vaginitis - is an infectious inflammation of the vaginal mucosa specific or nonspecific nature, evolving due to changes in the composition of its normal microflora and the weakening of local immune mechanisms.Vaginitis leader in the structure inflammatory diseases of lower genital tract, and among all gynecological diseases on vaginitis accounts for almost 70% of cases.
At the heart of most of vaginitis infection is present.There is also a small group of vaginitis noninfectious origin, in which inflammation of the vagina provoked allergic diseases or psycho-emotional disorders.
vaginitis has no age restrictions, and may develop as a little girl and a woman from going through menopause.Its symptoms are varied and depend on the characteristics of the infection, which it provoked.
The risk of vaginitis in normal vaginal microflora composition and a good place immunity minimal.Quantitative changes in the microbial composition of the vagina, and abnormal pH shift local environment c
acute vaginitis in children can be infectious and non-infectious (eg allergic) origin.The mucosa of the vagina is very vulnerable children, and the composition of its flora finally formed, all this creates favorable conditions for the development of inflammation.
Physiological causes contribute to the development of vaginitis in older postmenopausal women when under the influence of estrogen decrease takes place in the vagina thinning mucous and develop atrophic processes.
during pregnancy with the natural changes in the composition of the vaginal microflora and reducing immune most other developing vaginitis fungal origin.Acute Candida vaginitis is present in 40 - 46% of pregnant women.
Inflammation in vaginitis can occur in acute form with bright signs.The most pronounced clinic belongs to a specific vaginitis with gonorrhea, trichomoniasis or candidiasis.
Chronic vaginitis develop in patients without acute inflammation who treated or had treated him properly.Chronic vaginitis may be asymptomatic and occur only during an exacerbation.
When bacterial infection often appears subacute vaginitis with softly pronounced inflammatory symptoms.
only significant symptom of vaginitis any origin are abnormal discharge (whites) and the characteristic inflammatory changes of the vaginal mucosa.The nature and amount of secretions determines the infectious agent.
initial diagnosis of vaginitis is not difficult, it is placed during a pelvic exam.Characteristic signs of local inflammation can diagnose vaginitis, a laboratory study helps to establish its cause.
vaginitis therapy involves the elimination of infections with antibacterial drugs and the subsequent restoration of normal vaginal environment indicators.
causes of vaginitis
The causes of vaginitis are closely connected with the state microbiocenosis vagina.In healthy women of childbearing age vaginal flora is represented by lactobacilli (98%) and a small population of opportunistic pathogens (2%), which can not cause significant damage to the vaginal mucosa due to the small number.Due to the presence vaginal lactobacilli protects genitals upstream from potential infection, so their number should remain constant and significantly exceed the number of other microorganisms.As part of the normal vaginal microflora present in a small amount of Staphylococcus epidermidis, Streptococcus, Corynebacterium, mycoplasma, fungi and others.
surface layer of epithelial cells in the vagina is constantly updated.Exfoliated "old" cells contain glycogen, lactic acid bacteria use it for the synthesis of lactic acid.As a result, the vagina is always maintained constant acidity (pH 3,8 - 4,5), which does not allow to breed unwanted microflora.Lactobacillus acidophilus is also created on the surface of the protective film that prevents the infection penetrates into the deeper layers of the epithelium.
if under the influence of unfavorable conditions in the vagina reduces the amount of lactic acid bacteria, changing pH of the medium, and conditionally pathogenic microflora begins to proliferate, displacing the remaining lactoflora.Accordingly, the more lactic acid bacteria are killed, the more space is left free, and the more germs able to take it on a competitive basis.This results in a local infectious - inflammatory process.
source of inflammation in infectious vaginitis are:
- opportunistic pathogens, which are part of the normal microflora.If you change the parameters of normal vaginal environment their numbers increased and they become pathogenic.
- Pathogens penetrating the vagina from the outside: chlamydia, gonorrhea, trichomonas, viruses and the like.
nonspecific inflammation of the vagina often provoked by no one pathogen and microbial association.
vaginitis reasons linked to the age of patients.
acute vaginitis in girls due to the age characteristics of the vagina.Most vaginitis in children younger than ten years associated with thin, thin-skinned of the vaginal mucosa, alkaline vaginal environment and low resistance to infection.
