vaginitis
Introduction
Introduction to vaginitis Vaginitis is inflammation of the vaginal mucosa and submucosal connective tissue, and is a common disease in gynecological clinics. In normal healthy women, due to anatomical and biochemical characteristics, the vagina has a natural defense function against the invasion of pathogens. When the natural defense function of the vagina is destroyed, the pathogen is easy to invade, leading to vaginal inflammation. Young women and postmenopausal women are deficient in estrogen. The vaginal epithelium is thin, the intracellular glycogen content is reduced, and the vaginal pH is as high as about 7, so the vaginal resistance is low, which is more susceptible to infection than puberty and women of childbearing age. TCM theory, long-term use of medicinal rose water to drink can ease the treatment of vaginitis. basic knowledge The proportion of illness: 0.02%-0.05% Susceptible people: women Mode of infection: contact infection Complications: cervicitis cervical erosion pelvic inflammatory disease annex inflammation infertility
Cause
Cause of vaginitis
Rinse the vagina frequently with lotion (15%):
Some women prefer to wash the vulva or vagina with lotion. It is believed that this can keep the vulva clean. It is not known that frequent use of lotion will break the acid-base balance of the vagina, thus increasing the chance of infection of vaginitis.
Not paying attention to personal hygiene (25%):
Vaginitis can also be transmitted by using a public toilet or swimming in a public swimming pool. Among them, vaginal inflammation caused by Trichomonas vaginalis and Candida albicans is more likely to occur. In addition, women do not pay attention to menstrual hygiene, do not change underwear frequently, the disinfection of underwear is not strict will also cause vaginitis.
Unclean hygiene products (20%):
Women who use unclean or poorly sanitized hygiene products can also easily cause vaginitis. For example, dirty hand paper, sanitary napkins, pads.
Abuse of antibiotics (20%):
Abuse of antibiotics is also a major cause of vaginitis. This is because antibiotics also inhibit the growth of some beneficial bacteria in women while killing pathogenic bacteria. This gives the harmful bacteria a chance to cause vaginitis. Common is fungal vaginitis.
Due to sexual life (20%):
Frequent sexual behavior is the main cause of vaginitis, menstrual sexual behavior, sexual behavior is also clean and so on are also the cause of vaginitis.
Prevention
Vaginitis prevention
1. After treatment, most patients with yin- inflammatory disease can be cured, but some people are prone to relapse. In order to avoid the recurrence of vaginitis, it is best to wear loose and breathable underwear, avoid tights, jeans and other clothing. In addition, the underpants are preferably cotton, dried in the sun after washing.
2, when the menstrual cramps should use sterile cotton pads, pay special attention to avoid bacterial infections. Bathroom equipment must be cleaned to avoid sharing by multiple people to reduce the probability of infection.
Complication
Vaginitis complications Complications Cervicitis Cervical erosion Pelvic inflammatory disease Attachment inflammation Infertility
1. If vaginitis is not effectively treated, it may cause ascending infection of bacteria in the vagina, causing gynecological diseases such as cervicitis or cervical erosion.
2, some vaginal inflammation will also be implicated in other organs, causing pelvic inflammatory disease, annex inflammation and other reproductive organs inflammation.
3, severe vaginitis can cause female infertility, this is because the inflammatory cells in the vagina will affect the operation of sperm or phagocytosis of sperm, causing infertility.
Symptom
Symptoms of vaginal symptoms Common symptoms of vaginal discharge yellow vaginal adhesions red leucorrhea water vaginal discharge sexual intercourse after menopause vaginal discharge increased leucorrhea slag-like itching vaginal leucorrhea brown leucorrhea
Fungal vaginitis
Monilial or mycotic vaginitis is caused by a mold infection. Its incidence is second only to trichomonas vaginitis.
The most common symptoms of Candida infection are vaginal discharge, genital and vaginal burning itching, external dysuria, and vulva map-like erythema (fungal or candida vulvovaginitis). The typical leucorrhea is curd-like or lumpy, and the vaginal mucosa is highly red and swollen. It can be seen that the white goose-like plaque adheres and is easily peeled off. The underlying is the erosion base of the damaged mucous membrane, or the shallow ulcer is formed. In severe cases, the ecchymosis can be left behind. . However, leucorrhea does not all have the above-mentioned typical characteristics, from water samples to curd-like leucorrhea, and some are completely thin, clear, serous exudates, which often contain white flakes. The itching symptoms of fungal vaginitis during pregnancy are particularly serious. Even sitting down, suffering from abnormalities, there may be symptoms such as frequent urination, dysuria and dyspareunia. In addition, about 10% of women and 30% of pregnant women are mold carriers, but there is no clinical manifestation.
Trichomonas vaginitis
Trichomonas vaginitis is a common vaginitis caused by Trichomonas vaginalis.
The main symptoms of vaginal discharge and genital itching vaginitis are thin foamy leucorrhea and genital itching. If other bacteria are mixed, the discharge is purulent and may have odor. The itching area is mainly vaginal opening and vulva. There may be burning, pain, or sexual pain. If there is an infection in the urethral opening, there may be frequent urination, dysuria, and sometimes hematuria. During the examination, vaginal mucosa congestion can be seen. In severe cases, there are scattered bleeding spots. There are a lot of leucorrhea in the posterior iliac crest. It is grayish yellow, yellowish white thin liquid or yellowish green purulent secretion, often foamy. The vaginal mucosa of the worms can be found without abnormalities. A small number of patients have trichomoniasis in the vagina without inflammatory reaction, called the worm. Some people think that trichomoniasis can not cause inflammation when it exists alone, because it consumes glycogen in vaginal epithelial cells, changes the vaginal pH, destroys the defense mechanism, and promotes secondary bacterial infection, so it is often before, during or after the menstrual period. When the vaginal Ph changes, it causes an onset of inflammation.
