Vulvovaginitis: symptoms, photos, treatment of vulvovaginitis

Causes of vulvovaginitis, treatment and first symptoms (photos)

Vulvovaginitis is one of the most common gynecological diseases. Girls of the first year of life, as well as persons of prepubertal and postmenopausal age groups are most susceptible to this pathology. But in the presence of predisposing factors, combined lesions of the vulva and vagina can also develop in women of reproductive age.

Although vulvovaginitis is not a potentially life-threatening condition, special attention is paid to its treatment. This is due not only to the physical discomfort that patients experience. Inflammation of the external genitalia and vagina can be complicated by an ascending urinary infection with the sequential development of urethritis, cystitis and pyelonephritis. Possible damage to the cervix with infection of the endometrium.

Causes of vulvovaginitis

The provoking factors and main causes of inflammatory diseases of the lower parts of the female genital organs include:

hypovitaminosis;
physiological reasons: pregnancy, menstruation;
hormonal changes: during pregnancy, during menopause;
uncontrolled use of antibiotics, hormonal drugs;
chemotherapy and radiation therapy for cancer;
reduced immunity and immunodeficiency states (HIV infection);
non-compliance with genital hygiene;
endocrine diseases (diabetes mellitus, hypothyroidism);
childhood infections in girls (measles, scarlet fever);
diseases of the gastrointestinal tract and allergic diseases;
termination of pregnancy, curettage for medical reasons;
traumatic injuries to the genital organs (rough sexual intercourse, first sexual intercourse, ruptures during childbirth, wearing tight and synthetic underwear, wearing an intrauterine device);
sexually transmitted infections (STIs): frequent changes of sexual partners, refusal to use condoms are the main causes of inflammatory diseases of a specific etiology (chlamydia, gonorrhea, etc.).

Today, vulvovaginitis increasingly occurs as a result of the presence of hidden infections, such as ureaplasmosis, mycoplasmosis, chlamydia, etc. this infection can be transmitted from mother to child during childbirth, as well as through household contact.

An important factor in the appearance of vulvovaginitis is a decrease in the endocrine function of the ovaries, obesity, diabetes mellitus, as well as other diseases leading to a decrease in the body’s resistance to infections.

Causes of vulvitis and predisposing factors

Specific inflammation caused by pathogens of sexually transmitted diseases (chlamydia, trichomonas, gonococci, etc.) is much less common. The main cause of vulvitis can be: Escherichia coli (E. coli), staphylococcus, fungi of the genus Candida, streptococcus or bacteria of the genus Pseudomonas and Proteus.

It should be borne in mind that vulvitis as an independent disease is rare, that is, primary vulvitis. Basically, inflammation of the vulva is a separate symptom of a disease (colpitis, cervicitis, diabetes mellitus, other pathologies) - secondary vulvitis.

The main causes and predisposing factors of inflammation of the external genitalia in women:

bacterial infections of the genital organs - banal colpitis, cervicitis, vulvovaginitis (as a separate symptom of the underlying disease);
specific infections, including sexually transmitted diseases;
active sex life;
physiological phenomena (pregnancy, menstruation);
diseases of the endocrine system (diabetes mellitus, lack of thyroid hormones, etc.);
use of intrauterine contraceptives;
taking antibiotics and corticosteroids;
wearing tight underwear made of synthetic fabrics;
using soap, shampoo, shower gel or other personal hygiene products (including sanitary pads and napkins) that irritate the skin;
frequent cycling, horse riding;
frequent douching;
washing powders and fabric softeners;
menopause and menopause.

At risk are women with sensitive skin, who have previously had allergic reactions, and who have an active sex life.

Classification of vulvovaginitis

Currently, several characteristics of the disease are taken into account when making a diagnosis. Therefore, several clinical classifications of vulvovaginitis are used simultaneously:

By type of pathogen: nonspecific bacterial, specific, tuberculosis, diphtheria, viral, fungal (candida), protozoal.
According to the presence of an infectious agent: infectious and primary non-infectious.
By type of course: acute, subacute and chronic.

Primary non-infectious forms of the disease include allergic vulvovaginitis, inflammation due to foreign bodies in the vagina, masturbation and trauma, helminthic infestations, tissue changes due to dysmetabolic and endocrine disorders.

Symptoms of vulvovaginitis

Vulvovaginitis (see photo) can occur in acute or chronic form, and the symptoms of the disease will differ.

Symptoms of acute vulvovaginitis:

redness, swelling of the vulva;
pain in the lower abdomen, which can sometimes radiate to the sacrum;
itching and burning in the genital area, which intensifies during urination;
pain in the external genital area;
difficulty urinating, which is sometimes accompanied by difficulty defecating;
general weakness;
vaginal discharge, most often purulent;
painful intercourse;
if vulvovaginitis is caused by E. coli, then liquid discharge from the vagina is yellow-green in color and has an unpleasant odor.

