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Desquamative Inflammatory Vaginitis

Medically Reviewed.Last updated on 07/25/2026.

Desquamative inflammatory vaginitis (DIV) is a rare type of vaginitis that causes lots of vaginal discharge, pain with sex and pain with peeing. DIV isn’t caused by bacterial or fungal infections, like other types of vaginitis. It’s treatable with steroids and other medications.

What Is Desquamative Inflammatory Vaginitis?

Desquamative inflammatory vaginitis (DIV) is a rare type of vaginal inflammation. With DIV, the squamous cells that line your vagina become irritated and shed off. It leads to symptoms like increased discharge that’s yellowish green in color and pain with sex.

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Prescription medications can help treat this condition. But it may come back.

Symptoms and Causes

Symptoms of DIV

DIV symptoms may include:

  • A lot of yellowish-green vaginal discharge
  • Itchiness in your vulva or inside your vagina
  • Pain with sex
  • Pain when you pee
  • Redness in your vulval area
  • Bleeding after sex

These symptoms are your body’s way of telling you something is off. They have many possible causes, so it’s important to see a healthcare provider to get checked out.

DIV causes

DIV happens when cells that line and protect your vagina shed off. This may allow bacteria to overgrow, which messes up the pH balance of your vagina.

Researchers don’t know exactly why the cells slough off, but estrogen may be involved. That’s because DIV is most common in females who have low estrogen levels due to menopause and conditions like primary ovarian insufficiency.

Low estrogen can also lead to vaginal atrophy, when the lining of your vagina gets drier and thinner. So, you may have this condition, as well.

There’s not much you can do to prevent DIV. It’s not related to contagious bacteria or sexually transmitted infections (STIs).

Complications of DIV

Desquamative inflammatory vaginitis can cause very uncomfortable symptoms that disrupt your quality of life. It can also affect your relationship with your sexual partner(s).

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If you have symptoms of DIV, it’s important to talk to your healthcare provider. They want to help you, not judge you.

Diagnosis and Tests

How doctors diagnose this condition

DIV is rare, so it may take some time to get a diagnosis. Your healthcare provider will need to rule out common causes of vaginitis, like bacterial vaginosis (BV) and STIs.

Your provider will ask about your symptoms and medical history. They’ll do a pelvic exam to look for signs of vaginal inflammation and atrophy.

During the exam, your provider will take a sample of your vaginal discharge. They’ll test the pH level of the discharge and look at it under a microscope. Looking at cells under a microscope is necessary to confirm the diagnosis.

Management and Treatment

How is it treated?

Your healthcare provider will prescribe an antibiotic and/or steroid to treat desquamative inflammatory vaginitis. Antibiotics help with bacteria, and steroids help with inflammation.

You’ll insert the medication inside your vagina with an applicator (like a tampon) for several weeks. Use the medication as directed by your provider. It may be helpful to wear panty liners or sanitary pads to absorb vaginal discharge.

If you also have vaginal atrophy, your provider may recommend topical estrogen in addition to the DIV treatment.

Outlook / Prognosis

What can I expect if I have this condition?

Most people with DIV find some relief with treatment. But the condition tends to come back (recur). Your healthcare provider can discuss treatment options with you.

A note from Cleveland Clinic

It can be embarrassing to talk about vaginal symptoms with a healthcare provider. But excessive discharge and pain with sex are signs that something is wrong. You don’t have to live in discomfort. Your healthcare provider will guide you through the diagnosis process. They can figure out if DIV is the cause and prescribe medications to treat it.

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Medically Reviewed.Last updated on 07/25/2026.

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References

Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

Care at Cleveland Clinic

When you have vaginitis, getting relief from your discomfort is probably top of mind. Cleveland Clinic’s experts can craft a treatment plan that works for you.

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