Vaginitis - What Is It? First Signs, Causes And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms and treatment of vaginitis

What is vaginitis?

Vaginitis is an inflammation of the entire vaginal mucosa, which is caused by the activity of pathogenic microbes. Vaginitis is the most common disease in gynecology. Unfortunately, today the number of patients with vaginitis is increasing. As statistics tells us, every third woman of childbearing age suffers from vaginitis.

According to recent studies, the development of vaginitis is directly related to sexual activity and is considered a sexually transmitted disease.

Favorable factors for the development of vaginitis are the penetration of pathogenic microorganisms into the vagina (gonococcus, Trichomonas, pinworms) from dirty clothes and unwashed hands, non-compliance with personal hygiene rules. Often, the disease develops with prolonged mechanical irritation of the mucous membrane. Girls 5-12 years old can get vaginitis if they get an infection with the blood stream with flu, scarlet fever.

Allergic and bacterial vaginitis is common during puberty. This disease should not be ignored, as it can cause negative consequences for women's health.

Content:

• Causes of vaginitis
• The mechanism of development of vaginitis
• Varieties of vaginitis
• Vaginitis symptoms
• Diagnostics
• Vaginitis treatment
• Treatment of vaginitis during pregnancy
• How to treat vaginitis without potent drugs?
• Prevention
• Consequences of untreated vaginitis

Causes of vaginitis

The vagina is represented by a muscular tube, which is lined from the inside with a stratified epithelium. The upper layer of the epidermis contains a lot of glycogen. They feed on bacteria that are normally always present in the vagina. The beneficial flora include Dederlein sticks and lactic bacteria.

These microbes break down glycogen and secrete lactic acid. This will protect the vagina on both sides. Dederlein's rods line its epithelium with a dense layer, and lactic acid bacteria produce an acidic secret. The pathogenic flora cannot multiply in it. Another reliable factor in protecting the vagina is its ability to cleanse itself. The cells of the organ secrete mucus, which flows down the walls of the vagina and comes out. Along with it, exfoliated epithelial particles and dead microbes leave him.

The level of sex hormones determines the level of glycogen in the cells of the vagina. Its accumulation is stimulated by estrogens, and progesterones slow it down. Most of the progesterones in the blood are found before the next menstruation. It is not surprising that it is during this period that women more often turn to a gynecologist with a complaint of acute vaginitis, or a relapse of the chronic form of the disease.

The following factors can provoke the development of the disease:

• Injuries of the vagina received during labor. Because of this, its walls lose the ability to close. The vaginal opening always remains open. A similar situation can be observed after surgery on the genitals.
• Hormonal imbalance in the body: postponed childbirth, pregnancy, abortion. Many women experience vaginitis during postmenopause.
• To provoke a decrease in immunity are ways of stress, experiencing strong emotions, serious illnesses and infectious processes in the body.
• Violation of hygiene rules. The pathogenic flora rapidly increases in number in menstrual blood and other vaginal secretions.
• Diabetes. This process causes excess deposition of glycogen in the walls of the vagina, causing itching and poor nutrition.
• Bacteria that cause genital infections are capable of provoking vaginitis. Infection occurs during unprotected intercourse.

The mechanism of development of vaginitis

Vaginitis is always characterized by inflammation, but it is not always pathogenic microorganisms that cause it. Sometimes a violation develops when the walls of the vagina are injured. This can occur with careless douching, with rough intercourse, with the use of personal hygiene products that are distinguished by an aggressive composition. Sometimes vaginitis develops as a result of an allergic organism. It can occur on lubricants, on contraceptives, on tampons.

The infection can enter the vagina from the external environment, that is, by the ascending route. In this case, bacteria are introduced into the body from the labia, urethra or anus. The second way of spreading the infection is downward. In this case, bacteria enter the vagina from the center of chronic infection that exists in the body. Such a focus may be tonsils, carious teeth, inflamed kidneys. The bacteria reach the vagina through the bloodstream.

The destroyed cells of the vaginal mucosa will produce certain biological substances. They lead to vasodilation, which causes the blood to stagnate. Leukocytes and plasma leak from the walls of the capillaries. This leads to local swelling.

Since the vaginal mucosa is permeated with nerve endings, its swelling provokes irritation. This leads to discomfort. It manifests itself in pain and itching.

