Features of diagnosis and treatment of atrophic colpitis

According to statistics, every second girl who comes to see a gynecologist has encountered such an intimate disease as colpitis at least once in her life.

Colpitis or vaginitis is an inflammatory process of an infectious or non-infectious nature, affecting the mucous membrane of the vagina, and in some cases, the vulva.

This disease brings a lot of discomfort - from discharge and unpleasant odor to painful sensations during sexual intercourse, and worsens a woman’s quality of life.

At the initial stage of development, the infection is not dangerous, but the lack of timely qualified medical care or self-medication can lead to serious complications.

Causes of the disease

Depending on what is the cause of colpitis, one can distinguish specific, that is, caused by an infectious agent, and non-specific, caused by vaginal microorganisms, which normally do not cause problems in a healthy woman, but when exposed to certain factors begin to multiply intensively, causing discomfort and leading to pathological processes.

It is important to correctly determine the cause of the inflammatory process and prescribe appropriate treatment precisely aimed at eliminating the problem.

The most common causes of vaginitis are:

● Sexually transmitted infections.

A large group of diseases is caused by infections acquired through unprotected sex.

There are microorganisms that can be transmitted in this way from an infected partner through mucous membranes, but do not cause any harm to a healthy person, since his immune system suppresses the proliferation of pathogenic microflora.

However, if particularly pathogenic microorganisms occur, as well as with decreased immunity, the presence of microtrauma or concomitant diseases, an inflammatory process develops.

Colpitis can be caused by syphilis, chlamydia, gonorrhea, trichomoniasis, human papillomavirus, ureaplasmosis and many others.

The most reliable option for preventing vaginitis in this case is the use of barrier contraception methods during sexual contact.

● Damage to the vaginal mucosa.

The mucous membrane plays a very important role as a barrier that prevents microorganisms from entering the thickness of the vaginal walls. Injury to it can occur both during sexual contact and with medical instruments during improper manipulation. Through microtrauma, bacteria and microorganisms penetrate tissue and multiply there, causing inflammation.

● Impaired blood supply.

With blood, not only oxygen enters the vagina, but also many nutrients that ensure the normal functioning of the mucous membrane. With a lack of microelements, it becomes thinner and does not produce a sufficient amount of natural secretions, which leads to the formation of microtraumas.

● Endocrine diseases.

The proper functioning of the endocrine system is also responsible for the sufficient production of natural vaginal secretions and the timely renewal of the mucous membrane. With diseases of the ovaries, thyroid gland, pancreas and adrenal glands, a hormonal imbalance occurs in a woman’s body, which can lead to inflammatory processes in the vagina.

● Antibiotics.

Long-term use of broad-spectrum antibacterial drugs can lead to disruption of the vaginal microflora. The effect of antibiotics is that they destroy all pathogenic microorganisms, but along with them they also kill beneficial bacteria that make up the natural microflora.

● Weak immune system.

Immunity plays an important role in the human body, accurately identifying pathogenic microorganisms and eliminating them. After surgical interventions, long-term use of antibiotics, vitamin deficiencies, general exhaustion of the body and previous diseases, the immune system weakens and becomes unable to repel the attacks of infections, which provokes colpitis.

Provoking factors

Treatment of colpitis should be adjusted according to the cause of the pathology. With the exception of the atrophic form, vaginitis is a disease of women of childbearing age. The starting mechanisms of the process can be the following factors:

• long course of antibiotics;
• lack of personal hygiene;
• non-compliance with hygiene of sexual contacts;
• unbalanced diet;
• decreased immunity;
• viral or bacterial sexually transmitted disease;
• hormonal dysfunctions;
• psychosomatic disorders;
• pregnancy;
• climacteric changes in the body.

Types of colpitis

Depending on the cause of colpitis, several types can be distinguished. Each form of the disease has different manifestations, recovery time and risks of complications, so the approach to treatment must be selected individually.

Candidiasis colpitis

A type of infection called thrush is caused by the fungus Candida. These fungi can live in the body for years without causing any discomfort, and certain factors can trigger their intensive growth and lead to inflammation. Candida colpitis occurs both as a result of unprotected sex and with weakened immunity, dysbacteriosis, and antibacterial therapy.

Atrophic colpitis

Most often they appear in women after the onset of natural menopause, when the amount of estrogen decreases, due to which the vaginal epithelium becomes insufficiently moisturized, it becomes thinner, and microcracks appear. For a woman, colpitis is accompanied by a lot of discomfort, dryness, itching, and pain during sexual intercourse.

Atrophic colpitis can also occur in girls who have undergone surgery to remove the ovaries or uterus, and after taking certain medications.

Trichomonas colpitis

Associated with infection by the microorganism Trichomonas vaginalis. Transmission of the infection occurs during sexual intercourse with an infected partner without the use of barrier contraception.

At an early stage of development of the disease, it is easily diagnosed and treated. But an advanced stage can lead to chronicity of the disease, the cure of which is a big problem. In this case, periods of exacerbation are replaced by short periods of remission.

Trichomonas colpitis is dangerous because, in the absence of competent and timely treatment, it leads to dangerous complications, including infertility.

Infectious agents

In the case of a specific nature of the disease, the causative agents are sexually transmitted infections, and in the case of a nonspecific nature - opportunistic microflora.

Among the factors that provoke opportunistic microorganisms to become pathogens, the following can be identified:

● Frequent use of panty liners;

● Wearing underwear made of artificial materials;

● Tight clothing that does not allow ventilation of the genitals;

● Failure to maintain regular intimate hygiene;

● Weakening of the body’s immune defense due to stress, taking antibiotics, vitamin deficiency, and malnutrition;

● Abortion;

● Diabetes mellitus;

● Postmenopausal period.

