Colpitis is a common gynecological disease. It affects mainly women of reproductive age.
It occurs under the influence of both general and local factors. This is an inflammation of the mucous membrane of the vaginal walls.
In medicine, the disease has another name - vaginitis. Before starting treatment, you need to understand the causes, risk factors, consequences and precautions.
Risk factors
At any age, the cause of the disease lies either in one’s own pathogenic microflora or in the action of an infection ( when bacteria, viruses or fungi enter the vagina).
The causes of colpitis are:
What risk factors predispose to the development of the disease? The main unfavorable circumstance turns out to be insufficient intimate hygiene.
Female genital organs should be washed 2 times a day. For this it is better to use special means intimate hygiene.
Regular soap leads to acid imbalance and the growth of bacteria in the vagina.
Improper sexual hygiene significantly increases the risk of pathogens.
Pathological disorders of the endocrine system ( diabetes mellitus, hypothyroidism, ovarian diseases) can also become serious factors in the development of the disease.
Injuries to the vagina and damage to the genital organs contribute to the pathogenic activity of pathogens.
Symptoms, signs
The disease can have both specific and nonspecific origin.
Specific pathology is caused by:
- Viruses.
- Candida- fungi that exhibit pathological activity during reproduction. The process is accompanied by itching and cheesy discharge. Fungi can begin to multiply due to weakened immunity, and can also be transmitted sexually.
- Trichomonas, gonococci, chlamydia - penetrate the vagina during sexual contact. As a result, abundant foamy discharge appears that has an unpleasant odor.
- Mycoplasmas. General symptoms specific colpitis: swelling and velvetyness of the vaginal walls, bleeding when touched.
Nonspecific colpitis is caused by Pseudomonas aeruginosa and Escherichia coli, staphylococci, streptococci.
The ways they enter the vagina can be different.
At the same time, the woman feels weak, lethargy. Body temperature may rise to subfebrile (from 37 to 38).
Painful symptoms spread to the external genitalia. There is purulent plaque and swelling.
Possible complications
Many women consider colpitis to be a mild illness that can go away without treatment. However if you ignore the symptoms, it will go into a sluggish form.
The symptoms will become less pronounced, but this does not at all indicate a recovery process. At the first symptoms, you need to go to a gynecologist to find out the cause and prescribe treatment.
In the complete absence of treatment, cervicitis may occur - inflammation of the cervix. Endometritis is possible(inflammation of the uterine mucosa) and salpingoophoritis (disease of the appendages).
Such pathologies lead to infertility and increase the risk of ectopic pregnancy.
If you ignore the symptoms, there are many dangerous consequences:
- the chronic form is more difficult to treat with medications;
- provoking diseases genitourinary system, for example, urethritis, cystitis;
- in girls, lack of treatment can result in fusion of the inner or outer labia.
The likelihood of infection spreading in the area genital tract increases with sex during menstruation.
When and which doctor to go to
Colpitis usually indicates other pathologies in a woman's body. If the immune system is weakened, bacteria multiply, causing inflammation of the vagina.
As soon as itching or burning appears in the perineal area, the external genitalia become red, or uncharacteristic discharge (white, creamy, cheesy, with pus) begins to bother you, you should immediately contact a gynecologist.
The doctor will conduct an examination, prescribe tests, and interview the patient. During laboratory research types of pathogens will be identified.
What experts say about colpitis:
How to treat: features of therapy in gynecology
Treatment of colpitis consists of general therapy carried out at home. The emphasis is on elimination of inflammation of the vaginal mucosa.
Tampons are used with antiseptics. If the endocrine system malfunctions, the patient is prescribed tablets that restore hormonal background.
In gynecology, when symptoms are detected and a correct diagnosis of chronic or acute colpitis is made, treatment is comprehensive.
General restorative, antibacterial therapy does not stop until the doctor himself cancels it.
During recovery should abstain from sexual intercourse. The sexual partner is also prescribed antibacterial baths.
Results
Colpitis, or vaginitis, is an inflammatory process of the mucous membrane of the vaginal walls. It develops as a result of the spread of infection.
Women with weakened immune systems are especially susceptible to the disease.
Key points to consider:
- most common reason vaginitis - insufficient hygiene of the intimate area;
- disruption of the endocrine system, perineal injuries can trigger the disease;
- at the first suspicion, you should contact a gynecologist;
- treatment is carried out both with tablets and local agents;
- for specific colpitis, treatment is necessary for both the woman and her sexual partner;
- you cannot self-medicate;
- To prevent the disease, you need to strengthen your immune system;
- the disease quickly becomes chronic.
If you take these provisions into account, recovery will be painless and quick.
It is also important to remember about disease prevention.
Update: December 2018
One of the most common female “sores” is colpitis. This disease affects mainly the fairer sex of childbearing age, but it does not ignore both girls and postmenopausal women. In order not to miss the development of colpitis, every woman should know its symptoms in order to immediately begin treatment. But it is important to remember that any disease, especially of an infectious nature, such as colpitis, should not be tried to be treated on your own, you should consult a doctor.
Definition of “colpitis”
When the vaginal mucosa becomes inflamed due to infection by pathogenic microorganisms, colpitis is said to occur. Another name for colpitis is vaginitis, from the Latin word “vagina,” which means vagina. The incidence of the disease is 60 – 65%.
Classification of colpitis
Depending on the type of pathogen that provoked the disease, colpitis is divided into specific and nonspecific. Specific vaginitis is caused by gonococci, trichomonas, fungi and other infections.
According to the localization of the initial infectious focus, colpitis is divided into:
- primary, when the process immediately develops in the vagina;
- secondary, in case of infectious agents entering the vagina from other places (ascending - from the surface of the vulva and descending - from the uterine cavity).
The course of the disease is determined by the following forms:
- acute colpitis;
- subacute colpitis;
- chronic colpitis;
- sluggish vaginitis;
- latent (hidden) vaginitis;
- asymptomatic colpitis.
Separately, senile or atrophic (age-related) colpitis is distinguished.
Vaginal microflora is normal
Normally, in a healthy woman of childbearing age, the vaginal microflora consists of 95–98% lactobacilli or Doderlein bacilli. Doderlein rods break down glycogen, which is “received” from desquamated epithelial cells of the superficial layer of the vaginal mucosa. When glycogen is broken down, lactic acid is formed, due to which the pH of the vaginal environment shifts to the acidic side (4.5 or less). The acidic vaginal environment is a kind of protection against pathogenic microbes, as many of them are not able to grow and reproduce in such conditions. Lactobacilli also produce hydrogen peroxide and a number of antibiotic-like substances, which strengthens the defense and prevents the colonization of the vagina by unwanted microorganisms.
In addition to lactobacilli, bifidobacteria live in the vagina, which also protect it from infection. The vital activity and number of lactobacilli depends on the production of estrogen. Therefore, with the onset of premenopause, when estrogen production decreases, the vaginal mucosa becomes thinner and the number of lactic acid bacteria decreases, which leads to the development of age-related colpitis.
Also, under various other conditions that lead to a decrease in lactobacilli in a healthy and young woman, the vagina is very quickly populated by “invaders” - pathogenic microorganisms.
In addition to lacto- and bifidobacteria, other microorganisms are present in small quantities in the vagina:
- streptococci;
- enterococci;
- peptococci;
- staphylococci;
- bacteroides;
- fungi of the genus Candida and others.
Causes of colpitis
As already noted, the disease is caused by the colonization of the vagina by pathogenic microorganisms or the activation of opportunistic pathogenic flora. Opportunistic pathogenic flora is represented by microbes that, in a normal state of immunity, are in equilibrium with the normal flora, but the balance is very fragile. Once the immune system is weakened, this flora becomes pathogenic. The following types of microorganisms can cause vaginitis:
In girls, vaginitis can be caused by pathogens of childhood infections that penetrate the vagina through the bloodstream (secondary vaginitis). These may be measles pathogens and others.
But in order for the disease to begin to develop, certain conditions or predisposing factors are required:
- non-compliance or, on the contrary, excessive passion for intimate hygiene;
- hidden sexually transmitted infections;
- promiscuous sex life;
- endocrine pathology (thyroid diseases);
- trauma to the genital organs (rough sexual intercourse, deflowering);
- tight synthetic underwear;
- pregnancy and menstruation (hormonal changes and weakened immunity);
- menopausal age;
- oncological diseases and their treatment (chemotherapy, radiation);
- acquired and congenital immunodeficiency states;
- lack of vitamins;
- allergic reactions;
- antibiotic treatment, especially uncontrolled;
- taking hormones;
- abnormalities of the genital organs (gaping genital cleft or prolapse of the vaginal walls);
- damage to mucous membranes during childbirth;
- ovarian hypofunction;
- use of an intrauterine device;
- improper and irrational nutrition;
- diseases of the digestive tract;
- spontaneous and artificial termination of pregnancy;
- curettage of the uterine cavity.
Clinical picture
The clinical picture of the disease is quite varied and is largely determined by the type of pathogen and the form of its course. The main signs of vaginitis are:
- burning, itching in the vagina;
- the amount of vaginal discharge increases significantly, the nature of which is different (curdled, purulent, homogeneous milky, foamy, bloody or mixed with blood);
- the discharge has an unpleasant odor
- possible redness and swelling of the labia;
- aching or nagging pain in the lower abdomen;
- pain during coitus;
- dysuric disorders (frequent and painful urination);
- temperature increase.
In the case of acute colpitis, all manifestations are pronounced: burning and itching are significant, heaviness in the lower abdomen suggests problems with internal organs, discharge is abundant. In severe cases of the disease, a significant increase in temperature is possible, up to 38 degrees or higher. As a rule, this picture is characteristic of specific colpitis (gonorrheal or trichomonas).
With chronic colpitis, the picture is less bright, the symptoms are erased. The disease lasts a long time, with periodic exacerbations. The discharge becomes moderate, serous or serous-purulent.
When examined on a chair in the mirrors, swelling, hyperemia and “looseness” of the vaginal mucosa are revealed. Petechial and pinpoint hemorrhages are noticeable on the mucosa; reddish nodules (infiltrates) and erosive areas may appear. In advanced cases, the cervix is involved in the inflammatory process, which leads to cervicitis or pseudo-erosion.
Trichomonas colpitis
This form of the disease is caused by Trichomonas, which is sexually transmitted. The household route of infection with Trichomonas, as some patients prefer to think, is impossible, since the pathogen quickly dies in the external environment. The symptoms of Trichomonas colpitis are so pronounced that the diagnosis is not difficult. Characterized by significant leucorrhoea, which has a very unpleasant odor. The discharge is usually foamy and has a yellowish tint. If nonspecific microflora attaches, the discharge becomes green. The infection spreads very quickly, affecting the cervix, the uterus itself and the urethra, which is manifested by dysuric disorders and pain in the lower abdomen. Sexual intercourse is unpleasant and even painful, accompanied by discharge mixed with blood.
