Colpitis: Symptoms and Treatment
- Pathogenesis of the disease
- Classification of colpitis
- Characteristic symptoms of colpitis
- Diagnosis of colpitis
- Treatment of colpitis
- Prevention and prognosis of colpitis
Colpitis (synonym for vaginitis) is one of the most common pathologies of the female genital organs. This pathological condition is characterized by inflammation of the mucous membrane of the vagina, which develops as a result of the penetration of infectious agents, as well as due to chemical or mechanical traumatic exposure.
Most often, vaginitis affects women of reproductive age. Its intensity depends on what caused the development of the disease, as well as on the age of the patient.
It should be noted that vaginitis can occur not only in the reproductive age, but also in older women, as well as in girls. In each case, the disease proceeds with its own characteristic features, accompanied by inflammation of the vulva.
Pathogenesis of the disease
The main reasons for the development of colpitis include:
- Bacterial, fungal and viral infections (including sexually transmitted infections).
- Various allergic reactions.
- Drugs for topical use (tablets and suppositories);
- Chemical reagents used as douching solutions;
- Foreign bodies.
Internal factors in the development of the disease are functional disorders of the ovaries, malfunctions in the pancreas and thyroid gland, impaired digestion and decreased immunity.
The external factors that provoke the development of the pathological process include the long-term and inadequate use of antibiotics, cytostatics and hormonal drugs. At the same time, intrauterine contraceptives, stress effects, as well as environmental, climatic, and sanitary and hygienic factors can provoke colpitis.
The most common causative agent of colpitis becomes staphylococcus or streptococcus, Proteus, E. coli, mycoplasma , gonococcus, chlamydia, trichomonas and yeast-like fungus of the genus Candida. As a rule, microorganisms and viruses that penetrate the vagina, very quickly die in the process of self-purification inherent in a healthy female body. However, with the development of gynecological pathologies, irrational use of contraceptive contraceptives, violation of the principles of sexual hygiene, vaginal injuries and non-compliance with the rules of intimate hygiene, the natural process of self-purification is disturbed, which contributes to the development of the disease.
Classification of colpitis
In clinical practice, colpitis differ in the type of pathogen.
In the case when the disease is caused by a trichomonas infection, trichomonas colpitis is diagnosed;
Vaginal dryness provokes the development of atrophic colpitis;
Yeast-like fungi of the genus Candida cause candidal colpitis;
In the case when the patient develops purulent inflammation of the vagina caused by E. coli, streptococcus, staphylococcus and other microorganisms, we are talking about non-specific (aerobic) colpitis.
If vaginitis occurs due to the simultaneous exposure of several types of microorganisms, a mixed form of the disease is diagnosed.
Characteristic symptoms of colpitis
The most characteristic symptoms of the disease include itching and burning in the vagina, as well as swelling and hyperemia of the mucous membrane. In women, pain develops during intercourse, in some cases erosion occurs, and there are plentiful discharge of purulent or cheesy character, often with an unpleasant odor.
However, with a long course of the disease, signs of colpitis become less noticeable. However, after a cold, hypothermia, overwork, or after intercourse, they can manifest with a new force. Also provoke a relapse of the disease can close synthetic linen, which has an irritating effect on the external genitalia.
Often with inadequate treatment of colpitis, the pathological process becomes chronic, and then the inflammation spreads in the ascending ways, affecting the urethra, uterus and fallopian tubes, and causing such serious diseases as cystitis , endometritis, cervicitis and even infertility.
Trichomonas vaginitis is one of the most common urogenital abnormalities caused by a specific simplest microorganism that moves with the help of flagella. In some cases, Trichomonas does not cause any clinical symptoms and a person, even unaware that he is sick, is a carrier of infection (in the absence of an inflammatory process, this is a matter of trichomonadal carrier). The incubation period of trichomonas vaginitis can last up to 1 month (usually 1-15 days). During this time there is an active reproduction of the pathogen on the mucous membranes of the genital organs.
Often Trichomonas colpitis can be supplemented with other urogenital infections (this condition in clinical practice is called mist infection). This form of the disease leads to the fact that female sexual function begins to fade away, that is, sex becomes painful and ceases to bring satisfaction. In the acute form of Trichomonas vaginitis, on average one week after infection, itching and burning appear in the area of the external genitalia in women (the infectious process proceeds with damage to the external genitalia in the form of vulvovaginitis). Further, there are abundant frothy discharges of yellow-gray color, with impurities of pus and with a very unpleasant odor. The patient becomes irritable and nervous, her performance is impaired and insomnia develops.
When the disease becomes subacute, the symptoms of Trichomonas vaginitis are not so pronounced. In the absence of adequate treatment, the disease becomes chronic, which leads to the development of inflammatory processes not only in the urinary system, but also in other pelvic organs (endometritis, cervicitis, salpingoophoritis).
