Atrophic colpitis - is structural and functional changes in the vaginal epithelium dishormonal origin.Atrophic changes in the vaginal mucosa often associated with prolonged physiological gipoestrogeniya in women postmenopausal.Postmenopausal atrophic colpitis clinically manifested several years after the completion of the physiological ovarian hormonal activity in older women.Since it is based on the presence of physiological reasons, as the disease it is considered only in case of pronounced clinical manifestations that require medical correction.
Another form of atrophic vaginitis - Atrophic colpitis reproductive period.It is not connected with the physiological age-related hormonal changes in the tissues of the vagina, and with artificial menopause.Atrophic colpitis diagnosed in young women in the background removal of the ovaries, radiation therapy or hormone replacement therapy, which implies the exclusion of estrogen synthesis.
Normal vaginal mucosa performs many u
Another defense mechanism vaginal epithelium is its ability to maintain the constancy of the microenvironment.A healthy vagina is always a level of acidity - pH thereof is always within 3.8 - 4.5.Also constantly quantitative microbial content: about 98% of its present lactobacilli, and the remaining space occupied by opportunistic microorganisms.Due to the vaginal mucosa lactobacilli maintain constancy of the environment and prevent inflammatory changes.Exfoliated cells of the surface epithelial layer contain a lot of glycogen, which "feed" lactobacilli, remove lactic acid and adjusting the acidity.
All structural changes in vaginal epithelium are controlled by estrogen and is closely related to the menstrual function.Estrogen deficiency affects the condition of the vaginal mucosa and the composition of the microflora.
hypoestrogenism status periodically occurs in every healthy woman, but atrophic colpitis they are not observed.To vagina irreversibly atrophic changes require long growing gipoestrogeniya, culminating in the complete absence of synthesis of estrogens that occurs in post-menopausal.
atrophic vaginitis clinic ambiguous.For most women, it flows quite slowly and casually diagnosed by visual inspection of the vaginal mucosa.In the case of the onset of symptoms, women are concerned about dryness, itching and discomfort in the area of the vagina, with the accession of inflammatory changes appear whites.
atrophic vaginitis initial diagnosis is put in normal gynecological examination, and confirm it with a colposcopy and laboratory studies.
Like most diseases, atrophic colpitis can be eliminated only one way - to eliminate its cause.If you can compensate for a deficiency of estrogen effect on the vaginal epithelium, the disease disappears.
term "colpitis" indicates the localization of inflammatory changes in the vagina, so use wording such as "atrophic colpitis cervix" or "atrophic vaginal colpitis" correctly.Instead of "colpitis atrophic vaginal" and "atrophic cervical colpitis" should use the correct wording of the diagnosis - "atrophic colpitis."
atrophic vaginitis Causes
only reason for the development of atrophic processes in the mucosa of the vagina is a natural or artificial estrogen deficiency.
In the absence of the effect of estrogen after menopause, the vaginal epithelium becomes thin, brittle and insufficiently moistened.The amount of exfoliated cells at mucosal surfaces is sharply reduced, and this leads to a deficiency of glycogen and as a consequence, a quantitative reduction lactoflora population.Vacant after the death of lactobacilli took the pathogenic microflora.
atrophic vaginal mucosa are not able to cope with increased reproduction of unwanted organisms, so they continue to vegetate, become pathogenic and provoke a local inflammatory process.
mechanism of atrophic vaginitis in the background artificial menopause does not correlate with physiological aging of the organism, but it is also associated with the exception of estrogenic effect on the vaginal epithelium.
hypoestrogenism status of not only entered in postmenopausal women.Short reduction in estrogen seen:
- In the postpartum period, especially in nursing.After birth, the ovaries takes time to restore proper hormonal regulation of the status of the vagina during this period gipoestrogeniya can cause temporary changes in the vaginal epithelium atrophy.
- Chronic ovarian hormonal dysfunction, when there is a long marked estrogen deficiency.
- Survivors of a strong psycho-emotional upheaval women.
- When endocrine disorders (diabetes, thyroid disease and adrenal glands).
