Vaginitis means inflammation of the vaginal wall. There are no glands in the vagina. The epithelial lining responds to the stimulus of hormones.
Types of Vaginitis
- Vulvovaginitis
- Trichomonas V.
- Monolial(candida albicans)
- Non-infective
- Non-specific
- Senile or atrophic
- Secondary vaginitis
Vaginitis Non-Infective
Causes
- Trauma
- Burns
- Allergy
- Idiopathic
Symptoms and signs
- Redness
- Swelling
- Discharge
- Dysuria
Treatment
- Elimination of the causative factor
- Medicines
- Rest
Vaginitis Non-Specific
Causes
- Chemicals
- Contraceptives
- Douches
- Drugs
- Foreign bodies
- Pessaries
- Tampons
- Trauma
- Vaginal and cervical surgeries
Symptoms and signs
- Red, swollen, tender vagina
- Irritation
- Burning
- Dysuria
- Frequency
Investigations
Smear and culture
Treatment
- Medicines
- Improvement of general health
- Inserting water dispersible buffered vaginal jelly
- Locally applied cream
Vaginitis Secondary
The primary cause is not the vagina, but somewhere else in the body.
Causes
Foreign body
- Vaginal pessary
- Contraceptives
- Tampons
Chronic infection of the cervix
Endo cervicitis
Childbirth injuries
Complete perineal tear
Fistulae
- Vesicovaginal
- Uretero-vaginal
- Recto-vaginal
Malignancies of the genital tract
Treatment
Treating the primary pathology cures the related disease.
Prevention
- Drink plenty of water
- Correct dietary habits. Fried and spicy foods are to be avoided, as are pickles and other savouries.
- Get good sleep
- Exercise. A brisk early morning walk is helpful
- Take Fibre-based diet
- The bowel can be emptied with the help of suppositories or warm water enema.
- Maintain proper hygiene
- Wear clean lingerie
- Suspend sexual relations until gets cured
- Avoid mental stress
Vulvovaginitis
The common age group is the first five years of life, but any prepubertal girl can be affected.
Causes
Infecting organisms are:
- Candida
- E.coli
- Gonococcus
- Pneumococcus
- Staphylococcus
- Streptococcus
- Threadworms
- Trichomonas vaginalis
Transmission by
- Clothes
- Hands
- Mother
- Toilet
- Utensils
A foreign body inserted into the vagina
Symptoms and signs
- Profuse, purulent vaginal discharge
- Reddened, oedematous vulva
- Soreness
- Irritation
- Dysuria
- The child constantly handling/scratching the external genitalia
- P/R may reveal a foreign body
Investigations
- Culture and sensitivity test of discharge
- EUA(examination under anaesthesia)
Treatment
- Medicines
- Removal of foreign body
- Isolation from other children
Senile Vaginitis
Occurs in women a few years after menopause.
Causes
- Lack of oestrogen.
As a result of oestrogen deficiency, the vaginal epithelium becomes thin and atrophic. The glycogen content and acidity of the vagina are lowered. Hence the local resistance to infection is reduced.
- Injury from a neglected pessary
- Diabetes
Symptoms and signs
- Purulent, offensive, slightly blood-tinged vaginal discharge
- Soreness
- Inflamed, tender vagina with excoriated skin
- Frequency
- Dysuria
- Low-grade chronic urethritis
- Patchy, granular vaginitis(these red spots may bleed on touching)
- Infection may move upwards(senile endometrium, pyometra)
Investigations
- Speculum examination
- Vaginal cytology
- Diagnostic curettage
- Biopsy of cervix
Treatment
Oestrogen therapy
- Oral
- Pessary
- Vaginal cream