antifungal treatment is also possible during pregnancy. Some women will be given a medical recommendation for maintenance treatment over a longer period, depending on their medical history.
About 80% of pregnant women who are treated see a marked improvement in their symptoms.
Vaginosis is a vaginal infection caused by bacterial contamination. It can have more consequences during pregnancy. It is the second leading cause of vaginal infections, after the fungus Candida albicans.
From 10 to 30% of pregnant women will be affected by vaginosis, compared with 10% of women in general. It too is diagnosed by taking a sample of vaginal secretions. Vaginal pH is more alkaline with vaginosis (above 4.5), but it is often the odour that points to the diagnosis, without any other steps being needed before treatment is considered. Only if required, a sample of vaginal secretions (a smear) can also be taken.
During pregnancy and after childbirth, bacterial vaginosis can be responsible for:
Bacterial vaginosis is therefore not trivial. It can have a major impact on the health of pregnant women, new mothers and their babies. It is important to recognize its symptoms and to report them to your doctor, so that you can be treated if needed and at the right time, and avoid possible repercussions on the outcome of the pregnancy or postnatal infections.
The vaginal flora is very sensitive; several factors can throw the micro-organisms out of balance and cause bacterial vaginosis, including:
Unlike vaginitis, vaginosis has no link with diabetes, genetics, certain autoimmune diseases or taking immunosuppressants.
About 50% of affected women have no symptoms. When they are present, symptoms may include:
At present, treatment of bacterial vaginosis is indicated only for women with symptoms, using appropriate antibiotic therapy. In addition, taking probiotics may be suggested to support the gut's natural defences, thanks to lactobacilli.
Any infection treated with antibiotics can disturb the fragile balance of the gut microbiota. Weakened, it no longer fully carries out its immune function. Antibiotics attack not only the bad bacteria but also the good ones, which reduces the body's natural ability to defend itself against other invaders. You treat an infection, but at the same time you make the body more vulnerable — hence the importance of preventive measures.
Along the same lines, taking extra probiotics starting in pregnancy could reduce, or even prevent, the occurrence of vaginitis and vaginosis throughout gestation and postnatally. Rather than waiting for the infection before reacting, you can act ahead of time, as prevention.
To do this, you can favour foods rich in probiotics, such as kefir, dairy products, fermented soy or sauerkraut. The goal is to encourage good protective bacteria to colonize the urogenital environment, to keep vaginal pH as normal as possible and to prevent unpleasant symptoms in the expectant or new mother.
In the end, taking probiotics can help prevent the common and recurrent vaginal infections that are vaginitis and vaginosis.
The prenato.ca website and the comprehensive information it contains are intended as practical tools for expectant and new parents, as well as for women throughout the various stages of their lives. This information is not intended to replace the skills, knowledge, or experience of qualified healthcare professionals who are familiar with the specific facts, circumstances, and symptoms of each individual. Consequently, Prenato and its staff cannot be held liable for any adverse effects or consequences resulting from the use of the information provided on this site. It is the user's responsibility to consult a physician or a qualified healthcare professional appropriate to their specific needs for any personal health concerns.
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