Colpitis: symptoms and treatment
- Pathogenesis of the disease
- Classification of colpitis
- Characteristic symptoms of colpitis
- Colpos Diagnosis
- Treatment of colpitis
- Prevention and prognosis of colpitis
Colpitis (a synonym for this term vaginitis) is one of the most common pathologies of female genital organs. This pathological condition is characterized by inflammation of the mucous membrane of the vagina, which develops due to the penetration of infectious agents, as well as due to chemical or mechanical traumatic effects.
Most often, vaginitis affects women of reproductive age. Its intensity depends on what caused the development of the disease, as well as the patient's age.
It should be noted that vaginitis can occur not only in reproductive age, but also in older women, as well as in girls. In each case, the disease occurs with its own characteristics, 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 solutions for douching;
- Foreign bodies.
Internal factors in the development of the disease are functional abnormalities of the ovaries, malfunctioning of the pancreas and thyroid gland, violation of digestive processes and decreased immunity.
External factors that provoke the development of the pathological process include long-term and inadequate use of antibiotics, cytostatics and hormonal drugs. At the same time, intrauterine contraceptives, stressful effects, and also ecological, climatic and sanitary-hygienic factors can provoke colpitis.
Most often Staphylococcus or Streptococcus, Proteus, Escherichia coli, Mycoplasma , Gonococcus, Chlamydia, Trichomonas and yeast-like fungus of the genus Candida become the causative agent of colpitis. As a rule, microorganisms and viruses that penetrate the vagina die very quickly in the process of self-purification inherent in a healthy female body. However, with the development of gynecological pathologies, irrational use of contraceptives, violation of the principles of sexual hygiene, vaginal trauma and non-compliance with the rules of intimate hygiene, the natural process of self-purification is violated, which contributes to the development of the disease.
Classification of colpitis
In clinical practice colpites differ in the type of pathogen.
In the case when the disease is caused by trichomonas infection, trichomonas colpitis is diagnosed;
Vaginal dryness provokes the development of atrophic colpitis;
Yeast-like fungi of the genus Candida cause candida colpitis;
In the case when the patient develops purulent inflammation of the vagina, caused by E. coli, streptococcus, staphylococcus and other microorganisms, it is a matter of nonspecific (aerobic) colpitis.
If vaginitis occurs due to simultaneous exposure to 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. Women develop soreness in sexual intercourse, in a number of cases, erosion occurs, and there are abundant seborations of purulent or curdled nature, often with an unpleasant odor.
However, with a long course of the disease, colpitis becomes less noticeable. However, after a cold, hypothermia, overwork or after intercourse, they can manifest themselves with renewed vigor. Also, a close synthetic linen, which irritates the external genitalia, can provoke a relapse of the disease.
Often, with inadequate treatment of colpitis, the pathological process passes into a chronic form, and then the inflammation spreads along the ascending paths, 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 pathologies caused by a specific protozoan microorganism, moving with the help of flagella. In some cases, Trichomonas does not cause any clinical symptoms and the person, even unaware that he is sick, is the carrier of the infection (in the absence of the inflammatory process it is a question of trichomonadonance). The incubation period of trichomonas vaginitis can last up to 1 month (usually 1-15 days). During this time, there is active propagation of the pathogen on the mucous membranes of the genital organs.
Often trichomonas colpitis can be supplemented by other urogenital infections (such a condition in clinical practice is called a mystic infection). This form of the disease leads to the fact that the female sexual function begins to gradually fade, that is, sexual intercourse becomes painful and ceases to bring satisfaction. In the acute form of trichomonas vaginitis, an average of a week after infection in the external genital area, women develop itching and burning (the infection occurs with the external genitalia in the form of vulvovaginitis). Then there are copious foamy discharges of yellow-gray color, with impurities of pus and with a very unpleasant odor. The patient becomes irritable and nervous, her working capacity is broken and insomnia develops.
