What is the proper way to clean the vagina and treat vaginal infections?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: October 7, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Limpieza Vaginal Adecuada y Tratamiento de Infecciones Vaginales

La limpieza vaginal debe ser externa y suave, evitando duchas vaginales que alteran la flora normal, mientras que las infecciones vaginales requieren diagnóstico específico y tratamiento dirigido según el patógeno causante. 1

Higiene Vaginal Normal

  • La vagina es un órgano con capacidad de autolimpieza que mantiene un equilibrio natural de microorganismos, principalmente lactobacilos productores de H2O2 que mantienen un pH ácido (≤4.5) 1
  • Se debe limpiar solo la parte externa (vulva) con agua y jabón suave, sin introducir productos dentro de la vagina 1
  • Evitar duchas vaginales, ya que están asociadas con alteraciones de la flora vaginal normal y mayor riesgo de vaginosis bacteriana 1

Diagnóstico de Infecciones Vaginales

Las tres infecciones vaginales más comunes son:

  • Vaginosis bacteriana (VB): Reemplazo de lactobacilos normales por bacterias anaerobias, Gardnerella vaginalis y Mycoplasma hominis 1
  • Candidiasis vulvovaginal: Generalmente causada por Candida albicans 1
  • Tricomoniasis: Causada por Trichomonas vaginalis 1, 2

Evaluación diagnóstica:

  • Medición del pH vaginal (>4.5 sugiere VB o tricomoniasis) 1
  • Examen microscópico con solución salina para identificar tricomonas o células clave de VB 1
  • Examen con KOH al 10% para identificar levaduras o pseudohifas de Candida y realizar prueba de aminas ("whiff test") 1

Tratamiento de Infecciones Vaginales

1. Vaginosis Bacteriana

  • Síntomas: Flujo vaginal homogéneo, blanquecino, no inflamatorio, con olor a pescado 1
  • Diagnóstico: Requiere tres de los siguientes: flujo característico, células clave en microscopía, pH >4.5, olor a pescado con KOH 1
  • Tratamiento: Metronidazol en dosis única o régimen de 7 días 1, 2

2. Candidiasis Vulvovaginal

  • Síntomas: Prurito, irritación vulvar, flujo blanco, dolor vaginal, ardor vulvar, dispareunia 1
  • Diagnóstico: Síntomas + identificación de levaduras/pseudohifas en preparación con KOH o cultivo positivo 1
  • Tratamiento:
    • Agentes intravaginales: Clotrimazol, miconazol, terconazol, butoconazol o tioconazol 1, 3
    • Agente oral: Fluconazol 150 mg en dosis única 1

3. Tricomoniasis

  • Síntomas: Flujo vaginal amarillo-verdoso, mal olor, irritación, disuria 1, 2
  • Diagnóstico: Identificación de tricomonas móviles en examen en fresco o cultivo 1, 2
  • Tratamiento: Metronidazol en dosis única, tratando también a la pareja sexual 2

Consideraciones Especiales

  • Automedicación: Solo se recomienda en mujeres previamente diagnosticadas con candidiasis que experimentan los mismos síntomas; si los síntomas persisten después del tratamiento o recurren en 2 meses, se debe buscar atención médica 1

  • Infecciones recurrentes: Pueden requerir tratamientos prolongados o profilácticos 2, 4

  • Embarazo: El tratamiento debe ser supervisado por un profesional de la salud debido a posibles efectos sobre el feto 2

  • Alternativas terapéuticas emergentes:

    • Probióticos para restaurar la flora vaginal normal 5, 4
    • Peróxido de hidrógeno al 3% como lavado vaginal único para VB recurrente 6

Errores comunes a evitar

  • Usar duchas vaginales: Alteran el equilibrio natural de la flora vaginal y aumentan el riesgo de infecciones 1
  • Diagnóstico incorrecto: Las mujeres a menudo se autodiagnostican incorrectamente y pueden tratarse de manera inapropiada 7
  • No tratar a las parejas sexuales: En casos de tricomoniasis, es necesario tratar también a las parejas para evitar reinfecciones 2
  • Identificar Candida sin síntomas: Aproximadamente 10-20% de mujeres tienen Candida en la vagina sin síntomas y no requieren tratamiento 1

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Research

Vaginal infections: diagnosis and management.

American family physician, 1993

5
Research

New strategies for local treatment of vaginal infections.

Advanced drug delivery reviews, 2015

6
Research

Recurrent bacterial vaginosis--an old approach to a new problem.

International journal of STD & AIDS, 1996

7
Research

Vaginal infections update.

Journal of midwifery & women's health, 2012

Related Questions

What is the treatment for vaginal inflammation evident by the presence of pus cells in a vaginal swab result, indicating a mild to moderate inflammatory response?
What is the appropriate management for a 46‑year‑old woman with mild malodorous urine and vaginal discharge, negative for Candida, Trichomonas, Chlamydia, Gonorrhea, and sterile pyuria on urine dipstick?
What is the differential diagnosis and treatment for a 4-year-old female presenting with vaginal symptoms?
What is the best course of treatment for a reproductive-aged female patient with a history of bacterial vaginosis (BV), presenting with vaginal odor, subclinical hypothyroidism, slightly elevated fasting glucose, and low calcium levels, who is due for STI screening and Pap/HPV co-testing?
What treatment is recommended for a patient with bacterial vaginosis (BV) presenting with a malodorous smell, who has tried boric acid capsules and over-the-counter (OTC) Canesten (clotrimazole) with some relief?
What are the best management strategies for migraines in someone with a history of seizures?
What is the recommended dose of hydroxyzine (prn) for an adult with cardiac impairment experiencing anxiety?
What is the recommended protocol for switching from hydroxyzine (Atarax) 25 mg twice daily (bid) to buspar (buspirone)?
At what age should a risk-reducing mastectomy (RRM) be considered for individuals with BRCA (Breast Cancer Gene) mutations?
What is the management for a 6-month-old male baby with hypospadias who experiences swelling of the foreskin when passing urine?
What is the recommended dose of ibuprofen (Nonsteroidal Anti-Inflammatory Drug, NSAID)?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question