There is a complex balance maintained at the vagina of the skin and normal flora (noninfectious bacteria normally found at the vagina). The pH maintained at the vagina inhibits infection but can be disrupted by many factors causing negative symptoms. The most common causes of vaginitis are Bacterial vaginosis (BV), Candida vulvovaginitis (yeast), Trichomonas, and STI such as Neisseria gonorrhea or Chlamydia trachomatis. Additional causes are not due to infection but may cause the same symptoms, including the following Atrophic vaginitis, retained foreign body i.e. retained tampon, dermatitis in reaction to hygienic products i.e. body wash, soap, detergent, feminine products, antibiotics, vaginal scars,. lesions / growths or fistulas, skin disorders of the vagina: lichen sclerosis, eczema, psoriasis, malignancy, vestibulodynia (pain on penetration of the vagina 3-6 months in the absence of infection), and desquamative inflammatory disorder: rare skin disorder of skin sloughing without infection in perimenopausal women.