Bacterial vaginitis
Bacterial vaginosis is mainly caused by vaginal vaginal bacteria, which can be transmitted through sexual relations.
The typical clinical symptoms of this disease are markedly increased vaginal abnormal secretions, which are thin homogeneous or thin paste, grayish white, grayish yellow or milky yellow with a special fishy smell. Since alkaline prostatic fluid can cause the release of amines, it is manifested as an increase in odor after sexual intercourse or after sexual intercourse. The vaginal pH value increases during menstruation, so the odor can be aggravated during menstruation or menstruation. The patient's vulva has discomfort, including varying degrees of genital itching, generally no obvious time, but itching is more obvious in rest and mood. There are still varying degrees of external burning sensation, and some patients have sexual pain. Very few patients have lower abdominal pain, difficulty in sexual intercourse and abnormal urination. The vaginal mucosa epithelium showed no obvious hyperemia at the time of onset.
Examine
Vaginitis check
First, gynecological examination: This is a most routine examination of women's health, the purpose is to initially screen for possible diseases, and take the secretions specimens for necessary examination.
Second, vaginal secretion examination: The purpose of this examination is to check the vaginal cleanliness, whether there are mold, trichomoniasis, bacteria (clue cells, pus cells) infection.
Third, vaginal secretion culture: In the diagnosis of vaginitis, the purpose of this examination is to determine which pathogen is infected by the patient, to provide an accurate diagnosis basis for the doctor.
Fourth, drug sensitivity test: The purpose of this test is to detect which kind of drug is sensitive to the pathogen, can be targeted to improve the treatment effect.
V. Electronic colposcopy: The advantage of this examination is that it can magnify 50 times accurately and clearly to observe the relevant lesions of the vagina and cervix, and accurately select suspicious parts for biopsy, for cervical cancer and precancerous lesions. Early detection and early diagnosis are of considerable value.
Diagnosis
Diagnosis of vaginitis
Inspection diagnosis
1, non-specific vaginitis take secretions for smear, with Gram stain microscopic examination, you can find common pathogens, and no mold or trichomoniasis.
2, fungal vaginitis take secretions for smear, stained with Gram, under the microscope can find a group of Gram-positive densely stained oval spores, or visible pseudohyphae and budding cells connected into a chain Shaped or branched. The most reliable method is to perform a mold culture test.
3, Trichomonas vaginitis take secretions and a small amount of warm saline that has been dripped on the glass tablets to reconcile, microscopic examination. Visible activity of Trichomonas vaginalis. If the trichomoniasis is not found in a special case, the culture method may be used instead, and the test result is highly accurate.
4, the secretion examination of senile vaginitis should be distinguished from trichomonas, fungal vaginitis. Pay attention to the cervix, the size of the uterus and its morphology, the source of bleeding and the results of vaginal cytology, if necessary, for cervical or endometrial biopsy to rule out the possibility of uterine cancer.
Diagnostic criteria
1, vaginal discharge is grayish white, very sticky, even like batter, uniform, but not purulent secretions, the amount is uncertain.
2. The amine content in the secretion is particularly high, so it is fishy smell. When sexual intercourse or activity, the odor is aggravated by promoting the release of amine. The amine flavor can also be released after adding 10% potassium hydroxide to the secretion.
3, ph value in vaginal secretions increased, ph range of 5.0-5.5, while normal people are 4.5-4.7.
4. The clue cells can be detected in the wet smear of vaginal secretions.
Diagnose based on
a. More leucorrhea should be caused by vaginitis, need timely treatment. Analysis of the symptoms of vaginitis, diagnosis and finding the cause is a necessary step before treatment. Patients themselves can also compare the symptoms of common vaginitis with their own, understand the condition, and cooperate with the doctor to treat, these have a great impact on the treatment effect.
b. The most common symptoms of vaginitis are leucorrhea, vulva and vaginal burning itching, external dysuria, erythema with erythema (mycotic or candida vulvovaginitis). The typical leucorrhea is curd-like or lumpy, and the vaginal mucosa is highly red and swollen. It can be seen that the white goose-like plaque adheres and is easily peeled off. The underlying is the erosion base of the damaged mucous membrane, or the shallow ulcer is formed. In severe cases, the ecchymosis can be left behind. .
c. If there is bloody vaginal discharge after sexual life, there may be vaginal inflammation, but don't worry, because it is the first time you can observe for a few days, pay attention to the genital cleansing in these days, if you repeat If it appears, it is recommended that you go to the hospital for gynecological examination and leucorrhea routine examination in time to determine whether there is vaginal inflammation or cervical inflammation. It is necessary to carry out symptomatic anti-inflammatory treatment.
d. However, leucorrhea does not all have the above-mentioned typical characteristics, from water samples to curd-like leucorrhea, if any are some of the thin, clear, serous exudates, which often contain white flakes. Itching is particularly serious in the symptoms of fungal vaginitis during pregnancy. Even sitting and restless, painful, there may be symptoms of vaginitis such as frequent urination, dysuria and dyspareunia. In addition, about 10% of women and 30% of pregnant women are mold carriers, but there is no clinical manifestation.