Atrophic colpitis
With atrophic colpitis, there are practically no symptoms. The disease progresses sluggishly, patients may or may not complain. The most common concerns are burning and itching, a feeling of “tightness” in the vagina and its dryness. Sexual intercourse is painful, after which bloody discharge appears or even minor bleeding occurs. Due to a decrease in the number of lactobacilli, which perform a protective function, opportunistic microorganisms actively multiply in the vagina, which provoke local inflammatory processes and increased secretions. Such discharge is watery and contains an admixture of blood after certain procedures (vaginal washing and douching, gynecological examination). When examined in the speculum, a pale pink, thinned mucosa with many pinpoint hemorrhages is revealed. In many cases, vaginal dryness makes insertion of speculum difficult.
Diagnostics
After collecting anamnesis and complaints, an objective examination of the patient is carried out, which includes:
- examination of the mucous membrane of the vaginal walls and cervix in gynecological speculum (discharge, its consistency and smell, the presence of ulcerations on the vaginal walls and pseudo-erosion or cervicitis on the cervix are assessed) - the examination is carried out without prior preparation (do not wash);
- bimanual palpation of the uterus and appendages to identify complications of vaginitis (endometritis and/or adnexitis);
- examination of the labia, urethra, clitoris and inner thighs for swelling and ulceration, maceration and fissures (flowing discharge may irritate the listed structures).
From laboratory tests required:
- microscopy of secretions obtained from the cervical canal, posterior vaginal fornix and urethra (allows you to determine the bacterial flora, including Trichomonas and fungi, gardnerella and gonococci;
- bacteriological culture of vaginal discharge to identify the pathogen and determine its sensitivity to antibiotics (if possible, after a 3-week course of antibiotic therapy;
- PCR diagnosis of major sexually transmitted infections (Trichomonas, gonococci, chlamydia and ureaplasma).
Colposcopy is prescribed and performed according to indications.
Systemic therapy
In case of severe colpitis or in case of chronicity of the process, treatment agents are prescribed, used orally or intramuscularly. In the case of specific colpitis caused by gonococci, intramuscular administration of cephalosporin antibiotics (ceftriaxone, cefixime) or tetracycline is indicated. For vaginitis caused by trichomonas, nitroimidazoles (trichopolum, tinidazole, metronidazole) are prescribed. Severe nonspecific colpitis requires the prescription of broad-spectrum antibiotics - amoxiclav (penicillins) or azithromycin (macrolides). In the treatment of colpitis of fungal origin, the following drugs are used: fluconazole, orungal, pimafucin, ketoconazole and others.
Atrophic colpitis
In the case of senile vaginitis, hormone replacement therapy is usually prescribed. Treatment with hormones can be both local and systemic. For local therapy, estrogen preparations are used in the form of vaginal tablets or ointments (Ovestin, estriol). The course of treatment lasts 2 weeks and is repeated if necessary. Cliogest, Climodien, Angeliq and other drugs (tablets, patches) are prescribed as systemic hormone therapy. Treatment is long and continuous (5 years). If a secondary infection occurs, treatment is carried out according to the principles of treatment of acute colpitis with the prescription of etiotropic drugs locally, and, if necessary, orally.
Restoration of vaginal microflora
Restoring the natural flora of the vagina refers to the second stage of treatment for vaginitis:
- bifidumbacterin - intravaginally 5 - 6 doses, which are diluted with boiled water and administered daily or 1 suppository twice a day - the course of treatment is 10 days;
- bifikol – intravaginal administration of 5 doses daily for up to 7 days;
- Lactobacterin – intravaginal administration of 5 doses in a course of 10 days;
- acylact – 1 suppository daily for 10 days.
At the same time, multivitamins and immunomodulators are prescribed.
Traditional methods
Folk remedies do not lose their relevance in the treatment of diseases. Traditional methods are used as an addition to the main (drug) treatment of colpitis. For douching, decoctions and infusions of medicinal herbs are used:
- chamomile (2 tablespoons boil in 1 liter of water for 15 minutes, filter the broth and cool);
- do not forget about condoms during casual sexual intercourse;
- maintain intimate hygiene (wash twice a day);
- refuse narrow and tight underwear, as well as synthetic underwear;
- lead healthy image life (refusal bad habits, exercise, multivitamins, especially in the winter-spring period);
- control weight (prevent obesity and excessive weight loss);
- use pads and tampons without fragrances;
- do not get carried away with douching;
- use detergents for intimate hygiene with a neutral environment and without fragrances;
- strengthen immunity;
- having one permanent sexual partner.
Question answer
Question:
Are physiotherapy procedures used to treat colpitis?
Answer: Yes, UHF and UV irradiation are widely used to treat the disease. For chronic vaginitis, SMV therapy is prescribed in parallel with electrolyte cauterization for the vaginal area.
Question:
Why is vaginitis dangerous?
Answer: Firstly, untreated acute colpitis can become chronic. Secondly, there is a high risk of ascending infection with the development of endometritis and adnexitis, which can subsequently lead to. Vaginitis also provokes the occurrence of cervicitis, pseudo-erosion of the cervix, and in children synechiae of the labia. Possible damage to the urethra and Bladder( And ).
Question:
Can colpitis occur after using spermicides and local contraceptives, for example, Pharmatex suppositories?
Answer: Yes, spermicides included in gels and creams affect the natural microflora of the vagina, which provokes the activation of opportunistic microbes. Therefore, this type of contraception should not be the main one.
Question:
Fungi were found in my smear. Itching and burning are bothersome. Is treatment necessary?
Answer: Yes, if fungi are detected and there are complaints, a diagnosis of candidal colpitis is made and its treatment is mandatory.
Colpitis is an isolated inflammation of the vaginal mucosa in women, caused by various external or internal factors. Colpitis is also often called vaginitis. In addition, this pathology is often combined with inflammatory processes in neighboring anatomical areas. In particular, in some sources colpitis is identified with vulvovaginitis, which affects not only the mucous membrane of the vagina, but also the vulva.
Colpitis is considered one of the most common diseases in gynecological practice, and most women have encountered this problem at least once in their lives. Its prevalence is ubiquitous and covers everything geographical zones and all countries of the world. Colpitis is considered not a dangerous disease, but if it is delayed medical care or when trying to self-medicate, severe complications may occur.
Normal vaginal microflora
The normal microflora of the vagina is represented mainly by microorganisms that do not require oxygen for life ( so-called anaerobes), and to a lesser extent – by microorganisms that consume oxygen in the process of life ( aerobes). Together, these bacteria perform a number of functions necessary for the normal functioning of the organ. The vaginal microflora has three main functions:
- Enzymatic. This function consists of breaking down a number of foreign substances and converting them. This also includes maintaining the acidic pH characteristic of the vaginal cavity.
- Vitamin-forming. As a result of the vital activity of microbes, a number of vitamins are formed that are necessary for the vaginal mucosa. If there is an imbalance in the vaginal microflora, the mucous membrane begins to thin and bleed.
- Protective. This function is based on the mechanism of competitive suppression of foreign bacteria. Microbes introduced from outside will not be able to develop normally, as they will not have enough nutrients.
The microflora of the vagina during childbearing age is represented by:
- permanently inhabiting microorganisms;
- random microflora.
Permanently resident microorganisms
First of all, these microorganisms include the so-called Doderlein bacillus. This is a type of lactic acid bacteria that normally inhabits the vaginal mucosa. The ratio of these bacteria to other microorganisms in healthy patients is at least 95%. Their main function is to maintain an acidic environment ( due to the release of hydrogen ions during life processes) and competitive suppression of other microbes. In addition to normal competition, lactic acid bacteria can produce hydrogen peroxide and a number of other substances with antimicrobial properties in small quantities.Lactobacilli are dependent on the level of estrogen in the blood. Their number may vary slightly depending on the phase of the menstrual cycle or the onset of pregnancy. Doderlein's sticks do not pose a risk of developing colpitis under any circumstances, but, on the contrary, protect women from this disease.
Random microflora
Random microflora includes all other types of bacteria. According to various sources, normally up to 40 different types of microorganisms can be found in the vagina of a healthy woman. However, their total number is approximately 2 - 5% of all microorganisms living in the vagina.In addition to permanently inhabiting microorganisms, the following types of bacteria are most often found:
- Staphylococcus;
- Corynebacterium;
- Bacteroides–Prevotella;
- Micrococcus;
- Gardnerella vaginalis;
- Mycoplasma hominis.
Under normal conditions, the following factors influence the vaginal microflora:
- production of female sex hormones;
- rhythm of sexual life;
- pregnancy;
- abortion;
- use of antibiotics;
- some diagnostic and therapeutic procedures;
- taking hormonal medications;
- gynecological operations.
Causes of colpitis
As mentioned above, a number of different reasons can lead to the development of colpitis. Among them there are both internal factors, which represent disturbances in the functioning of the body, and external ones, which include injuries and infections. Ultimately, each of the reasons, one way or another, leads to an acute inflammatory process and an imbalance in the bacterial microflora of the vagina. The latter contributes to delaying recovery and requires especially careful treatment. Determining the causes of colpitis is important from several points of view. Firstly, it will help you choose the right treatment and eliminate the disease. Secondly, finding out the causes of colpitis often indicates the presence of sexually transmitted diseases that affect the entire reproductive system. Thus, it is possible to quickly stop the pathological process and avoid serious complications. Thirdly, infectious colpitis poses a risk of infection for all sexual partners of the patient, which indicates the need for preventive screening of potential patients.
From the point of view of development mechanisms, there are the following types of colpitis:
- mechanical damage to the vaginal mucosa;
- malnutrition of the mucous membrane;
- diseases of the endocrine system;
- long-term use of antibiotics;
- allergic reactions;
- failure to comply with personal hygiene rules;
- decreased immunity.
Sexually transmitted infections
There are a number of diseases, the predominant route of transmission of which is unprotected sexual contact. As a result, pathogenic microorganisms directly enter the vaginal mucosa from the infected mucous membrane of the sexual partner. Normally, our own normal microflora suppresses the growth of microbes. However, in case of weakened immunity, concomitant microtraumas or dysbacteriosis, an inflammatory process begins in the mucous membrane. In addition, some particularly pathogenic microorganisms can lead to the development of the disease even under normal conditions without associated complications.Colpitis can be caused by the following sexually transmitted diseases:
In each specific case, the causative agent of the disease enters the vaginal mucosa during unprotected sexual intercourse. Thus, limiting the number of sexual partners and using condoms plays a leading role in the prevention of this type of colpitis.
