Colpitis - this inflammatory changes of the vaginal mucosa infectious origin.At the heart of vaginitis infection is always present.Pathogens can get to the vaginal mucosa from the outside, such as when specific obesity, genital infections caused by pathogens (gonococci, Trichomonas) or viruses.Also, inflammatory changes in the mucous can trigger opportunistic microorganisms that live in the vagina of healthy women.It was formed as a bacterial colpitis - inflammation of the vagina without the participation of foreign flora.
Kolpity diagnosed in 65% of patients of all ages and are considered the most common inflammatory disorders of the external genitalia.
development of inflammation of the vagina is only possible if changes in the composition of its normal microflora in combination with weakened immune defense mechanisms.
microflora of the genital tract throughout life undergoes a series of physiological changes.On its qualitative and quantitative composition affect age, nervous,
at physiological, not accompanied by complications of pregnancy, the fetus in the womb of a female sterile.On the eve of the birth and the first time after the birth of her mucous membranes of the genital tract are influenced by hormones (estrogen and progesterone) of the mother, some of them produced during pregnancy by the placenta, and the rest have migrated to the fetus from the mother through the placental blood vessels.After the birth of a girl receives a certain amount of hormones of the mother during breastfeeding, milk.Hormones mother's ability to support children's vaginal mucous cells synthesize and store glycogen, which is an ideal substrate for the growth of lactic acid microorganisms.
Sterile vaginal newborn girl starts populated familiar adult female microflora after the first day after birth.In the first month after the birth of the micro-structure of the vaginal microflora of the vagina similar to healthy adult women, mother's hormones and then eliminated from the child's body, and the vagina begins an independent process of gradual formation of normal "female" microflora.During the life of one month to eight years of children's vaginal mucous thin, thin-skinned, poor cope with the infection, which explains the greatest number of detectable inflammation of the vagina in children under the age of ten.
Since the beginning of puberty (puberty), when the ovaries girls begin to synthesize their own hormones again vagina gradually changes its composition and by the end of puberty (16 years) is in its composition and functions similar to that in adult women.
In healthy women of childbearing age vaginal microflora of 98% is represented by small number of lactobacilli and opportunistic microorganisms: streptococci, staphylococci, Corynebacterium, E. coli and others.The dominant presence lactoflora vagina provides protection from infectious aggression.It forms on the surface of epithelial kind of protective film (glycocalyx), which does not allow germs to penetrate into the underlying layers.The surface layer of the vaginal mucosa is constantly updated."Old" cells comprise exfoliated epithelial glycogen and lactobacilli synthesized from lactic acid.The acidic environment is not conducive to opportunistic pathogens, so they can not vegetate.Thus the vagina maintains a constant acidity (pH 3,8 - 4,5), where undesirable microorganisms multiply and cause inflammation is not capable.
taking place in the vaginal epithelium of structural and functional changes are closely connected with the state of hormonal ovarian function.Therefore, in menopause, when the ovaries gradually stop the production of hormones in the vagina changes begin again.Estrogen deficiency leads to a thinning of the mucous layer, reducing the number of lactobacilli and change pH.
constancy of the vaginal environment is the key to women's health.The decrease of lactobacilli leads to the creation of favorable conditions for the development of infection and subsequent inflammation.Obesity in children and the elderly are caused by physiological reasons.
Colpitis, like all the inflammation is acute, subacute and chronic course.The only symptom of vaginitis present at any of its forms are abnormal vaginal discharge (leucorrhoea), and their size and appearance determine the causative agent.Festering copious when coleitis often indicate the specific nature of inflammation (gonorrhea, trichomoniasis).
diagnosis of vaginitis does not imply complex diagnostic procedures.As a rule, enough for a diagnosis examination examining smear "flora", as well as the results of bacteriological examination.
vaginitis treatment depends on the cause and selected according to laboratory studies.Therapy is aimed at eliminating the infection and restore normal vaginal microbiocenosis.
only cause vaginitis is an infection.However, not all women have an infection of the vagina triggers inflammation.A healthy vagina is able to cope with infectious aggression.
risk of inflammation depends on the condition of vaginal microbiocenosis, namely, reducing the number of lactobacilli in its composition.When lactic acid bacteria becomes low, the space takes on a competitive basis is present conditionally pathogenic microflora and pH change contributes to its excessive reproduction.
