In older patients, the vaginal mucosa is often involved in the inflammatory process, in which case vulvovaginitis is diagnosed. In adult patients, primary and secondary inflammation of the vulva with timely initiated treatment rarely causes dangerous complications, but in young girls, a disease that occurs at an early age can provoke the development of synechiae - adhesions of the labia minora.
Secondary vulvitis (infectious), which occurs against the background of inflammation of the internal genital organs, is mostly characteristic of women of childbearing age. Complications of vulvitis can cause infertility.
Symptoms of vulvitis
The main symptoms that appear when vulvitis:
- itching and burning of the vulva,
- pain in the area of the vestibule,
- puffiness and redness of the genital lips,
- enlarged inguinal lymph nodes
- deterioration of general well-being,
- sleep disorders.
In addition, the discharge of various colors and thickness, serous or purulent character, which accumulate in the folds between the labia, with a long course of the disease in girls - the formation of adhesions (synechiae) between the labia minora.
The nature of whiter may be different. For example, a candidal vulvitis is characterized by thick, cheesy, milky-colored secretions, which, when removed, expose a finely eroded, hyperemic surface of the epithelium.
The severity of symptoms depends on the ethology and severity of the inflammatory process. Acute vulvitis is accompanied by severe physical discomfort with the following symptoms:
Chronic inflammatory process in the area of the external genital organs is usually manifested by the following symptoms:
- intermittent itching,
- discomfort during urination and intercourse,
- redness in the depth of the folds and around the existing epithelium defects,
- scanty discharge.
What kind of doctors to use for vulvitis
Treatment of vulvitis
In the acute form of the disease or exacerbation of chronic with severe inflammation and deterioration of health should follow a diet with the exception
You should drink plenty of warm liquid, preferably with a high content of vitamin C:
- dried fruits compote,
- currant juice,
- cranberry juice,
- cranberry juice.
During treatment, the external genitals should be thoroughly cleaned at least 3 times a day. To do this, use a weak solution of manganese, an infusion of herbs:
After the procedure, it is necessary to thoroughly dry the perineum: moisture prevents the healing of tissues. You can not rub the genitals with a towel, it is better to do promakivayuschie movement in the direction of front-back.
Preference is given to broad-spectrum antibiotics:
Fungal lesions are treated with topical antifungal drugs:
When vulvitis they are not prescribed inside due to the large number of side effects.
When allergic vulvitis requires the appointment of antihistamines:
They will eliminate the painful itching, reduce swelling and inflammation.
If the disease has developed against the background of insufficient production of estrogen (ovarian disease, menopause), the treatment is carried out with hormonal preparations for local use:
With herpesvirus infection, acyclovir is prescribed as an ointment - it accelerates the healing of painful blisters.
The vulva is irrigated with antiseptics:
To speed up healing, ointment is applied to the mucosa:
Folk remedies for the treatment of vulvitis at home
Therefore, do not use lotions, compresses, when washing you can not use clean water, but you must take disinfecting and astringent solutions, after a bath, washing or douching, you should thoroughly dry the vulva with cotton wool or a soft cloth, and then dust it as described above. Here it is appropriate to apply the same sessile baths as in the acute stage, washing the vulva with a solution of potassium permanganate (1: 1,000–5,000), oxycyanic mercury (1: 5,000–10,000), sublimate (1: 5,000–1,000 ). The patient can do these procedures herself at home.
Lubrication of affected areas with solutions of silver nitrate (2–5%), protargol (3–10%) is more intensive, but the doctor must produce these lubrications. Silver nitrate causes sharp pains, which, however, quickly pass, so it should be resorted to only in those stubborn cases where the above treatment did not give good results within 10 to 15 days. When treating nervous women, it is sometimes necessary to refuse it.
Eliminate the symptoms of vulvitis, respectively, to alleviate the patient's condition will help herbal sit baths, washing with decoction of herbs and their drinking. There are several recipes suitable for all types of vulvitis:
Causes of vulvitis
The incidence of vulvitis provoke the following reasons:
- failure to follow the rules of genital hygiene,
- mechanical injury to the vulvar mucosa,
- inflammation of the bladder,
- irritation of the vaginal mucosa,
- reduced immunity
- radiation therapy,
- venereal diseases,
- excessive use of drugs
- the presence of fistulas in the urinary tract and intestines,
- hormonal or metabolic disorders,
- allergic reactions
- scratching genitals.
Vulvitis is primary and secondary. In the first case, inflammation is promoted by injuries and hygiene violations, which in most cases is typical for children. The fact is that children's skin is very delicate and thin, so the risk of its damage is maximum. It is also noted that girls who suffer from acute respiratory viral infections, tonsillitis and other viral diseases are susceptible to the disease.
Vulvitis in girls
Vulvitis in infants is associated with the anatomical features of newborn babies: the girl’s labia is wide open, and the PH level in the vagina exceeds that of an adult woman, while the mucous membrane is very vulnerable, therefore the protective functions of the vagina are reduced.
Vulvitis in infants is associated not only with anatomical features, there are also chemical, mechanical and infectious causes of the disease. If the child is constantly in the diaper, the greenhouse effect causes irritation and diaper rash, which becomes the cause of vulvitis.
Vulvitis in a child in 40% of cases is caused by pinworms - parasites, which are localized in the anus, from where the eggs of parasites penetrate the vagina. Quite often, a child’s vulvitis occurs when personal hygiene is not followed, and in this case parents are guilty for not properly washing babies or letting them go for a walk on the beach or swim in the sea without panties.
The symptoms of vulvitis in children can be very different, depending on the cause of its occurrence. Very often, a vulvitis in a child is accompanied by discomfort of the external genital organs, there is a burning sensation, itching, and also pain when walking and urinating, an increase in the inguinal lymph nodes is possible.
Sometimes there is a selection of different colors and odors. With the defeat of the vagina with E. coli appear yellow-green discharge with an unpleasant smell, staph infection is accompanied by thicker yellow-white discharge, with candidiasis appear white raids.
Abundant discharge with a pungent odor and an admixture of blood appear when a foreign object enters the vagina. In advanced cases, with delayed treatment, ulcers and erosion can form on the mucous membranes.
Thus, pathological changes in the tissues are accompanied by a adhesive process, which leads to the accretion of the labia minora (synechia). Often, children’s vulvitis is caused by pinworms and is very acute - the child wakes up in the middle of the night with complaints of pain, severe itching, burning of the external genital organs, teeth creak in a dream, etc.
The most common cause of vulvitis in children are helminths, therefore, in addition to the primary treatment, anthelmintic drugs are prescribed. For the treatment of vulvitis in children are also used drugs that have a desensitizing effect, for example, calcium supplements and antiallergic drugs.
If the cause of vulvitis is a reduced immunity, then the administration of immunostimulants and vitamins is prescribed. In the acute form of vulvitis, the child is shown bed rest. For patients of all ages, a diet is recommended, where flour products, spicy, smoked and salty foods are excluded. It is necessary to eat dairy products, greens, fruits and vegetables.
Classification of vulvitis
Depending on the age category, the following types of inflammation of the vulva and vagina are distinguished:
- in the period of infancy (from 0 to 12 months),
- in the children's period (from 1 to 8 years),
- in prepubertal age (from 8 years before menarche),
- puberty (after the onset of menarche).
Depending on the duration of the disease, vulvitis is divided into:
- acute (flow up to 1 month),
- subacute (up to 3 months, alternating periods of exacerbation and remission),
Also, this pathology may be infectious (caused by pathogenic and conditionally pathogenic microbes) and non-infectious genesis (trauma, including the introduction of a foreign body into the vagina, burn, allergy or impaired metabolic processes).
Infectious inflammations of the vulva are divided into non-specific, which are caused by conditionally pathogenic microflora and specific.
In addition, vulvitis are divided into primary, when infection of the vulva is caused from outside microbes and secondary, if there are other foci of infection in the girl's body (carious teeth, tonsillitis, otitis media, etc.).
Diagnosis of vulvitis
To clarify the type of pathogen and its sensitivity to drugs prescribed for antimicrobial therapy, it is necessary to take a smear from the mucous with an obligatory microscopy and culture on nutrient media. Performing clinical and biochemical blood tests helps to identify comorbidities that can be a source of infection or inhibit the body’s immunity.