Symptoms of specific types of vulvovaginitis:

Gonorrhea:

purulent discharge;
itching, burning, pain;
frequent painful urination;
Symptoms of gonorrhea in women disappear relatively quickly.

Trichomoniasis:

after infection with the disease, there is an incubation period of 3–5 days;
foamy vaginal discharge of a gray-yellow color with an unpleasant odor;
itching and burning, redness of the external genitalia;
in the granulosa form of the disease, the vaginal mucosa has a granular surface and a bright red color.

Syphilis:

the disease has an incubation period of 3–4 weeks;
at the site of pathogen penetration, a hard chancre appears: an erosion or ulcer of a round or oval shape, in the area of which there is a thickening of the skin;
during the illness, the woman is not bothered by pain;
lymph nodes in the groin area enlarge;
after some time, general malaise is noted, the woman’s body temperature rises - secondary syphilis develops;
Many nodules appear on the mucous membrane of the vulva, which are painless, but contain a large number of pathogens inside, and therefore are very contagious.

Candidiasis:

against the background of redness, swelling, itching, burning, and pain, white, curd-like discharge from the vagina occurs.
Bubbles appear in the vulva area, which burst open, leaving behind erosions. In the future, crusts remain at the site of erosion.

Herpes:

the disease lasts 2–4 weeks;
general symptoms are noted: increased body temperature, weakness, lethargy;
Bubbles with a diameter of 2–8 mm appear on the skin and mucous membrane of the vulva, which burst and leave ulcers.

Human papillomavirus infection:

A characteristic manifestation of human papillomavirus vulvovaginitis is genital warts, which appear on the skin and mucous membranes in the area of the external genitalia and anus. Gradually they grow, merge with each other, and sometimes reach such large sizes that they resemble tumors. At the same time, sexual intercourse is greatly difficult.

Allergic conditions and autoimmune diseases:

Vulvovaginitis is accompanied by severe itching, burning, and redness. The discharge is usually liquid and transparent. Symptoms occur during contact with the allergen. Later, infection and corresponding symptoms appear.

Causes of itching

Irritation in a child’s intimate area can occur due to various reasons. Redness and itching are a specific reaction of the skin and mucous membrane of the genital organs to an external or internal irritant. This phenomenon is often observed in girls aged 7–12 years, although the problem can appear at 5. In some cases, the malaise can be eliminated by changing hygiene products, in others serious drug treatment will be required.

Poor hygiene

In the first years of a child's life, the responsibility for care lies with the parents. Violation of a girl's personal hygiene leads to problems. Rare and improper washing causes irritation and redness of the intimate area. Unwashed hands and dirty underwear can cause inflammation in the perineum.

The infection occurs due to hypothermia of the body in winter. In summer, it is provoked by swimming in dirty ponds and contact with sand and earth on the genitals.

Care products

The cause of the trouble may also lie in the incorrect selection of personal care products. They are often replete with all kinds of dyes, fragrances, additives and other harmful chemical components. Delicate baby skin reacts negatively not only to soap and shampoo. Wet wipes, diapers, soap, toilet paper and even baby cream can cause redness.

Signs of chronic vulvovaginitis

The chronic form of vulvovaginitis is characterized mainly by constant itching in the vulva and whitish thick “curdled” vaginal discharge. Redness, swelling, pain and burning disappear. For little girls, this stage of the disease is dangerous due to fusion (synechia) of the labia, up to the closure of the urethra.

A long course of vulvovaginitis can contribute to the formation of condylomas, polyps, and scar formations in the vagina, which in the future can negatively affect a girl’s sex life and her reproductive function. Less commonly, severe damage and rejection of the vaginal mucosa occurs.

Diagnostics

If vulvovaginitis is suspected, diagnosis begins with collecting anamnesis and examining the woman in a gynecological chair. Based on the nature of the discharge and the formation of purulent plaque, the doctor can assume the causative agent of the infection. Pay attention to hyperemia, local swelling of the mucous membrane, and the formation of small ulcers. During the examination, the doctor takes a swab of vaginal discharge. Bacteriological analysis reveals thrush or other pathogenic microflora, sensitivity to treatment of vulvovaginitis with antibiotics.

Additionally, blood and urine are donated. To confirm the diagnosis, it is necessary to do an ultrasound examination of the organs located in the pelvis. An ultrasound examination will help to exclude concomitant inflammation of the uterus and appendages. Often the infection spreads further from the vagina, which requires more serious therapy. If a viral infection is suspected, PCR (polymerase chain reaction) is performed.

