Identifying the cause of vaginitis can be a challenge.1

Vulvovaginitis is a spectrum of conditions that are responsible for vaginal and vulvar symptoms. Identifying the cause of these symptoms is critical because each condition requires a specific treatment.1

The most common causes of vaginitis include bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis.1 They can occur separately or combined.2

Bacterial vaginosis is the most common cause of vulvovaginitis.1

The normal vaginal microbiota is dominated by bacteria from the Lactobacillus species. Lactobacilli have a beneficial role: they help protect women from infection and maintain a healthy microbiota by producing lactic acid and by competing with other bacteria.1

Bacterial vaginosis is an imbalance in the normal proportion of bacteria, which occurs when there is an overgrowth in anaerobic bacteria such as Gardnerella vaginalis. Anaerobic bacteria are germs that can survive and grow where there is no oxygen. They are part of the normal flora, but their number is usually kept under control thanks to the beneficial role of the Lactobacillus species.1

Bacterial vaginosis is the most common cause of vaginal symptoms in women of reproductive age (22–50% of all vulvovaginitis cases).1 It affects 21 million women in the US, which represents almost 1 in 3 women aged 14–49.4



21 million

women are affected by BV4


1 in 3

women aged 14-49 have BV4

Vulvovaginal candidiasis (VVC), the second most frequent cause of vulvovaginitis.1

Vulvovaginal candidiasis is a fungal infection caused by a yeast of the Candida species.1 It is often called a yeast infection and is not considered a sexually transmitted infection (STI). There are different species of Candida that can cause VVC, some of which are known to be less sensitive or resistant to traditional therapeutics.5 Therefore, it is important to know which strain causes the infection to be able to adapt the treatment and prevent the infection from reoccurring.5

Vulvovaginal candidiasis affects 6.8 million women in the US at any given time, which makes it the second most common cause of vulvovaginitis after bacterial vaginosis (17–39% of vulvovaginitis cases).1,3 Most women will have it at least once in their life.1



3 in 4

women have at least 1 episode during their lifetime1


2 in 5

women have ≥ 2 episodes in their life1

Candida species
differentiation matters

Learn more

Trichomoniasis, the most common non-viral STI in the US.6

Trichomoniasis is a sexually transmitted infection (STI) caused by the parasite Trichomonas vaginalis (TV).
It is by far the most common non-viral STI in the US, accounting for more new infections each year than chlamydia, gonorrhea and syphilis combined.6,7



women aged 14–59 have TV infection1


6.9 million

people affected in the US6

In many cases women are infected with more than one pathogen.2

28% of women with vulvovaginitis have multiple causes to their symptoms, which makes accurate diagnosis and treatment challenging.2 Most often, it is a combination of bacterial vaginosis and vulvovaginal candidiasis, but it can also be BV, VVC and TV at the same time.2


Rates of single and multiple-infections in women
with an identified cause of vulvovaginitis*2

1 out of 4
women with
vulvovaginitis have
multiple infections.2


Adding to the complexity of the condition, the symptoms of vulvovaginitis are unspecific and overlapping, which makes accurate diagnosis and treatment difficult, but critical.1,8-11

Symptoms BV VVC TV
Abnormal vaginal discharge X X X
Odor X   X
Burning sensation during urination X X X
Irritation in the genital area X X X
Redness   X X
Painful intercourse   X X
Painful urination   X X


How is vaginitis diagnosed?

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*Single- and multiple-infection rates in symptomatic women with an identified cause of vulvovaginitis determined by BD MAX™ Vaginal Panel on clinician-collected samples (n=1,121).2

BV, bacterial vaginosis; STI, sexually transmitted infection; TV, Trichomonas vaginalis; US, United States; VVC, vulvovaginal candidiasis.

1. Brown H and Drexler M. Popul Health Manag. 2020;23(S1):S3–12.
2. Gaydos CA et al. Obstet Gynecol. 2017;130(1):181–9.
3. Benedict K et al. BMC Women’s Health. 2022;22(1):147–55.
4. Koumans EH et al. Sex Transm Dis. 2007;34(11):864–9.
5. Thompson A et al. Eur J Clin Microbiol Infect Dis. 2020;39(1):39–44.
6. Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States, CDC. Last updated January 25, 2021. Accessed February 18, 2022.
7. Coleman JS et al. Obstet Gynecol Surv. 2013;68(1):43–50.
8. Paladine HL and Desai UA. Am Fam Physician. 2018;97(5):321-329.
9. Bacterial Vaginosis - fact sheet, CDC. Accessed July 11, 2022.
10. Vulvovaginal Candidiasis, CDC. Accessed July 11, 2022.
11. Trichomoniasis CDC Fact Sheet, CDC. Accessed July 11, 2022.