Atrophic, or senile (senile) vaginitis is an inflammatory disease of the vagina that develops in women after the onset of natural menopause, oophorectomy, or ovarian irradiation. Most often, it affects patients who have reached 55-60 years of age.
The main cause of the development of the disease is the lack of female sex hormones (hypoestrogenism). Due to their deficiency, proliferative processes in the vaginal epithelium stop, the mucous membrane becomes thinner and becomes dry and vulnerable. The disappearance of lactobacilli leads to activation of non-pathogenic microflora, which grows in the vagina. The most characteristic clinical symptoms of atrophic colpitis include itching, burning, dryness and prolapse of the vaginal walls, pain in the process of urination, dyspareunia, contact vaginal blood discharge.
According to experts, the feeling of dryness in the vagina occurs because of a violation of blood circulation in the vaginal walls. As a result, against the background of hormonal deficiency, atrophic processes in muscles, vessels and mucous membrane develop, which leads to the development of progressive hypoxia of the vaginal wall.
Itching and soreness caused by atrophic colpitis are due to atrophic changes occurring in the labia minora. At the same time, sclerotic processes may develop in the vulvar ring, leading to atrophy of stratified squamous epithelium (precancerous condition).
Thrush or candidal vaginitis is a lesion of the mucous membrane of the vagina, provoked by opportunistic yeast fungi of the genus Candida. Most often, this form of pathology affects women of reproductive age. Typically, candidal colpitis develops due to decreased immunity, after infectious diseases, long-term use of hormonal and antibacterial drugs, in patients suffering from diabetes and with an unbalanced diet, when carbohydrates are dominant in the diet. Also, severe stresses, a change in the pH of the vagina and poor environmental conditions can trigger the development of candidal colpitis.
The symptomatology of this disease depends on the form of the pathological process.
Candidacy is a condition that proceeds without any clinical signs and does not cause any discomfort to the woman. At the same time, this form of pathology can easily be detected by laboratory research, and it can also be the cause of infecting the child as it passes through the infected birth canal of the mother.
Acute candidal colpitis is a disease with pronounced symptoms. Patients complain of burning and itching and in the vagina, aggravated during sexual contact, after urination, and after taking a warm bath. Appear greyish-white cheesy discharge, not having a pungent smell, swelling and vaginal hyperemia.
Chronic candidal vaginitis is a disease characterized by a relapsing course. It occurs in approximately 2-3% of women of reproductive age. Most often, symptoms of the disease occur a week before menstruation or after sexual contact.
This form of the pathological process develops due to imbalance of the vaginal microflora. It is provoked by some conditionally pathogenic microorganisms (E. coli, Staphylococcus aureus, Streptococcus, Proteus, etc.). Normally, in small quantities, they are permanent inhabitants of every healthy organism, however, with unfavorable factors, conditionally pathogenic microflora is activated and begins to multiply rapidly, displacing lactobacilli. This condition develops as a result of disruption of the immune or endocrine system, due to hormonal and infectious pathologies, metabolic disorders, as well as due to non-compliance with intimate hygiene rules.
With the development of nonspecific colpitis, patients develop watery, bloody, foamy or purulent discharge, swelling and vaginal hyperemia, pain, itching and burning, increasing during urination and the process of sexual contact.
Diagnosis of colpitis
The diagnosis is made after studying the data of the anamnesis, the clinical picture, the patient's complaints and the results of the laboratory examination. First of all, to identify the nature of the disease will allow a carefully collected history and gynecological examination of the vagina and cervix with the help of mirrors. For the acute form of coleitis, looseness, swelling and hyperemia of the mucous membranes of the vaginal walls are characteristic. They are strongly thickened and covered with a serous or serous-purulent film coating. In the chronic form of the disease, insignificant discharge is noted, mucosal defects are mild.
In order to better understand the nature of the pathological changes, the patient is performed colposcopy. However, specialists receive the most objective information after laboratory research methods are carried out.
First of all, a microscopic examination of smears is carried out, which allows to determine the nature of the causative agent of colpitis. When conducting bacteriological analysis, the nature of the disease (specific or non-specific) is specified. And also after studying bacteriological seeding of discharge from the vagina, the sensitivity of microflora to antibacterial drugs is determined.
At the present stage, the most promising method by which such specific causative agents of colpitis, such as mycoplasma, chlamydia, ureaplasma, leptotrix, mobilunkus, etc., are identified, is the polymerase chain reaction (PCR).
At the same time, according to medical indications, an enzyme immunoassay, a bacteriological urine culture, a cytological smear taken from the cervix and an analysis of the hormonal status can be prescribed. For the detection of concomitant gynecological pathologies, an ultrasound of the pelvic organs is performed.
