Venereology
Vaginitis
Information on vaginitis
Vaginitis! One of the most common problems of women today, especially in the summer months. According to surveys, vaginitis is the most common reason why women visit their gynecologist, as 75% of women will suffer from vaginitis at some point in their lives and, most of them, more than once. Vaginitis is a microbial infection or inflammation that disrupts the normal secretions of the vagina and is often accompanied by vaginal sinusitis or cervicitis. Symptoms such as vaginal fluids, itching, inconvenience in contact, and skin sensations in the sensitive area are some of the typical symptoms. Vaginitis is due to germs such as bacteria, fungi or parasites. "Atrophic vaginosis" occurs after menopause with the same symptoms but it is not associated with germs but with the absence of estrogen. Vaginosis is cured according to the cause but also prevented.
 
What Are The Symptoms Of Vaginitis?
Normally, vagina features the so-called normal flora, dominated by lactobacilli, which play a protective role and prevent pathogenic microbes from entering. If the balance of lactobacilli is disturbed, vaginitis occurs. Many times, vaginosis has no symptoms and diagnosis happens accidentally when women visit the gynecologist for the annual Pap test or gynecological examination. Other times they result in disturbing the composition of normal vaginal secretions. Symptoms of vaginitis include irritation and itching in the vagina, redness in the vaginal walls and white viscous secretion from the vagina, which may also show redness and swelling. The secretions are strange in colour and odor, and sometimes there is some blood from the vagina. Sometimes vaginitis is perceived with pain during sexual intercourse or enuresis. In cases of inappropriate and timely treatment, the symptoms are those of endoproliferative inflammation with severe abdominal pain and fever.

What Causes Vaginitis?
Vaginitis does not always have clearly recognized causes. Many times it is the result of infection by pathogenic microorganisms such as bacteria and fungi, either from the large intestine, migrating to the vagina through the perineum or finding an opportunity to grow due to some disturbances in the natural flora of the vagina.

The female genitals are colonized by a multitude of micro-organisms that are what gynecologists call a natural flora. The vagina, therefore, has these normal microbes that prevent pathogenic microbes from entering. In normal flora there are microorganisms called lactobacilli which play a protective role. Normal flora is fed by female hormones, estrogen. In many cases, vaginitis occurs when the pH of the vagina is disturbed. Many factors can contribute to this change, such as pregnancy, menopause, pre-period, drugs such as antibiotics, stress, aromatic soaps and tight clothing.

When a chronic antibiotic or frequent use of antiseptics destroys normal flora, pathogenic microorganisms are easily developed. The same happens when the estrogen or body defense is reduced. Most vaginosis is due to microorganisms such as fungi, bacteria, trichomonias and chlamydia.

Candida vaginitis
Candida vaginitis is the most common type, due to the Candida Albicans fungus, which is naturally present in the mucosa of the perinatal region and helps to maintain the acidic pH of the vagina. Vaginal candidiasis is the most common inflammation of fungi that attacks the genitourinary system and especially women of childbearing age and during pregnancy. Indeed, about two-thirds of women of childbearing age may have at least one episode of candidiasis and in a percentage of 5% of cases they may persist for more than three times a year. Also, due to transmission and sexual intercourse, inflammation often occurs to the man. Symptoms of fungal vaginosis may be mild to severe and include:
  • Itching and irritation of the vagina and vulva
  • Feeling burned during intercourse or urination
  • Redness and swelling of the vulva
  • Pain in the vagina
  • Invisible, white, odorless vaginal secretion with a picture like that of cottage cheese
Vaginitis needs oral or topical treatment with antifungal agents such as fluconazole and itraconazole. It is advisable to treat the sexual partner as well, to avoid reinfection. Probiotic formulations that restore normal gut flora are equally important to reduce relapse rates, especially for the digestive tract, perineum and genitals.

Bacterial vaginitis
It is called bacterial vaginosis, because there is no inflammation in the vagina. This condition is due to the large replacement of normal vaginal microbial flora by other pathogenic microorganisms such as Gardnerella vaginalis, Mycoplasma hominis and other anaerobic bacteria. Anaerobes produce large amounts of enzymes, which are responsible for substances that give a characteristic nasty odor to the vaginal fluids. A 90% of women with bacterial vaginosis are symptomatic and the problem is discovered in the gynecologist after laboratory tests and may coexist with fungal or trichomoniasis vaginitis.

In bacterial vaginosis, treatment is recommended in symptomatic women through metronidazole or clindamycin creams. Research has shown that the response of a woman to the treatment and the possibility of a recurrence of bacterial vaginosis is not affected by the treatment of her sex partners. Therefore routine treatment of sexual partners is not recommended. Finally, it should be noted that during these treatments, alcohol consumption should be avoided and special attention paid to sexual activity as these creams tend to alter the effectiveness of the condom.

Trichomoniasis Vaginitis
This type of vaginitis is common at a reproductive age and is due to the trichomonas, a lamellar protozoan. Women with trichomoniasis vaginitis complain of thin, smoldering, yellowish-green, often sparkling fluids, accompanied by redness and itching. In most cases, trichomonas is transmitted by sexual intercourse. However, a woman, especially during the summer months, may be infected by the toilet or by using infected personal items. Nitroimidazoles are the only class of drugs that is effective in the treatment of trichomoniasis sinusitis. The sexual partners of patients with trichomonas infection should also be treated. In any case, abstinence from sexual activity is recommended during treatment and until both comrades are asymptomatic.

Vaginitis From Chlamydia
It is a highly sexually transmitted form of vaginosis caused by the bacterium chlamydia trachomatis. 80% of women infected with this bacterium show no symptoms and that is why it is very difficult to diagnose. They usually feature slight blood flow, especially after a sexual act, and low back pain or waist. In contrast, chlamydia-infected men exhibit symptoms at a rate of 50%. If the infection is not treated therapeutically, it can cause many complications, the main one being infertility. Chlamydia can be easily treated with antibiotics, such as azithromycin and oxicicline. The sexual partners of patients with chlamydia sinusitis should also be treated. In any case, abstinence from sexual activity is recommended during treatment and until both comrades are asymptomatic.

How to Prevent Vaginitis
For the prevention of vaginitis, experts recommend the following:
  • Always use a condom during sex.
  • Avoid the use of antiseptic soaps that disrupt the natural flora of the sensitive area.
  • Restrict the use of tampons and prefer the sanitary napkin, which should be changed frequently.
  • Do not wear very tight trousers and, in general, avoid synthetic clothes, preferring comfortable and loose clothes made of natural materials such as cotton, linen or silk.
  • Do not lie down on the sand but use a towel.
  • After bathing in the sea or swimming pool, change their swimsuits directly.
  • Watch your diet avoiding the many carbohydrates. Also, women who suffer from diabetes should take care to keep their sugar at the same level.
  • Wash and sweep the genital area from front to back so that the faecal bacteria are not transported to the vagina.
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