When the disease acquires a subacute course, the symptoms of trichomonas vaginitis are less pronounced. In the absence of adequate treatment, the disease turns into a chronic form, which leads to the development of inflammatory processes not only in the urinary system, but also in other organs of the small pelvis (endometritis, cervicitis, salpingo-oophoritis).
Atrophic, or senile (senile) vaginitis is an inflammatory vaginal disease that develops in women after the onset of natural menopause, ovariectomy or ovarian irradiation. Most often, it affects patients who are 55-60 years of age.
The main cause of the disease is the lack of female sex hormones (hypoestrogenia). Because of their deficiency proliferative processes in the epithelium of the vagina stop, the mucous membrane becomes thinner and becomes dry and vulnerable. The disappearance of lactobacilli leads to the activation of non-pathogenic microflora, vegetating in the vagina. The most characteristic clinical symptoms of atrophic colpitis include itching, burning, dryness and lowering of the vaginal walls, pain during urination, dyspareunia, contact blood vaginal discharge.
According to experts, a feeling of dryness in the vagina arises because of a violation of blood circulation in the vaginal walls. As a consequence, against the background of the hormonal deficiency, atrophic processes develop in the muscles, vessels and mucous membrane, which leads to the development of progressive hypoxia of the vaginal wall.
Itching and soreness arising from atrophic colpitis are due to atrophic changes occurring in the labia minora. Simultaneously, in the vulvar ring, sclerotic processes can develop, leading to atrophy of multilayered planar epithelium (precancerous state).
Thrush , or candidal vaginitis - is a lesion of the mucous membrane of the vagina, provoked by opportunistic yeast-like fungi from the genus Candida. Most often this form of pathology affects women of reproductive age. As a rule, candidal colpitis develops due to a decrease in immunity, after infectious diseases, prolonged intake of hormonal and antibacterial drugs, in patients with diabetes mellitus and in an unbalanced diet, when carbohydrates predominate in the diet. Also, to provoke the development of candida colpitis may be severe stress, a change in the pH of the vagina and poor environmental conditions of residence.
The symptomatology of dna disease depends on the form in which the pathological process takes place.
Candidacy is a condition that occurs without any clinical signs, which does not cause any discomfort to the woman. At the same time, this form of pathology can easily be detected in laboratory research, and it can also cause infection of the child when it passes through the mother's infected maternal pathways.
Acute candidiasis colpitis is a disease with pronounced symptoms. Patients complain of burning and itching and in the vagina, intensifying during sexual intercourse, after urination, and after taking a warm bath. Appear grayish-white cheesy discharge, not having a sharp odor, there is swelling and hyperemia of the vagina.
Chronic candidiasis vaginitis is a disease characterized by a recurring course. It occurs in about 2-3% of women of reproductive age. The most common signs of the disease occur a week before the month or after sexual contact.
This form of pathological process develops due to a violation of the balance 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, under adverse factors, the opportunistic microflora is activated and begins to multiply rapidly, displacing lactobacilli. This condition develops due to disruption of the immune or endocrine system, due to hormonal and infectious pathologies, metabolic disorders, and also because of non-compliance with the rules of intimate hygiene.
With the development of nonspecific colpitis, patients develop watery, bloody, foamy or purulent discharge, puffiness and hyperemia of the vagina, pain, itching and burning that intensify during urination and during sexual intercourse.
The diagnosis is made after studying the history of the patient, the clinical picture, the patient's complaints and the results of the laboratory examination. First of all, to reveal the nature of the disease will allow a carefully collected history, as well as gynecological examination of the vagina and cervix with the help of mirrors. The acute form of colpitis is characterized by looseness, swelling and hyperemia of the mucous membranes of the vaginal walls. They are strongly thickened and covered with serous or serous-purulent film coating. With a chronic form of the disease, minor discharge is noted, mucosal defects are poorly expressed.
