What Is Vaginitis
Vaginitis is an inflammation of the vaginal mucosa and submucosal connective tissue. It is a common disease in gynecological clinics and can be affected by all ages. In a normal physiological state, the biochemical mechanism of the tissues of the vagina is sufficient to defend against the invasion of external microorganisms. If the defense mechanism of vaginal tissue is destroyed, pathogenic bacteria can take the opportunity to enter and cause vaginal inflammation. Clinically, it is mainly characterized by changes in the characteristics of leucorrhea and itching and burning pain of the vulva. It may also be accompanied by symptoms such as painful intercourse, dysuria, and urgency. Common vaginitis includes non-specific vaginitis, bacterial vaginitis, candidal vaginitis, trichomonal vaginitis, fungal vaginitis, senile vaginitis, infant vaginitis.
What Is The Cause Of Vaginitis
The parasitic bacteria in the vagina are out of control, leading to infection. There are dozens of microorganisms in the vagina of healthy women. If the pH value of the vagina is changed, it is easy to cause flora imbalance and disease. Little girls and postmenopausal women due to lack of estrogen, the intracellular glycogen content is reduced, and the vaginal PH is as high as about 7, so the vaginal resistance is low, and it is more susceptible to infection than adolescent and childbearing women.
Infection from the outside world. Mainly contact with infected toilets, bathtubs, bath seats, towels, use of unclean toilet paper, etc.
There are many predisposing factors, including diabetes, exogenous hormones (estrogen, corticosteroids), preference for sweets, colony conversion and so on.
Infection secondary to other sites.
When the natural defense function of the vagina is destroyed, pathogens are easy to invade, leading to vaginal inflammation. Under normal circumstances, vaginal bacilli dominate the vagina, and a small amount of anaerobic bacteria, mycoplasma and candida form a normal ecological balance.
However, when the body's immunity is weakened, endocrine hormones change, or external factors, such as tissue damage, sexual intercourse, disrupt the ecological balance of the vagina, these resident flora will become pathogenic bacteria, breaking the vaginal barrier and causing infection.
What Are The Symptoms Of Vaginitis
Vaginitis can be divided into many types, and different types of vaginitis have different symptoms.
- Typical clinical symptoms are marked increase of abnormal vaginal discharge, which is thin and homogeneous or thin and pasty, and is gray-white, gray-yellow or cream-yellow, with a special fish odor.
- Because alkaline prostatic fluid can cause amine release, so the performance for sexual intercourse or after sexual intercourse smell worse.
- The pH value of the vagina rises during menstruation, so the odor during or after menstruation can also be aggravated.
- Some patients will have varying degrees of burning sensation or have pain during intercourse. A very small number of patients have lower abdominal pain, dyspareunia, and abnormal urination. However, the vaginal mucosal epithelium has no obvious hyperemia at the time of onset.
- Vaginitis often occurs together with other vaginally transmitted diseases, so its clinical manifestations may be affected by concurrent vaginal diseases and vary.
- Thin, foamy vaginal discharge increases and vulvar itching. If there is a mixed infection of other bacteria, the discharge will be purulent and may have a foul smell. The pruritus is mainly in the vagina and vulva, occasionally with burning, pain, painful intercourse and other manifestations.
- If there is an infection of the urethra, frequent urination, painful urination, and sometimes hematuria may be seen.
- During the examination, congestion of the vaginal mucosa can be seen, and in severe cases, there are scattered bleeding spots. The posterior fornix has a large amount of leucorrhea, which is gray-yellow, yellow-white thin liquid or yellow-green purulent secretions, often foamy.
- A small number of patients have trichomoniasis in the vagina without inflammation.
- Increased leucorrhea. The typical leucorrhea is curd or lumpy. The vaginal mucosa is highly red and swollen, with white sore-like plaques attached and easy to peel off. Underneath is the erosion base of the damaged mucosa, or shallow ulcers are formed. In severe cases, ecchymosis may be left. However, leucorrhea does not all have the above-mentioned typical characteristics. Leucorrhea can appear from watery to curd-like. For example, some are completely thin and clear serous exudates, which often contain white flakes.
- Vulva itching, vaginal burning and itching, difficulty urinating.
- During the acute period, there may be a slight increase in body temperature, increased white blood cells, general fatigue, discomfort in lower abdomen, increased vaginal discharge, purulent, serous or bloody, and a burning sensation in the vagina.
- The speculum shows congestion of the vaginal mucosa, sometimes superficial small ulcers, and the pH value of the vagina is relatively alkaline.