- urine and feces,
- general blood analysis,
- blood test for HIV / AIDS
- smear of vaginal discharge to determine the microflora,
- seeding vaginal discharge to determine sensitivity to drugs,
- if necessary: examination for gonococcus and human papillomavirus.
Prevention of vulvitis
Prevention of vulvitis is in compliance with the rules of body and genital hygiene, treatment of various inflammatory diseases of the female genital and any chronic diseases, especially metabolic-endocrine. It is also necessary to improve immunity, eat well and go in for physical exercise, since all these criteria are an excellent prevention of vulvitis.
Observing these simple rules, one may not encounter vulvitis at all. These measures are the key to women's health. Parents should pay special attention to their children. Vulvitis in girls, not cured in childhood, can cause infertility in the future.
Questions and answers on the topic "Vulvitis"
Question:Hello. I am 24, there was one pas without protection. After it - painful urination, I passed a urine test, the gynecologist said that there are bacteria and prescribed an antibiotic for me. Also a smear (it seemed to me again thrush), but I cannot drink an antibiotic - vomiting is strong. Then other symptoms appeared - itching, reddening of the small lips and, it seems to me, there is a whitish discharge. But the doctor said that according to the initial analysis there is no thrush. Do I need to pass a smear again? The doctor did not speak about pa, I forgot.
Answer: Hello! The doctor needs to say everything. Consult a doctor again for examination and selection of antibiotic. It should be noted that the diagnosis of STDs is always a complex of tests for sexually transmitted diseases. None of the methods is sufficient to establish an unambiguous diagnosis.
Question:Hello, I am 17 years old. Permanent partner, protection - condoms. Recently, I have greatly increased my left labia majora. She came to the gynecologist only on the third day after that (a long queue), the tumor was almost gone. Passed tests for Urs, sugar. The amount of sugar increased, Urs negative. They said that it is possible bacterial vulvitis, recommended candles Betadine. The recession of the tumor went by itself, even before I could start using candles. Now I do not feel any discomfort, except for a few white thick discharge. The left labia is now about 0.5 cm more than the right. Do not pass, regardless of the use of candles or not. Tell me what is it? And now what i can do?
Answer: Hello! You need to consult a gynecologist and get tested for infections, despite using a condom.
Question:Hello. My daughter is 10 years old, she’s not worried about anything, but I found a white plaque at her entrance to the vagina, we constantly monitor hygiene, we went to the gynecologist, she took a smear and said that we have a sharp vulvitis, we have 10-12 in a smear leukocytes, flora - rod, the rest of the dashes, assigned us the washing out of malavit and candles, hexicon D. pumpkin oil, evening tea tree oil and Supper Genferon Light, and at the second reception the doctor said that she had a ptosis of the vagina, the question is because of what happens the ptosis of the vagina, the causes of vulvitis, and why it did not heal the first time, everything was done according to the scheme, the treatment may not be correct, and it makes sense to turn to another specialist?
Answer: Hello. 10-12 leukocytes in a smear in a girl of 10 years is the norm. When vulvitis should be redness and itching, burning sensation. Such aggressive treatment is not necessary. The girl does not bother anyone. It is necessary to observe hygiene, to rinse the girl with ordinary running water without using soap. About the omission of the vagina, this is nonsense. Consult an on-site inspection to another pediatric gynecologist.
Question:Hello, I am 13 years old, 2 months ago I started a strong burning sensation and an unpleasant feeling in the zone of the genitals. I thought I just had a cold. I decided to wait a bit until the cold passes, but no, every day constantly began to get stronger and stronger. And then I decided to tell my mother, she took me to a gynecologist. The gynecologist prescribed me an extract of chamomile and a mixture of rotokan, also metrogil ointment. In addition, I bought oak bark and sage, another solution of miramestin. I started to process everything, but nothing passes. Tell me what to do?
Answer: Hello. You have been prescribed the right treatment. But you forgot to write how many days you were treated. If the treatment does not help, you will have to re-consult a gynecologist. They probably took smears from you. These are tests that help find out the cause of the disease. But now they will take more seed from you. This analysis is taken as an ordinary smear. But it helps to find out which drugs suit you. Pay attention to digestion. Temporarily give up sweets. Use more sour-milk products. If you have weight problems, and there are diabetes cases in your family, you will need to contact an endocrinologist. At the time of the survey can be used antifungal drugs (fluconazole), interferon preparations with vitamins (viferon) gel topically, as well as probiotics (bactistatin), but only if prescribed by your doctor.
Anatomical features of the vulva
The vulva is the female genital area. She is outside the pubic bone. It includes the external genital organs - the labia, the Bartholin glands, the eve of the vagina, the hymen, the pubis, the clitoris, the bulb. The pubis is a tubercle formed by highly developed subcutaneous tissue. Down from it are paired skin folds. These are large labia, which form two adhesions in the places of their convergence. In their anterior third is located onion vestibule - dense venous formation. In the posterior third of the lips are paired Bartholin glands. The labia minora are located inside the large lips that cover them. The entrance to the vagina covers the hymen - fold of the mucous membrane. It includes blood vessels, nerves, muscle fibers. In its original form, the hymen has a small hole. As a result of the first sexual intercourse, it increases. After childbirth, it collapses, leaving the myrrhapes. The blood supply to the vulva is due to the obturator artery and genital branches.
Depending on the etiology of the disease, primary and secondary vulvitis are distinguished. In the first case, the cause of the disease is poor hygiene or injury. Secondary vulvitis develops due to infection by other organs. These can be the kidneys, tonsils, uterus, etc.
The primary manifestation of the disease is typical for girls who have not reached child-bearing age, as well as women who have reached menopause. This is due to the peculiarities of the processes occurring in the genitals. The mucosa of the vulva in girls is thinner and is easily traumatized.Local immunity is not strong enough. The microflora does not contain Doderlein's bacilli, but is replete with cocci forms.
In women who have reached menopause, there are irreversible changes. Menstruation stops, estrogen levels decrease, mucosal surface atrophy. It "dries out" due to a decrease in vaginal discharge. Its surface is damaged, infected. So there is a primary disease.
Women of childbearing age are more resistant to infections, leading to the primary vulvitis. They have a more stable hormonal background and domination of fermented milk microflora in the vagina. Secondary vulvitis is a consequence of the inflammatory manifestations of a non-specific and specific reaction. These can be diseases such as endocervicitis, colpitis, cervicitis, etc.
The acute course of the disease is provoked by nonspecific conditional pathogenic microflora, pinworms, fungi, and trichomonads. The main causes of vulvitis:
- Inflammatory diseases of the genital and urinary organs. This may be endometritis, endocervicitis, vaginitis, pyosalpiks, cystitis.
- Violation of the rules of individual hygiene. Particularly careful attention to hygiene should be paid during menstruation.
- Hormonal failure, which reduces the amount of estrogen.
- Uncontrolled intake of immunosuppressants and antibiotics.
- Parasitic diseases caused by worms.
- Allergic reaction to hygiene products.
- Some diseases: diabetes, tumors, leukemia.
- External impact: chemical, thermal, mechanical. Wearing tight clothing has a negative effect. Possible mechanical damage to the organs of the vulva during sexual contact. The cause of the disease can be a long wearing pads.
The formation of acute vulvitis in women is favored by the lack of estrogen. This condition is observed in children under childbearing age and women after menopause.
Signs of disease
For the disease of the acute form in women, the following symptoms are characteristic:
- hyperemia, swelling of the genital organs,
- discharge: purulent, watery, blood,
- enlarged lymph nodes,
- painful, aggravated by walking, touching, urinating,
- severe itching, burning,
- may cause purulent vesicles.
Most often, acute vulvitis is characterized by copious secretions. The labia become bright red, swelling strongly. This leads to discomfort in the process of walking and pain when urinating. In the area of the external genital organs there is intolerable itching and burning. In patients with vulvitis, fatigue is observed, an increase in body temperature is possible. Women feel some weakness. Sometimes on the surface of the genital organs are found small bubbles, which are a consequence of the inflammatory process. Inside they have pus.
