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ID: 256
Category: Obstetrics and Gynecology
CreatedBy: 1
UpdatedBy: 1
createdon: 26 May 2023
updatedon: 26 May 2023

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Author: Khoa Tran
Published May 26, 2023
Updated May 26, 2023

Table of contents

Vaginitis

Etymology and Pronunciation

vaginitis (vaj-uh-NAHY-tis)
vagina - Latin for "sheath" or "scabbard". Refers to he passage leading from the opening of the vulva to the cervix of the uterus in female mammals.
-itis - Greek for "inflammation".

History of Vaginitis

In 1928, Dr. Albert Döderlein first described the presence of lactobacillus bacteria in the vaginal microbiome (published from The Journal of Infectious Diseases Vol. 43, No. 3, pp. 218-227). He suggested that these bacteria play an essential role in maintaining the health of the vagina. 

In the 1950s, the development of the microscope allowed researchers to observe microorganisms that cause vaginitis. This led to the identification of Trichomonas vaginalis, a protozoan parasite that is now recognized as one of the primary causes of vaginitis. 

In recent years, advances in DNA sequencing technology have made it possible to explore the vaginal microbiome in greater detail. Scientists can now identify the different types of bacteria present and understand how they interact with each other and the host. This has led to a better understanding of the causes of vaginitis, and improved diagnosis and treatment options.

Modern Understanding of Vaginitis

Vaginitis is a medical condition where the vagina becomes inflamed. Normally, the vagina has a balance of good and bad bacteria, but when this balance is disrupted, it can lead to irritation, itching, and discharge. 

There are three common types of vaginitis: yeast infections, bacterial vaginosis, and trichomoniasis. Yeast infections are caused by an overgrowth of yeast in the body. Bacterial vaginosis is caused by an overgrowth of bacteria in the vagina, and trichomoniasis is caused by a parasite. 

Vaginitis is very common and many women experience it at some point in their lives. Women who are pregnant, have diabetes, or use antibiotics are more likely to get vaginitis. Additionally, certain behaviors like douching or using scented products around the vaginal area can also disrupt the balance of bacteria and lead to vaginitis.

Causes of Vaginitis

- Bacterial Vaginosis (BV): BV occurs when there is an overgrowth of harmful bacteria in the vagina, disrupting the natural balance of bacteria. The exact cause of BV is not fully understood, but factors such as douching, multiple sexual partners, and a history of sexually transmitted infections (STIs) may increase the risk.
- Yeast Infections: Candida, a type of fungus that normally resides in the vagina, can overgrow and lead to a yeast infection. This can be triggered by factors such as hormonal changes (e.g., during pregnancy or while taking certain medications), weakened immune system, uncontrolled diabetes, or the use of antibiotics that disrupt the natural balance of vaginal flora.
- Trichomoniasis: Trichomoniasis is a common sexually transmitted infection caused by a microscopic parasite called Trichomonas vaginalis. It spreads through sexual contact. Unprotected sex, having multiple sexual partners, and a history of other STIs can increase the risk of trichomoniasis.
- Hormonal Changes: Fluctuations in hormone levels, particularly estrogen, can affect the vaginal environment and make it more susceptible to inflammation and infections. Hormonal changes may occur during pregnancy, menopause, or while using hormonal contraceptives.
- Allergic Reactions or Irritants: Some women may develop vaginitis due to an allergic reaction or irritation from certain substances. This can include irritants such as douches, soaps, perfumes, scented products, latex condoms, spermicides, or other personal care products.
- Foreign Bodies: Introduction of foreign objects into the vagina, such as forgotten tampons or condoms, can lead to irritation and infection.
- Poor Hygiene Practices: Inadequate hygiene practices, such as infrequent washing, using harsh soaps, or improper wiping techniques (back to front instead of front to back) can disrupt the natural vaginal flora and increase the risk of vaginitis.

It's important to note that the specific cause of vaginitis may vary from person to person. Some individuals may experience multiple factors contributing to their condition, while others may have a single identifiable cause. It is recommended to consult a healthcare professional for an accurate diagnosis and appropriate treatment based on the specific cause of vaginitis.

Treatments for Vaginitis

- Antifungal medications: If the vaginitis is caused by a fungal infection, antifungal medications can be used. These medications can be prescribed in the form of creams, tablets or suppositories.
- Antibiotics: If the underlying cause of vaginitis is bacterial infection, your healthcare provider may prescribe antibiotics. These medications kill the harmful bacteria and help clear the infection.
- Topical corticosteroids: Topical corticosteroids might be prescribed to reduce inflammation and itching caused by vaginitis. These medications are usually available in the form of creams and ointments.
- Probiotics and lifestyle changes: Probiotics and lifestyle changes might also help manage vaginitis. Probiotics can help restore the balance of bacteria in the vagina, while lifestyle changes like wearing cotton underwear and avoiding scented products might help prevent future infections.

Lifestyle Changes

- Practice Good Hygiene: Maintain proper hygiene by washing the external genital area with mild, fragrance-free soap and warm water. Avoid using harsh soaps, douches, or scented products, as they can disrupt the natural balance of vaginal flora.
- Avoid Irritants: Steer clear of potential irritants that can trigger vaginitis symptoms. These may include scented tampons, pads, and toilet papers, as well as perfumed products like soaps, lotions, and bubble baths. Opt for unscented and hypoallergenic alternatives.
- Wear Breathable Underwear: Choose underwear made from breathable fabrics such as cotton, which allows air circulation and reduces moisture build-up. Avoid tight-fitting underwear and nylon or synthetic materials that can trap heat and moisture, promoting bacterial growth.
- Practice Safe Sex: Consistently use condoms and practice safe sex to reduce the risk of sexually transmitted infections (STIs) that can cause or contribute to vaginitis. Limit the number of sexual partners and consider regular STI screenings.
- Avoid Douching: Douching disrupts the natural balance of bacteria in the vagina and can lead to vaginitis. It is recommended to avoid douching altogether.
- Maintain a Healthy Diet: Eating a balanced diet that is rich in nutrients can support a healthy immune system and vaginal health. Include probiotic-rich foods like yogurt and fermented foods, as they can promote the growth of beneficial bacteria in the vagina.
- Stay Hydrated: Drink an adequate amount of water daily to help maintain hydration and promote overall vaginal health.
- Manage Stress: High stress levels can potentially affect the body's immune system and hormone balance, which may impact vaginal health. Engage in stress-management techniques such as regular exercise, deep breathing exercises, meditation, or engaging in hobbies to reduce stress levels.
- Avoid Prolonged Moisture: After swimming or exercising, change out of wet or sweaty clothing promptly to avoid prolonged moisture in the genital area, which can create an environment favorable for bacterial overgrowth.

It's important to note that while lifestyle changes can contribute to better vaginal health and reduce the risk of vaginitis, they may not be sufficient to treat an existing infection.

Symptoms

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Vaginal discharge
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Vaginal pain and soreness
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Painful intercourse (sex)
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Abnormal vaginal bleeding
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Itching in the vagina and vulva
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Vaginal rash

Confirmation Tests

- Vaginal swab
- Microbial cultures

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