- Senile Vaginitis
- Vaginal secretions increase, the secretions are thin and light yellow, and in severe cases, they are bloody purulent and smelly.
- Itching and burning sensation in the vulva.
- The vaginal mucosa shrinks, and sometimes there is urinary incontinence.
- Vaginal mucosa has hyperemia, redness and swelling, and bleeding spots on the mucosa can also be seen, the fornix and cervix are the most obvious. In severe cases, ulcers or flushing and erosion of the vulva can also be formed. The ulcer surface may adhere to the opposite side, and the adhesion may cause bleeding due to separation during inspection. Severe adhesions can cause vaginal stenosis or even atresia, and poor drainage of inflammatory secretions may cause vaginal empyema or uterine empyema.
- It is usually caused by secretion stimulation in children. The child cries, irritates, or grasps the vulva due to burning pain.
- The mucous membrane of the urethral orifice and vagina is congested and edema, the labia minora may be adhered, and purulent secretions flow out from the vagina. The amount may be more or less, and it may have a foul smell.
- An anal examination should be done during the examination to exclude foreign bodies and tumors in the vagina.
Vaginitis of Pregnant Women
During pregnancy, the body's resistance is reduced, and the vaginal sugar content is increased, which is prone to vaginitis, especially fungal vaginitis is more common, coupled with not dare to use drugs at will, it will quickly aggravate the inflammation.
- Haemophilus vaginitis. Infections are mostly mild and are more common in sexually active women. In the acute phase, vaginal discharge increases, fishy or ammonia smells, and the vulva is moist and uncomfortable, often accompanied by vaginal burning sensation, painful intercourse, and vulvar itching.
- Menstrual vaginitis. It is mostly caused by not paying attention to hygiene during the menstrual period, especially the use of unclean menstrual supplies which causes the vulva to be contaminated by unclean substances. It is manifested as a sinking and burning sensation in the perineum, and increased vaginal discharge.
- Honeymoon vaginitis. More common in newly married women. Mainly caused by carelessness of sexual organs and sexual hygiene. It is manifested as increased leucorrhea, itching and pain inside and outside the vagina, and redness and swelling of the mucous membrane.
- Purulent vaginitis. It is more common in women with vaginal tears or birth injuries. It is manifested as increased vaginal discharge, yellow pus-like appearance, with fishy smell, burning and pain in the vagina, and redness and swelling of the mucous membrane.
- Simple vaginitis. It gets worse one week before the menstruation, and it relieves to a certain extent after the menstruation. The skin is flushed and swollen, and severe itching is felt, which may be accompanied by a burning sensation in the vulva and vagina. A large amount of white thick, curd-like leucorrhea. There may be symptoms such as vaginal pain, irritation and dyspareunia.
- Chancroid vaginitis. Labia majora or labia minora one or more small red papules, quickly burst, expand into soybean big or larger ulcers, the substrate is soft, filth, pus, have obvious pain, gradually expand.
How To Check For Vaginitis
Intravaginal diagnosis. Limited to women with sexual experience, the doctor with a gloved index finger and middle finger, gently insert your vagina, touch the cervix, at the same time use another hand to press the abdomen, can check out whether the uterus increases, or tubal, ovarian swelling or tumor phenomenon.
Double diagnosis of rectum and abdomen. Use your fingers to reach into the anus and press the other hand to press the abdomen, and touch whether there is a foreign body in the vagina, the size of the uterus and the pelvic cavity.
Routine Examination of Leucorrhea
pH value. The pH value is often used in laboratory tests to indicate the pH value. Normal pH is 4.5. When suffering from trichomonal or bacterial vaginitis, the pH value of leucorrhea increases, which can be greater than 5-6.
Vaginal cleanliness. Observe whether there are vaginal bacilli, pus cells and other bacteria through a microscope, and judge the cleanliness of the vagina according to the number of bacteria seen.
Trichomonas or mold detection. After the leucorrhea has been processed, it can be observed through a microscope to determine whether there is trichomoniasis or mold based on its shape.
Amine test. Leucorrhea suffering from bacterial vaginosis can emit a fishy smell, which is caused by the volatilization of the amines present in the vaginal discharge after being alkalized by potassium hydroxide.
Clue cell. The clue cell refers to the vaginal epithelial cell with many bacilli on the edge. If the edges of vaginal epithelial cells are seen in the hanging drop smear of the microscope to be granular or stippled, causing the edges to be blurred, this is the clue cell. It is the most sensitive and specific sign of bacterial vaginosis. Clinicians can make a diagnosis of bacterial vaginosis based on the positive amine test and clue cells.
