Skip to main content

Understanding and treating desquamative inflammatory vaginitis (DIV)

When persistent vaginal discharge and irritation don't respond to standard treatments, specialist care can provide the right diagnosis and relief
Vulvovaginal Health icon

Desquamative inflammatory vaginitis (DIV) is an inflammatory condition of the vagina characterised by profuse vaginal discharge, irritation, and pain that is often mistaken for a persistent infection.

If you’ve been experiencing ongoing vaginal discharge, burning, and discomfort despite multiple courses of antibiotics or antifungal treatments, you may have DIV. This condition requires specialist diagnosis and treatment to provide lasting relief.

At The Women’s Health Vulvo-Vaginal & Genitourinary Clinic, we specialise in diagnosing and treating DIV. Our team can help you find the right treatment when standard approaches haven’t worked.

DIV is often misdiagnosed, but with proper treatment, symptoms can be effectively managed. Let us help you find answers.

Do you have desquamative inflammatory vaginitis?

You may have DIV if you experience:

  • Profuse, purulent (yellow or green) vaginal discharge
  • Vaginal burning, irritation, or soreness
  • Painful intercourse due to vaginal inflammation
  • Vaginal redness and inflammation
  • Spotting or bleeding after intercourse
  • Symptoms that don’t respond to antibiotics or antifungal treatments
  • Tests showing inflammation but no clear infection
  • Symptoms that worsen after menopause

If this sounds familiar, it’s time for a specialist assessment.

Contact usBook a consultation

Common causes and risk factors

1. Inflammatory Response

DIV is characterised by an inflammatory response in the vagina, with an increased number of inflammatory cells (particularly white blood cells) in the vaginal discharge.

2. Hormonal Factors

DIV is more common in post-menopausal women, suggesting that low oestrogen levels may play a role in its development.

3. Altered Vaginal Flora

The normal balance of bacteria in the vagina is disrupted, but unlike bacterial vaginosis, DIV involves significant inflammation.

4. Immune System Factors

Some researchers believe DIV may have an autoimmune component, though this is not fully understood.

5. Chronic Irritation

Previous infections, treatments, or irritants may trigger the inflammatory response that characterises DIV.

How we diagnose and treat DIV

Comprehensive history

We’ll discuss:

  • When symptoms started and how they’ve progressed
  • The nature and amount of vaginal discharge
  • Previous diagnoses and treatments
  • Impact on sexual function and daily comfort
  • Menopausal status and hormonal factors
  • Use of irritants or products that may worsen symptoms
Thorough examination

A careful examination will reveal:

  • Vaginal redness and inflammation
  • Purulent vaginal discharge
  • Areas of erosion or irritation
  • Extent of vaginal involvement
Microscopic examination

The key to diagnosing DIV is microscopic examination of the vaginal discharge, which shows:

  • Increased inflammatory cells (white blood cells)
  • Absence of typical infection (no yeast, no bacterial vaginosis)
  • Vaginal epithelial cells showing inflammatory changes
  • Vaginal pH is typically elevated (above 4.5) in DIV
Treatment approach

Treatment for desquamative inflammatory vaginitis may include:

  • Topical corticosteroids
  • Topical oestrogen
  • Clindamycin cream
  • Symptom management
  • Ongoing monitoring

Frequently asked questions

Q: Is DIV an infection?

A: No, DIV is not an infection, though it’s often mistaken for one. It’s an inflammatory condition that causes symptoms similar to infection but doesn’t respond to standard antibiotic or antifungal treatments.

Q: How is DIV different from bacterial vaginosis or yeast infections?

A: DIV is characterised by significant inflammation and purulent discharge, whilst bacterial vaginosis typically has a fishy odour and thin discharge, and yeast infections cause thick, white discharge with itching. Microscopic examination can distinguish between them.

Q: Is DIV contagious or sexually transmitted?

A: No, DIV is not contagious and cannot be transmitted through sexual contact. It is an inflammatory condition.

Q: How long does treatment take?

A: Most women notice improvement within a few weeks of starting treatment, but ongoing maintenance therapy may be needed to prevent recurrence.

Q: Can DIV come back after treatment?

A: DIV can recur, particularly if underlying factors (such as low oestrogen) are not addressed. Ongoing maintenance treatment may be needed for some women.

View all FAQ

Take the first step towards the right diagnosis

If you've been struggling with persistent vaginal discharge and irritation that hasn't responded to standard treatments, it's time for a specialist assessment. DIV is treatable with the right approach.
Contact usBook a consultation