The epithelial glands, in response to irritation, begin to produce more mucus in order to flush the pathogenic flora from the surface of the vaginal walls. When the leukocytes die en masse, the discharge becomes purulent. The capillaries are destroyed, so blood can be seen in the mucus. If infectious agents become the cause of inflammation, then the discharge acquires an unpleasant odor. It indicates specific inflammation.

Varieties of vaginitis

Depending on how long a woman's inflammation lasts, the following types of vaginitis are distinguished:

• Acute inflammation. It lasts no more than 8 weeks.
• Subacute inflammation. It lasts longer than 8 weeks, but no more than 6 months.
• Chronic inflammation. It lasts more than half a year. The periods of exacerbation are followed by phases of remission.

There is a classification of the disease depending on the cause of its occurrence:

• Nonspecific vaginitis caused by bacteria. These microbes belong to conditionally pathogenic flora. Its representatives are bacilli, staphylococci and streptococci.
• Trichomonas vaginitis, which occurs with trichomoniasis.
• Mycoplasma vaginitis. Its pathogens are mycoplasmas. They enter the vagina during unprotected intercourse.
• Gonorrheal vaginitis caused by gonococci.
• Candidal vaginitis. It is provoked by yeast fungi of the genus Candida. They are responsible for the onset of thrush.
• Allergic vaginitis. Such a reaction of the body occurs in response to the ingress of allergens into the vagina.
• Atrophic vaginitis. It is a consequence of a drop in the level of estrogen in the blood. Hormone deficiency can be associated with menopause, ovarian hypofunction, or ovarian removal.

Depending on the nature of the inflammation, the following types of vaginitis are distinguished:

• Purulent vaginitis. The discharge will be thick, with an unpleasant odor. Their color ranges from yellow to green.
• Mucous vaginitis. The discharge is cloudy, thick and viscous.
• Serous vaginitis. The discharge is liquid and transparent.

Vaginitis symptoms

Depending on the cause that led to the development of vaginitis, its symptoms will differ. At the same time, the disease rarely leads to a deterioration in the general well-being of a woman. Body temperature does not exceed subfebrile marks. If it rises to high values, and intense pain occurs in the vaginal area, then this indicates a severe inflammatory process with spread to the uterus and adipose tissue.

Bacterial vaginitis

This inflammation is caused by opportunistic aerobic bacteria. These microbes do not need oxygen in order to reproduce. Normally, they are always present on the surface of the skin, but their number is small. When the female body is weakened, these bacteria grow. They are able to penetrate the vagina and begin to actively reproduce there. In this case, the patient develops purulent discharge, which has a yellow-green color and an unpleasant odor.

During the examination of the organ, the doctor visualizes areas of redness and swollen walls. They are covered with purulent mucus. The smear will reveal epithelial cells, which are surrounded by a dense layer of bacteria. Dederlein's sticks have been reduced. Sometimes they are missing. The disease often becomes chronic. Over the years, a woman will notice a slight yellowish discharge.

Trichomonas vaginitis

Vaginitis caused by Trichomonas develops a few days after intercourse without a condom (provided that the partner has been infected). Sometimes it takes 3 days until the first symptoms of the disease appear, and sometimes a month. As soon as there are many bacteria in the vagina, the corresponding clinical signs will appear.

The discharge is frothy. They give off an unpleasant odor. Their color can be whitish or yellow. The woman experiences itching in the perineum and pain in the lower abdomen.

Trichomonas have flagella with which they can move. If the disease is left untreated, the bacteria will spread to the uterus, ovaries and even the abdominal cavity. The symptoms of the disease will gain intensity. The pain will become unbearable. The body temperature will rise to feverish levels. Menses become irregular.

When examining the vagina, the doctor visualizes the inflamed and red walls, which are covered with foamy discharge. Less often there is a latent course of the disease. In this case, vaginitis betrays itself only as a slight inflammation of the organ's epithelium.

Gonorrheal vaginitis

Gonococci are sexually transmitted. Inflammation develops 3 days after unprotected intimacy. The woman feels pain and burning in the vaginal area, the discharge becomes purulent. White films can be seen in them. They are represented by areas of the epithelium of the mucous membrane, which begins to flake off with gonorrheal vaginitis.