Treatment of the disease
If a woman has a vulvitis, treatment is prescribed individually for each patient after a thorough examination. First of all, the patient must comply with bed rest. It is also necessary to completely abandon sexual activity during therapy. Strongly discouraged itching. This will lead to additional infection, worsening of symptoms and an increase in the duration of therapy.
Depending on the degree of the disease, the gynecologist prescribes an individual course of treatment. It may include the following activities:
- Local treatment of the vulva medical compositions. For this, chlorhexidine and decamethoxin are used.
- Treatment with antimycotic drugs.
- Vaginal suppositories, tampons, pills. Since the causative agents of the disease may differ, in each case, the method is chosen individually. The drug used should depress the specific microorganism.
- Antiviral ointment. Recommended for the treatment of acute vulvitis is instillagel, vocaline, betadine, etc.
- Immune modeling therapy.
- Physiological local procedures. For the treatment of vulvitis prescribed UV, electrophoresis with novocaine or calcium chloride.
- Acceptance of specific antibiotics, taking into account the causes of the disease.
- Drying treatment. Well proven funds based on zinc oxide, streptotsida, folliculin, talc.
- Reception of vitamin preparations. Among the recommended - aevit, riboflavin, thiamine chloride, ascorbic acid, etc.
In the case of severe itching, due to which a woman has insomnia, it is possible to prescribe a sleeping pill. If you do not pay attention to acute vulvitis, treatment may take longer. Untreated disease can turn into a chronic form, which is accompanied by periods of exacerbation.
Traditional methods of treatment
Fully cure acute vulvitis folk remedies will not succeed. They serve as ancillary activities only. The popular methods include douching and taking baths. To do this, you can use the following plants:
- Pharmacy chamomile. From it is prepared infusion. To do this, in 1 liter of boiling water add 1 tbsp. lie flowers plants. Infusion should boil for 10 minutes. After that, it is cooled. Used for douching and baths, pre-mixed with 1 liter of water and 200 milliliters of infusion.
- Oak bark. 2 liters of boiling water take 2 tbsp. lie crust, which is first crushed. Infusion should boil for 10 minutes. Use as chamomile, diluted with water.
- Composition of knotweed, oak bark, chamomile and nettle. At 1 liter of boiling water take 2 tbsp. lie collection. Grass insist for half an hour. After straining is used for douching and baths.
- Horse alum At 1 liter of boiling water take 1 tbsp. lie plant root. After he infused for half an hour, it is filtered. Used tincture in the form of heat.
In any case, to treat vulvitis in women, traditional methods are used in complex therapy. Herbs for douching and baths should be used only after consulting with a gynecologist.
Exacerbation of acute vulvitis
Without timely treatment, acute vulvitis can cause unpleasant complications:
- the development of chronic vulvitis, which often recurs and is more difficult to treat,
- may develop cervical erosion,
- lack of proper treatment can lead to infertility,
- the infection that caused the vulvitis can spread to other parts of the urogenital system,
- possible inflammation of the inner layer of the uterus, that is, the appearance of endometritis,
- in postmenopausal women, untreated disease leads to hypoxia of the vaginal walls,
- in girls, the union of the genital lips is possible - synechia.
In order to prevent the occurrence of complications, it is necessary to begin treatment at the onset of the first symptoms of the disease. Also, do not treat acute vulvitis in women alone. This can lead to negative consequences.
Mechanism of disease development
According to statistics, such a pathology of the external genital organs in the vast majority of cases occurs in the elderly after menopause, in newborn girls and adolescents before the onset of menstruation. This is due to the level of female hormones, estrogen. The fact is that under the influence of these biologically active substances in the mucous membrane covering the vagina and the inner surface of the labia, lactobacilli develop, which are called Doderlein's rods. Their function is to convert glycogen (a substance formed under the influence of progesterone) into lactic acid.
This maintains a constant acidic environment in the vagina, which is detrimental to many pathogens. In children and women after 45 years of age, these processes are slowed down due to the lower estrogen concentration than in the reproductive age. Therefore, their external genitals are subject to the development of the inflammatory process. Pathogens can be mixed flora of staphylococci, streptococci, enterococci, Escherichia coli, fungi, etc. In this case, it is a non-specific form of the pathology of the female external genital organs. Sometimes it is caused by infections that are transmitted during sex (gonorrhea, chlamydia, trichomoniasis), mycobacterium tuberculosis, in gynecology this type of disease is called specific vaginitis.
With the development of bacterial microflora on the mucous membrane, the body reacts. It consists in the isolation of inflammatory mediators that act on cellular receptors and cause itching, redness and other clinical signs of pathology. The disease may be primary, that is, occur by itself. If symptoms develop against the background of other diseases of the genital, then doctors talk about secondary vulvitis.
One of the main causes of vulvitis, especially in girls and women under 45, is the weakening of the body's defenses. Reduced immunity may be due to a systemic bacterial or viral disease, prolonged use of certain drugs (glucocorticoids, cytostatics), deficiency in the diet of essential vitamins. The risk of inflammation of the external genital organs increases with alcohol abuse, taking drugs. Other causes of vulvitis are:
- non-compliance with the rules of intimate hygiene,
- late replacement of tampons and pads during menstruation,
- diaper rash due to the peculiarities of the female constitution (for example, the formation of skin folds on the external genitalia with excess weight),
- injuries, scratches, scratching,
- wearing close synthetic underwear,
- dermatological diseases (psoriasis, eczema),
- allergic reaction to pads and personal hygiene products, latex.
The risk of developing inflammation increases with the presence of concomitant diseases of the genital and endocrine systems (colpitis, vaginitis, diabetes mellitus). The occurrence of chronic or acute vulvitis contributes to the violation of the vaginal microflora. A similar situation can occur on the background of pregnancy, long-term antibiotic treatment, intake of improperly selected oral contraceptives, gynecological diseases, accompanied by a decrease in estrogen production. Depending on the cause of the onset of symptoms of vulvitis in women in gynecology, the following forms of the disease are distinguished:
- Atopic vulvitis occurs in response to a specific reaction to an allergen on the external genitalia.
- Candida vulvitis is a consequence of the pathological reproduction of fungi of the genus Candida.
- Atrophic vulvitis is mainly found in old age or in diabetes due to disruption of the mucous membrane structure.
Also distinguish the bacterial form of inflammation that occurs under the influence of pathogenic microflora. It can also be caused by internal infections of the excretory system (cystitis, urethritis), fistulae between the bladder and the vagina. Depending on the form of vaginitis in a woman, the gynecologist selects the appropriate treatment. It consists in the use of drugs for both local and systemic use.
On the Internet, you can easily find a photo, what a vulvit looks like. The first note of redness and swelling of the labia and vestibule of the vagina. Also worried about severe itching and burning. In addition, doctors describe the following symptoms of vulvitis in women:
- acute pain, aggravated by touching, walking, intercourse,
- heavy discharge from the vagina,
- purulent plaque on the mucous membrane of the internal organs,
- areas of hyperemia and ulcerative lesions of the perineum,
- pain when urinating and emptying the bowels.
Subacute vulvitis is somewhat different in symptoms. Signs are not so pronounced. The chronic form of the disease is accompanied by a blurred clinical picture. Itching, burning and pain can disappear for a while, and then, under the influence of any factors or against the background of weakened immunity, reappear.
Secondary vulvitis manifests signs of concomitant diseases. If it is vaginitis or colpitis, then characteristic purulent discharge from the vagina with an unpleasant odor appears. With the defeat of the upper structures of the reproductive system (uterus, fallopian tubes or ovaries) pains in the lower abdomen, painful and heavy periods, menstrual disorders, fever occur. The symptoms of specific vaginitis can be assumed and its pathogen. Vaginal discharge and plaque on the mucous membrane are characteristic of various sexually transmitted infections.
Ways to detect the disease
When vulvitis diagnostics begins with a survey of the patient. The diagnosis can be assumed based on the described clinical signs. This is followed by a mandatory examination on the gynecological chair. The doctor notes reddened and edematous external genitalia, draws attention to the condition of the skin of the perineum, vaginal discharge, color, consistency and smell.