Mechanical damage to the vaginal mucosa
Mechanical damage is microtrauma of the mucous membrane, which can have various causes. The most common of these is uncomfortable conditions during sexual intercourse ( insufficient moisture, poor gliding). This causes the mucous membranes of the glans penis and vagina to become overly stretched and torn. A similar mechanism for the appearance of microtraumas can be observed when foreign objects or medical instruments are inserted into the vagina during diagnostic or therapeutic procedures. The end result is a violation of the integrity of the mucous membrane. Normally, it is an impenetrable barrier for most microbes and prevents them from developing in the thickness of the walls. When microtraumas occur, bacteria find themselves in more favorable conditions - in the thickness of tissues, so they begin to multiply faster, disrupting the normal balance of microflora. In such cases, it is not necessary to introduce microbes from the outside. Opportunistic microbes that were harmless to healthy mucous membranes easily cause serious inflammation when they penetrate deep tissue.Malnutrition of the mucous membrane
As mentioned above, the normal vaginal mucosa is better protection from most pathogenic microbes. However, its integrity can be compromised not only as a result of microtrauma during sexual intercourse, but also due to some internal factors. These include, for example, impaired blood supply. As you know, oxygen and all the necessary nutrients enter the tissues with blood. If there is insufficient blood supply to the tissue of the vaginal wall, the mucous membrane simply becomes thinner and weakens, which increases the risk of microtrauma. In addition, the work of mucous cells is disrupted. They stop producing normal physiological secretions, which can change the pH in the vagina.Most often, colpitis due to malnutrition occurs after massive bleeding. For example, the risk of such situations increases in the postpartum period among young mothers. Compression or thrombosis of the arteries supplying the vaginal walls is extremely rare.
Nutritional disorders can also include a lack of certain vitamins that are necessary to maintain the integrity of the mucous membranes. First of all, this is vitamin A. It is formed in the intestine when provitamins, the so-called free carotenoids, enter it. As a result of biotransformations, carotene from food is converted into vitamin A, necessary for the mucous membranes of the body. With its deficiency, women have a tendency to both colpitis and inflammation of other mucous membranes.
Hypovitaminosis A is observed with insufficient consumption of the following foods:
- carrot;
- spinach;
- tomatoes;
- legumes;
- melons;
- fruits.
Of course, hypovitaminosis requires a very long-term lack of these foods, which in practice is quite rare. However, this increases the risk of developing colpitis, especially in combination with other risk factors.
Endocrine system diseases
Some diseases of the endocrine system can seriously affect the condition of the vaginal mucosa. First of all, we are talking about female sex hormones - estrogens. They have a wide spectrum of action on various tissues in the body. One of the functions is the regulation of the glands in the vagina and regular renewal of its mucous membrane. Estrogens are produced in the ovaries, so many diseases of this organ can lead to the development of colpitis.Most often, as a result of a decrease in estrogen levels, a special form of colpitis develops - atrophic colpitis. It has a number of characteristic differences from other forms of this disease. Other hormonal disorders affect the condition of the vaginal mucosa to a lesser extent, but diseases of the thyroid, pancreas, and adrenal glands can also predispose to inflammatory processes.
Long-term use of antibiotics
Long-term use of antibiotics can directly affect the state of the bacterial microflora of the vagina. Many antibacterial drugs have a fairly wide spectrum of action and, in addition to the main causative agent of the disease, also kill normal microorganisms. In case of intestinal dysbiosis, special medications are usually prescribed to restore the normal balance of bacteria. In this regard, much less attention is paid to the vaginal microflora. Preventive treatment along with antibiotics is usually not prescribed, but dysbiosis is diagnosed after the development of colpitis and the appearance of specific symptoms.Thus, an increased risk of developing colpitis may be observed after pneumonia, tuberculosis and other severe infectious diseases that are treated with a long course of antibiotic therapy. Dysbacteriosis caused by antibiotics is especially dangerous if taken uncontrolled. Self-medication with antibiotics, unfortunately, is quite common. At the same time, only a competent specialist can choose the right drug, its dose and regimen. Self-medication with antibiotics in women often results in prolonged colpitis, which is difficult to respond to treatment. The problem is that only some of the bacteria sensitive to the antibiotic died. The remaining microbes became resistant to the drugs they encountered. It is these microorganisms that begin to grow rapidly in the absence of competitors, causing an inflammatory process. It is very difficult to treat such patients, since the causative agents of the disease are often resistant to the most common antibiotics.
Allergic reactions
Colpitis can also result from a local allergic reaction. This is explained by the patient’s individual intolerance to certain chemical compounds. First of all, we are talking about those complex chemicals that come into direct contact with the vaginal mucosa. Often the cause of inflammation is condoms, lubricants, medicinal ointments and suppositories.The mechanism of development of allergic colpitis comes down to the work of local cells immune system. Once on these cells, the allergen ( allergy-provoking substance) starts a chain of biochemical reactions. The body begins to fight the introduction of foreign material. From a clinical point of view, this is manifested by acute intense inflammation of the vaginal mucosa. Such colpitis usually responds well to treatment, and to prevent it it is only necessary to limit the body’s contact with the allergen.
Failure to comply with personal hygiene rules
Unfortunately, even in modern developed society there are often cases of banal non-compliance with the simplest rules of personal hygiene. For the genitals, they involve regular rinsing of the mucous membranes with warm boiled water. If this simple procedure is not carried out, over time, plaque from the remains of urine, semen and bloody discharge after menstruation. It is an extremely favorable environment for the development of pathogenic bacteria. Thus, the balance in the vaginal microflora is disrupted.In addition, the accumulation of organic substances leads to a banal process of decay. This weakens the mucous membrane, it becomes thinner and becomes more sensitive to mechanical stress. In particular, we are talking about the early appearance of microtraumas with the development of the infectious process. Without observing basic rules of personal hygiene, treatment of colpitis with antibiotics can take a very long time, without bringing a noticeable effect.
Decreased immunity
Weakening of general immunity rarely becomes a direct cause of the development of colpitis, but is a serious factor predisposing to the appearance of this disease. The immune system in healthy people is responsible for recognizing infection and timely destroying pathogenic microbes. It is a protection no less reliable than the vaginal mucosa itself.With some diseases, the immune system may be weakened. The result is easier reproduction of opportunistic and pathogenic microbes. Their growth is not limited by antibodies circulating in the blood. Without strengthening the general immune system, treatment of colpitis also rarely gives good results.
Reasons for a weakened immune system may include:
- severe infectious diseases;
- lack of vitamins and minerals in food;
- some oncological diseases of the blood and hematopoietic system;
- bone marrow transplantation;
- long-term treatment with antibiotics;
- long-term treatment with corticosteroid drugs.
Symptoms of colpitis
The intensity and nature of symptoms during colpitis may vary. This is largely determined by the duration of the disease and the reasons that led to its appearance. Regardless of the clinical form of colpitis, symptoms are usually local. Such general manifestations of the disease as increased body temperature, muscle pain or headaches are rarely observed, mainly with purulent forms of colpitis. Often there are asymptomatic or mild forms, when the patient has almost nothing to worry about, so she puts off going to the doctor. The most common symptoms of colpitis are:
- smell;
- moderate pain or discomfort;
- symptoms of specific complications.
Vaginal discharge
Vaginal discharge during colpitis can be observed in any phase of the menstrual cycle and rarely depends on it. The nature of the discharge may vary depending on the cause of the disease. Light or milky discharge may be normal. Bacterial colpitis caused by opportunistic microorganisms is characterized by copious, homogeneous discharge that may contain gas bubbles. For candidiasis ( fungal infection) the discharge usually contains flakes, and the color and consistency are cheesy. A characteristic sign of trichomoniasis is a dirty green discharge, sometimes foamy. The duration of discharge can vary from several days to several years.Smell
The smell can also be different depending on which bacteria led to the development of colpitis. The mechanism of its appearance is quite simple. Pathogenic microbes, in the course of their life activity, decompose a number of chemical substances (mostly sugars and proteins), releasing gaseous substances. It is these substances that cause the appearance of the characteristic odor. It can vary from the smell of “rotten fish” to a sweetish smell, indicating an intense process of decay. With candidiasis, the odor is usually absent, but with bacterial infections it is most pronounced during periods of heavy discharge.Moderate pain or discomfort
Severe pain with colpitis is rare. Most often, patients complain of a burning sensation that intensifies when urinating. It appears due to irritation of the inflamed vaginal walls by toxic substances contained in the urine. The pain syndrome will be even more pronounced during sexual intercourse.Discomfort is most often characterized by severe itching in groin area or a feeling of heaviness in the lower abdomen. Direct pain is more typical for bacterial colpitis and colpitis that develops after injury to the vaginal mucosa.
Symptoms of specific complications
Colpitis usually does not pose a serious health risk, since specific complications are rare. A threat may arise if medical care is not provided in a timely manner. Then the infection begins to spread up the birth canal, successively affecting the cervix, uterus, fallopian tubes, and ovaries. This, in turn, can lead to symptoms such as irregularities in the menstrual cycle, cessation of menstruation ( amenorrhea), difficulties conceiving a child, severe pain in the lower abdomen. With severe and deep damage to the mucous membrane, short and minor bleeding from the vagina may be observed.Types of colpitis
Depending on the reasons that led to the development of colpitis, several forms of this disease are distinguished. Each of them is characterized by certain clinical manifestations and requires an individual approach to treatment. In addition, depending on the form of the disease, the doctor can make predictions for the future regarding the timing of recovery and the likelihood of complications. The following types of colpitis are distinguished:
- candidal colpitis;
- atrophic colpitis;
- Trichomonas colpitis.
Candidiasis colpitis
Candidiasis colpitis ( yeast colpitis, thrush) is a specific inflammation of the vaginal mucosa caused by a fungus from the genus Candida. These fungi are opportunistic microorganisms and can be found not only in the vaginal cavity, but also on the oral mucosa or in the large intestine. Thus, infection can occur after an episode of oral or anal sex, in the presence of additional risk factors ( dysbacteriosis, weakened immunity).Often the cause of the development of candidal colpitis is a course of antibiotic therapy. The fact is that fungi are not sensitive to antibacterial drugs, so antibiotics do not affect their growth and reproduction. The course of treatment reduces the bacterial population ( both lactic acid and opportunistic) in the vagina, which becomes an impetus for the intensive development of fungi. Also, candidal colpitis is often observed in pregnant women, especially in the third trimester.
Diagnosis and treatment of this type of colpitis is usually not difficult due to the characteristic symptoms and simple microbiological confirmation of the diagnosis. Treatment comes down to the use of antifungal drugs that will reduce the population of the causative agent of colpitis.
Atrophic colpitis
Atrophic colpitis or atrophic vaginitis is an inflammatory process in the vaginal mucosa caused by a serious decrease in estrogen content ( female sex hormones).For reasons of occurrence, atrophic colpitis is divided into three main types:
- postmenopausal ( in older women);
- in patients with artificial menopause ( who have had their ovaries or uterus removed);
- colpitis while taking certain medications.
Clinically, atrophic colpitis is manifested by dryness, itching, burning in the vagina and painful sensations during sexual intercourse. All these manifestations usually appear 5 to 6 years after the onset of natural menopause ( in old age). Similar symptoms can be observed during artificial menopause.
Diagnosis of atrophic colpitis is based on data on the onset of menopause, patient complaints, determination of vaginal pH, colposcopy and microbiological examination.
