Vaginitis - Symptom & Treatment of Bacterial, Atrophic Vaginitis

What is Vaginitis?

Inflammation and infection of the vagina are common gynecologic problems, resulting from a variety of pathogens, allergic reactions to vaginal contraceptives or other products, or the friction of coitus. The normal vaginal pH is 4.5 or less, and Lactobacillus is the predominant organism. At the time of the midcycle estrogen surge, clear, elastic, mucoid secretions from the cervical os are often profuse. In the luteal phase and during pregnancy, vaginal secretions are thicker, white, and sometimes adherent to the vaginal walls. These normal secretions can be confused with vaginitis by concerned women.

Vaginitis can be described as an inflammation of the vagina and vulva. It is a fairly common problem with women. Bacterial and Atrophic Vaginitis can be avoided by taking proper treatment in the initial stages itself. Normal healthy women do not suffer from the sensations of the itching, burning, pain or irritation due to Vaginitis. There is increase in the frequency or discharge of urine which is accompanied with an unpleasant order.

Symptom of Vaginitis

When the patient complains of vaginal irritation, pain, or unusual discharge, a careful history should be taken, noting the onset of the LMP; recent sexual activity; use of contraceptives, tampons, or douches; and the presence of vaginal burning, pain, pruritus, or unusually profuse or malodorous discharge. The physical examination should include careful inspection of the vulva and speculum examination of the vagina and cervix. The cervix is cultured for gonococcus or chlamydia if applicable. A specimen of vaginal discharge is examined under the microscope in a drop of 0.9% saline solution to look for trichomonads or clue cells and in a drop of 10% potassium hydroxide to search for candida. The vaginal pH should be tested; it is frequently greater than 4.5 in infections due to trichomonads and bacterial vaginosis. A bimanual examination to look for evidence of pelvic infection should follow. The symptoms of vaginitis are

No woman can predict what symptoms she will experience, or how severely. Therefore, the management of Vaginitis needs to be as personalized as the symptoms themselves.

Causes of Vaginitis

The most rare causes of vaginitis are:

Trichomonas vaginalis Vaginitis

This protozoal flagellate infects the vagina, Skene's ducts, and lower urinary tract in women and the lower genitourinary tract in men. It is transmitted through coitus. Pruritus and a malodorous frothy, yellow-green discharge occur, along with diffuse vaginal erythema and red macular lesions on the cervix in severe cases. Motile organisms with flagella are seen by microscopic examination of a wet mount with saline solution

Treatment of Vaginitis

Vulvovaginal Candidiasis

A variety of regimens are available to treat vulvovaginal candidiasis. Women with uncomplicated vulvovaginal candidiasis will usually respond to a 1- to 3-day regimen of a topical azole. Women with complicated infection (including four or more episodes in 1 year, severe signs and symptoms, non-albicans species, uncontrolled diabetes, HIV infection, corticosteroid treatment, or pregnancy) should receive 7–14 days of a topical regimen or two doses of fluconazole 3 days apart. (Pregnant women should use only topical azoles.)

Single-dose regimens

Clotrimazole (500-mg vaginal tablet) or tioconazole ointment (6.5%, 5 g). Fluconazole, 150 mg orally is also effective.

Three-day regimens

Butoconazole (2% cream, 5 g), clotrimazole (two 100-mg vaginal tablets), terconazole (0.8% cream, 5 g, or 80-mg suppository), or miconazole (200-mg vaginal suppository) once daily.

Seven-day regimens

Clotrimazole (1% cream or 100-mg vaginal tablet), miconazole (2% cream, 5 g, or 100-mg vaginal suppository), or terconazole (0.4% cream, 5 g) once daily.

Fourteen-day regimens

Nystatin (100,000-unit vaginal tablet once daily), boric acid capsules (600 mg gelatin capsule inserted vaginally, daily).

Recurrent vulvovaginitis (maintenance therapy)

Ketoconazole (100 mg orally) once daily for up to 6 months, clotrimazole (500-mg vaginal suppository) once weekly, fluconazole (100–150 mg orally) once weekly, or itraconazole (400 mg orally) once monthly or 100 mg orally once daily.

Women Medical Diseases

Abnormal Uterine Bleeding
Ovulatory cycles
Anovulatory Cycles
Pelvic Pain
Premenstrual or Menstrual Pain
Uterine Pain
Adnexal Pain
Vulvar or Vaginal Pain
Pre Menopause
Ahumada-Del Castillo syndrome
Anovulatory cycles
Asherman's syndrome
Atrophic vaginitis

vulvodynia symptom
celebrex vulvodynia
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cause of vulvodynia
Cervical ectropion
Cervical mucous
Cervical polyp
Androgen Insensitivity Syndrome
Congenital Adrenal Hyperplasia
Bartholin gland cyst