Further diagnosis of vulvitis is aimed at identifying its causes and possible concomitant diseases. For this purpose, a smear from a vagina is taken from women and sent to the laboratory for bacposal and determination of the sensitivity of microorganisms to antibiotics. A urine test is also needed to eliminate kidney damage. If the nature of the discharge indicates a sexually transmitted infection, you need to donate blood for examination by PCR (polymerase chain reaction) to identify its causative agent.
In the presence of non-specific vulvitis, it is necessary to examine the uterus, ovaries and fallopian tubes. For this, an ultrasound of the pelvic organs is prescribed. For greater information, it is advisable to carry out using a transvaginal sensor. If cancer or benign growths are suspected, a PET (positron-emission tomography) MRI or CT scan should be performed.
Also, depending on the severity of symptoms of vulvitis, the doctor makes a conclusion about the acute or chronic course of inflammation. This is of great importance in determining the tactics of further treatment. If the patient is having a sex life, an additional analysis is conducted for HCG (human chorionic gonadotropin) to confirm or exclude a possible pregnancy. The fact is that antibiotics are often needed for the treatment of vulvitis, and many of them are toxic to the fetus.
Suppositories for local use
Treatment of vulvitis in women requires an integrated approach. This necessarily includes the use of antibiotics or fungicidal preparations, ointments, suppositories and antiseptic solutions. Showing drugs to strengthen the immune system, the normalization of the microflora of the vagina, various multivitamin complexes. In identifying sexually transmitted diseases, similar therapy is needed for men. Doctors believe that it is advisable to use such candles for vulvitis:
- Polygynax, thanks to a combination of antibiotics and fungicide, these vaginal capsules are used to treat non-specific and candidal forms of inflammation.
- Terzhinan. In composition, these suppositories are similar to Polygynax, however they additionally contain prednisone, which has anti-inflammatory action. Due to this, the drug effectively eliminates the itching, swelling and redness of the labia.
- Betadine contains povidone-iodine. This compound has an antimicrobial effect against gram-positive and gram-negative bacterial and fungal flora.
- Hexion with chlorhexidine. Vaginal tablets or suppositories are used for inflammation caused by pathogens of venereal diseases (trichomonads, gonococci, chlamydia, ureaplasma).
- Klion-D (Neo-Penotran) contains metronidazole and miconazole. Most often prescribed for trichomoniasis and candidiasis.
- Ginalgin. In addition to metronidazole, chlorquinaldol, which is active against resistant strains of staphylococcus, is part of the product.
To apply these drugs for vulvitis should be 1 to 2 suppositories per day. The duration of therapy is determined by the doctor. Dissolving, the active component of the candle evenly spreads through the mucous membrane of not only the vagina, but also the external genitalia. In addition, it is also a prevention of vaginitis.
Ointments and solutions
Creams used to treat vulvitis should be applied with a thin layer to the affected areas of the perineum. In addition to the antimicrobial effect, these drugs also soften and moisturize the mucous membrane. Therefore, they are appointed for the treatment of atrophic forms of inflammation. For the treatment of acute and chronic vulvitis use the following drugs:
- Liniment synthomycin - a cream with a broad-spectrum antibiotic. It is active against non-specific microflora and gonococci.
- Levomekol is similar in effectiveness to synthomycin, but it also contains methyluracil, which contributes to the rapid recovery and healing of tissues.
- Triderm - a cream with a complex effect. It consists of the antibiotic gentamicin, the anti-inflammatory component betamethasone and the fungicidal agent clotrimazole. Due to this, the drug eliminates itching, swelling and other symptoms of inflammation, destroys the bacterial and fungal flora. The only "minus" of the drug is its relatively high price (about 740 rubles).
- Lactagel is prescribed in parallel with the main treatment therapy. Он восстанавливает нарушенную микрофлору слизистой оболочки влагалища и наружных половых органов.
The advantage of the method of how to treat vulvitis ointments, is the rapid onset of effect. The drug is applied directly to the site of the pathological process. In addition, this method of application minimizes the risk of systemic side effects. Contraindications to the appointment of ointments is an increased sensitivity to the components of the drug.
Also for rubbing and washing away doctors recommend Miramistin solution. It is a drug used to treat and prevent sexually transmitted diseases and exacerbations of chronic vulvitis, provoked by gram-positive and gram-negative flora. In addition, they recommend baths and lotions with a weak solution of potassium permanganate (potassium permanganate). For this purpose, you can also use decoctions of medicinal plants.
Antibacterial and symptomatic therapy
Vulvitis antibiotics are used for the acute course of the inflammatory process and the risk of spreading the disease to the vagina and upper parts of the female reproductive system. In addition, these drugs are needed for sexually transmitted infections. For the treatment of non-specific forms of pathology prescribed Amoxiclav (Augmentin) at a dosage of 625 mg three times a day. It contains amoxicillin in combination with clavulanic acid, which increases its effectiveness. The duration of therapy is up to 14 days.
When trichomoniasis is shown metronidazole (Trichopolus). It is also used in parallel with other antibiotics in the treatment of vulvitis. The pattern of application is different. The drug is prescribed by 250 - 500 mg twice a day for two weeks, or 2 g on the first and third day of therapy. Azithromycin (Sumamed) is effective for gonorrhea and ureaplasma lesions. I drink it in a dosage of 500 mg once a day for three days.
Erythromycin is effective against infections caused by chlamydia. To achieve the desired result, it is necessary to take 500 mg 4 times a day. Doxycycline is indicated for gonorrhea. On the first day of treatment, vulvitis is drunk at a dosage of 200 mg, and then transferred to 100 mg per day.
Symptoms of vulvitis (itching, pain) often cause insomnia, irritability. Therefore, magnesium and vitamins of group B are indicated. Prescribe such drugs as Magnesium - B6 in the form of ampoules with a drinking solution or tablets, Magnicum. Often, mucosal inflammation is associated with a weakened immune system. Preparations with echinacea (for example, Immunal), Proteflazid, Immunoflazid are suitable for its strengthening, Viferon is shown in severe cases. When taking antibiotics, additional medicines are prescribed to restore the intestinal and vaginal microflora.
Alternative Medicine Recipes
Treatment of vulvitis folk remedies should be carried out only after consulting a doctor. The fact is that although medicinal plants have a certain antiseptic effect, they are not able to cope with a serious bacterial infection. Therefore, without the use of antibiotics, treatment at home can lead to the development of chronic vulvitis. The forums have received many positive reviews of the following recipes for combating inflammation:
- Tablespoon of the round-leaf wintergreen pour a glass of boiling water and leave for several hours. Then strain and make lotions with a solution 2 - 3 times a day.
- Prepare a cool decoction of chamomile at the rate of 20 g per 200 ml of hot water, strain. To add to solution for sedentary trays.
- Two tablespoons Hypericum herb pour half a liter of boiling water and leave for 2 - 3 hours. After cooling, strain and use twice a day to wash.
- You can make trays and lotions with a mixture of medicinal plants: 10 g of oak bark and chamomile flowers, 30 g of nettle leaves and 50 g of knotweed herb. Take 2 tbsp. mix, brew a glass of hot water.
In the process of treatment of vulvitis it is necessary to adjust the diet. To reduce itching should abandon spicy and salty foods. It is also recommended to exclude alcohol, sweets from the diet. Food should contain all the necessary vitamins and minerals, vegetables and fruits. It is necessary to adhere to the rules of hygiene and refrain from sexual intercourse until inflammation has finally been cured.
Features of symptoms and treatment of the disease in children
According to Dr. E.O. Komarovsky, the main causes of vulvitis in infants and young children are diaper dermatitis and poor hygiene. The development of inflammation also contributes to the wearing of uncomfortable synthetic underwear, especially when playing sports, and perineum combs during enterobiasis. In most cases, girls develop non-specific vulvitis. Infection with gonococci, trichomonads and other such flora can occur when using common underwear or during childbirth.