Trichomonas colpitis
Trichomonas colpitis is one of the most common forms of this disease. The infection is caused by the microorganism Trichomonas vaginalis or ( less often) other types of Trichomonas. Infection most often occurs through unprotected sexual intercourse, but the possibility of infection through household items cannot be ruled out. When Trichomonas enters the vaginal cavity, it begins to actively multiply, affecting the cells of the mucous membrane. This quickly leads to the formation of a characteristic plaque and the appearance of discharge. If you seek medical help late, the infection may become chronic. Then the disease will proceed with periods of exacerbations and remissions ( subsiding of symptoms), difficult to treat. Diagnosis of trichomoniasis usually does not present serious difficulties. The main risk is associated with the spread of infection to other organs of the reproductive system, and the most severe consequence of trichomoniasis is infertility.Diagnosis of colpitis
In the vast majority of cases, diagnosing colpitis does not present any particular difficulties. The first suspicion of this disease may appear to the doctor after getting acquainted with the patient’s complaints, and to detect the inflammatory process it is enough to conduct an ordinary gynecological examination. The problem is that for a full diagnosis it is important not only to detect the inflammation itself, but also to establish its causes. Colpitis often occurs in combination with other gynecological diseases and may be the result of disturbances in the functioning of other organs and systems. Thus, the task of a doctor examining a patient with colpitis becomes somewhat more complicated. The main tasks in formulating a diagnosis are:
- determining the boundaries of the inflammatory process;
- detection of concomitant inflammatory processes in other organs of the reproductive system ( cervix, uterus, uterine appendages);
- determination of the causative agent of the disease in the case of infectious colpitis;
- analysis of dysbiosis that accompanies colpitis;
- determining the resistance of microbes that cause colpitis to various antibiotics;
- checking hormonal levels ( blood estrogen levels);
- determining the nature of structural changes in the mucous membrane, if any;
- detection of chronic diseases and determination of their influence on the appearance of colpitis.
To collect information for colpitis, the following diagnostic procedures are used:
- standard gynecological examination;
- colposcopy;
- rectal examination;
- cytological analysis;
- bacteriological analysis;
- aminotest;
- general blood test and biochemical blood test;
- general urinalysis and biochemical urine analysis;
- blood test for hormones.
Standard gynecological examination
A routine examination at a gynecologist’s appointment involves a visual acquaintance with the symptoms of the disease. To detect the inflammatory process or other pathologies in the vaginal cavity, special gynecological speculums are used. This is the name of a medical instrument that helps to expand the walls of the vagina and make its cavity more convenient for examination. Usually this procedure is painless and causes only mild discomfort, but for patients with colpitis it can cause pain.The problem is that the inflamed vaginal mucosa itself causes pain. In case of contact with medical instruments ( in particular, with a gynecological speculum) the pain intensifies. In rare cases, for gynecological examinations in such patients it is necessary to use painkillers.
For a more complete collection of information, it is not recommended to remove discharge or plaque from the walls of the vagina before going to the gynecologist. This may cause an incomplete picture of the disease and lead to errors in diagnosis. Also, you should not wash yourself before undergoing bacteriological and cytological analysis. Discharges and plaques are usually waste products of the vaginal microflora and carry valuable diagnostic information.
Colposcopy
Colposcopy is an alternative to a standard gynecological examination. The difference is that during a colposcopy, the doctor uses a special technique to examine the vaginal cavity. Ordinary colposcopes are binocular magnifiers with a source of directional light. This helps to examine the surface of the vaginal walls in more detail and more thoroughly understand the nature of the damage.More modern models of colposcopes are equipped with a special video camera, which is inserted into the vaginal cavity. This procedure is less painful for patients and more informative for the doctor. Usually, colposcopy is enough to diagnose colpitis, and doctors stop at this stage. Other studies are prescribed only in cases where the specialist does not understand the reasons for the development of inflammation.
Ultrasound
Ultrasound ( ultrasonography ) of the small pelvis is required only for those patients who have signs of inflammation outside the vaginal cavity or experience any complications of colpitis. Most often they look for signs of inflammation of the uterus or ovaries. In particular, an ovarian cyst can cause hormonal imbalance, which will affect the condition of the vaginal mucosa.Of the complications of colpitis that are diagnosed using ultrasound, first of all, pathological fistulas and abscesses should be noted. Fistulas form in patients with advanced chronic colpitis. The inflammatory process in such cases lasts for years, leading to the formation of deep defects in the vaginal wall. A fistula is an abnormal connection of the vagina with another hollow organ ( usually the rectum). It requires surgical treatment to close the lumen. Ultrasound helps determine exactly whether the fistula is connected to another organ or is a blind protrusion of the wall.
Abscesses in the vaginal wall can form due to the proliferation of specific pyogenic bacteria. They are localized in the submucosa of the organ or in the tissue of the vaginal glands. In most cases, we are talking about the Bartholin gland, located in the vestibule of the vagina. An ultrasound shows the size of the cavity with pus and its exact location. This provides the surgeon with information for successful surgical treatment.
Depending on the localization of pathological processes, the following ultrasound options may be prescribed:
- Ultrasound abdominal cavity to assess the functioning of internal organs;
- Ultrasound of the pelvis to detect pathological processes in this area ( endometritis, ovarian cysts, neoplasms, etc.);
- Ultrasound through the vaginal cavity, in which the sensor will be inserted directly into the vagina to obtain a clearer picture;
- Ultrasound through the rectal cavity.
Rectal examination
A rectal examination is a digital or visual examination of the rectum. This examination is recommended for all patients with colpitis. In this case, the doctor will look for pathological holes ( fistulas, which were mentioned above) or signs of neoplasms.The following methods are used to examine the rectal cavity:
- Finger examination. In this case, the doctor inserts the index finger into the rectum, carefully palpating the walls of the organ. This examination may reveal lumps or abscesses in the intestinal wall. This will provide indirect information about possible reasons development of colpitis.
- Colonoscopy. Colonoscopy involves inserting a special camera attached to a flexible cable into the rectum. This allows you to carefully examine the walls of not only the rectum, but also the upper parts of the large intestine.
- Sigmoidoscopy. Sigmoidoscopy involves inserting a sigmoidoscope into the rectum - a hollow metal tube that facilitates examination of the walls of the organ.
Cytological analysis
Cytological analysis is a study of cellular composition. To do this, the doctor takes a smear from the vagina or a scraping from the vaginal wall during a gynecological examination. During examination under a microscope, the nature of the pathological process can be determined by characteristic changes in the cells. Cytological analysis is carried out mainly for atrophic colpitis or with concomitant pathology of the cervix.Bacteriological analysis
Bacteriological analysis is aimed at identifying microorganisms in the vaginal cavity. To carry it out, a special smear is taken. If there is vaginal discharge, it can also become material for bacteriological analysis. Taking a smear or sample of discharge is a completely painless procedure and lasts only a few minutes. Typically, the doctor will try to take several swabs from different areas. This eliminates the possibility of missing focal inflammation ( inflammation involving only a small surface of the vaginal wall).The material obtained from the patient can be examined in various ways:
- Bacterioscopy. This analysis involves staining the bacteria with special dyes and examining them under a microscope. An experienced doctor can determine their type by the shape and color of microorganisms and make a conclusion about the cause of inflammation. Usually, this is an opportunistic microorganism that has multiplied due to an imbalance of the microflora.
- Cultural examination. Culture research is the inoculation of microbes on nutrient media that stimulate their growth. Over time ( usually 12 – 48 hours) characteristic colonies appear on the nutrient medium. Based on their shape, an experienced doctor can also tell which specific microorganism formed them. This analysis takes a little longer, but it allows you to obtain the bacteria that cause the disease in its pure form.
- Antibioticogram. Antibioticogram is a study of the sensitivity of microorganisms to various antimicrobial drugs. To carry it out, it is necessary to isolate a pure culture of the pathogen. This analysis provides the most important information necessary for prescribing antibacterial therapy. A similar study is carried out in the case of colpitis of fungal origin. Obtaining the results of an antibiogram can take several days, so it is not prescribed to all patients. This analysis is indicated only for women with chronic colpitis, which cannot be treated with standard antibiotics and require individual selection of drugs.
Aminotest
Aminotest is a method for the rapid detection of bacterial colpitis. It is based on the determination of a specific odor that appears as a result of the activity of most pathogenic microbes. To conduct an amino test, the doctor takes a scraping from the back wall of the vagina and, in the laboratory, adds potassium hydroxide to the resulting sample ( CON). The test is considered positive if the resulting mixture emits a distinct smell of rotten fish. This test can be performed by dropping the above solution on a speculum after a standard examination. This method does not give a 100% correct result, since some opportunistic microorganisms ( for example, gardnerella) will give a false negative result.General and biochemical analysis of blood and urine
Blood and urine tests are standard procedures for most patients with gynecological diseases. Based on the results of these studies, the doctor makes a conclusion about the physiological ( normal) and pathological processes in the body and the work of various organs and systems. This is necessary to detect any concomitant diseases and disorders. Detection of chronic pathologies requires a more careful approach to treatment, since they are contraindications to the prescription of a number of drugs.Regarding the diagnosis of colpitis, a general and biochemical blood test can determine the intensity of the inflammatory process. This is usually manifested by an increase in the level of leukocytes and a shift in the leukocyte formula to the left ( the appearance of immature forms of leukocytes in the blood), increased ESR ( erythrocyte sedimentation rate), the appearance of C-reactive protein in the blood. It should be noted that you cannot rely solely on the results of a blood test. The above changes appear only with severe inflammation. Sluggish colpitis with scant symptoms may not cause an increase in leukocytes or ESR.
Blood test for hormones
As noted above, atrophic colpitis can be a consequence of a lack of estrogen in a woman’s body. In these cases, hormonal drugs are prescribed as the main treatment. To accurately select the dose, the doctor needs to know how low the level of sex hormones is. It is for this purpose that the patient may be prescribed a blood test. Depending on your specific situation, this may require temporary cessation of combined oral contraceptives ( if the patient takes them). In each individual case, you should consult a gynecologist or endocrinologist about this.Treatment of colpitis
Treatment of colpitis of any origin should be comprehensive, that is, include both local and general therapy. The emphasis in it is not only on eliminating the symptoms of the disease, but also, mainly, on fighting the infection that caused the pathology. In addition, it is necessary to pay attention to eliminating concomitant diseases and increasing immunity ( to prevent exacerbations).Timely diagnosis plays a particularly important role in the treatment of colpitis, because the sooner treatment of the disease begins, the greater the likelihood of a quick recovery. Accurate determination of the microbe that causes the disease, its sensitivity to antibiotics or identification of other forms of colpitis will help prevent the occurrence of relapses and complications, as well as the transition of the acute form of colpitis to the chronic one.
The general principles of treatment of colpitis are:
- etiotropic therapy;
- treatment of the patient's sexual partners;
- restoration of normal vaginal microflora;
- treatment of concomitant diseases;
- diet;
- the use of physiotherapy;
- traditional methods treatment.
