Vaginitis

The main cause of vaginitis is the ingress and reproduction of pathogenic microflora into the vagina with weakening of the body, non-compliance with hygiene, prolonged mechanical traumatization of the mucous membrane. In childhood, vaginitis can develop with the introduction of infection in a hematogenic way with blood flow in scarlet fever, influenza. The most common factors predisposing to the development of vaginitis are:

• Suppression of the natural microflora of the vagina. It can occur as a result of deterioration of the environmental situation, stress, uncontrolled medication (especially hormones and antibiotics), decreased immune reactivity and resistance to infections. Under these conditions, representatives of the normal microflora inhabiting the vagina become potentially dangerous and can themselves cause the development of vaginitis. In addition, the local immunity of the vagina becomes unable to resist urogenital infection.
• Mechanical injury of the genitals. Carrying out diagnostic and therapeutic procedures - abortions, curettage of the uterine cavity, probing of the uterine cavity, hysterosalpingoscopy, placement and removal of the IUD (intrauterine device), hydrotubation, childbirth in case of non-compliance with aseptic norms increase the risk of vaginitis several times. Mechanical injury of tissues during manipulations reduces their redox capabilities, and infection can also be introduced from the outside on gloves or tools. In addition, improper use of hygienic and therapeutic tampons contributes to the spread of infection. Injuries and foreign bodies of the vagina also contribute to the development of vaginitis.
• Unprotected sexual relations and frequent change of sexual partners. Most pathogenic microorganisms that cause vaginitis enter the vagina sexually. Attempts to treat them independently lead to chronization of the inflammatory process, imbalance in the vaginal environment, recurrence of vaginitis.
• Hormonal disorders and changes. Pregnant women, women with diseases of the endocrine glands, hypofunction of the ovaries, as well as patients in the menopausal period, when there is a decrease in the level of estrogen in the body, are predisposed to the occurrence of vaginitis.

Types of vaginitis vary:

• by the nature and duration of inflammation – vaginitis of acute, subacute, chronic course;
• by age of patients - vaginitis of girls, women of childbearing, postmenstrual period;
• according to previous factors - post-abortion, postpartum, postoperative, allergic vaginitis;
• by the nature of the exudate - vaginitis serous, serous-purulent, gangrenous, etc.;
• by the nature of the pathogen - specific and nonspecific vaginitis.

Specific and non-specific vaginitis

By the nature of the infectious agent that caused the inflammation, specific and nonspecific vaginitis are distinguished.

Gynecology refers to specific vaginitis inflammatory processes caused by:

• gonococcus (gonorrhea vaginitis);
• trichomonas (trichomonas vaginitis);
• pale treponema (syphilitic vaginitis);
• chlamydia (chlamydial vaginitis);
• mycobacterium tuberculosis (tuberculous vaginitis);
• mycoplasma, ureaplasma (mycoplasma or ureaplasma vaginitis).

If the pathogenic flora is mixed (other bacteria, viruses, fungi are present) in combination with the above pathogens, then vaginitis is still specific. The development of nonspecific vaginitis is caused by conditionally pathogenic microorganisms, which normally form part of the natural microflora of the vagina, but under certain conditions become pathogenic:

• proteus, staphylococcus, streptococcus, E. coli, gardnerella, pseudomonas aeruginosa (bacterial vaginitis);
• yeast-like fungi of the genus Candida Candida, protozoan fungi Candida spp., Bacteroides spp., U. urealyticum, Corynebacterium spp., etc. (fungal vaginitis);
• human papillomavirus, herpes simplex virus (viral vaginitis);
• mixed vaginitis.

Specific and non-specific vaginitis have similar symptoms, the fundamental difference between them is in the principles of treatment: when a woman develops a specific infectious vaginitis, all her sexual partners are examined and treated. Vaginitis often has a mixed form, caused by specific pathogens, which are joined by a secondary opportunistic infection. This significantly complicates the process of diagnosis and treatment of vaginitis. Therefore, each patient with signs of vaginitis needs to undergo a laboratory examination for the presence of sexual infections.