Diagnosis of inflammation is carried out by a pediatric gynecologist. He examines the crotch area and takes smears with tampons soaked in saline. This manipulation must be done carefully, without affecting the hymen. Treatment of vulvitis in children under one year and young children is carried out at home and consists of the following:
- sit trays with chamomile decoction, a weak solution of potassium permanganate or soda (for candidiasis),
- crotch treatment with peach, sea buckthorn oil or Vitaon Baby to relieve irritation,
- lotion with oak bark or zinc oxide,
- washing with the use of solution Tsiteal (diluted with water in a ratio of 1:10),
- treatment of the mucous membrane of the external genital organs with 1% ointment with hydrocortisone, Levomekol, Bepantenom.
If after a week the symptoms of vulvitis do not disappear, the disease is further treated with antibiotics. Assign Augmentin at a dosage of 40 mg / kg, Erythromycin (30 to 50 mg / kg), Metronidazole (the amount is calculated individually). The course of therapy is from 5 to 10 days. Additionally, you must pass a urine test to eliminate inflammation of the urinary tract.
In the absence of proper treatment, vulvitis in women can lead to such complications as:
- cervical erosion,
- sluggish flow of infectious diseases affecting other overlying organs,
For a child, it is also a dangerous disease that can cause the following unpleasant consequences:
- labia or synechia,
- development of polyps
- violation of the structure of the vagina,
- condom formation,
- violation of childbearing function.
At risk are:
- women and girls who are not hygienic,
- promiscuous women
- allergy sufferers
- children with weak immune systems.
As a preventive measure against vulvitis, it is recommended to regularly undergo an examination by a gynecologist, to monitor hygiene and not to start treatment for legal diseases.
Symptoms and signs
The following symptoms are characteristic of the acute form of vulvitis:
- burning and itching of the vulva,
- redness with purulent wounds on the vulvar mucosa.
Chronic vulvitis occurs with frequent relapses and has characteristic features:
- severe itching and burning of the genital mucosa,
- soreness when walking and urinating.
Common symptoms are as follows:
- redness and swelling of the labia,
- itching in the vulva,
- burning sensation in the vagina,
- heavy discharge from the vagina of unknown origin
- discomfort during urination,
- condition of malaise, accompanied by increased body temperature,
- fluid blistering, which is often confused with the genital herpes virus,
- diffuse nature of the hyperemia of the large and small labia,
- affection of the labia majora with small erosions with purulent secretions,
- enlarged inguinal lymph nodes.
It should be noted that in medical practice there are cases of a hidden form of vulvitis, when the disease can be detected only by an experienced gynecologist during a detailed examination.
If we consider by species, candidal vulvitis also has characteristic features:
- hypermia of the labia,
- swelling of the clitoris,
- hypertrophy of the labia minora,
- sores on the inner thighs and in the genitals,
- discomfort and intolerable itching of the vulva,
- pain on palpation and urination,
- white cheesy discharge with an unpleasant smell,
- pain during sexual intercourse,
- fever and lymph nodes in the groin.
The manifestation of any of these symptoms is an alarming signal that you should visit the gynecology clinic as soon as possible and undergo a comprehensive examination by a qualified specialist.
In girls, the problem manifests itself in the form of:
- burning sensation
- depressed mood on the background of the inflammatory process causing discomfort to the child,
- swelling of the labia and the skin around them,
- pain when going to the toilet,
- characteristic of this disease discharge from the vagina.
Are you seeing similar symptoms in yourself or in your loved ones? Make an appointment!
It is a yeast-like fungal disease of the vulva and is diagnosed as follows:
- analysis of the patient's complaints of pain, burning and itching,
- examination of the external genital organs is carried out by bimanual palpation,
- signs of inflammation are detected by gynecological microscopy,
- bacteriological examination of secretions for susceptibility to antibiotics,
- the condition of the vulva and cervix is evaluated using colposcopy,
- a clinical picture of the disease is made taking into account the previously transferred diseases of the genital organs and possible surgical interventions.
It affects the mucous membrane of the female genital organs under the influence of various allergens and is manifested by the following symptoms:
- sensation of itching in the region of the external genital organs,
- irritation and redness of the vulvar mucosa,
- intermittent burning sensation.
The diagnosis in this case is based on:
- medical examination,
- patient symptoms and complaints
- the results of laboratory tests prescribed by the attending gynecologist.
It develops against the background of a decrease in estrogen, which causes thinning of the multilayered epithelium of the vagina and manifests itself:
- dyspareunia (tenderness in the pelvic area during intercourse),
- inflammatory relapses,
Diagnosis of atrophic vulvitis includes:
- examination by a gynecologist at a colposcope,
- taking a smear on the microflora and determining the pH of the vaginal environment,
- taking a sample of Schiller.
This type is found in women during artificial menopause and in old age.
Vulvitis is treated comprehensively on the basis of the established clinical form of the disease. Depending on this, therapy may include:
- drug anti-inflammatory treatment,
- use of antifungal drugs,
- surgical removal of the affected areas.
The treatment of vulvitis of a specific and non-specific nature consists in:
- recognition of disease factors contributing to its occurrence,
- eliminating the cause of the disease,
- conducting preventive therapy that prevents the recurrence of the disease.
Tablets and candles are used to:
- eliminate the pathogen causing the inflammatory process,
- relieve discomfort symptoms,
- adjust the microflora of the vaginal mucosa.
Candles in the treatment of vulvitis have:
- antibacterial and antifungal effects,
- an overwhelming effect on the growth of the fungus of the genus Candida.
Ointments also have an antibacterial effect and are prescribed for such phenomena:
- acute course of the disease,
- presence of synechium,
- chronic pathological form of the disease.
It is advisable to combine such ointments, depending on the manifestations of the disease.
In the case of ineffective drug treatment is prescribed:
- infusion therapy,
- surgical methods of radiosurgery, cryodestruction, which allow to save the patient from extensive damage.
Treatment of candidal vulvitis involves:
- local and general therapy with antifungal drugs,
- abstinence from sexual relations for the period of treatment until full recovery,
- herbal infusion,
- taking vitamin complex to improve immunity,
- proper diet
Drugs in this case include:
- antifungal candles
- anti-inflammatory tablets,
- streptocid for genital powder,
- baths with manganese,
- use of anesthesin and hydrocartisone ointment.
Treatment of atrophic vulvitis involves drug therapy:
- hormonal drugs,
- the use of vaginal suppositories and ointments,
- a course of drugs aimed at restoring the vaginal epithelium and reducing menopausal syndrome,
- the use of local drugs to normalize the pH of vaginal secretions,
- the use of etiotropic local therapy.
Testimonials from both doctors and patients suggest that, regardless of the individual characteristics, treatment should include diet therapy for greater efficiency. The prognosis for timely and adequate treatment is favorable.
Prevention is the treatment of gynecological and extragenital diseases, as well as in compliance with the rules of personal hygiene.
Treatment of vulvitis at home involves a number of activities based on herbal medicine:
- douching and baths of healing herbs for inflammation of the external genital organs,
- the use of lotions soaked in medicinal broths,
- use herbal infusions inside.
To eliminate the itch when vulvitis such popular methods are relevant:
- the use of soothing lotions dipped in herbal decoction of Hypericum,
- rejection of spicy and salty foods
- using tampons from onions,
- washing away with silver water and 2% potassium permanganate,
- sedentary baths infused on oak bark.
Folk remedies for internal use include:
- infusion of viburnum (use three times a day for a quarter cup),
- white acacia flowers (just chew)
- extract of Hypericum (take a quarter cup a day),
- infusion of nettle (take a teaspoon at least three times a day),
- infusion of leaves of the wintergreen.
Folk treatment for allergic vulvitis requires caution to the choice of herbs and involves a number of the following activities:
- drinking nettle leaf juice inside (1 teaspoon 3 times a day),
- use of infusion of viburnum inside,
- syringing infusion of pharmaceutical chamomile and onion peel,
- use of baths made from decoction of plum bark, calendula leaves and sandy immortelle,
- applying to the inflamed hearth of lotions dipped in the broth of a round-leaved wintergreen.