Etiotropic therapy
Etiotropic therapy is a treatment method aimed at eliminating the cause of the disease. In the treatment of colpitis, etiotropic therapy is the basic method. Treatment is carried out using antibacterial, antiviral or antifungal drugs, depending on which microorganisms caused the disease. In some cases, combination drugs are used.As mentioned above, colpitis is divided into two types - specific and nonspecific. Depending on the type of colpitis, appropriate treatment is prescribed. Treatment of nonspecific colpitis is carried out using combination drugs with an effect aimed at eliminating bacterial and fungal infections. The main place is given to broad-spectrum drugs.
Local etiotropic treatment consists of toileting the external genitalia and douching the vagina with various antiseptic solutions ( potassium permanganate, furacilin, chlorhexidine). Vaginal tampons soaked in galascorbine and sea buckthorn oil can also be used for local treatment. In the presence of anaerobic or mixed microflora, drugs such as metronidazole, betadine, dalacin can be prescribed, and in case of fungal etiology - diflucan, clotrimazole, terzhinan.
Treatment of specific colpitis is carried out depending on the causative agent of the disease:
- for colpitis with fungal etiology ( most often, Candida) prescribe antifungal drugs;
- if colpitis is caused bacterial infection (for example, gonococcus), antibacterial drugs are prescribed;
- for colpitis caused by Trichomonas, metronidazole is prescribed, a drug that has a strong antimicrobial effect. However, metronidazole is contraindicated in the first trimester of pregnancy. If necessary, metronidazole can be used in the second and third trimester of pregnancy, but with caution, as the drug crosses the placental barrier and can potentially harm the baby.
Drugs most often used in the treatment of colpitis
| A drug | Release form | Dose | Reception mode | Duration of treatment |
| Nystatin | vaginal suppositories | 500,000 units | 2 times a day | 10 -14 days |
| Ketoconazole | cream | 200 mg | 1 per day | 5 days |
| Fluconazole (Diflucan) | pills | 150 mg | 1 per day | 1 day |
| Metronidazole | pills | 250 mg | 3 times a day | 7 - 10 days |
| Cephalexin | capsules | 500 mg | 4 times a day | 7 days |
| Ampicillin, tetracycline | pills | 2 g | 1 per day | 7 days |
| Metronidazole | vaginal tablets | 500 mg | 1 per day | 7 – 10 days |
Antibiotic therapy is recommended to be used after an antibiogram - determining the sensitivity of identified microorganisms to antibiotics. Carrying out an antibiogram is very important, since incorrectly prescribed treatment, firstly, is not effective, and secondly, it can lead to changes in the normal microflora of the vagina.
Treatment of sexual partners
Colpitis is often caused by sexually transmitted infections. In this case, it is advisable to treat both sexual partners at the same time. This is done to avoid re-infection and relapse of the disease. In most cases, with colpitis, the patient’s condition allows for sex, so there is a risk that the partner will introduce a new portion of pathogenic bacteria to the mucous membrane during unprotected sexual intercourse. For these reasons, after diagnosis, during treatment and until completion of the course of treatment, it is necessary to abstain from sexual intercourse. Continuation of an active sexual life is often recommended only after a control analysis, which is carried out simultaneously in both partners.Restoration of normal vaginal microflora
It is worth considering that long-term use of antibacterial drugs negatively affects the vaginal microflora. Therefore, after a course of treatment, it is necessary to restore normal biocenosis ( microflora composition) vagina. This is done with the help of special preparations – eubiotics. They are a portion of normal lactic acid bacteria that inhabit the vaginal mucosa. With their intake, normal vaginal acidity is restored, and the proliferation of pathogenic microbes stops.The most common eubiotics in gynecological practice are:
- Vagilak;
- lactobacterin;
- biovestin.
Treatment of concomitant diseases
Also, concomitant diseases should be treated at the same time and the influence of predisposing factors should be eliminated or reduced. Thus, in the presence of ovarian hypofunction, it is necessary to correct their activity, that is, to regulate the deficiency or excess of sex hormones in the body. If the patient has serious chronic diseases that affect metabolism in general ( thyroid diseases, diabetes mellitus, etc.), it is necessary to achieve stable remission of the disease. This will allow you to fully carry out the course of treatment without fear of complications from other organs and systems. In particular, with bacterial colpitis, diabetes mellitus can contribute to the spread of infection and inhibit the restoration of the mucous membrane. If you take insulin correctly and regularly adjust your blood sugar levels, recovery will come faster.Diet
Following a diet is necessary to strengthen the general condition of the body, the immune system, and the speedy restoration of damaged tissues. For colpitis, diet is not a mandatory item in complex treatment, so it comes down to some general recommendations.- dairy products;
- products containing polyunsaturated acids ( fish oil, shrimp, cod, tuna);
- foods containing large amounts of fiber ( vegetables and fruits, grains);
- foods rich in vitamins B, E, A, C and minerals.
Application of physiotherapy
Physiotherapeutic methods of treatment are not very popular in the treatment of colpitis, but in the chronic course of the disease they can seriously help. Most of them are painless and have almost no contraindications. On average, to complement the antibacterial treatment of colpitis, a course of 3–5 sessions is prescribed ( depending on the intensity of symptoms).Physiotherapeutic methods of treating colpitis have the following goals:
- reduction of bacterial or fungal intoxication;
- relief of inflammation;
- relief of itching;
- stimulation of local immunity.
- FUV irradiation ( short wave ultraviolet irradiation) vaginal mucosa;
- half-baths with potassium permanganate, which is strong oxidizing agent, sanitizing infected areas and providing a disinfectant effect;
- zinc electrophoresis – zinc ions cause the destruction of fungal mycelium.
To increase immunity and reactivity of the body, the following methods of stimulating immunity are used:
- heliotherapy;
- air baths;
- thalassotherapy;
- LOK ( laser blood irradiation);
- SUV irradiation ( mid-wave ultraviolet irradiation).
Traditional methods of treatment
Considering the fact that in most cases colpitis is a moderate nonspecific inflammation of the mucous membrane, many patients successfully use folk remedies for treatment. Most of them are based on the effects of various medicinal plants. For a more effective combination of traditional and alternative medicine, it is recommended to warn the attending physician about the methods used. folk remedies Oh. This should also be done when a woman has been unsuccessfully treated with herbs in the past. Some folk remedies may affect the therapeutic effect of medications, which should be taken into account by the doctor when prescribing a course of treatment. Typically, specialists do not insist on the mandatory abolition of herbal treatment, but, on the contrary, give valuable instructions regarding the regimen for taking the medications.Folk remedies used in the treatment of colpitis
| Means | Cooking recommendations | Therapeutic effect | Reception mode |
| Calendula infusion | 1 teaspoon of pharmaceutical two percent infusion of calendula is diluted in 1 glass of warm water. | It has a disinfecting effect, especially effective for trichomonas colpitis. | Douching is carried out 1 – 2 times a day. |
| Sea buckthorn oil | Soak ordinary cotton swabs in oil and gently squeeze them out. | Helps restore damaged epithelium. With the permission of the attending physician, it can be used in the treatment of not only bacterial, but also atrophic colpitis. | Installation of tampons is carried out 1 - 2 times a day for 10 - 15 minutes. The course of treatment is continued for 10–14 days, after which, as a rule, epithelization of the damaged areas occurs. |
| Mumiyo | 4–5 grams of the substance are dissolved in 1 glass of warm boiled water. An ordinary cotton swab is moistened in the resulting solution. | Improves local metabolism in the vaginal mucosa and has a weak antimicrobial effect. | Tampon installations can be carried out 1 – 3 times a day ( preferably in the evening, before bed). The duration of treatment is usually several weeks, depending on the severity of the disease. |
| Eucalyptus | In 1 glass of warm boiled water, dilute 1 teaspoon of ready-made pharmacy tincture. | It has a moderate anti-inflammatory, antimicrobial and nourishing effect on the vaginal mucosa. | The solution is used for douching several times a day. The duration of the course of treatment is discussed with the attending physician. |
| St. John's wort | To prepare the infusion, add 2 tablespoons of dry herb to 1 liter of boiling water. The mixture is boiled for 10 minutes over low heat and infused for another half hour. | St. John's wort has a pronounced antimicrobial effect, inhibiting the growth of pathogenic bacteria. | The decoction is used for douching several times a day ( 2 – 3 times). At the same time, regularity of procedures is important. Douching is carried out until there is a visible improvement in the general condition. |
| mistletoe | For 1 liter of boiling water you need 4 - 5 tablespoons of dry herbs. | Mistletoe improves the regeneration of damaged epithelium and improves tissue nutrition. | The course of treatment lasts from several days to several weeks, depending on the severity of the disease. Douching is done several times a day. |
Some features of the treatment of colpitis in pregnant women. Treatment should be carried out strictly under the supervision of a physician. The difficulty is that many methods that are very effective are simply unacceptable for the body of a pregnant woman and can harm the child in the womb. At the same time some medications, harmless for pregnant women, do not have the desired effect.
Drugs that are used to treat colpitis during pregnancy can be divided into two groups:
- Drugs that can be used in the first trimester. These are nystatin, pimafucin, terzhinan, vagotil, hexicon.
- Drugs that can be used in the second and third trimester. These are metronidazole, meratin combi, clotrimazole.
Prevention of colpitis
Specific prevention of colpitis ( vaccines) does not exist, since this disease can be caused by many different reasons. Nonspecific prevention includes a number of measures that significantly reduce the risk of developing colpitis. - regular visits to the gynecologist;
- compliance with personal hygiene rules;
- treatment with antibiotics only as prescribed by a doctor;
- Seeing a doctor at the first signs of colpitis;
- strengthening general immunity.
Regular visits to the gynecologist
The best way Prevention of colpitis is a regular visit to a gynecologist for a standard gynecological examination. This will help to promptly identify signs of any disturbances in the reproductive system. Elimination of these disorders can prevent the development of colpitis.Currently, it is believed that women of reproductive age should undergo a preventive gynecological examination at least once a year. In the case of pregnancy, in the postpartum period and during menopause, preventive examinations can be made more frequent, since at this age women are most predisposed to colpitis of various etiologies ( of various origins).
Maintaining personal hygiene rules
This item involves caring for the vaginal mucosa, regularly washing with warm water or using special disinfectants. You should pay special attention to the problem of introducing intestinal microflora into the vagina. Often these mistakes become the cause of the development of bacterial colpitis. The introduction of intestinal bacteria into the vagina can occur through improper use of toilet paper ( the movement should go from front to back, from the labia to the anus). This mechanism most often causes colpitis in girls. In women of reproductive age, E. coli can enter the vagina if traditional sexual intercourse took place immediately after anal sex. In general, to prevent colpitis, it is recommended to clean the vaginal mucosa after sexual intercourse ( unless we are talking about trying to conceive a child).Compliance with the rules of personal hygiene also means regularly changing underwear and caring for the skin in the groin folds. Otherwise, microbes that normally live on the surface of the skin can multiply and, once they enter the vaginal cavity, cause an inflammatory process.