However, episodes of hypoestrogenism infrequently provoke a full-fledged hospital atrophic vaginitis in women of reproductive age.As a rule, in this case the existence of a temporary short-lived and reversible atrophy.They pass on their own as soon as the ovaries start to function properly, and the amount of estrogen is returned to normal.
symptoms of atrophic vaginitis
Postmenopausal atrophic colpitis declares itself in five or six years after menopause.It should be noted that the atrophic processes in the vagina is not always accompanied by severe clinical picture.A large number of women diagnosed during a pelvic exam atrophic changes in the vaginal mucosa indicate the absence of any symptoms of atrophic vaginitis subjective.
probability of the onset of symptoms of atrophic vaginitis depends on the age of the woman: the risk of atrophic inflammation of the vagina increases with the number of years since menopause.Thus, women who have experienced menopause six years ago, has a greater chance of atrophic colpitis than the one in which after two years have passed menopause.
Subjective sensations associated with atrophic coleitis thinning, dryness, increased vulnerability of the vaginal mucosa, as well as natural weakening local immune defense mechanisms.Most women complain of a burning sensation, itching, and dryness and "tightness" in the area of the vulva and / or vagina.Symptoms of discomfort sometimes worse pain, especially during intimacy.
These unpleasant sensations caused by the processes of atrophy.When stratified epithelium becomes thinner, exposed numerous nerve endings that cause unpleasant symptoms.
Allocation in atrophic coleitis also provoked atrophic changes.The sharp decline in the number of lactobacilli and disruption of normal acidity favored by excessive growth of the number of colonies of opportunistic pathogens, which provoke local inflammation.There are slimy, almost watery whites in moderation.Also cause abnormal discharge may be an infection that gets into the vagina from the outside, then the characteristics of cables will depend on the type of infection.
Allocation in atrophic coleitis may contain an admixture of blood.The thin mucous layer is easily injured, there are minor sukrovichnye or dark spotting short-term nature.
Any spotting, be it scarce or abundant spotting in postmenopausal women are the reason for the survey, as they are not always associated with vaginal atrophy.
During a pelvic exam atrophic mucosa looks pale and thin, through it can be shine through small blood vessels.Sometimes on the surface of the vagina can be seen small (point) hemorrhage.Upon contact with the gynecological instruments mucosa may bleed slightly.
If the vagina there is an inflammatory process, rendered areas hyperemia and edema, and there are abnormal watery, serous or sero-purulent discharge.
symptoms of atrophic inflammation are not special, they are similar to other inflammatory origin, such as bacterial or fungal (Candida).It is not excluded as the presence of specific inflammation.To clarify the cause of the inflammatory process, conducted laboratory studies of smears and crops.
Structural changes in the vaginal epithelium studied by using a colposcope.Colposcopy helps to clarify the severity of atrophic changes and determine the nature of local inflammation.
Atrophic colpites differ persistent recurrent course with the growth of pathological symptoms.
definite diagnosis of atrophic vaginitis can be set only by a doctor.
treatment of atrophic vaginitis
atrophic vaginitis therapy can not be called legkovypolnimoy task.The main problem is that the cause of the disease is a physiological state of an organism - its aging, which can not be eliminated.
Drug-free methods of dealing with the symptoms of atrophic vaginitis are ineffective.
Unfortunately, often women alone "treat" will be unpleasant symptoms in the vagina.Since they often associate them with the appearance of infection or inflammation, for the treatment of selected antibacterial and anti-inflammatory agents.Indeed, sometimes the symptoms of atrophic vaginitis subjective when it disappear, but the actual cause of the disease remains and continues to progress as a result of pathological symptoms return again.
only way to get rid of the unpleasant symptoms of a woman on hormone therapy remains today.Artificially imposed from the outside estrogens designed to "deceive" the vaginal mucosa.Simulating physiological estrogenic effect on the vaginal epithelium, hormone therapy helps to restore trophism of the mucosa and reduce the degree of atrophy.
Hormone replacement therapy (HRT) can be carried out as a systemic medications (pills) and local (local) action.The effectiveness of medications in both groups is comparable, regardless of the route of administration.The amount of the drug, as well as its duration of use is determined only by the doctor.
Local treatment involves the use of vaginal suppositories or ointments containing estrogen (estriol).Many women are well known Ovestin candles, Elvagil, Estrokard.
Systemic hormonal replacement therapy is also based on the use of estrogen.Appointed tablet formulations Ovestin, Ginodian depot, klimonorma and the like.
Along with synthetic hormones can be used homeopathic remedies and plant hormones, which are plant-derived estrogens (Klimadinon).
effectiveness of the therapy is regularly assessed by visual inspection, laboratory examination and colposcopy.If the symptoms of atrophic vaginitis disappear, the composition of the vaginal microflora is correct and Colposcopic and cytological picture indicates a "mature" epithelium, treatment is successful.