Desquamative inflammatory vaginitis (DIV) is a rare condition that affects the vaginal walls and causes irritation, inflammation, and increased vaginal discharge. This condition is not well known and is often misdiagnosed as other types of vaginal infections, which makes it challenging to treat. In this article, our experts at New Age Women’s Health will discuss the causes, symptoms, diagnosis, and treatment options for DIV.

What Exactly Is Desquamative Inflammatory Vaginitis (DIV)?

Desquamative inflammatory vaginitis (DIV) is a condition that affects the vaginal walls and can cause vaginal itching, discharge, and pain. The word “desquamative” points to the shedding of the vaginal lining, while “inflammatory” describes the inflammation that occurs in the vagina. 

Who Can Get DIV?

DIV can affect any woman, but it is more commonly seen in women who are of reproductive age. Women who are postmenopausal may also develop DIV due to the thinning of the vaginal lining that occurs during this time.

How Common Is This Condition?

Doctor Explaining Diagnosis to Her Female Patient

DIV is a relatively rare condition, and the exact prevalence is unknown. However, it is believed that DIV is underdiagnosed due to its similarity to other vaginal infections.

Does Desquamative Inflammatory Vaginitis Hurt?

Women who have DIV may experience pain, itching, and burning sensations in the vaginal area. Pain may also occur during intercourse and urination.

Common Desquamative Inflammatory Vaginitis Symptoms

The DIV symptoms can vary from woman to woman, but the most common ones include:

  • Increased vaginal discharge, which may be thick and yellowish in color
  • Vaginal itching and intense burning
  • Pain during intercourse
  • Painful urination
  • Vaginal bleeding

These symptoms may be more severe during menstruation.

Main Causes of Desquamative Inflammatory Vaginitis

The precise cause of DIV is unknown, but it is believed to be related to vaginal atrophy and an imbalance in the vaginal flora. The vaginal flora is made up of bacteria, yeast, and other microorganisms that keep the vagina healthy. When the balance of these microorganisms is disrupted, it can lead to inflammation and other symptoms.

Other factors that may contribute to the development of DIV include:

  • Hormonal changes: Hormonal changes in the body can disrupt the normal balance of bacteria in the vaginal flora. This imbalance can lead to an overgrowth of harmful bacteria and increased inflammation, triggering DIV. Hormonal changes can occur due to menopause, pregnancy, oral contraceptives, or hormonal therapies. In this case, vaginal atrophy can also be linked to the cause of DIV.
  • Immune system disorders: Women with immune system disorders such as HIV, lupus, or Sjogren’s syndrome are at an increased risk of developing DIV. These disorders weaken the immune system, making it harder for the body to fight infections and inflammation.
  • Antibiotic use: Antibiotics can disturb the natural balance of bacteria in the vagina, leading to an overgrowth of harmful bacteria. Women who have taken antibiotics frequently or for prolonged periods of time are at a higher risk of developing DIV.
  • Sexual activity: Sexual activity can introduce harmful bacteria into the vagina, causing inflammation. Women who have multiple sexual partners or engage in unprotected sex are at a higher risk of getting DIV.
  • Personal hygiene: Poor personal hygiene, such as not washing hands before inserting tampons or wearing tight-fitting clothing, can increase the risk of developing DIV. These habits can introduce harmful bacteria into the vaginal area and lead to inflammation.
  • Chemical irritants: Exposure to chemical irritants, such as perfumes, vaginal douches, or soaps, can also affect the natural balance of vaginal bacteria, leading to inflammation and an increased risk of developing DIV.

How Is DIV Diagnosed?

A healthcare provider may diagnose DIV based on a woman’s symptoms and a physical exam. A swab of the vaginal discharge may also be taken and examined under a microscope to determine if there is an overgrowth of bacteria or yeast. 

Under the microscope, a large amount of white blood cells are seen, as well as an elevated pH and absence of healthy bacteria, also known as lactobacilli.

In some cases, a biopsy of the vaginal tissue may be necessary to rule out other conditions that can cause similar symptoms.

The Treatment Options for DIV

Treatment for DIV typically involves a combination of medications and lifestyle changes. These may include:

  • Antibiotics: Antibiotics may be prescribed to treat any bacterial infections that may be contributing to the symptoms of DIV.
  • Steroid creams: Steroid creams may be applied to the vaginal area to reduce inflammation and relieve vaginal itching and burning.
  • Vaginal moisturizers: Vaginal moisturizers can help relieve dryness and irritation in the vaginal area.
  • Avoiding irritants: Women with DIV should avoid using scented products in the vaginal area and should avoid douching.

In some cases, hormone therapy may also be prescribed to help regulate hormonal imbalances that may be contributing to the development of DIV.

Is It Possible to Prevent DIV?

Preventing DIV involves maintaining a healthy vaginal environment. Some steps you can take to promote vaginal health include:

  • Avoiding scented products: Avoid using scented products in the vaginal area, such as soaps, powders, and sprays. These products can affect the vaginal flora negatively and trigger irritation and inflammation. Vaginal douches should also be avoided at all times. 
  • Practicing good hygiene: Wash the external genital area with mild soap and warm water daily, and rinse well. Soaps should not be used inside the vagina! After using the toilet, always wipe from front to back to avoid introducing bacteria from the rectal area into the vagina.
  • Using protection during sexual activity: Using condoms during sexual activity can help prevent contracting sexually transmitted infections (STIs) that can disrupt the vaginal flora and lead to inflammation.
  • Avoiding douching: Douching can cause vaginal flora imbalance and lead to inflammation and other vaginal problems.

What Is the Outlook for Desquamative Inflammatory Vaginitis?

The outlook for DIV is generally good with proper treatment. Most women respond well to antibiotics and steroid creams; symptoms typically improve within a few weeks of starting treatment.

In the case of chronic vaginitis, DIV can recur even after successful treatment. The likelihood of recurrence depends on several factors, including the condition’s underlying cause, the severity of the symptoms, and the effectiveness of the treatment. Women with underlying immune system disorders or hormonal imbalances may be more likely to experience recurrent episodes of DIV. It is also possible for the condition to recur if the underlying cause is not correctly identified and treated. Regular check-ups with a healthcare provider can help identify any early signs of recurrence, allowing for prompt treatment to minimize symptoms and prevent DIV from turning into chronic vaginitis.

When Should I See a Doctor?

Doctor Talking to Patient

If you experience symptoms of DIV, such as increased vaginal discharge, vaginal itching, and pain, you must see your healthcare provider for an accurate diagnosis and appropriate treatment. 

Pay Us a Visit

DIV is a relatively rare condition that affects the vaginal walls and causes inflammation, irritation, and discharge. It is often misdiagnosed as other types of vaginal infections, which makes it challenging to treat. Treatment typically involves a combination of medications and lifestyle changes, and the outlook is generally good with proper treatment. If you experience symptoms of DIV, make it a point to see your healthcare provider for an accurate diagnosis and appropriate treatment. You’re welcome to schedule an appointment with us at New Age Women’s Health, where you can count on top-notch care and compassion.