Bacterial Culture Check
Taking vaginal secretions for smear examination can detect the pathogenic bacteria of bacterial vaginitis. To determine and distinguish the types of bacteria, fermentation tests and assimilation tests must be carried out, and the morphological characteristics of their colonies must be identified.
Mycoplasma Chlamydia Detection
Non-gonococcus vaginitis of mycoplasma and chlamydia infection can be confirmed by taking cervical mucus for testing. If you have sex, especially sexual intercourse pain, lower abdomen bulge, have more than two sexual partners, continuous medication does not improve or repeatedly hair author, cervical erosion, then, mycoplasma chlamydia examination is necessary.
Drug Sensitive Test
If a diagnosis of non-gonococcus vaginitis is made, this test is important in order to select the appropriate antibiotic for you. Drug sensitivity test: S- sensitive, M- moderately sensitive, R- resistant.
How To Prevent Vaginitis
- Pay attention to personal hygiene and keep the vulva clean and dry. Wash and change underwear frequently. Do not share bath towels or bathtubs with others. Do not wear nylon or similar airtight underwear. Bath towels and underwear used during illness should be boiled and disinfected.
- Pay attention to disinfection when using public restrooms to eliminate the source of infection.
- Pay attention to the rational use of broad-spectrum antibiotics and hormones. Diabetes patients should pay special attention to skin and vulva cleansing.
- Sexual intercourse is prohibited during treatment, or condoms are used to prevent cross infection. Vaginal medication and sitz bath should be avoided during menstruation. Patients with recurrent episodes should check their husbands' urine and prostatic fluid, and if necessary, check them repeatedly. If they are positive, they should be treated together.
- Patients with vaginitis should stabilize their mood, strengthen their physical fitness and improve their autoimmune function. Actively eliminate predisposing factors and treat various inflammations of reproductive organs in time.
How To Treat Vaginitis
Keep the vulva clean and dry, and avoid scratching. Sexual life is prohibited during treatment. Underwear and washing towels should be boiled for 5-10 minutes to eliminate pathogens, and sexual partners should be treated.
Commonly used drugs: Baking soda water, lactic acid solution, acetic acid solution, potassium permanganate solution, antibiotics.
If you think you have vaginitis, you should see a doctor as soon as possible. The doctor determines the treatment plan that suits you based on your actual illness.
How To Identify Vaginitis
Mainly the identification of various types of vaginitis. For details, see the specific description of symptom diagnosis.
Difference From Vaginal Cancer
The main clinical manifestations of vaginal cancer are:
- Irregular vaginal bleeding, bleeding after sexual intercourse and bleeding after menopause
- Leucorrhea increases, and there are even watery and bloody secretions in the vagina accompanied by foul smell. As the disease progresses, waist and abdominal pain, and dysuria (including frequent urination, hematuria, painful urination, blood in the stool, constipation, etc.) may occur.
- Vaginal secretions are grayish white, very viscous, even batter-like, uniform, but not purulent secretions, and the amount varies.
- The amine content in the secretion is particularly high, so it has a fishy smell. During sexual intercourse or after activities, the odor is often aggravated by promoting the release of amine. The amine smell can also be released after adding 10% potassium hydroxide in the secretion.
- The ph value in vaginal secretions increases, the ph range is 5.0-5.5, while that of normal people is 4.5-4.7.
- Clue cells can be detected in wet smear of vaginal secretions.
Among the above-mentioned four criteria, the diagnosis can be confirmed by those with more than three items, and the fourth item is emphasized as a necessary diagnostic criterion.
What Are The Complications Of Vaginitis
- Trichomonas: It can be complicated by trichomoniasis urethritis, cystitis, and pyelonephritis. Because trichomoniasis can swallow sperm, it can cause infertility and affect sexual life.
- Candidiasis: Complicated with other sexually transmitted diseases such as AIDS, condyloma acuminatum, gonorrhea, and non-gonococcus vaginitis.
- Nonspecific: It can cause vaginal adhesion, vaginal pus or uterine pus, and easily cause pelvic inflammatory disease, premature rupture of membranes and chorioamnionitis.
- Bacterial: induce genital infection, pelvic inflammatory disease, perirenal inflammation, sexual pain, etc.
- Senile: causing vaginal adhesion, vaginal pus or uterine pus.
- Infantile: it can cause adhesion of labia minora. when adhesion occurs, there is a small hole above or below, and urine will flow out of the hole.