Types of Vaginitis

What is vaginitis and causes of its development

Vaginitis is a group of female vaginal diseases accompanied by inflammation. There are many causes of vaginitis but usually it is the action of infectious agents in the presence of predisposing factors.



Vaginitis causes:

  • Failure to observe the rules of intimate care or, on the contrary, excessive care (frequent douching);
  • Endocrine glands dysfunction (often it is diabetes and thyroid pathologic condition);
  • Vaginal traumas (may be caused by defloration, aggressive sex, surgeries, intrauterine devices and even too tight underwear);
  • Sexually transmitted pathologies (gonorrhea, chlamydia, trichomoniasis etc.);
  • Scarlet fever and measles (in the childhood);
  • Lack of vitamins and minerals;
  • Predisposition to allergic reactions;
  • Any pathological conditions of digestive system, especially accompanied by intestinal dysbiosis;
  • Decreased resistance to infections or immunodeficiencies of any origin (HIV);
  • Physiological transformations of hormonal balance (puberty, pregnancy, menopause);
  • Long-term or uncontrolled use of antibiotics and hormonal medications;
  • Surgical abortion or miscarriage;
  • Oncological diseases (vaginitis caused by radio and chemotherapy).

Types of vaginitis and clinical presentation

There is an acute and a chronic form of vaginal inflammation and both may be infectious and non-infectious.

General symptoms for all types of vaginitis:

  • subjective sensations such as burning and itching;
  • general sign of inflammation (hyperemia, vaginal edema);
  • dysuric events (frequent urination);
  • copious foul-smelling discharge (in case with atrophic condition, on the contrary, excessive vaginal dryness);
  • low fever or in rare cases febrile temperature;
  • discomfort and pain during intercourse and after it.

Acute vaginitis

This type of vaginitis is characterized by variable clinical manifestations. This disease causes significant discomfort to a woman. If it is caused by a bacterial flora, then one of the first symptoms  is copious discharge and its nature depends on the causative agent.

Chronic vaginitis

The disease develops for a long time and sometimes does not manifest any symptoms and causes inconvenience only in the exacerbation phase. In the remission almost all symptoms disappear and only itching may cause discomfort. Treatment of chronic vaginitis is difficult as the infection has already settled in the vagina and destroyed useful flora.

Etiology classification of vaginits

Atrophic vaginitis

The synonym of this pathology is vaginal dryness. This disease usually affects elderly women but it may occur at any age. Vaginitis relates to the dysfunction of genital glands which do not produce secretion anymore. The result of it is thinning of the vaginal mucous membrane, irritations and microtraumas. Very often such inflammation process constitutes a combined vaginitis as when the vagina is injured, it is accompanied by bacterial infection or dysbacteriosis. Unlike infectious vaginitis, the main symptom of this type of the pathology is pain.

Bacterial vaginitis

This pathological condition develops in the result of ratio distortion between useful lactic bacteria and  bifidobacteria leading to the development of conditionally pathogenic flora. It is impossible to detect any certain causative agent as diagnostic methods identify many of them.

The main reasons of bacterial vaginitis are decreased immunity and improper genital hygiene as well as a long-term use of antibacterial medications. One of the predisposing factors is diabetes. In the majority of cases, vaginal dysbiosis is accompanied by intestinal  dysbiosis and combined pathological condition needs to be treated.

The most important thing in treating bacterial vaginitis is restoration of a useful vaginal microflora.

Yeast vaginitis

This is considered to be the most common vaginal disease in women. Yeast vaginitis is caused by excessive growth of the yeasts that belong to the genus Candida. Decreased immunity or immunodeficiency in HIV are the predisposing factors for this condition. Etiologically, vaginitis may relate to the uncontrolled use of antibiotics. The most typical symptom of yeast vaginitis, which is also called vaginal thrush, is cheesy-like white discharge. A woman may notice a thick white coating in her vagina and on her underwear.

To treat this type of the disease, a very specific anti-mycotic drug is used, however it is very difficult to get rid of candidiasis as microorganisms adapt very rapidly to the therapy.

Trichomonal vaginitis

The causative agent of this disease are trichomonads and the pathological condition itself relates to sexually transmitted infections. It can be acquired through unprotected intercourse or when using unusable condoms.