Bacterial colpitis developed with the participation of "their own" junk in the background microflora changes in the normal vaginal environment indicators.
specific colpites due to infection that gets into the vagina from the outside, and also depend on the composition of the local flora.Insufficient number of lactobacilli deprives the vagina ability to resist infection and promotes inflammation.
emergence of infectious inflammation of the vagina can provoke:
- Genital infections.Unprotected sex and frequent partner changes often lead to the appearance of colpitis specific origin.
- Improper personal hygiene.Ignoring the rules of hygiene of genitals helps to change the vaginal environment and proliferation of opportunistic pathogens in the genital tract.
Contrary to what many patients do not benefit and excessive hygiene measures.Too frequent douching "washed out" of the vagina not only the unwanted microbes and lactobacilli.
Using unsuitable for personal hygiene cosmetics provokes inflammatory allergic reactions, irritation of the mucous and helps reduce its protective properties.For the hygiene of genitals warm enough to use clean water or special products containing lactic acid.
- endocrine diseases, especially diabetes and thyroid disease.
- Mechanical damage to the vaginal mucosa.Violation of the integrity of the vaginal epithelium during childbirth, abortion, violent sexual intercourse, douching improper or incorrect medical procedures to help infections to penetrate the thickness of the vaginal mucosa.
- Reduction of immunity, including allergic conditions.
- System goiter, including the background of antibiotic therapy.
physiological causes of vaginitis are:
- Pregnancy.Natural changes in the ratio of sex hormones during pregnancy in combination with reduced immune defense disbiotic provoke disorder in the vagina and contribute to the emergence of vaginitis.
- menstruation.On the eve of menstruation due to natural causes of hormonal changes in the vagina pH and the proportion of microorganisms in the composition of the microflora.
- atrophic changes in the mucous on the background of menopause.
Colpitis not always primary.So, the girls initially localized inflammation in the tissues of the vulva and then rises into the vagina and cause of secondary vaginitis in women may be a downward infection with primary localization in the cervix or uterus.
Symptoms and signs of vaginitis
vaginitis clinical picture is largely determined by its origin and form, but not very varied symptoms.Usually colpites any etiology occur with similar clinic, and their causes and forms of influence only on her terms.
The clinic colpitis lead all the following symptoms:
- abnormal discharge.Select with coleitis have all the patients, they can be heavy and be moderate, and the color varies from white and gray to green.Bacterial colpitis in some cases, can occur almost asymptomatic minor secretions.
Acute colpitis often provokes a specific flora, it appears copious purulent or seropurulent belyami.Chronic inflammation of the vagina, usually characterized the slim, constant release.
the appearance and quantity of vaginal discharge affects the type of infection.Most nonspecific colpitis is not the only pathogen and microbial association, so the nature of discharges depends on what kind of bacteria it contains.
Sometimes at the initial examination the doctor is often possible with a high probability guess which provoked phenomena of vaginitis infection.Acute colpitis caused by Trichomonas, characterized by profuse, malodorous, yellow-green discharge characteristic "foamy" appearance.Thick white discharge when coleitis fungal origin (candidiasis) are similar to cottage cheese or sour milk.
In marked acute coleitis when the vaginal mucosa appear foci of purulent inflammation with rejection and subsequent formation of the wound surface, discharges a small amount of blood.
Odors cables due to the presence of E. coli in them, trichomonas and bacterial colpitis often gives secretions smell of stale fish.
- Unpleasant sensations (discomfort, itching, burning) in the area of the external genitalia.Copious irritate the inflamed mucosa and provoke subjective disorders.The most intense itching and burning feeling in the area of patient vulva (vestibule).Sometimes the resulting allocation irritate delicate, containing a large number of nerve endings, the vulva, involving it in the inflammatory process.