Elderly patients have atrophic vaginitis nature.Given the lack of estrogen vaginal mucosa it becomes thin, dry and vulnerable.Processes atrophy sharply reduce the ability to resist infection of the vagina.
To develop infectious - inflammatory process in vaginal mucosa predispose:
- Improper personal hygiene or lack thereof.During the hygiene measures there is a mechanical removal of unwanted microflora of genitals.
too hard intimate hygiene can also trigger vaginitis, as during aggressive douching washed away not only pathogenic microflora, and lactobacilli.
- Abortion and diagnostic and treatment involving manipulation of the surgical instruments.Mechanical damage to the mucous allow infection to penetrate the mucosa through the wound surface.
- The use of aggressive chemicals for personal care.After their use can appear areas of inflammation, burns and microtrauma, unable to resist infection.
- Chaotic sex.Frequent change of partners can cause venereal infection and to reduce local immunity.
- disbiotic system disorders, hormonal and endocrine disease.
- Long-term courses of antibiotics, especially as self-medication.
Vaginitis is not always the primary.So vaginitis in girls develop after the initial inflammation of the vulva, and in women with infection in the cervix (endocervicitis) or uterus (endometritis) secondary vaginitis appear after the infection goes down into the vagina.
Symptoms and signs of vaginitis
Complaints vaginitis patients do not differ in the wide variety, as the vaginal epithelium responds to the infection of any origin inflammatory response.The severity of symptoms is determined by the causes and forms of inflammation.Sometimes the patient survey clearly indicate the situation and provoke the disease - hypothermia, stress, unprotected sexual intercourse, the use of antibiotics and others.
Causes Treatment of patients to the doctor when vaginitis are:
- Abnormal vaginal discharge.Their number is always greater than the norm, and the appearance depends on the type of infection.They can be in color white, grayish, yellow and even green, and look at the consistency of liquid or thick, contain an admixture of blood or abnormal inclusions.
subacute nonspecific vaginitis is characterized not abundant, but persistent vaginal discharge.
Acute vaginitis specific nature manifested copious purulent or serous-purulent belyami.When Candida vaginitis vaginal discharge thick, heavy, white in color and have a distinctive kind of cheesy because of the large number of flaky inclusions.
Trichomonas vaginitis is characterized by abundant greenish belyami with an unpleasant "rotten" smell.
- unpleasant subjective sensations in the vulva.Vulvar tissue contains a large number of nerve endings and are extremely sensitive.Flowing from the vagina abnormal discharge, falling in the vulvar mucosa, provoking a burning sensation and / or itch.Candida vaginitis can be accompanied by severe, sometimes painful itching in the vagina.
- dysuria.Dysuria occur in the propagation of the inflammatory process in the urethra (urethritis).
- An increase in temperature.There debilitated patients in acute inflammation.
- Pain during intimacy.They are associated with severe mucosal edema genital tract.
Unfortunately, often the patient at the first symptoms of vaginitis are trying to cope with inflammation, relying on the information in the media, friends advice or recommendations pharmacists.Indeed, sometimes they are able to "guess" the desired drug and eliminate the disease.However, such situations are more likely to develop a different scenario when under the influence of randomly selected antibacterial disappear symptoms but not the disease itself, which is no adequate therapy is transformed into a chronic form.
vaginitis can not be self-diagnosed because its symptoms are also common to many other gynecological ailments.To the diagnosis was correct, necessary gynecological examination and laboratory diagnosis.The girls spent only an external examination.
During a pelvic exam determines the characteristic signs of inflammation.The mucosa of the vagina swelling, hyperemic, sometimes with traces of hemorrhage (small red dots).In the vagina there is a large number of cables, and on its walls may be present dense grayish film.In marked acute vaginitis inspection cause the patient pain due to the strong inflammatory edema of the vagina.When the inflammatory process involved tissue of the vulva, diagnosed symptoms of acute vulvitis.
