Why Comprehensive Vaginal Health Testing Is Essential, with Kameelah Phillips, M.D.

Kameelah Phillips, M.D.

Credit: Tebra

When it comes to vaginal health, many women assume that vaginitis and sexually transmitted infections (STIs) are entirely separate issues. But as Kameelah Phillips, M.D., a board-certified obstetrician-gynecologist (OB-GYN), explains, the reality is more complex. With overlapping symptoms and the potential for coinfections, failing to test for both can lead to missed diagnoses and delayed treatment. In this conversation, Phillips sheds light on the misconceptions surrounding vaginitis, the benefits of comprehensive testing and why normalizing these discussions is essential for women’s health.

Many patients assume that vaginitis and STIs are completely separate issues. Can you clarify how they overlap and why this misconception persists?

Kameelah Phillips, M.D.: Absolutely. I can think of a few reasons for this misconception. First, people are understandably concerned about STIs. Public health campaigns, college health programs and media messaging all tend to focus heavily on STIs, while vaginitis doesn’t get the same attention. That’s why I think conversations like this are so important — we need to raise awareness.

Vaginitis is also an uncomfortable topic for many. When women experience vaginal discomfort or inflammation, their first thought often goes to STIs because that’s what they’ve been taught to worry about. They may not know much about vaginitis because we don’t discuss it enough, and that lack of awareness can make it feel embarrassing to bring up.

But vaginitis affects over 21 million women in the U.S. annually and is one of the leading reasons for OB-GYN visits. Because its symptoms overlap with those of STIs, many women assume it must be an STI rather than considering other potential causes. This is why testing for both is critical. For example, bacterial vaginosis (BV) is one of the most common causes of vaginitis, but it’s often overlooked because STIs take priority in the diagnostic process.

Why should STI co-testing be a routine part of vaginitis evaluation, and how does that approach benefit both patients and providers?

KP: When a patient comes in with vaginitis symptoms, I always explain what vaginitis is and what the possible causes might be. But beyond that, I also conduct a nucleic acid amplification test (NAAT) — a highly accurate swab test that helps me diagnose infections.

This test is important because research shows that one in five women who present with vaginitis symptoms also have an STI. For sexually active individuals, especially those of reproductive age, regular STI testing is crucial. Missing or delaying an STI diagnosis can have serious consequences, including infertility, pelvic inflammatory disease and chronic pain.

Vaginitis and STIs often occur together, and having vaginitis can actually make a person more susceptible to STIs. That’s why a comprehensive approach — testing for both conditions at the same time — ensures patients receive accurate diagnoses and appropriate treatment without unnecessary delays.

Despite its accuracy, NAAT is still underutilized in some settings. What are the barriers preventing its wider adoption, and how can we address them?

KP: There are several barriers to broader NAAT adoption. First, health care access remains a major challenge. Many Americans live in health care deserts, where testing options are limited due to economic or geographical constraints.

Second, physician and health care provider education needs improvement. Many providers aren’t fully aware of NAAT’s benefits or don’t integrate it into routine care. Educating providers on its accuracy, sensitivity and ability to detect multiple infections at once is key to increasing its use.

Lastly, there are logistical and financial barriers. Some clinics and health care settings may lack the resources to implement NAAT, or insurance coverage may be inconsistent. But the more we talk about the advantages — such as its ability to provide quick, accurate diagnoses with just one swab — the more likely providers and policy makers will prioritize its adoption.

From a patient’s perspective, what are the benefits of a more comprehensive, one-step testing approach?

KP: The biggest advantage is convenience. A single swab can test for multiple infections, which is a game-changer, especially for patients with limited access to health care or busy schedules. They don’t have to keep coming back for multiple tests or second-guess their diagnosis.

Another key benefit is that infections often occur together. For example, I frequently see vaginitis paired with yeast infections. If I only treat one and not the other, the patient remains uncomfortable.

I recently had a patient who came in thinking she had bacterial vaginosis, and we ran the NAAT test. It turned out she also had chlamydia. Because we caught it early, we were able to treat her promptly and protect her reproductive health. That’s the kind of impact this type of comprehensive testing can have.

What advice do you have for women who feel uncomfortable discussing their symptoms or asking for STI tests during routine visits?

KP: I try to normalize STI testing as part of routine gynecologic care. If you’re sexually active, testing is simply a responsible and proactive step in managing your health — just like checking your blood pressure or cholesterol.

When I see patients, I casually ask, “Are you sexually active? Any new or same partners? How do you feel about testing today?” Making it a natural part of the conversation removes stigma and helps patients feel more comfortable.

I also remind patients: trust, but verify. Even in monogamous relationships, STI testing is important because undiagnosed infections can have serious long-term consequences. My goal is to prevent complications like pelvic inflammatory disease and infertility, and regular testing is a key part of that.

Before we wrap up, is there anything else you’d like our audience to know?

KP: Yes! I want to address a common point of confusion: BV and whether it’s an STI. Some recent studies suggest BV might be considered an STI, but current medical guidelines do not classify it as one. However, BV can increase your risk of getting an STI, which is something many people don’t realize.

This is why it’s so important to seek proper treatment instead of just using over-the-counter products to mask symptoms. I’ve seen too many patients self-treat BV without a proper diagnosis, only to miss other infections that require medical treatment. Regular, comprehensive testing and a strong relationship with a health care provider are essential for maintaining vaginal and reproductive health.

This transcript was edited for clarity.