Treatment with antibiotics only as prescribed by a doctor
As noted above, self-medication with antibiotics is the cause of dysbiosis in the vaginal cavity. The use of any antibacterial drugs must be agreed with a specialist. In this case, if necessary, medications will be prescribed that will support the normal microflora of the vagina. Patients who take antibiotics at their own risk do not take such drug prophylaxis, which increases the chances of developing colpitis.Seeing a doctor at the first signs of colpitis
From the general treatment plan for colpitis, it can be understood that early stages the disease is much easier to treat. By and large, any type of colpitis sooner or later comes down to excessive proliferation of pathogenic bacteria. If you do not consult a doctor at the first symptoms, the inflammatory process can become chronic and lead to morphological changes in the mucous membrane. The consequence is a decrease in the elasticity of the vagina, decreased sensitivity, dryness, as well as the development of serious complications - fistulas and abscesses. In addition, the infection, without timely treatment, can quickly spread upward into the uterine cavity, leading to more serious problems with the reproductive system. For these reasons, you should consult a doctor at the first obvious signs of colpitis - the appearance of stable itching, nagging pain in the lower abdomen or vaginal discharge.Strengthening general immunity
Strengthening overall immunity involves adequate intake of vitamins, minerals and other nutrients. A healthy diet along with avoiding alcohol and smoking contributes to the normal functioning of the immune system. In such patients, the body reacts more quickly to the ingress of any specific pathogenic organisms. The cells of the vaginal walls are more resistant to infection, which reduces the likelihood of developing colpitis.Inflammatory processes in the organs of the genitourinary system in women can occur for various reasons, but the most common of them is the penetration and development of infection. Colpitis is considered one of the most common such diseases. It can manifest itself in various forms and types. Symptoms of this inflammatory process occur in women at any age, and almost everyone experiences them at least occasionally, including during pregnancy. Timely treatment will relieve many complications.
Content:
Description of the disease
Colpitis (or vaginitis) is an inflammation of the mucous membrane lining the vagina. Most often, this disease is combined with inflammation of the vulvar membrane, and the pathological process is called vulvovaginitis. It often extends to cervical canal cervix, which leads to cervicitis. Usually, young adult women experience symptoms of colpitis, but a similar disease can also appear in little girls, as well as older women.
Types of colpitis
Depending on the origin of the inflammatory process, colpitis is distinguished between infectious and non-infectious nature.
Infectious colpitis
It occurs due to the effect of pathogenic microorganisms on the mucous membrane. In turn, they can be specific and conditionally pathogenic, therefore infectious colpitis is divided into 2 types:
- Specific colpitis, which develops due to penetration into the vaginal mucosa of pathogens of infectious infections, mainly sexually transmitted (Trichomonas, chlamydia, gonococci, herpes viruses and others).
- Nonspecific colpitis. It occurs as a result of the activation of opportunistic microbes (staphylococci, streptococci, Proteus, E. coli). They are always present in the body, but their content and activity are regulated by beneficial bifidobacteria and lactobacilli. These bacteria produce lactic acid and create an environment that is fatal to pathogenic microorganisms. Harmful microflora begins to develop only when, for some reason, there is a significant decrease in the number of protective bacteria (due to taking antibiotics, for example).
There is another classification of infectious colpitis, according to which it is divided into bacterial, fungal (candidiasis, or thrush) and viral (the causative agents are herpes viruses, papillomaviruses or citalomegavirus).
Non-infectious colpitis
Atrophic colpitis. The cause of inflammation of the vaginal mucosa is the thinning (atrophy) and modification of the structure of the vaginal epithelium that occurs in women during menopause. The pathology occurs due to estrogen deficiency, which affects the condition of the mucous membranes.
Allergic colpitis. Inflammation occurs due to exposure of the mucous membrane to allergens, which may be present in hygiene products or medicinal ointments. You may also be allergic to the material from which the condom is made.
Colpitis is called primary if the inflammatory process occurs directly in the vagina. Or secondary if inflammation of the vagina begins due to infection from the uterus (descending path) or from the vulva (ascending path).
Forms of the disease
Colpitis occurs in acute or chronic form.
Acute form– this is the initial phase of the disease, when pathological manifestations arise, which are not always paid due attention. Acute colpitis is easy to eliminate if diagnosed in time.
Chronic form is an advanced disease characterized by periodic disappearance and recurrence of symptoms. Treatment in this case becomes more difficult, since due to the weakening of the protective properties of the mucous membranes, pathogens of many concomitant infections penetrate into them.
Possible complications of colpitis
The most common complication of the inflammatory process that occurs in the vagina is its spread to the uterine cavity, as well as to the appendages. This leads to disruption of the periodicity of menstruation, ovarian dysfunction, amenorrhea, infection fallopian tubes and infertility.
A complication of inflammation of the appendages is ectopic pregnancy. Colpitis can provoke the occurrence of ailments such as cervical erosion, endometritis, and kidney inflammation.
Chronic infectious colpitis, which manifests itself over years, is especially difficult to treat. In this case, there is a high probability of infecting a sexual partner. The most serious complication may be the appearance of abscesses (large ulcers in the vagina), as well as the formation of fistulas directly connecting the vagina to the rectum.
Video: Consequences of colpitis
Causes of colpitis
There are many factors that contribute to the development of infection, weakening the protective properties of the vaginal mucosa and its irritation. They are the main causes of colpitis.
These factors include:
- A decrease in general immunity as a result of colds and infectious diseases, as well as previous operations, stress or addiction to smoking and other bad habits.
- Mechanical damage to the vaginal mucosa (during sexual intercourse or manipulation with gynecological instruments). Entry of a foreign body into the vagina (colpitis often occurs for this reason in little girls).
- Inept douching, which can result in thermal or chemical burns of the mucous membrane (when using too concentrated solutions of chemical antiseptics). Too frequent douching in any case leads to the washing out of the beneficial microflora of the vagina.
- Long-term use of certain medications. For example, antibiotics are prescribed to treat many diseases. At the same time, they are able to destroy not only harmful bacteria, but also beneficial microflora. Colpitis is also caused by the use of hormonal drugs with antiestrogenic effects, which worsen the condition of the mucous membranes of various organs.
- Endocrine diseases. They lead to an imbalance of hormones, as well as a decrease in immunity. Colpitis often occurs in women with impaired ovarian function, who have diseases of the thyroid, pancreas and adrenal glands. With diabetes, the process of tissue regeneration is disrupted, and susceptibility to infections sharply increases.
- Age-related hormonal changes during pregnancy or menopause.
- Improper nutrition, leading to obesity or exhaustion of the body, and the occurrence of vitamin deficiency.
- Congenital disorder of the structure of the genital organs or vaginal prolapse as a result of acquired diseases.
- Impaired blood supply to the mucous membrane due to injuries to the pelvic organs or diseases of the hematopoietic organs.
- Refusal to use mechanical contraceptives during sexual intercourse. A woman can become infected with various types of infection from a partner, who himself sometimes does not realize that he is sick, or treats this problem unconsciously.
Warning: Women who frequently change sexual partners are especially at risk. Firstly, they have an increased risk of contracting specific infections. And secondly, unprotected sexual contact with a new partner leads to changes in the vaginal microflora. At the same time, the likelihood of developing its own opportunistic bacteria and fungi increases.
Failure to comply with personal hygiene rules contributes to inflammation. Wearing tight synthetic underwear plays a negative role. At risk for colpitis are women who have problems with the intestines and bladder. These organs are anatomically located near the vulva and vagina.
Manifestations of colpitis
Symptoms of colpitis appear in women, as a rule, quite clearly. Some distinctive signs may appear in diseases of different origins, but in general their manifestations are similar.
General symptoms
Unusual discharge. If the intensity and consistency of normal leucorrhoea constantly changes throughout the cycle, then with colpitis the discharge is invariably abundant and liquid. They have an unpleasant odor and a characteristic color. Such discharge causes irritation of the skin in the vulva, perineum, and inner thighs, whereas normally they should not cause any discomfort.
Redness and swelling of the external genitalia. Irritation and inflammation lead to tissue swelling.
Burning and itching in the vagina. They get worse in the afternoon, especially when walking.
Pain in the lower abdomen, radiating to the lower back. Unpleasant sensations may occur during sexual intercourse.
Increased urination. Its cause is the spread of the inflammatory process to the ureters. When the bladder becomes inflamed, urination becomes painful.
Fever. It usually stays at around 37.2°-37.5°.
All these symptoms are stressful for the body, causing neuroses, depression, insomnia and weakness.
Manifestations of acute colpitis
A woman develops profuse, foul-smelling mucous discharge, which may be white or yellowish-green in color. Sometimes you can see streaks of blood in them. They can be foamy and heterogeneous.
Cystitis appears, possibly with an increase in body temperature. There is a pain in the vagina, a pressing pain in the lower abdomen. At gynecological examination there is redness, swelling and soreness of the vaginal mucosa.
Manifestations of chronic colpitis
As the disease becomes chronic, the symptoms weaken significantly. For quite a long time the woman feels quite healthy. She is only bothered by scanty discharge with an unpleasant odor, as well as itching and burning sensations in the vagina before menstruation. However, if any unfavorable conditions arise (hypothermia or overheating of the body, a woman finds herself in unusual conditions, climate change, increased stress), ailments manifest themselves with renewed vigor. Their appearance can even be triggered by the consumption of certain foods. The cause of relapse is sexual intercourse.
Features of the manifestations of some infectious colpitis
Unlike colpitis of hormonal or traumatic origin, infectious inflammatory processes are contagious. As a rule, their presence can be suspected by certain characteristic signs.
Trichomonas colpitis
The causative agents of the infection are microorganisms of the protozoan species – Trichomonas. The inflammation usually spreads to the cervix and urinary organs. Trichomonas can activate the activity of other pathogenic microbes (mycoplasmas, streptococci), which complicates treatment. Characteristic signs of Trichomonas colpitis are copious foamy discharge of a yellow-green color with a strong unpleasant odor.
Chlamydia
Candidiasis colpitis
The cause of the disease in women is the pathological proliferation of Candida fungus in the vagina. Candidiasis is known as thrush, since the discharge resembles cottage cheese in appearance and has a characteristic smell of sour milk. A white coating appears on the surface of the mucosa. An attempt to remove it leads to the appearance of droplets of blood.
Video: Features of manifestations of thrush. Treatment
Diagnosis of colpitis
First of all, the vagina and cervix are examined using speculum and a colposcope. The lower abdomen is palpated to detect enlarged ovaries, as well as other signs of complications.
To confirm the diagnosis, the following laboratory tests are performed:
- microscopic analysis of a smear from the vagina and cervix to detect fungi and other microorganisms;
- bacteriological culture of a smear to determine the type of bacteria and select the appropriate antibiotic to which they are most sensitive;
- PCR analysis of the contents of the smear for quick and accurate determination of the type of infection;
- cytological analysis of the mucous membrane of the cervix, which can be used to ensure the absence of atypical cells and serious pathologies in this organ;
- Enzyme-linked immunosorbent test (ELISA), which allows you to detect antibodies in the blood to pathogens of latent infections (mycoplasmas, chlamydia, herpes virus, human papilloma and others).