Elderly patients five years after menopause often develop atrophic vaginitis where the vagina becomes a "dry" and thins mucous.Itching, burning and pain in the vagina.
Laboratory diagnosis helps to identify the culprit of inflammation, as well as pointed out the need for antibiotic treatment.The required list of tests includes:
- smears, "flora", the material for the study is taken from the vagina, urethra and cervical:
- screening for sexually transmitted infections (PCR);
- bacteriological examination of vaginal seeding.
more research methods are assigned according to the clinical situation.For example, when atrophic vaginitis need colposcopy, and in violation of urination investigated urinalysis to rule out diseases of the bladder and kidneys.
laboratory-confirmed genital infections require a parallel survey of the patient's partner.
Acute vaginitis should be eliminated as soon as possible.Inflammation of the mucous in acute vaginitis becomes loose, vulnerable and incapable of long to contain the spread of infection.Without proper treatment the infection penetrates into the deeper layer of the mucosa, appearing only during exacerbations.
developing chronic vaginitis due to improper treatment of acute inflammation.As a rule, such a situation arises when the patient stops taking medication on their own or take them incorrectly.Also, the transformation of acute inflammation in a chronic process may occur when an attempt to self-medication.
In the chronic stage of vaginitis symptoms are slight and limited to moderate serous (sometimes seropurulent) secretions and itching.Overall condition is not suffering, no pain.The disease lasts for many months or years.Exacerbation of chronic vaginitis and were obliterated.Unexpressed symptoms of chronic vaginitis, unfortunately, not often leads patients to the doctor.In general, they prefer to be treated independently, but "treat" only the symptoms, not the cause of the disease.As a result, again infection "hiding", and chronic inflammation continues.
gynecological examination pattern of inflammation of the vaginal mucosa (swelling and redness), expressed softly, a small number of cables.On mucosa of vulva and vagina lower part can be rendered small ulcerations.
sluggish chronic infection of the vagina in women with reduced immunity is a threat to the upstream genitals, as it can penetrate into the cervical canal, climb into the uterus and cause inflammation.
vaginitis in the group decided to allocate so-called non-specific (or bacterial) vaginitis.They do not have a specific pathogen and opportunistic microorganisms: Escherichia coli, streptococcus, staphylococcus and other germs present in the vagina.
at nonspecific vaginitis infection does not fall outside of the vagina, and develops due to the small number of microorganisms present in the composition of normal microflora.When under the influence of provoking factors, the number of lactobacilli in the vagina begins to decrease, there are favorable conditions for intensive breeding of unwanted microflora.When the number of pathogens becomes significant and begins to exceed the number of lactobacilli, developing local infectious inflammation.Thus, the pathogenic microflora becomes pathogenic and causes the symptoms of nonspecific vaginitis.
nonspecific vaginitis may occur in the form of acute purulent vaginitis or have features of chronic inflammatory diseases.Severity of symptoms depends on the source of infection.
Usually there are two forms of nonspecific vaginitis: seropurulent and diffuse.
seropurulent vaginitis has no clear clinical picture.It may be accompanied by a slight inflammatory changes in the vaginal mucosa or acquire traits expressed purulent process.
main symptoms of nonspecific vaginitis is abnormal discharge.They may be liquid, watery, frothy.If the surface of the vaginal mucosa are many epithelial exfoliated cells, they fall into the vaginal secretions and the discharge becomes thick.Often whites have an unpleasant odor and contain an admixture of blood, accompanied by itching and / or burning, especially when involved in the inflammatory process delicate tissues of the vulva.
In severe purulent inflammation of the vagina mucosa becomes edematous, thickened, covered with purulent films.When you delete a purulent vaginal wall from the films in their place formed a bleeding wound surface.Attempts to sexual intercourse and pelvic exam causing the patient severe pain.
chronic nonspecific vaginitis occurs without obvious clinical manifestations.Most whites patient concerned, and the general condition does not change.
Perhaps it is impossible to find an adult woman who is not experienced with vaginal secretions to.