vaginitis

Colpitis: description

Colpitis (or vaginitis) is the medical term for acute or chronic vaginal inflammation. This can be caused by various types of pathogens (mostly bacteria) as well as mechanical or chemical irritation (such as chemicals). Usually the vulva is inflamed at the same time, so the outer female genital area (with labia, etc.). Physicians then speak of vulvovaginitis. Colpitis is one of the most common infections in the female genital area and can affect women of all ages.

Normally, pathogens in the vagina can not survive because the prevailing milieu is too acidic for it. Responsible for the acidity is the healthy vaginal flora, which mainly consists of lactic acid bacteria (lactobacilli). By shedding sugars from the sheath cells into lactic acid, they provide a low pH in the vagina – as protection against infections such as colpitis.

A decisive influence on the mucous membrane and the acidic environment of the vagina has the female sex hormone estrogen. It supports the growth and regular renewal of the vaginal mucosa. In addition, estrogen raises the level of sugar in the vagina, which increases the healthy lactic acid bacteria.

Two forms of vaginitis

Physicians distinguish two forms of vaginitis:

• Primary vaginitis: A larger number of pathogens enter the vagina and confuse the natural vaginal flora so that it leads to inflammation.
• Secondary vaginitis: The environment of the vagina is so disturbed that sporadically present disease-causing bacteria multiply and trigger inflammation.

Colpitis: symptoms

The most important sign of vaginal inflammation is an increased outflow. Physicians speak of fluorine vaginalis. The consistency of the outflow depends on the cause. For example, a gray, fluid and foul-smelling discharge indicates bacterial vaginosis, a common form of bacterial vaginal inflammation. If the vaginitis is caused by trichomonads (unicellular parasites) (trichomoniasis), the discharge is yellow-green, frothy, malodorous and accompanied by itching. Infections with candida fungi cause a white-yellowish, creamy to friable, odorless discharge and itching.

Other common symptoms of vaginitis include pain and burning in the vagina area. The pain can occur during intercourse (dyspareunia) or independent of mechanical irritation. Even painful urination can accompany a vaginitis.

Depending on the cause, different changes of the mucous membranes, such as blotches or diffuse redness, papules or flat and slightly bleeding ulcers (ulcers), also appear in the vagina.

In many cases, the vaginal inflammation spreads to the vulva. This vulvovaginitis is characterized by redness, itching or pain in the labia.

In some cases, a colpitis remains asymptomatic, ie without discomfort.

Colpitis: causes and risk factors

Most commonly, bacteria cause colpitis, such as staphylococci, streptococci, Escherichia coli, or anaerobic bacteria (such as Gardnerella vaginalis). Another bacterial agent of vaginitis are gonococci – the causative agents of the sexually transmitted disease gonorrhea (gonorrhea).

Apart from bacteria, other pathogens such as fungi (Candida fungi, etc.), viruses (HPV viruses, herpes viruses, etc.) or parasites (such as trichomonads) can cause colpitis.

In addition to these infectious vaginitis, there are also forms of vaginal inflammation, which are caused by chemicals or other irritants. For example, a traumatic vagina is usually caused by foreign bodies in the vagina, for example, by a forgotten tampon or a pessary.

Atrophic colpitis is one of the non-infection-related vaginal inflammation. It occurs in women during or after the menopause, because they no longer completely build up the vaginal mucosa due to the increasing estrogen deficiency. This reduces the local defense against pathogens. In the further course of the initially non-infectious vaginal inflammation, therefore, germs such as bacteria or fungi can easily settle and multiply.

Risk factors of colpitis

The development of vaginal inflammation often involves a wide variety of risk factors. For example, poor or exaggerated hygiene, frequent partner changes and foreign bodies in the vagina play a role. Metabolic diseases can also promote vaginitis. These include, for example, diabetes mellitus, obesity (obesity) and Cushing’s syndrome. Iron deficiency, tumors, surgery and genetic predisposition can also contribute to the development of colpitis. The same applies to certain medications such as antibiotics, corticosteroids (“cortisone”) and anticancer drugs.

All of these factors can disrupt the vaginal flora and thus pave the way for vaginitis. Basically, but also in a healthy vaginal flora, a form of vaginitis.

Colpitis: examinations and diagnosis

In case of suspected colpitis, the gynecologist is the right person to contact. In the context of an initial conversation, this raises the medical history (medical history). You have the opportunity to describe your symptoms and complaints exactly. The doctor will also ask you specific questions, for example, if you have had such symptoms in the past or are taking any medications.

After the anamnesis a gynecological examination takes place. The doctor looks closely at the vaginal mucosa. An inflamed mucous membrane, for example, the doctor recognizes redness and swelling. Occasionally, small blisters or ulcers may be seen on the vaginal mucosa. Also, the increased discharge, which may be visible in the vagina, is an indication of colpitis.

In order to be able to identify possible causative agents of the vagina, the doctor takes smears from the vaginal mucosa. Under the microscope can be seen in the smears, for example, whether mushrooms, bacteria or worms have spread in the vagina. For more precise proof, a culture of the pathogen sometimes has to be created in the laboratory.

Older women often have atrophic colpitis. In most cases, no pathogens can be detected.

Important in case of suspected colpitis is also the exclusion of other causes of the complaints. For example, in older women with colpitis always a possible cancer tumor to diagnose.

In addition, the doctor will identify possible risk factors for colpitis, such as certain metabolic diseases or a wrong hygiene technique. Such factors should, if possible, be eliminated or at least reduced to reduce the risk of recurrent vaginal inflammation.

Colpitis: treatment

The treatment of infection-related colpitis depends on the pathogen or the pathogens. For example, antibiotics (such as metronidazole) are used against bacteria and so-called antifungals (such as clotrimazole) against fungi. Sometimes also antiseptic agents (betaisodona) are prescribed. They work against bacteria, fungi, viruses and protozoa.

The active ingredients are applied locally (in the form of suppositories or creams) or systemically (usually as tablets). In sexually transmitted pathogens of vaginitis the partner should be treated.

If no pathogens can be found as the cause of vaginitis, but there is a deficiency of the vagina (dysbiosis), are used drugs (such as probiotics), which bring the vaginal flora back into balance.

Atrophic colpitis is treated with hormone preparations – estrogen supplements that are taken locally or ingested.

Colpitis: disease course and prognosis

With timely and consistent therapy, vaginal inflammation can be treated well. As a rule, she heals without complications. Sometimes, however, the inflammation can spread as the germs rise. For example, inflammation of the cervix (cervicitis), the lining of the uterus (endometritis) or the fallopian tube (pelvic inflammatory disease) can occur.

In order to reduce the risk of re-inflammation after healed colpitis, existing risk factors should be eliminated or reduced. To avoid, for example, an exaggerated intimate hygiene, as it can disturb the vaginal flora. Women should therefore refrain from vaginal irrigation and Intimkosmetika (such as Intimdeos), which are not adapted to the acidic vaginal environment. Conversely, a lack of intimate hygiene favors a colpitis.

Colpitis in pregnancy

A vaginal inflammation during pregnancy can cause premature labor or a premature rupture of the bladder and thus a miscarriage. It is therefore essential to treat vaginitis in pregnant women.

Because the causative agents of vaginal inflammation (such as herpes viruses, gonococci or chlamydia) can infect the newborn during natural birth, becomes more acute in pregnant women vaginitis usually a cesarean section performed.