The walls of the vagina are edematous, have a bright color. On them are types of raspberry papillae. When the disease is severe, films will be visible on the surface of the organ. If you remove them, then erosions are visible under them, which bleed and do not heal.

Candidal vaginitis

This vaginitis is triggered by Candida fungi. They are sown in a smear for every fifth woman. Inflammation develops only in those patients whose immunity is malfunctioning. Metabolic disruptions and hormonal imbalances are the impetus for the manifestation of the disease.

The first symptom of candidal vaginitis is vaginal dryness and itching. The external genitals become edematous, which indicates developing vulvovaginitis. A few days later, the woman notices that the nature of the discharge is changing. Curdled clots appear in them, which resemble cottage cheese grains. The mucus gives off a sour smell. Sometimes there is a lot of secretions, and sometimes they are absent.

Vaginitis of this type often develops before the onset of the next menstruation or while carrying a baby. Often, the disease becomes chronic.

Atrophic vaginitis

This vaginitis is a companion for women entering the menopausal period. Patients complain of intense itching. The vagina becomes dry, the discharge is odorless, and there are very few of them.

The doctor visualizes the pale mucous membrane of the vagina, which gives off yellowness. Bruises are visible on its surface. The disease can be accompanied by the formation of adhesions.

Chronic vaginitis

Vaginitis of a chronic course is characterized by periods of exacerbation and calm. Signs of inflammation are weak, the discharge is insignificant. The disease has been troubling a woman for several years.

Chronic inflammation leads to pathological changes in the vaginal wall. It becomes dense, rough and loses elasticity.

Diagnostics

If symptoms of vaginitis appear, you should consult a gynecologist. The doctor will examine the woman using mirrors. He will then assess the level of acidity in the vagina. This test is performed using a litmus strip. Violation of the vaginal microflora is diagnosed at a pH above 5.

The smear that the doctor takes from the walls of the vagina is sent to the laboratory. There it is examined on various nutrient media. The overgrown colonies of bacteria make it possible to diagnose and choose a treatment. If there is a suspicion of genital infections, then a PCR study is carried out.

Vaginitis treatment

Treatment is carried out at home. A woman is not issued a sick leave, she can continue to go to work. If the disease was provoked by a genital infection, then both partners should receive therapy.

During the treatment, you need to refrain from intimacy. In addition to eliminating the inflammatory reaction, it will be necessary to restore the vaginal microflora and eliminate the cause of vaginitis. For this, all chronic infections are treated. It is important to stop using harsh personal hygiene products that can trigger an allergic reaction. Patients with diabetes mellitus should receive appropriate insulin therapy.

Treatment can be carried out both with local drugs and by taking medications by mouth. Local therapy involves the use of drugs in the form of vaginal tablets or capsules, such as the drug Macmiror complex® (vaginal capsules / cream) is intended for the systemic treatment of vulvovaginitis. Its active ingredient nifuratel has antimicrobial, antifungal and antiprotozoal activity. In clinical studies, Macmiror® has proven to be highly effective against fungi, bacteria, Trichomonas and their associations with other pathogenic agents. Macmiror® creates favorable conditions for maintaining a healthy vaginal biocenosis.

Antibacterial agents:

• Amoxicillin tablets, Clindamycin suppositories. These drugs are prescribed for nonspecific vaginitis.
• Ornidazole and Metronidazole tablets and Tinidazole suppositories are used to treat Trichomonas vaginitis.
• Fluconazole in single-dose tablets and Mitomycin (Econazole, Isoconazole) in suppositories for the treatment of fungal vaginitis.

When the antibiotic treatment is completed, the patient is prescribed suppositories with beneficial bacteria (Acylact, Lactonorm). They allow you to bring the microflora of the vagina back to normal. When the antimicrobial treatment is completed, the patient is prescribed intravaginal probiotics with beneficial bacteria to restore the intimate microflora. The second stage in the form of a probiotic is extremely necessary for thrush in order to restore the intimate microflora and reduce the risk of repeated exacerbations, as well as maintain local immunity. If you do not quickly restore lactoflora, the activation of opportunistic microflora is possible, which will lead to an exacerbation of thrush or bacterial infections. For the same reason, antifungal therapy for thrush may not be effective enough. Therefore, it is important after the first stage of treatment aimed at destroying the infection,carry out the second stage - to restore the balance of beneficial microflora.