It is worth noting that the folk treatment of vulvitis with herbal decoctions and recipes is an additional tool that helps relieve symptoms, but does not cure the cause of the disease. The effectiveness of the cure depends on the complex therapy, including drugs, prescribed by an experienced gynecologist with high qualifications. Otherwise, you risk turning your illness into a chronic form with all the ensuing consequences.
Vulvitis during pregnancy
The disease in this case is also manifested characteristic symptoms in the form of:
- burning sensation
- redness and swelling of the genitals,
- pain when urinating,
- discomfort while walking,
- thick secretions that are characteristic of thrush,
- formation between the lumen of the small sexual lips white film.
Manifestations of such signs in a pregnant woman require an urgent visit to a doctor and a comprehensive examination to prescribe an effective therapy that does not harm the fetus.
Causes of vulvitis during pregnancy can be the following:
- the secondary form of the disease as a result of irritation of the external genital organs with pathological vaginal discharge, which is also characteristic of colpitis,
- the presence of microorganisms in the body of trichomonas, chlamydia, gonorrhea or other bacteria,
- infection of the body with gonococcus,
- chronic diseases of the genital organs,
- violation of personal hygiene,
- various genital trauma,
- hormonal changes,
- violation of the microflora of the vagina,
- frequent stress
- weakening of the immune system
- allergic reaction to hygiene products.
The emergence of the inflammatory process in pregnant women can be triggered by physiological changes associated with the carrying of the fetus, as well as by many other precipitating factors. Diagnosis should be carried out by the attending gynecologist.
Treatment of vulvitis during pregnancy includes:
- bacterial preparations, harmless to the body,
- herbal infusion baths,
- the use of ointments to prevent further development of the infection.
It should be noted that during pregnancy, the use of many drugs and especially antibiotics is prohibited due to the negative impact on the development of the fetus. However, any inflammatory processes during pregnancy must be treated so that the disease does not turn into a chronic form and does not harm the child.
There are several limitations in the treatment of vulvitis in pregnant women:
- it is possible to apply only sparing safe means in the form of light solutions for washing and only upon doctor's prescription,
- complete rejection of antibiotics,
- eliminate food irritants.
For the safety of fetal health during pregnancy, the use of aggressive drugs is better to postpone.
This disease is a fairly common disease of the external genital organs at an early age. In small newborn girls, it can occur for the following reasons:
- development of diaper dermatitis,
- lack and excess of child hygiene,
- hygiene products,
- swimming in open water
- the presence in the body of intestinal parasites,
- physiological features,
- weak immunity,
- allergic reaction to hygiene products, drugs and clothing,
- mechanical damage to the vulvar mucosa.
Vulvitis in a baby girl can occur due to:
- lactobacillus deficiency,
- increased pH of the vaginal environment,
- infection during childbirth,
- irritation of the mucous membrane of the vulva of the child against the background of diaper dermatitis.
Vulvitis in girls 2-3 years old occurs on the background:
- reduce the protective properties of the body,
- chronic foci of infection
- the presence of pinworms in the body
- conditionally pathogenic aerobic flora,
- genital lesions with various viruses,
- the development of yeast fungi in the vaginal mucosa,
- the presence in the body of gonococci or chlamydia,
- infection with diphtheria bacillus,
- helminthic invasions,
- improper hygiene
- the use of bactericidal soap, which is prohibited in children,
- irritation of the mucous from improperly chosen linen.
To prevent vulvitis in girls under 5 years old and older, it is required:
- strict hygiene
- strengthening the immune system through a properly chosen diet and taking vitamins with minerals,
- use of dairy products,
- regular examination at the children's gynecologist.
This disease is diagnosed in children on the basis of:
- examination of the pediatric gynecologist,
- child complaints
- laboratory research.
Symptoms and treatment of vulvitis in children
Do babies should alarm you:
- the appearance of diaper rash and irritation in the vulva,
- dried skin on the surface of the genitals,
- redness and swelling of the labia,
- restless sleep
- constant crying baby.
Candida vulvitis in children has pronounced symptoms:
- an increase in the inguinal lymph nodes
- heavy discharge
- the child complains of burning and intense itching in the genital area.
Symptoms of acute vulvitis in girls include:
- redness of the genitals,
- clitoris swelling,
- the distribution of hyperemia in the groin area, thighs and pubis,
- feeling of intense itching in the perineum,
- burning sensation in the genital area while walking,
- pain with palpation,
- discomfort during urination,
- appearance of erosions and small ulcers on the mucosa.
The symptoms of chronic vulvitis in a child manifest as well as in the acute form of the disease, only with frequent relapses. The baby will express her discomfort by constant crying and scratching of the genitals.
Treatment in girls involves a range of activities aimed at:
- stopping the pathogen of inflammation,
- removal of unbearable symptoms of itching and burning,
- elimination of the causes of the disease,
- improving the overall health of the child and his immune system.
Treatment of adhesive vulvitis in children suggests:
- sessile trays with calendula, chamomile and St. John's wort herbal infusions,
- washing with antiseptic solutions of potassium permanganate and furatsilina,
- taking sedatives to eliminate itching.
In some cases, with adhesive vulvitis, surgical intervention is prescribed in the form of dissection of the labia minora.
The treatment of the disease in infants is as follows:
- a toilet of the external genital organs is held 2-3 times a day with chamomile decoction and a light solution of furatsilina,
- apply ointment for local use,
- hygiene rules are followed.
Treatment of childhood allergic vulvitis in girls includes:
- avoiding contact with the allergen,
- use of antihistamines, in the form of ointments and tablets as prescribed by a doctor,
- dusting inflamed areas.
Treatment of acute vulvitis in girls suggests:
- antibacterial drugs,
- the use of antifungal agents topically in the form of special ointments,
- debridement of affected areas
- taking antihistamine drugs inside,
- carrying out physiotherapy by the method of ultraviolet irradiation and ultraphonophoresis of the vulva using gels and antiseptic solutions,
- holding darsonvalization.
Vulvitis ointment treatment for girls is an effective local treatment and, as a rule, helps relieve swelling and reddening of the labia.
This article presents only familiarization information that cannot replace consultation with an experienced gynecologist and, moreover, cannot replace a comprehensive examination. At the first symptoms of an illness in you or your child, you should make an appointment with a doctor as soon as possible. You can find a suitable doctor or the nearest gynecology center on our portal, using search engine filters, and choose a specialist by rating, location, or patient reviews. Or contact our help desk, we will help you to find out the specialist you need. Do not expose yourself and your loved ones to danger, protect your health!
1. Causes of vulvitis
The disease can occur by itself or be the result of infection of the overlying departments of the reproductive system.
Factors that contribute to infection are the folding and vulnerability of the mucous membrane, increased blood supply and high humidity.
The causes of primary vulvitis can be:
- 1 Violation of hygiene of the external genital organs (especially in children under one year and pre-school age).
- 2 Obesity and intertrigo.
- 3 Exposure to chemicals (panty liners, personal hygiene products), physical factors (temperature) and mechanical injuries (scratching, friction).
- 4 Endocrine diseases, in particular, diabetes.
- 5 Inflammatory diseases of the perineum, hemorrhoids.
- 6 Psoriasis and eczema.
- 7 Omission and prolapse of the vagina.
Inflammation of the vulva often develops on the background of colpitis, cervicitis, endometritis. The following factors can provoke vulvitis:
- 1 Pregnancy.
- 2 Long-term antibiotic treatment or misuse.
- 3 The use of oral contraceptives with a high content of estrogen.
- 4 Treatment with cytostatics, glucocorticoids, radiation therapy.
- 5 Diseases of the endocrine system.
- 6 Ovarian dysfunction.
- 7 Immune disorders after a serious illness, injury.
- 8 Worm infestations.
- 9 Scleroderma or vulvar dystrophy.
Vulvitis often occurs in childhood and adolescence. In girls, pathology is often caused by staphylococci and streptococci, in adolescents candidiasis and bacterial vaginosis are more common. If the child has a tendency to allergic reactions, the risk of developing the disease increases. In preschool age, hygiene, contact allergies, and enterobiosis are of primary importance.
According to the clinical course, three forms of vulvitis are distinguished:
- 1 Acute - lasts no more than 1 month.