General blood and urine tests for leukocytes are performed. The condition of the uterus, ovaries and kidneys is examined using ultrasound.
Treatment of colpitis of various types
The treatment method for colpitis in women depends on the cause of the disease, the nature of the symptoms and the presence of complications.
Local and general treatment is carried out.
Local therapy for colpitis
It consists of treating the vagina and vulva with disinfectant solutions (the so-called sanitation is carried out - irrigation of the mucous membranes). Douching is carried out with a weak solution of potassium permanganate, soda, zinc sulfate or rivanol. Decoctions of sage, calendula, and chamomile are also used.
Vaginal suppositories (betadine, makmiror, lomexin, nystatin) have a disinfecting effect, restoring the acidity of mucus and its ability to destroy pathogenic microbes, as well as fight fungus. Physiotherapy methods are used (UHF - exposure to high frequency current, electrophoresis, UV irradiation of the external genitalia, laser irradiation).
General treatment
First of all, the causes are eliminated (causal therapy is carried out). In this case, antibiotics (doxycycline, azithromycin) and antiviral drugs (acyclovir) are used. For the treatment of trichomonas colpitis, metronidazole is prescribed. Fungal vaginitis is treated with fluconazole, ketoconazole.
If it is necessary to eliminate hormonal disorders, women are prescribed treatment with combined oral contraceptives. Drugs are also used to increase the content of beneficial bacteria in the vaginal microflora (vagilac, bifidumbacterin, acylact). During treatment, control smear and blood tests are carried out.
Note: In case of infectious colpitis, to achieve an effect, it is necessary to treat both sexual partners with antiviral and antifungal drugs. To avoid mutual infection, it is recommended to abstain from sexual intercourse until complete recovery.
Colpitis and pregnancy
Inflammation of the vagina, if it is not accompanied by diseases of other genital organs, and there are no deviations in their structure, does not interfere with pregnancy. In itself, this physiological condition often leads to the occurrence of colpitis of a hormonal nature.
Treatment is necessary, since intrauterine infection of the fetus or infection may enter the body during childbirth. Infection of the embryo with pathogenic bacteria or viruses leads to early termination of pregnancy.
The difficulty is that pregnant women can only take the most safe drugs. They are recommended to wash the vagina with infusions of medicinal herbs. For treatment, drugs that enhance immunity, as well as suppositories and antibacterial ointments are usually used.
Video: Signs of colpitis, causes, diagnosis, therapy
Prevention of colpitis
To reduce the risk of infection in the genitals, women are advised to pay special attention to the rules of intimate hygiene. It is necessary to use high-quality hygiene products that do not cause allergies. Underwear should be comfortable, made from natural materials. It is not recommended to use pads throughout the day, so as not to maintain conditions favorable for the development of fungi and bacteria.
The basis for preventing sexually transmitted infections is the use of condoms.
Diet plays an important role. It is necessary to avoid the abuse of salty and spicy foods and ensure that the body receives sufficient amounts of vitamins.
Colpitis is inflammatory disease vagina, most often of an infectious nature. The name of the disease is derived from the Greek word colpos; in Latin its equivalent is vagina. Due to this colpitis is a synonym for vaginitis; in medical practice you can encounter any of these concepts.
The vagina belongs to the lower genital tract and directly communicates with the external environment through its vestibule. The latter opens in the perineum between the labia minora, so it often develops into colpitis. The vagina is a hollow muscular organ whose main function is to receive sperm during sexual intercourse. The inside is lined with multilayered epithelium - its strength is similar to the epidermis of the skin, but its top layer does not keratinize. In its thickness there are numerous glands that produce mucus to lubricate the vagina during intercourse and maintain comfortable conditions for normal microflora. Under the mucosa lies a powerful muscular layer, built from striated fibers. A woman can arbitrarily tense and relax them, and if desired and necessary, increase their strength through training (Kegel exercises). The outermost layer of the vagina is made of dense connective tissue that separates it from the other pelvic organs.
The structure of the female reproductive system
The vagina is directly connected to the uterus: the narrowest part of the uterus, the cervix, is “built into” its wall. The junction of the two organs is located in the upper part of the vagina, and the space behind it is called the vaginal vault. There are anterior, lateral and posterior arches, the latter being the deepest. It is where sperm accumulates after sexual intercourse and sperm penetrates the cervix.
At rest, the walls of the vagina are in a compressed state, with its anterior surface pressed against the posterior one. The mucous membrane forms multiple folds. This structure allows the organ to stretch significantly during sexual intercourse and the birth of a child. The vaginal epithelium has a close relationship with sex hormones and the composition of its cells changes depending on the stage of the cycle. Inside them there is a supply of carbohydrates in the form of glycogen grains, which serve as a nutrient substrate for the normal microflora of the vagina - lactobacilli or lactic acid bacilli. Microorganisms break down glycogen and synthesize lactic acid, so an acidic environment is normally maintained in the vagina, which has a detrimental effect on pathogenic and opportunistic microflora. In addition, lactobacilli produce hydrogen peroxide and substances with antibiotic-like activity. Any bacteria that accidentally enters the vagina from the external environment, rectum or from the partner’s penis die after some time and are excreted.
The number of glycogen grains in cells directly depends on the concentration of estrogen (female sex hormone) in the blood. In the first days of the cycle, estrogen levels are minimal, so the vaginal pH shifts from acidic to normal. During this period, a woman is most vulnerable to contracting STIs, since the internal environment of the vagina becomes less aggressive for pathogens.
The maximum release of estrogen into the blood occurs during ovulation - on average 14 days from the start of the cycle (counted from the 1st day of menstruation). The acidity of the vagina at this time is maximum - the pH reaches 4-5, which is detrimental to most representatives of pathogenic microflora. The risk of contracting an STI during this period is significantly reduced, so sex with a sick partner does not always lead to transmission of the pathogen.
Vaginal pH levels at different stages of a woman’s life
The vagina has the ability to self-cleanse - its epithelial cells are constantly exfoliated and excreted along with mucus into the external environment. Intensification of this process for any reason leads to the formation of leucorrhoea - mucous discharge - in a noticeable amount. Immune cells migrate in the thickness of the mucous membrane, capable of binding and neutralizing foreign bacteria that enter it. They also secrete a protective protein IgA (immunoglobulin A) onto its surface, which destroys microbial bodies. Therefore healthy women Vaginitis is an extremely rare phenomenon; only aggressive STI pathogens can cause it. Also the likelihood of its occurrence is increased by provoking factors:
All of these reasons negatively affect the state of the immune system, resulting in a general and local decrease in defense mechanisms. STI pathogens and nonspecific microflora are able to multiply on the surface of the mucous membrane and penetrate deep into it.
Classification
There are several different criteria by which existing forms of the disease are divided into groups.
Depending on the cause of vaginitis, there are:
According to the duration of the flow, they are distinguished:
- Spicy– symptoms persist for no more than 2 weeks;
- Subacutes y – up to 2 months;
- Chronic (recurrent)– over 2 months.
According to the nature of the damage to the mucous membrane, colpitis can be:
- Diffuse– the entire internal surface of the vagina is swollen, hyperemic, the mucous membrane is granular, there are no plaques;
- Serous-purulent– the mucous membrane is unevenly thickened, inflamed, some areas are covered with plaque in the form of a white-gray film. The plaque is difficult to remove and leaves behind a bleeding ulcer.
Along the route of infection, the following are distinguished:
- Primary vaginitis– the pathogen enters the vagina from the outside;
- Secondary– microorganisms penetrate through the blood or lymph flow from foci of infection of a different location.
Symptoms
The clinical picture directly depends on the cause that led to the development of the disease.
Bacterial
Bacterial colpitis is otherwise called “nonspecific”, since it is caused by opportunistic bacteria that normally live on the skin and in some human cavities. They are able to show their aggression only if the immune defense is reduced or the vaginal mucosa is injured. Symptoms appear suddenly, and it is often possible to trace the connection of the disease with previous sexual intercourse. A woman experiences a feeling of fullness in the vagina, heat in the pelvis. become profuse, purulent, mucopurulent, they may show streaks of blood during an erosive process on the mucosa. Their smell varies from weak to pronounced putrefactive, they can be liquid and foamy. A large admixture of pus and desquamated epithelium gives the discharge a cloudy white or yellow, their consistency becomes thick.
Acute vaginitis is often complicated. Inflammation easily spreads to the overlying parts of the genital tract, and the flowing discharge irritates the vulva, causing painful itching. A woman scratches her external genitalia, which aggravates the disease: it further injures the tissue and introduces new portions of opportunistic microflora. Pain in the vagina can be moderate or severe; sexual activity during acute inflammation becomes impossible.
The general condition is rarely affected, in some cases there is a moderate rise in temperature (up to 38 degrees C). When pathogenic microflora enters the lymphatic vessels, it leads to an enlargement of the inguinal lymph nodes, sometimes they become inflamed. In the latter case, in the area of the inguinal ligament on one or both sides, spherical formations of dense elastic consistency up to 1.5-2 cm in diameter, sensitive to palpation, and mobile are observed. As the symptoms of bacterial vaginitis subside, their size returns to normal.
Candida
The causative agent of the disease is the yeast fungus Candida, which belongs to the opportunistic microflora and normally inhabits the skin, cavities, and mucous membranes of humans. The microorganism enters the vagina from the rectum or with infected objects. The role of sexual transmission of candida is small, since men rarely carry enough of the fungus to become infected.
The disease begins acutely: burning, dryness, and severe itching appear in the vagina. Often, symptoms of colpitis develop before or during menstruation, after intense sexual intercourse, or taking antibiotics. After a few days they appear curdled discharge from the genital tract, they are white in color and have a sour smell. Such characteristic symptom gave another name to candidal colpitis - thrush. Although, some forms of the disease occur without such discharge, limited to painful itching in the vulva, intense pain and a burning sensation in the vagina. This course of the disease is explained by the release of organic acids by Candida cells as waste products. They irritate the sensitive nerve endings with which the lower third of the vagina is abundantly supplied. Constant scratching of the skin of the perineum and vulva leads to its thinning, replacement with connective tissue and loss of elasticity. Symptoms of colpitis intensify in the evening, especially after walking or physical activity. Often the listed symptoms are accompanied by an allergic component in the form of elements red rash on the skin of the vulva and perineum.
Candidal colpitis easily becomes chronic and carrier state even during treatment with antifungal drugs, especially if a woman has diabetes mellitus or treatment with immunosuppressive drugs (cytostatics, glucocorticoids). In this case, it periodically recurs or appears constantly, subsiding only during antifungal therapy.
The woman's general condition does not suffer, her body temperature remains normal. Severe itching can disturb sleep and daily activities, but there are no symptoms of intoxication - headache, loss of appetite, or general weakness. The inguinal lymph nodes do not respond or increase slightly in size.