Treatment of colpitis
Treatment of colpitis involves the use of drugs of systemic and local action that suppress activity and drastically reduce the number of the pathogen. As a rule, the treatment of the disease is carried out in a complex and is selected depending on the type of pathogen, the presence of comorbidities and the age of the patient.
Local treatment of colpitis
Local therapy involves two stages: etiotropic treatment aimed at eliminating the cause of the disease, and restoring the natural microflora of the vagina.
Etiotropic treatment involves the reorganization of the vagina and external genital organs (douching and the introduction of special tampons, vaginal suppositories and balls into the vagina). In this case, herbal decoctions, a solution of rivanol, zinc sulfate and potassium permanganate, sea buckthorn oil, galascorbine and various local antimicrobials are used. If the disease is characterized by persistently progressive course, the use of local antibacterial agents is indicated to the patients, and special physiotherapy procedures are prescribed.
At the end of the course of etiotropic therapy, it was recommended to use local preparations, which include live or dried probiotics. They increase the protective properties and contribute to the restoration of the natural microflora of the vagina.
General treatment of colpitis
Systemic therapy of the disease is prescribed to patients with severe clinical manifestations of colpitis in the absence of an effect from local treatment and depending on the type of pathogen that provoked the development of the inflammatory process. In accordance with the infectious agent, antibacterial and sulfa drugs are selected, vitamin and immunotherapy are prescribed, and phytotherapeutic and physiotherapeutic treatment is carried out.
Note: the appointment of physical procedures should take into account the existing contraindications.
In the acute stage of colpitis, UHF is shown to patients on the perineal region and ultraviolet irradiation of the vulva.
In the subacute and chronic stages, CMW therapy on the vaginal region, electrolyte cauterization, local darsonvalization, phonophoresis, laser irradiation of the vulva and UHF on the perineal region have proven themselves well.
Ozone therapy is currently used in the treatment of non-specific and bacterial colpitis. Thanks to ozone, which has immunomodulating, bactericidal, anti-stress, virus-soliton, fungicidal and desensitizing properties, microbial aggression is prevented and the level of protection is activated. Unlike antibiotics, ozone therapy does not have a negative effect on the body, and drug resistance of the pathogen does not occur to ozone.
As a rule, with timely treatment for medical care and adequate performance of all necessary prescriptions, the course of treatment for vaginitis is 5-7 days. During this period, experts strongly recommend to refrain from sexual contact, and, if necessary, should simultaneously treat the patient's sexual partner.
During the treatment of vaginitis, a gentle vegetable and sour-milk diet is indicated. Smoked, pickled and spicy dishes from the diet will have to be eliminated, as they have an irritating effect on the mucous membranes, and, to reduce swelling on the mucous membranes, you should limit fluid intake.
Treatment of atrophic vaginitis
Treatment of this form of obesity involves the restoration of the trophic vaginal epithelial layer and the prevention of recurrence of the disease. As a rule, hormone replacement therapy (local preparations in the form of ointments or vaginal suppositories) is indicated for atrophic colpitis. However, the patient may be prescribed drugs of systemic action, used in the form of tablets and patches.
Note: Systemic hormone therapy only with prolonged use (up to 5 years) allows you to achieve maximum effect.
Also phytoestrogens (herbal preparations) have proven themselves well.
In the diagnosis of atrophic colpitis, the effectiveness of the treatment is monitored during periodic examinations of the patient. It shows colposcopy, vaginal pH-metry and cytology. In the case when the use of estrogen is contraindicated in a woman, special herbal baths and douching are prescribed.
Prevention and prognosis of colpitis
Следует подчеркнуть, что вагинит, при проведении правильного и своевременного лечения не представляет серьезной угрозы для женского здоровья. В то же время, несоблюдение профилактических мер может серьезно повлиять на репродуктивную функцию и общее состояние пациентки. Прежде всего, следует тщательно соблюдать правила интимной гигиены и правила половой жизни, своевременно лечить общие и урогенитальные патологии, санировать хронические очаги инфекции, полноценно питаться, избегать стрессовых воздействий. При изменении характера выделений разумнее будет показаться гинекологу, который, при необходимости, назначит диагностическое обследование и адекватное лечение.
Женщинам в период менопаузы для предупреждения развития сенильного (атрофического) вагинита рекомендуется регулярно наблюдаться у специалиста. Врач своевременно назначит препараты заместительной гормональной терапии, которые уменьшат климактерические проявления, предотвратят развитие сердечно-сосудистых патологий и остеопороза, и окажут существенное влияние на состояние влагалищного эпителия. Для того чтобы предупредить развитие раннего климакса, специалисты рекомендуют отказаться от курения, рационально питаться и укреплять иммунитет. Течение атрофического вагинита благоприятно, однако в некоторых случаях заболевание может рецидивировать, значительно снижая качество жизни женщины.