Itching and burning are not always companions vaginitis, their appearance depends on the type of infection.Strong, painful itching accompanies colpitis candidiasis.
- dysuria.When the inflammation reaches the vulva, it extends to the urethra (urethritis), causing dysuria.
- Pain in the vagina, especially during intimacy.Also, it is not mandatory and there are a symptom of vaginitis due to expressed edema mucous vulva and vagina.
- Fever.The temperature rise in acute purulent obesity seen in debilitated patients.
All of the above symptoms but precipitates can be expressed to varying degrees or even absent.
Sometimes the patient can clearly indicate the event provoke selections.For example, unprotected sex, reception of strong antibiotics, respiratory infections, hormonal disorders, etc.
It should be understood that an increase in vaginal discharge without accompanying subjective feelings do not always indicate disease.Vaginal microflora is not able to maintain their normal performance constantly.Psycho-emotional disorders, hypothermia, temporary hormonal changes and other precipitating factors affect microbiocenosis vagina and can cause increasing amounts of emissions.However, the body healthy woman always cope with such episodes on their own, and only a shortage of protective forces of developing persistent inflammation of the mucous membranes.
Physiological increase in discharge occurs during ovulation (mid-cycle) and can last until the next menstrual period.Also, their number exceeds the norm in pregnant women.
vaginitis Diagnosis begins with a study of the state of the mucous of the external genitalia.During the inspection visualized signs of inflammation: the vaginal mucosa swelling, hyperemic, with pronounced inflammatory changes in the walls of the vagina can be seen petechial hemorrhages.In the present allocation of the vagina.
Laboratory diagnosis includes:
- microscopic examination of smears of discharge from the vagina, urethra, cervical canal (smears "flora");
- bakposev discharge;
- screened for genital infections (preferably by PCR).
Additional tests are carried out according to the clinical situation.
parallel examination must be a partner in the presence of patient laboratory confirmed specific inflammation.
Reduced estrogenic effect on the vaginal mucosa and the depletion of immune defense mechanisms during pregnancy predispose to physiological changes in the composition of the vaginal microflora.
Most others (46%) of pregnant women develop colpitis, caused by the fungus Candida.It is diagnosed in every second pregnant, often in the first and the last trimester.In fact, Candida colpitis is expressed dysbacteriosis vagina.
Pregnant with colpitis fungal origin may impose the following complaints:
- selection.Heavy to moderate vaginal secretions have a white or grayish-white color, contain specific komkovidnye flake or small inclusions.Thanks to them whites are similar to cottage cheese and curd (hence the name of vaginitis - "thrush").
- Burning and / or itching of the external genitalia.The intensity of itching increases after contact with water or a long walk.Itching increases in the evening and night, not allowing the patient to fall asleep and causing serious psychological and emotional disorders.Sometimes infected secretions flowing so strongly irritate the skin of the genital area that the patient of their combs, damaging the skin and provoking a new inflammation.
- dysuria.It should be noted that the dysuria in pregnancy is not always associated with infection of the vagina.
When viewed on the skin of the genital area can be found traces of scratching and irritation in the form of small bubbles, but the vagina shows all signs of inflammation (swelling, redness).Characteristic of Candida vaginitis is a sign of gray-white deposits on the mucosal surface.They are so closely related to the underlying tissues that attempt to separate them causes the release of blood spatula.
bright clinical picture is not always there.One-third of pregnant candidiasis colpitis asymptomatic and detected only at the time of inspection.
Among the specific agents of vaginitis in pregnant women often present pathogen trihomonaiza - trichomonas.Trichomonas is a sexually colpitis infection and is passed from partner to partner through unprotected sexual contact.
After 5-6 days after the invasion of infection on vaginal mucosa appear copious purulent discharge with a greenish tinge, a bad smell and the characteristic foamy appearance.There may be itching and burning.
Trichomonas differ pronounced mobility, so the subject of reduced immunity in pregnant women they can relatively easily penetrate into all the surrounding structures and trigger the inflammation not only in the vagina.