The most informative to date are vaginal smear microscopy, vaginal discharge, blood analysis by PCR. Regardless of the pathogen, any vaginitis must be treated, even if their manifestations are insignificant. The transition to a chronic course and the upward spread of infection cause inflammation in the ovaries, uterus, fallopian tubes and can be complicated by infertility.

Common symptoms for different types of vaginitis are:

• changes in the nature, smell, color, amount of vaginal discharge;
• itching, irritation, feeling of pressure and distension of the vagina and vulva;
• soreness of sexual intercourse and urination;
• minor contact bleeding.

However, different types of vaginitis have their own special symptoms. With gonorrheal vaginitis, the discharge is usually thick, purulent white-yellow. Trichomonas vaginitis is characterized by foamy greenish-yellow discharge. Abundant whitish-yellow whites accompany the development of bacterial coccoid vaginitis. With candidiasis vaginitis, curd-like white discharge has the appearance of loose flakes. Vaginitis caused by gardnerella is accompanied by transparent, unpleasant-smelling fish secretions.

In acute vaginitis, the discharge is always more abundant, the symptoms are more pronounced, accompanied by redness, swelling, soreness and a local increase in the temperature of the vulva and vagina. In the chronic form, vaginitis occurs with more moderate manifestations: pain is almost always absent, discharge is scantier, general well-being is better. Chronic vaginitis can occur for several months and years, worsening after viral infections, hypothermia, alcohol intake, during menstruation, pregnancy.

Consultation with a gynecologist is necessary if you: have unusual symptoms from the vagina; had unprotected sexual intercourse or sexual relations with several partners; you are considering pregnancy in the near future; after a course of treatment, symptoms of vaginitis persist. Drug therapy for vaginitis is prescribed taking into account the pathogen and factors predisposing to the occurrence of the disease. For the treatment of bacterial vaginitis, antibiotics are often prescribed taking into account the sensitivity of the pathogen, both orally and in the form of vaginal remedies.

Vaginitis caused by a fungal infection is treated with special antifungal candles or creams (miconazole, clotrimazole) and tablets (fluconazole). With trichomonas vaginitis, metronidazole or trichopol in tablets are prescribed. For the treatment of non-infectious vaginitis, it is important to eliminate the source of irritation: it can be washing powder, intimate sprays and gels, sanitary swabs or napkins. In the treatment of atrophic vaginitis, estrogens are prescribed in the form of vaginal tablets, creams or rings.

An important point in the treatment of vaginitis is to increase immunity and restore normal vaginal microflora. Long-standing, chronic vaginitis, as a rule, is difficult to finally cure, often accompanied by relapses. The duration of the course of therapy for vaginitis depends on the severity of the course of the disease and averages from 7 to 10 days. At the end of the course of vaginitis therapy, tests confirming the cure of the disease are necessarily taken.

Prolonged vaginitis causes emotional and sexual disharmony in a woman, as well as serious violations of her reproductive health. Women suffering from bacterial or trichomonas vaginitis are at greater risk of contracting sexually transmitted diseases and HIV infection.

Advanced forms of vaginitis increase the likelihood of spontaneous miscarriage, ectopic pregnancy, premature birth, premature discharge of amniotic fluid, intrauterine infection of the fetus and newborn with infections that caused inflammation. Therefore, the management of pregnancy in women with long-term chronic vaginitis requires special care.

In the postpartum period, vaginitis is a serious threat to the development of peritonitis, metritis, endometritis, sepsis in a woman. Infection of a newborn leads to violations of the intestinal microflora and a decrease in immune protection. With timely and proper treatment, vaginitis, as a rule, does not entail serious complications.

The observance of hygiene of the genitals can prevent the development of certain types of vaginitis and facilitate their course. The use of flavored intimate hygiene products, tampons, pads, napkins, as well as soaps with antibacterial properties should be avoided. Protected sex with the use of a condom, the exclusion of accidental sexual contact, will help to avoid sexual infections and the development of specific vaginitis.

In underwear, preference should be given to cotton products that provide air flow to the tissues of the external genitals. The nature of nutrition plays an important role in the prevention of vaginitis. The use of fermented milk food, fresh fruits and vegetables and the restriction of sweets will help the formation of the correct vaginal microflora, resistant to the development of vaginitis.