- 2 Subacute - up to 3 months.
- 3 Chronic - more than 3-6 months.
In practice, conditionally distinguish specific and non-specific vulvitis. The first group includes inflammatory processes caused by sexually transmitted infections (most often trichomoniasis, gonorrhea, genital herpes).
If bacteriological examination reveals staphylococci, E. coli, enterococci, Proteus, bacteroids, or other members of the normal microflora, then such a vulvitis is called non-specific.
Most often, inflammation provokes mixed flora. Fungal infection is not uncommon in women with hormonal disorders and immunodeficiencies.
2. Symptoms of the disease
Itching, burning and tingling in the area of the vestibule of the vagina are the main signs of vulvitis in women. The mucosa swells and reddens, with a certain discomfort. The severity of the inflammatory process may be different. In severe cases, hyperemia and edema extend to the inguinal region, perineum.
On the mucous membrane of the vulva appears plaque, which has a white color or various shades of yellow, greenish color. Women with vulvitis are usually concerned about discharge. Their nature depends on the type of pathogen.
Often there are discomfort or pain during intercourse. Disturbed dysuria (frequent, painful urination, often accompanied by urgent urges). General malaise, weakness are rare symptoms.
Acute vulvitis is manifested by a more pronounced inflammatory reaction, significant edema, and redness of the labia. Plaque may be pussy, cheesy. In chronic course, signs of inflammation are usually less pronounced, they disappear during remission.
Symptoms of atrophic vulvitis are somewhat different. The disease often occurs in women during menopause and is associated with a natural estrogen deficiency. Against the background of hormonal shifts, the mucosa of the vulva becomes thinner, easily injured. A woman has a feeling of dryness, tightness and itching.
Candidiasis (thrush) often occurs as a vulvovaginitis: inflammation is rarely limited to the mucous membrane of the vulva, the infection is found and higher in the vagina.
Thrush discharges have a characteristic cheesy texture, white color and a weak sour smell. Itching, discomfort, and burning can be quite severe. Candida vulvitis is often exacerbated during pregnancy.
3. Diagnostic methods
For the diagnosis of vulvitis, history is of great importance. It should be noted factors that increase the risk of developing the disease. It helps to establish the exact cause of inflammation and to choose the right treatment.
Psoriasis, diabetes mellitus, leukemia, scleroderma, or regular intake of glucocorticoids are provocateurs, so a complete cure is impossible with insufficient control of the underlying disease.
It is also important to assess such risk factors as unprotected sexual intercourse, the presence of several sexual partners, the use of aggressive chemical agents.
On examination, you can identify:
- 1 Hyperemic and edematous mucous membrane of the vulva.
- 2 Serous or purulent attacks.
- 3 Discharge from the genital tract of different nature, color and texture.
- 4 Traces of scratches on the vulva, ulcers and erosion.
- 5 In case of atrophic vulvitis, a thinned mucous membrane with bleeding areas.
- 6 The inguinal lymph nodes may be enlarged.
- 7 For women during a pelvic exam, inserting mirrors can be very painful.
Laboratory diagnosis includes the following activities:
- 1 Smear from the surface of the vulva.
- 2 Smear on flora and GN. In this case, a degree of purity of 3–4 is determined; in the test material, a large number of leukocytes, mainly coccal flora. In candidiasis, fungal cells and pseudomycelium are determined. When trichomonas vulvitis in a smear found Trichomonas.
- 3 Additionally, a bacteriological examination can be carried out (the household name is bacposev). The method allows to establish the type of microorganism and its sensitivity to antibiotics.
- 4 If you suspect an STI, PCR is recommended for major sexually transmitted infections (PCR-12).
In older women it is necessary to differentiate atrophic vulvitis from infectious-inflammatory. Examination can be supplemented with colposcopy and smear for cytology.
During the inspection note the smoothness and thinness of the mucous membrane of the vulva and vagina. When colposcopy, these signs are confirmed, there are similar atrophic changes in the vagina, there is uneven staining according to Schiller. Cytological examination of the smear determines the cells of the basal and parabasal layer.
Vulvitis - main symptoms:
- Swollen lymph nodes
- Swelling of the labia
- Enlarged inguinal lymph nodes
- Painful urination
- Pain during sexual intercourse
- Appearance of liquid bubbles
- Burning in the genital area
- Genital itching
- The appearance of sores
- Pain when moving
- Redness of the genitals
- Discharge from the genitals
Vulvitis in women is an inflammatory process involving the vulva, called the vulva. This area includes the clitoris, labia (both large and small), pubis, holistic hymen (in girls). In addition, the vulva itself belongs to the vagina, the glands contained in it, and the formation that covers the urinary canal and is located in the labia (bulb).
This disease has an acute and chronic course. If a woman begins to feel the first symptoms of acute vulvitis, then he should immediately begin to be treated so that he does not go into the chronic stage.
The causes of the disease
Factors that cause vulvitis are natural causes such as the presence of constant high humidity combined with the high temperature in which the genitals reside outside. In addition, the development of the disease leads to the presence of folds of the vulva and increased tissue sensitivity.
The main causes of vulvitis are:
- infections (staphylococci, streptococci, various fungi, as well as gonococci, chlamydia and various viruses),
- oral sex
- long-term use of antibiotics, drugs containing hormones, as well as agents that suppress the immune system (the immune system will decrease and inflammation of the genital organs may develop). The above remedies kill normal microflora and cause dysbiosis. It can manifest as genital candidiasis,
- other diseases, which include diabetes, as well as leukemia,
- malignant tumors that occur in the female genital organs,
- other inflammatory diseases - pyosalpinx, endometritis or vaginitis,
- inflammatory processes in the urethra,
- fistula formation between the vagina and bladder,
- the presence of worms (worms),
- allergic to various substances that are part of perfume or cosmetics, toilet paper, soap, deodorants,
- poor personal hygiene (especially for women who are overweight and prone to diaper rash). With insufficient care on the external genitals, inflammation occurs, which can also go to the internal genitals,
- mechanical factors, chemical type (masturbation, douching aggressive substances),
- long stay in wet conditions (swimming).
Vaginitis, vulvitis tend to develop at a time when the female body contains a large amount of the hormone estrogen - in childhood, transitional age, or in the postmenopausal period. Also, vulvitis often develops during pregnancy, which requires the close attention of a specialist and special treatment. Only a good specialist should treat him, and all the drugs he will prescribe should not harm the health of the unborn child.
Acute vulvitis characterized by such symptoms:
- the presence of redness in the vulva,
- swelling of the labia (large or small),
- painful sensations that become stronger during walking, urination, or intercourse,
- itching and burning sensations in the genital area,
- the presence of bubbles that contain liquid. After a while they break open and then become covered in a crust,
- the presence of plaque, ulcers, plaques (these symptoms are characteristic of a chronic course),
- in some cases - fever and malaise.
Chronic vulvitis prone to manifest in the form of itching in the genitals. Often this disease develops in women with diabetes. If the patient finds such a symptom as itching, you should not aggravate the situation and comb the genitals, because it can cause tissue infection.
Before contacting a specialist, you should take a warm bath, in which you can pour a decoction of chamomile flowers, calendula or train. It is also worth knowing that you should wipe the vulva carefully, making movements from front to back, but not vice versa. The genitals should always be clean and dry. The first symptoms of the disease should be a signal to go to a gynecologist, because treating acute vulvitis, which in the future may spread to the vagina and internal genital organs, will be more difficult.
Types of disease
The causes of the development of the disease divides the pathology into two types:
- primary type vulvitis - manifested in childhood or adolescence against the background of tendencies to other diseases,
- secondary type of vulvitis - manifested when a woman is in reproductive age and has other diseases.
According to the clinical course of the disease, it can be divided into:
- acute vulvitis. This ailment has more pronounced symptoms,
- chronic vulvitis. Symptoms are less pronounced. If the disease is not treated, complications in the form of ulceration will begin to develop (ulcerative vulvitis).