Trichomonas
Trichomonas colpitis is one of the most common sexually transmitted diseases. It is caused by Trichomonadavaginalis, which lives in the urethra of infected men. Extrasexual infection is extremely rare and is mainly associated with the passage of a child through the birth canal of a mother with trichomoniasis. Trichomonas is a mobile microorganism, therefore it easily penetrates from the vagina into the overlying genital tract, causing cervicitis, endometritis and into the urinary tract with the development of cystitis. The pathogen reduces the activity of sperm in both male and female genital organs, therefore In case of asymptomatic infection, the main complaint of patients is infertility.
The incubation period of trichomoniasis lasts from 5 to 15 days, during which time the pathogen penetrates the mucous membrane and multiplies intensively. Acute trichomonas colpitis is manifested by severe itching, burning in the vagina, liquid foamy discharge with an unpleasant odor. Symptoms of urinary tract damage are often associated- painful, frequent urine output in small portions, aching pain in the suprapubic area. The vaginal mucosa is swollen and painful, so sexual activity is impossible during this period. The itching in some cases is so severe that it disturbs night sleep; the woman scratches the vulva and perineum until it bleeds. The reaction of the inguinal lymph nodes is absent or moderate, the general condition is not disturbed.
Without proper treatment, trichomoniasis progresses to the subacute and then to the chronic stage. It can occur for a long time without symptoms, worsening during infectious diseases, pregnancy, or a decrease in overall immune defense. During remission, most women experience leucorrhoea and mild itching of the vulva.
Atrophic
Atrophic colpitis develops against the background of a lack of female hormones - estrogens
Atrophic colpitis develops with a lack of female sex hormones - estrogens. It is preceded by menopause, surgery to remove one or both ovaries, and ovarian hypofunction. In epithelial cells sensitive to hormonal levels, the number of glycogen grains, which serve as a nutrient substrate for lactophilic bacteria, decreases. As a result, the number of lactic acid rods decreases, and the vaginal pH shifts to the neutral side. Colonization of the mucous membrane occurs with nonspecific opportunistic microflora, which maintains chronic inflammation in it. Along with the described processes, the activity of the germ layer of the mucous membrane decreases, as a result of which it becomes thinner, loses its elasticity and becomes brittle.
Symptoms of colpitis develop gradually, starting with slight dryness in the vagina, burning during sexual intercourse, and insufficient production of lubrication. There may be scanty mucous membranes or milky white leucorrhoea, slight itching of the vulva. Over time, the signs of the disease increase, sexual life becomes impossible due to unpleasant sensations. Colpitis is chronic in nature with a persistent course and is not always amenable to therapy. The woman’s general condition is not affected, her body temperature remains normal, and the inguinal lymph nodes do not react.
Video: atrophic vaginitis, “Live healthy”
Colpitis during pregnancy
During the period of bearing a child, a woman’s hormonal levels undergo major changes: the amount of estrogen decreases and the concentration of progesterone increases. Corpus luteum hormone reduces the activity of the immune system to prevent it from conflicting with fetal proteins and preventing miscarriage. Therefore, in most pregnant women, frequent episodes of respiratory infections, exacerbation of chronic inflammatory foci and the addition of vulvitis and vulvovaginitis can be traced. Relative estrogen deficiency also plays a certain role in damage to the lower genital tract: the amount of glycogen in epithelial cells decreases, and the microflora becomes mixed instead of lactophilic.
Most often, colpitis during pregnancy is fungal in nature, and it is quite severe: with a large amount of discharge, pronounced swelling of the vaginal walls, painful itching and bursting pain in the perineum. Failure to maintain personal hygiene leads to nonspecific vaginitis, in which case the discharge from the genital tract is purulent with an unpleasant odor. It is easy to become infected with Trichomonas, as well as other sexually transmitted infections, so during pregnancy you should pay significant attention to barrier contraception.
in case of colpitis during pregnancy, it is worth using barrier contraception
From the vagina, the pathogen easily penetrates through the cervix into the uterine cavity and can lead to:
- Intrauterine infection of the fetus with delayed development, pneumonia, damage to the skin and mucous membranes;
- Threat of miscarriage and miscarriage;
- Inflammation of the placenta and fetoplacental insufficiency;
- Rupture of the genital tract during childbirth;
- Sepsis.
Diagnostics
The diagnosis is made by a gynecologist during the collection of complaints, studying the patient’s medical history, examination and based on the results of additional research methods. Different types of vaginitis have a set of characteristic signs that can be used to judge the cause of the disease.
Bacterial (nonspecific)
The predominant complaints are unpleasant purulent discharge, often mixed with blood. Inspection in mirrors during the acute stage is difficult: due to pain the woman tenses the muscles of the perineum and vagina, which prevents the insertion of the instrument. Visually, the mucous membrane is bright red, swollen, purulent deposits, pinpoint hemorrhages, and gray-white films are observed on its surface. Its surface may be granular due to raised, swollen papillae. The cervix is often involved, the vagina is filled with inflammatory contents that are released.
The main method for diagnosing vaginitis is smear microscopy
Microscopy plays the main role in the diagnosis of nonspecific vaginitis. The method allows you to study the species composition of the vaginal microflora, detect pathogenic microorganisms and estimate their quantity. With vaginitis, the discharge contains a large number of staphylococci, streptococci, gram-negative bacilli, dead immune cells - leukocytes, and desquamated epithelium. There are few lactobacilli; nonspecific microflora predominates.
Smear culture is rarely performed due to its low information content. It is mainly used for quantitative assessment of microorganisms various types, their sensitivity to antibacterial drugs. A general blood test becomes inflammatory only during the acute stage - the number of leukocytes increases, the number of young leukocytes increases, and the ESR accelerates.
Candida
Fungal colpitis is often associated with treatment with antibiotics, diabetes mellitus, and a history of pregnancy. With equal frequency, women complain of severe itching and characteristic discharge from the genital tract; usually these symptoms appear together. Inserting a speculum into the vagina causes a moderate pain reaction. Upon examination, edematous, hyperemic mucosa is visible, covered with a cheesy coating in the form of irregularly shaped islands 3-5 mm in size that do not merge with each other. In the acute stage, plaque is difficult to remove and leaves behind a bleeding surface; when the disease becomes chronic, it is easy to remove. The clinical picture is so characteristic that laboratory confirmation is usually not required. Difficulties arise when the disease lasts for a long time, the clinic is blurry, and there is no discharge.
When examining a smear under a microscope, rounded Candida bodies are visible, connected to each other in chains. Plaque areas consist of candida pseudomycelium, desquamated epithelial cells and dead leukocytes. A smear is carried out to clarify the nature of colpitis, since the method allows you to assess the ratio of normal microflora, opportunistic bacteria and fungi. At the same time, the sensitivity of the pathogen to antifungal drugs is determined. In cases of severe disease with frequent relapses, a blood test is performed for antibodies to candida - they are detected in high titers. Changes in the general blood test are absent or nonspecific - the number of eosinophils increases during an allergic reaction to the fungus, and the ESR accelerates.
Trichomonas
Trichomonas colpitis in a woman can be suspected if her sexual partner has chronic urethritis or after unprotected casual sex. The characteristic foamy appearance of the discharge, the involvement of the urinary tract, cervix, Barthollin glands and vulva in the pathological process also speak in favor of Trichomonas infection.
When examined in a speculum, the vaginal mucosa is uniformly hyperemic, swollen, and has visible pinpoint hemorrhages. Additionally, a bacterial culture of a smear is performed, the material of which is taken from the urinary tract, vagina and vulva. Microscopy of a native smear reveals mobile microbial bodies equipped with flagella or a membrane in the secretions.
Changes in general analysis blood appear during the acute stage - the number of leukocytes, immature forms of neutrophils increases, and ESR increases. Antibodies to Trichomonas are detected in the blood.
Atrophic
Diagnosis of atrophic colpitis is not difficult, unlike its treatment. The history clearly shows a connection between hypofunction of the ovaries or their removal and the gradual development of the disease. Upon examination, other signs of estrogen deficiency are revealed: decreased skin elasticity, increased fat content, increased hair loss on the head and excessive hair growth on the body. Looking in the mirrors causes discomfort burning sensation, the vaginal mucosa is hyperemic, thinned, and multiple hemorrhages are often found on its surface. Discharge is absent or scanty. The doctor takes a smear from the vagina and cervix for cytology - studying the cellular composition to exclude malignant degeneration of the epithelium. Pathogenic microflora, as a rule, is not detected either by microscopy or by bacterial culture. The number of lactobacilli is reduced, the proportion of opportunistic microflora increases.
General clinical blood tests remain normal. To clarify the nature of the lesion, the concentration of estrogen in the blood and its ratio with progesterone are determined.
Treatment
Treatment of colpitis is carried out on an outpatient basis; only women with severe purulent inflammation and pregnant women with a threat of miscarriage are hospitalized. The doctor selects management tactics and medications taking into account the main cause of the disease, concomitant pathology and the patient’s condition.
During an acute period of inflammation, a woman is advised to have sexual rest, a hypoallergenic diet with the exception of spices, smoked meats, marinades, citrus fruits, and chocolate. You should avoid hypothermia, overheating, avoid visiting steam rooms, saunas, swimming pools, and do not take a bath. During menstruation, sanitary tampons should not be used, and pads should be changed at least once every 4 hours. If the cause of colpitis is an STI, the male partner must undergo a course of antibiotic therapy even if he has no symptoms of the disease.
For bacterial vaginitis, the goal of treatment is sanitization of the vagina and subsequent normalization of its microflora. For this purpose it is prescribed
To consolidate the positive effect, a course of multivitamins is prescribed after the main course of treatment.
It is important to treat fungal vaginitis in full at the acute stage and prevent it from developing into a protracted course. For this purpose the following is prescribed:
- Systemic antifungal drugs – fluconazole capsules 150 mg orally once;
- Local antimycotics in the form of suppositories, tablets, ointments - pimafucin, nystatin, nitazol. Terzhinan suppositories have antifungal, antimicrobial and anti-inflammatory effects; they are prescribed for severe symptoms of inflammation;
- Antihistamines to eliminate itching - tavegil, suprastin, zodak;
- Immunomodulators for normalizing the immune response - thymalin.
For trichomonas colpitis, the following drugs are effective:
- Systemic antibiotics – metronidazole, fascigin;
- Local treatment with antibacterial suppositories - Klion D;
- Washing and sitz baths with antiseptics - a solution of potassium permanganate, a decoction of chamomile, calendula.
Treatment control is carried out within 2-3 menstrual cycles. The absence of trichomonas in smears taken after menstruation during this time indicates complete cure women.
For atrophic colpitis, the doctor selects hormone replacement therapy in the form of estrogen-gestagen drugs for oral use (femoston) and topically (divigel). If necessary, the vaginal microflora is corrected with preparations of lactic acid bacteria (vagilac, acylac).
L
It is preferable to treat colpitis during pregnancy with local drugs that are safe for the child - hexicon, terzhinan, nystatin. The need for other drugs is determined by the obstetrician-gynecologist, assessing the severity of inflammation and the microflora of the vagina.
Video: doctor about colpitis (vaginitis)