To treat vulvovaginitis, a woman who is sexually active needs to have blood and vaginal mucus tested for sexually transmitted diseases. This is necessary, since in patients aged 20–40 years this is a common cause of inflammation. Girls are recommended to have their stool tested for helminthic infestation. The entry of waste products of parasites into the vagina also contributes to the development of symptoms of vulvovaginitis.

Diagnosis of vulvitis

Now that we know what symptoms vulvitis has and what it is, we need to think about diagnosis.

The full range of diagnostic measures includes:

gynecological examination;
bacteriological examination with inoculation of material on nutrient media to determine the type of pathogen and its sensitivity to antibacterial drugs;
microscopy of a smear from the vaginal vault, cervical canal and urethra;
ELISA or PCR tests for a specific infection that can cause vulvitis.

Self-diagnosis and self-medication can lead to aggravation of the condition and various complications.

Treatment of vulvovaginitis

After identifying the cause of vulvovaginitis , etiotropic treatment begins:

if vulvovaginitis has developed due to another disease, it is necessary to treat the underlying disease;
for allergic vulvovaginitis, it is enough to stop exposure to the allergen and use an antiallergic drug, such as Suprastin or Zoditec;
vulvovaginal candidiasis is treated with the following drugs: Clotrimazole (vaginal tablets and 1% cream), Miconazole (2% cream or vaginal suppositories), Butoconazole (vaginal cream), Tioconazole (6.5 ointment), Terconazole (vaginal suppositories, cream), Nystatin (vaginal tablets), Fluconazole (150 mg - single dose, tablets orally), Diflucan;
for the treatment of bacterial vulvovaginitis, the following are used: Metronidazole (tablets or vaginal gel), Clindamycin in tablets and in the form of 2% vaginal cream, Terzhinan (vaginal tablets), Polygynax, oral tablets - Augmentin, Ampicillin, Cefradine;
for vulvovaginitis caused by the herpes virus, the following are used: Zavirax, Acyclovir, Valocyclovir, Larifan, Neovir;
Metronidazole and Tinidazole (oral tablets) are used in the treatment of trichomonas vulvovaginitis.

To alleviate the condition and relieve the inflammatory process in the area of the external genitalia, baths with chamomile, calendula, sage, St. John's wort, eucalyptus or soda are used. There are special aerosols for irrigation of the genitals (Hyposol). To restore the proper microflora of the vagina, vaginal suppositories “Vagilak” or “Acilakt” and the introduction of lactobacterin are used.

Complications of vulvitis

As a rule, inflammation of the external genitalia does not have serious complications. An exception is vulvitis or any other infectious disease of the genital organs during pregnancy. It is known that vulvovaginitis and vulvitis of an infectious nature can cause premature birth, complications during pregnancy and childbirth. The situation is aggravated by the fact that most drugs are contraindicated during pregnancy, so treatment is carried out only under the supervision of a doctor.

Chronic vulvitis can lead to the formation of adhesions on the genitals. A severe adhesive process can block the vestibule of the vagina and cause atresia. Frequent complications of vulvitis are cystitis, pyelonephritis, resulting from infection ascending the urinary tract.

Prevention

You can reduce the risk of developing an inflammatory process by following simple rules such as:

the use of contraceptives, which are selected together with the attending physician;
undergoing regular examinations by a gynecologist;
exclusion of casual sexual relations;
maintaining intimate hygiene;
timely and correct treatment of infectious lesions;
wearing underwear of a suitable size, choosing natural hypoallergenic fabrics;
limiting the use of hygiene products with strong aromatic fragrances and artificial colors;
refusal of frequent douching in order to preserve the natural microflora of the vagina;
use antibiotics only on the recommendation of a doctor, take probiotics.

Vulvovaginitis is not a serious disease, but it causes severe discomfort. With timely diagnosis and proper treatment, it goes away quickly. When the first symptoms appear, a woman or girl is advised to see a doctor. Self-therapy at home is also not worth it to prevent complications.

Prevention of vulvitis diseases

Prevention of violations of a girl’s reproductive health lies in the state of her general physical health.

Be sure to comply with:

rules of personal hygiene,
monitor the maintenance of immunity,
restrict your child from unhealthy eating habits,
promptly sanitize foci of chronic infection (especially tonsillitis, cystitis, upper respiratory tract diseases).

Timely sanitation of the vulva and vagina, correctly selected antibacterial treatment by a pediatric gynecologist during the acute course of the disease will prevent the transition to a chronic course of vulvitis and vulvovaginitis and help strengthen the reproductive potential of the girl.

The material was prepared on the basis of the dissertation work “Clinic, diagnosis and treatment of gynecological pathology in girls with urinary tract infections”, candidate of medical sciences, pediatric gynecologist Silenko O.N.

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