In order to better understand the nature of pathological changes, the patient is subjected to colposcopy. However, specialists receive the most objective information after laboratory methods of research have been carried out.
First of all, a microscopic examination of smears is performed, which makes it possible to determine the nature of the causative agent colpitis. At carrying out of the bacteriological analysis the character of disease (specific or nonspecific) is specified. And also after studying the bacteriological culture of vaginal discharge, 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 are detected, such as mycoplasma, chlamydia, ureaplasma, leptotriks, mobiluncus, etc., is the method of polymerase chain reaction (PCR).
At the same time, according to medical indications, an enzyme immunoassay, bacteriological culture of urine, a cytological smear taken from the cervix and an analysis for determining the hormonal status can be prescribed. To identify accompanying gynecological pathologies, ultrasound examination of the pelvic organs is performed.
Treatment of colpitis
Colpitis treatment involves the use of systemic and topical drugs that suppress activity and sharply reduce the number of pathogens. 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 concomitant pathologies and the age of the patient.
Local treatment of colpitis
Local therapy includes two stages: etiotropic treatment aimed at eliminating the cause of the disease, and restoring the natural microflora of the vagina.
Etiotropic treatment provides for the sanitation of the vagina and external genitalia (douching and insertion into the vagina of special tampons, vaginal candles and balls). In this case, herbal decoctions, rivanol solution, zinc sulfate and potassium permanganate, sea buckthorn oil, galascorbine and various local antimicrobials are used. If the disease is characterized by a persistently progressive course, the patients are shown to use local antibacterial agents, and they are given special physiotherapeutic procedures.
At the end of the course of etiotropic therapy, local use of drugs containing living or dried probiotics is recommended. 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 the effect of 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 sulfanilamide preparations are selected, vitamin and immunotherapy are prescribed, as well as phytotherapeutic and physiotherapeutic treatment.
Note: when appointing physical procedures, the contraindications should be taken into account.
In the acute stage of colpitis, patients are shown UHF on the perineal region and ultraviolet irradiation of the vulva.
In the subacute and chronic stage, well-proven CMV-therapy on the vaginal area, electrolytic cauterization, local darsonvalization, ultraphonophoresis, laser irradiation of the vulva and UHF on the perineal region.
In the treatment of nonspecific and bacterial colpitis, ozone therapy is currently used. Thanks to ozone, which possesses, immuno-modulating, bactericidal, anti-stress, virosolytic, fungicidal and desensitizing properties, microbial aggression is prevented and the level of protection is activated. In contrast to antibiotics, ozone therapy does not have a negative effect on the body, as well as to ozone, there is no drug resistance of the pathogen.
As a rule, with the timely application of medical care and adequate performance of all the necessary appointments, the course of treatment of vaginitis is 5-7 days. During this period, experts strongly recommend that you refrain from sexual intercourse, and, if necessary, you should simultaneously treat the patient's sexual partner.
During the treatment of vaginitis, a sparing vegetable and sour-milk diet is shown. Pickles, pickles and spicy dishes from the diet should be eliminated, since they are irritating to the mucous membranes, and to reduce the swelling on the mucosa, you should limit fluid intake.
Treatment of atrophic colpitis
Treatment of this form of colpitis involves the restoration of trophic epithelial layer of the vagina and prevention of recurrence of the disease. As a rule, with atrophic colpitis, hormone replacement therapy is indicated (local preparations in the form of ointments or vaginal suppositories). However, the patient may be prescribed systemic drugs, used in the form of tablets and patches.
Note: Systemic hormone therapy only with long-term use (up to 5 years) allows to achieve maximum effect.
Phytoestrogens (preparations of vegetable origin) are also not bad.
In the diagnosis of atrophic colpitis, the effectiveness of treatment is monitored during periodic studies of the patient. It is shown colposcopy, vaginal pH-metry and cytology. In the case when a woman is contraindicated in the use of estrogens, special herbal baths and syringings 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.