A characteristic symptom of trichomonal vaginitis is yellowish or greenish discharge indicating purulent inflammation. The discharge is foul-smelling and foamy. The clinical presentation of trichomonal vaginitis is evident.




The main diagnostic criteria of this type of vaginitis is detection of the causative agent in the smear as the symptoms are usually not specific.

Gonorrheal vaginitis

Gonorrhea-induced vaginitis is the rarest type of the disease. It is a complication of this pathological condition. There are almost no discharge or it accumulates on the posterior vaginal vault. The most typical symptoms are non-specific sign of inflammation manifested as redness and edema.

Chronic gonorrheal vaginitis almost never occurs and its acute form is easy to treat without the risk of a relapse.

Complications

Owing to untimely diagnostic or improper treatment, the following complications may occur:

  • Chronization of the disease (the danger of it is that it is extremely difficult to completely cure chronic vaginitis);
  • Synechiae or labial adhesion (typical for patients under 7 years old and some case require surgical intervention);
  • Cervical erosion (a dangerous condition which often evolves into malignant tumor);
  • Endometriosis (an excessive endometrial tissue growth outside the uterus, it may be complicated by the cysts or evolve into cancer);
  • Inflammation in the urogenital system (most often the kidneys are affected which poses the risk for developing acute or chronic kidney insufficiency);
  • Infertility (when the pathological process spreads to other parts of  the female reproductive system).

To prevent the development of dangerous and irreversible processes in the urogenital system, it is necessary to timely visit a doctor, obtain the diagnosis and follow indications for vaginitis treatment.

Vaginitis and pregnancy

Any type of vaginitis in pregnancy is a dangerous condition. If a woman is planning her pregnancy, first of all, she must completely cure the inflammation.

Vaginitis complications in pregnancy:

  • Ectopic pregnancy;
  • Premature placental abruption;
  • Fetal hypoxia;
  • Excessive or lack of delivery waters and premature rupture of membrane;
  • Miscarriage;
  • Infection and as a result abnormal fetal development.

Vaginitis treatment in pregnancy is difficult as the use of antibacterial medications negatively affects the fetus.

Diagnosis

  • Gynecologic examination. This method enables to detect visually the symptoms of inflammation such as mucous membrane redness and edema.
  • Inoculation of culture media. This method identifies a causative agent or excessive propagation of conditionally pathologic bacteria. Antimicrobial susceptibility test is performed to choose the most optimal treatment.
  • Polymerase chain reaction (PCR). This method is rarely used as it is very costly to perform it. However, this is the most informative test and in case other tests do not give a clear picture, PCR confirms the etiology of the disease. Additionally, PCR may exclude viral causes of the disease.

Vaginitis medication treatment and treatment  with natural remedies

The main rules to follow during the therapy:

  • Sexual abstinence;
  • In case with infectious vaginitis, both partners should be examined and treated.
  • Avoid alcohol and too spicy, salty and hot foods;
  • If vaginitis occurs in a child, the first rule to observe is to wipe a baby girl only from the front to the back to avoid one more infection;
  • Observe personal intimate care two times a day.

Basic principles of vaginitis treatment:

  • If the causative agent is the simplest microorganism, the most effective medication will be Metronidazole. It is used systematically in the form of tablets or topically in the form of gels and ointments.
  • Bacterial causative agents are eliminated with the help of antibacterial therapy, you should be aware, however, that the aim is not only to kill a pathogenic flora but to populate vagina with useful bacteria. For this reason, the use of antibiotics is combined with vaginitis suppositories containing eubiotics.
  • Yeast vaginitis is cured by the drug Clotrimazole which is administered topically and in advanced cases systematically.
  • Atrophic vaginitis requires topical treatment. Ointments, creams and suppositories are used to moisture vaginal mucous membrane.
  • If vaginitis is caused by some allergen or just a result of improper hygiene, additional therapy is not required. It is sufficient to change the habits (choose another soap, laundry detergent and underwear).
  • Natural remedies are allowable for symptomatic treatment. They help to get rid of itching and burning. Soothing baths or soaking therapy with herbal infusions are recommended.

It is not permitted to treat vaginitis without a consultation with a doctor as it may only aggravate the situation. If you noticed the first symptoms of inflammation, immediately visit a gynecologist.