Douching may also be recommended for a woman. Solutions for their implementation:

• A glass of water + 2 teaspoons of baking soda. After half an hour, they douche with a weak solution of potassium permanganate.
• Zinc sulfate (2 teaspoons) + a glass of water. This remedy is used for purulent inflammation.
• Protargol solution with a concentration of no more than 10%. Such treatment is prescribed for patients with persistent purulent vaginitis.
• Borax solution with a concentration of 1-3%. The remedy helps with yeast vaginitis.

It is useful to do sitz baths once a day. The duration of the procedure should be 15 minutes. To fill the bath, decoctions of medicinal herbs (chamomile, St. John's wort, oak bark, calendula) are used.

The hardest thing to cope with is vaginitis, which has become chronic. Such patients are shown to undergo physiotherapy (UHF, electrophoresis, magnetotherapy). They are also prescribed immunomodulators and vitamins. A woman can be referred to a specialized sanatorium.

Video: Obstetrician, gynecologist Tatyana Semenova Kuznetsova from the Moscow Doctor clinic talks about vaginitis:

Treatment of vaginitis during pregnancy

Vaginitis during pregnancy should not be ignored, regardless of the period in which the woman is. The patient should be put on a diet. She is forbidden to eat spicy, salty, sour and spicy foods. You should refrain from intimacy. It is important to wear comfortable underwear made from quality materials and use gentle hygiene products.

Treatment is prescribed by a gynecologist. It is carried out only after receiving the results of a smear on the flora.

Pregnant patients may be prescribed the following drugs:

• Candles Terzhinan or Hexicon. The course of treatment lasts 1-2 weeks. Each day you will need to enter one candle before bedtime.
• Candles Betadine. They are prescribed only for those pregnant women whose term does not exceed 12 weeks. During the 2nd and 3rd trimesters, they are not used, since they are capable of provoking a pathology of the child's thyroid gland.
• Polygynax. Some doctors prescribe these suppositories for the treatment of pregnant women, although the manufacturer does not recommend drug therapy for women in position. Candles are strictly prohibited 1-2 weeks before delivery.
• Klion-D, Neo-Penotran forte, Metromicon Neo, Meratin-Kombi. These drugs are prescribed for vaginitis caused by Trichomonas. The course lasts no more than 2 weeks.
• Pimafucin, Clotrimazole, Nystatin, Borax in glycerin. These suppositories are prescribed for vaginitis caused by fungal flora.

A woman will need to do baths with decoctions of herbs, you can wash the vagina. Although during pregnancy, experts recommend douching to refuse, or to carry it out with caution. Douching for more than 5 days is not recommended.

However, flushing the genitals with decoctions of warm herbs for vaginitis is useful. This helps to eliminate the symptoms of the disease and accelerate recovery.

How to treat vaginitis without potent drugs?

Vaginitis requires the use of antibiotics. You can't do without them. To make recovery faster, you can strengthen the immune system with vitamins, undergo physiological treatment and take anti-inflammatory drugs.

Women with fungal inflammation need to follow a diet. It is important to give up fatty foods, carbohydrates, spicy and salty foods.

Prevention

Prevention of vaginitis is reduced to the following activities:

• Using a condom during intimacy. This helps prevent genital infections. After unprotected sex, you can use Miramistin.
• High-quality intimate hygiene with the use of gentle genital care products. Your pads should be changed every 4 hours during your period.
• Ovarian diseases and menopause require the use of hormonal drugs.

Vaginitis is dangerous for pregnant women, as it can cause fetal infection. Therefore, the disease must be treated correctly and on time.

Consequences of untreated vaginitis

If the disease is not completely treated, then this threatens the transition of inflammation to the cervical canal, to the uterus and ovaries. The infection can affect not only the reproductive system, but also the urinary system.

Sometimes vaginitis develops during childhood. This threatens the development of synechiae, the appearance of ulcers, polyps and scars. In girls under 10 years of age, the vaginal mucosa is very thin, so the disease must be treated with special care. Appointments should be given by a pediatric gynecologist.

The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.