Vaginitis is an inflammation of the vagina. Briefly, I remind you that the vagina is the female genital organ that connects the uterine cervix to the vulva. In other words, the vagina is a cylindrical duct that connects the lowest portion of the uterus, called the cervix, to the external genitalia. Returning to vaginitis, in many cases this inflammatory process is caused by a weakening of the vaginal mucosa. This weakness makes the vagina more vulnerable to infectious attacks. Symptoms such as local pain, itching and irritation, often associated with vaginal discharge, appear.
As anticipated, the causes of vaginitis can be different. The event responsible for the inflammatory process, in fact, can be represented by infections, but also by irritation, hormonal alterations or trauma. Let's now see in detail all these possible causes starting from those of an infectious nature. Often, at the origin of vaginitis there is an alteration of the balance and acidity of the vaginal environment; the increase in local pH and the alteration of the microbial flora facilitate infections. In practice, the microorganisms normally kept under control by lactobacilli take over (which are the good bacteria that populate the vagina). Those responsible for the infection can be in particular fungi, such as Candida albicans, or bacteria, such as the Gardnerella vaginalis, or even protozoa, such as the Trichomonas vaginalis. Many infectious agents responsible for vaginitis are also responsible for sexually transmitted diseases, so they are transmitted through sexual intercourse. For example, vaginitis can be a symptom of gonorrhea or chlamydia. More rarely, viral agents such as Herpes simplex are involved. Vaginitis, however, is not caused only by infectious agents. Changes in the vaginal environment can in fact also be linked to systemic diseases, such as diabetes, or to the prolonged use of certain drugs, such as antibiotics and corticosteroids. Turning to the irritative causes, even certain chemical or physical stimuli can cause irritation of the vaginal mucosa. Among the chemicals that can increase the risk of vaginitis (or even cause allergic vaginitis) are detergents, perfumes, condoms, and spermicides. Among the physical causes, however, vaginitis can be caused by abrasions, prolonged mechanical stimuli, childbirth or rubbing caused by clothing that is too tight or not breathable. Also among the physical causes, vaginitis can be caused by the presence of a foreign body in the vagina. We specify that a foreign body means a condom or a tampon held in the vagina for too long. In addition to the infectious, irritative and traumatic causes that we have just seen, hormonal alterations are also a predisposing factor for vaginitis. After menopause, in fact, atrophic vaginitis can arise, caused by the drop in estrogen. For this reason, atrophic vaginitis is also known as climacteric or senile vaginitis. Regardless of the menopause, hormonal changes can also occur on other occasions, such as after childbirth or during breastfeeding, or after surgical removal of the ovaries. In all these situations, therefore, the risk of atrophic vaginitis increases.
As for the symptoms, vaginitis generally manifests itself with itching, burning, and vaginal or vulvar irritation. These symptoms are often accompanied by pain on urination or pain during sexual intercourse. In addition, small bleeding outside the menstrual period and vaginal discharge may appear in the presence of vaginitis. The appearance and amount of any vaginal discharge depends on the cause of the infection. For example, in the case of bacterial infections, usually one is dealing with grayish-colored and foul-smelling secretions. Candida vaginitis, on the other hand, typically causes a characteristic whitish vaginal discharge, with a cheesy appearance. Finally, the color of the vaginal discharge typically becomes greenish in the Trichomonas infection. Not only with regard to the discharge, but at a general level, it must always be borne in mind that the symptoms of vaginitis, and the possible complications, differ according to the agent responsible for the inflammation. Atrophic vaginitis, for example, also involves the occurrence of vaginal dryness and a thinning of the mucous membrane of the vagina. Other forms of vaginitis occur, however, almost asymptomatic.
The diagnosis of vaginitis is made on the basis of the symptoms and signs that emerged during the gynecological examination, during which the vaginal mucous membranes and the cervix are examined. To identify the cause responsible for vaginitis, samples of vaginal secretions can be taken, in order to identify the responsible pathogen through a microscopic or cultural examination. To obtain these samples, vaginal swabs are performed; in practice, a collection of the vaginal secretion is carried out through a long and thin cotton stick inserted in the vagina.
In the case of a bacterial vaginitis, therapy involves local or general administration of antibiotics. Metronidazole and tinidazole are mainly used, to be taken orally or to be applied topically, for a few days. In case of fungal infections, as in the case of candida, antifungal creams, vaginal candlesticks or antifungal drugs to be taken orally are used instead. Since some infections responsible for vaginitis are sexually transmitted, in these cases the partner must also undergo treatment, even when he does not exhibit symptoms. As for atrophic vaginitis, the use of a vaginal lubricant may be indicated in these cases. water-soluble, which helps relieve irritation and pain during intercourse. In addition, the topical application of hormones may be recommended to increase estrogen levels. Finally, in vaginitis caused by an allergic reaction, in addition to the suspension of the substance that caused the irritation, the use of cortisone and antihistamines may be indicated.
To the therapy of vaginitis, it is advisable to associate some useful behaviors to prevent and avoid subsequent infections or irritations at the vaginal level. First of all, it must be remembered that the use of condoms can help prevent some infectious processes that can be transmitted sexually. At the basis of any treatment there is also proper intimate hygiene. However, the use of intimate detergents should not be excessive; moreover, especially in the presence of allergic or irritative phenomena, preference should be given to detergents free of perfumes, preservatives and dyes. Another good rule is to choose clothing underwear that guarantee the right perspiration and do not irritate the genital area. Therefore synthetic materials should be avoided and cotton is preferred. Before concluding, it is necessary to remember that an infectious vaginitis not treated adequately can become chronic. Moreover, if the infection is spreads to the uterus, fallopian tubes and ovaries, it can compromise the woman's future fertility.