Types and forms of vulvitis
In clinical practice, distinguish between primary (isolated) and secondary vulvitis.
one.It should be noted that in adult women the primary form of the disease is almost not found, since the mucous membrane, due to the prevalence of sour-milk microflora, normal hormonal levels and acidic pH-environment, is more resistant to infection. However, the primary vulvitis is often registered among old women and girls. This condition occurs due to the anatomical and physiological characteristics of the mucous membrane of the vulva and changes that occur due to the low level of female sex hormones. In women of advanced years, in the period of postmenopausal women, atrophy of the mucous membrane of the urogenital organs is observed, the amount of vaginal secretions is significantly reduced, mucous membranes become thinner and dry. As a result, they are easily damaged and become most vulnerable to infection.
In childhood, the skin and mucous membranes of the vulva are thinner, and therefore they are easily injured. The microflora of the vagina of girls, in contrast to the “adult” microflora, is predominantly coccal, pH is alkaline, and local immunity is not fully formed. Also very often, vulvitis in girls can occur due to the presence of pinworms. They cause severe itching, due to scratching the mucous membrane is injured and infection penetrates. Sometimes vaginal discharge occurs in newborn girls. They are triggered by maternal estrogens released by childbirth into the child’s body. Such a state should not be considered pathology, and soon it will pass on its own.
2. Secondary vulvitis is a pathological condition that occurs more frequently. It occurs due to irritation of the external genitalia with infected vaginal and cervical secretions or infected urine (for diseases of the urinary tract).
Depending on the type of pathogen, it is customary to distinguish between bacterial and candidal vulvitis, and depending on the nature of the pathological transformations of the mucous membrane of the external genitalia, vulvitis is divided into atrophic, ulcerative and adhesive.
This disease is caused by yeast-like fungi of the genus Candida. It affects the large and small labia, the clitoris and the eve of the vagina. As a result, severe itching and burning develop, which intensifies before the beginning of the menstrual period and subsides slightly in the postmenstrual period. In patients with candidal vulvitis, the mucous membranes acquire a purple-bluish color, sometimes rashes appear on the vulva in the form of small vesicles (vesicles), and a white curd film forms on the area between the labia minora.
In women suffering from ovarian hypofunction, diabetes and myxedema, the pathological process sometimes extends to the perianal region and to the femoral-inguinal folds.
Bacterial vulvitis is a pathological condition triggered by conditionally pathogenic microflora, or sexually transmitted infections (gonococci, trichomonads, chlamydia). Much less often mycobacterium tuberculosis can provoke the disease.
During pregnancy, bacterial vulvitis, as a rule, develops on the background of reduced immunity, due to the activation of staphylococcal microflora. Due to the significant functional and hormonal changes that occur in the body of the future mother, specific and nonspecific pathogens are much easier to penetrate into the thickness of the mucous membrane of the external genitalia.
This form of pathology is characterized by thinning of the mucous membrane of the vulva, which often occurs in women after menopause. It should be emphasized that without hormone replacement therapy, atrophic vulvitis will steadily progress, and, in the end, will lead to the formation of painful erosions.
Ulcerative vulvitis is a chronic form of the pathological process, which is characterized by the formation on the damaged mucous membrane of the external genitalia of the plaque, in place of which, after removal, the ulcers remain. Most often, this pathology is found in patients of reproductive age.
Note: after healing of ulcers, there is often marked deformity of the external genitalia.
Adhesive vulvitis, or fusion (synechia) of the labia minora - is a disease of unknown etiology that occurs in girls under the age of five. It is characterized by adhesion of the labia, for which, in fact, got its name. At the early stage of the pathological process, an epithelial bridge is formed between the labia minora, which almost completely overlaps the vulva. In some cases, children complain of slow urination, but, at the same time, synechiae are much more often detected quite by chance, with careful examination of the external genital organs. At the same time, the labia minoras are connected along the “edge” to the front edge, where a small hole remains, from which urine leaves.
As a rule, this state does not cause any subjective sensations, and with the onset of puberty, its self-healing occurs. However, with the development of coarse adhesions, in some cases, surgical intervention (dissection of the labia minora) is indicated.
Diagnosis of the disease
Vulvitis is easy to diagnose, but the main thing is to start treating it correctly. Usually, one or more symptoms of the disease are the reason for going to a doctor. For example, itching or burning. The doctor, reviewing the history of life and disease, will make a conclusion about the presence of other diseases that could cause inflammation of the external genital organs. The gynecologist, who should be referred to a woman in such cases, will carry out a number of necessary diagnostic procedures in order to start treating inflammation on the basis of the data obtained.
Manipulations performed by a gynecologist:
- examine the organs with a magnifying glass. This will allow him to identify areas of inflammation, and to identify bubbles with fluid,
- will conduct a study (vaginal, rectal or bimanual),
- take a smear for cytology. It is able to reveal whether there are malignant cells on the external genital organs. Also, the analysis will identify the causative agent of the disease,
- conduct vulvoscopy if necessary,
- prescribe stool analysis, identifying worms.
Treatment for vulvitis is to eliminate the cause that causes the symptoms of the disease. If a woman has an acute stage of the disease, the gynecologist will recommend that she refrain from sex and carry out treatment in bed rest. It is possible to treat the disease with special medications that restore the microflora of the genital organs. In addition, the doctor prescribes the patient bathing, which contains decoctions of herbs, as well as solutions of chlorhexidine, potassium permanganate and other drugs.
Treatment of vulvitis requires the use of drugs of the antibacterial type (creams, ointments), which are applied to the region of the external genital organs, as well as injected into the internal organs (vagina). To cure the disease completely is to save the patient from the manifestation of all unpleasant symptoms. The fact that a woman is completely healthy, it will be possible to speak only after re-taking a smear, in which no pathogens will be detected.
Often, women after menopause develop atrophic vulvitis. This disease is usually diagnosed at a gynecologist's appointment. In some cases, the woman does not even make any complaints. Treatment of this disease should be only complex - taking vitamins, baths with medicinal herbs, as well as the treatment of the external genital organs with creams and ointments.
Treatment of vulvitis is also carried out with the help of vitamins (groups E, C, A). Allergic vulvitis is treated with the use of special antiallergic drugs. Also, in order to properly treat the disease, you need to eliminate allergens. For example, replace the product for intimate hygiene, soap and other cosmetic accessories. If a woman is diagnosed with an allergic vulvitis, then she needs to choose hypoallergenic hygiene products. To cure this disease is finally real both in adolescence and in postmenopausal age.
Allergic vulvitis or another kind of it can be prevented if you follow the rules of personal hygiene, as well as lead a safe sex life. You also need to avoid those factors that are fundamental to this disease. If a woman has noticed symptoms of vulvitis or vaginitis, then she should immediately consult a qualified doctor and undergo adequate treatment.
If you think you have Vulvitis and symptoms characteristic of this disease, a gynecologist can help you.
We also suggest using our online disease diagnostics service, which selects possible diseases based on the entered symptoms.
Candida vulvitis is an inflammatory process that affects the external genitals of a girl or woman. The causative agent of infection is Candida fungus, which lives in the vaginal microflora. The inflammatory process is activated only in the presence of a favorable environment for it - against the background of infectious diseases, with non-compliance with personal hygiene. It affects people from different age groups.
Genital herpes is the most common infectious disease that affects the mucous membranes or the skin of the genitals with characteristic rashes. The rash is like a small group of vesicles that can mutate into small ulcers.
Dysbacteriosis during pregnancy is a rather unpleasant phenomenon that women often face during the carrying of a child. Predominantly, women develop vaginal dysbiosis when the ratio of lactobacilli and opportunistic microorganisms is disturbed due to a decrease in general immunity. But intestinal dysbacteriosis during pregnancy is also common, which also occurs due to the death of normal microflora and the increased reproduction of pathogenic microorganisms in the organ.
Urethritis in women is an inflammatory disease that affects the walls of the urethra. In the absence of timely treatment, the pathological process quickly from the acute form becomes chronic, which leads to the development of other diseases.
Candida vulvovaginitis - an inflammatory process that develops in the vagina and the external part of the genital organs. As a rule, it appears in older women or in young girls. As for children, the disease manifests itself even in newborns. The reason for this may be an elementary lack of hygiene.
With exercise and temperance, most people can do without medicine.