Atrophic colpitis - symptoms and treatment

In the presence of inflammation against the background of atrophy, the first stage is sanitation (elimination of the infectious agent), and then measures to restore the microflora and mucous membrane.

Treatment of atrophy symptoms should be differentiated and individual.

For mild forms, local use of non-hormonal lubricants . Having sex on a regular basis has a positive effect [13]. In the absence of effect and more severe symptoms, estrogen therapy is prescribed.

Bladder training (behavioral therapy aimed at training the brain to control the urination reflex) is effective for overactive bladder, according to the International Menopause Society Vaginal estrogen is more effective against incontinence, while the benefit of systemic estrogen therapy for this symptom is not clear [13][15][16].

Urogenital disorders are an independent indication for hormonal therapy . Atrophic changes are best mitigated by topical estrogens (estriol). Estriol preparations for local use have minimal systemic absorption (plasma concentration does not exceed 20 pg/ml), and the positive effect occurs quickly - after 2-3 weeks. At the same time, hormonal therapy did not reveal a negative effect on the endometrium during long-term observation (from 6 to 24 months).

In the case of topical use of a low dose of estrogens, additional use of progesterone is not required. The use of local estrogens in women with cancer requires special caution and the need to consult an oncologist [12].

Estrogens help improve blood supply to the vaginal wall, restore the function of the mucous membranes of the urogenital tract, increase the number of lactobacilli and glycogen, maintain the optimal amount of collagen, ensuring sufficient thickness and elasticity of the epithelium, and also stimulate the secretion of immunoglobulins and increase local immunity, which prevents the development of recurrent infection [12]. Currently in Russia there are drugs containing only estrogen (suppositories and cream, which contains the antiseptic chlorhexidine), estrogen-gestagen-containing capsules with lactobacilli, as well as vaginal tablets with estriol and lactobacilli.

New treatments for moderate to severe dyspareunia include the FDA-approved oral selective estrogen receptor modulator ospemifene, but it has a number of contraindications and side effects.

Complex treatment of various urinary disorders, in addition to hormone therapy, includes consultation with a urologist and the use of drugs that have a selective effect on certain receptors of the urinary tract (M-cholinergic receptors, alpha-adrenergic receptors, beta-3-adrenergic receptors) [4].

In order to treat urinary incontinence, injections of drugs based on hyaluronic acid . Biorevitalization with hyaluronic acid is also in demand , as a result of which the mucous membrane is moistened, muscle tone is increased, and libido is increased. These techniques have a temporary effect, since over time, hyaluronic acid is broken down by an enzyme in our body.

It is effective to use a person’s own blood plasma , that is, platelet autologous plasma - a biological stimulator of regeneration processes.

Laser technologies are currently particularly popular in the prevention and treatment of vaginal atrophy, urinary incontinence and prolapse of the vaginal walls .

The technique is safe, painless, has a short rehabilitation course, and is performed on an outpatient basis. As a result, the condition of the skin and muscle tone improves, the mucous membrane restores elasticity and natural lubrication, its thickness and softness increases due to the processes of neocollagenesis and new vascularization.

Symptoms

Signs of this disease can be very different, depending on the cause of its occurrence and the stage of development. In later stages, the patient may experience increased body temperature, headaches, and general malaise. And at the initial stage of the disease, the most common manifestations are vaginal odor, unhealthy discharge, and painful sensations both during sexual intercourse and in everyday life.

Vaginal discharge

Vaginitis discharge is in no way related to the phase of the menstrual cycle. With candidiasis, they are white in color and have a heterogeneous cheesy texture. Trichomoniasis is characterized by gray-green discharge, and in the bacterial form it is foamy and has a uniform consistency.

Smell

Often a sign of the proliferation of pathogenic microflora in the vagina is odor. It may vary depending on the specific type of microorganism. Its appearance is due to the fact that in the process of life, bacteria decompose various substances, releasing gas, which in turn has an odor.

Pain

When the vaginal walls are inflamed, they often experience pain during sexual intercourse. Pain can also occur when urinating, when substances contained in the urine irritate the already irritated mucous membranes. Often women complain of the presence of burning and itching, and the pain is characteristic of inflammation as a result of mechanical damage.

Tests for colpitis

Diagnosis of colpitis in women is based on medical history, patient complaints, clinical picture and examination results. During a gynecological examination using a vaginal speculum, swelling of the mucous membrane of the vaginal walls is visible. Depending on the nature and severity of the inflammatory process, bleeding and purulent plaque may be observed. To determine the pathogen, the gynecologist takes tests from the surface of the cervix, vaginal walls, and urethral opening.

Bacteriological (culture) and bacterioscopic (smears on flora) tests make it possible to clarify the specific or nonspecific nature of colpitis. When inoculated on nutrient media, the sensitivity of microflora to antibiotics can be determined.

The number of leukocytes in a smear analysis is often within the normal range or slightly increased, especially in the presence of “latent infections” such as chlamydia, ureaplasmosis, etc. The number of epithelial cells in one field of view under a microscope exceeds the number of leukocytes. With trichomoniasis, a more significant number of leukocytes is determined. With bacterial colpitis, “key” cells are identified, which are cells of keratinized, squamous epithelium, covered with coccobacilli. The most promising method for diagnosing the cause of colpitis in gynecology is PCR tests.

Diagnosis of colpitis

What tests should be taken for colpitis?

Diagnosis of the disease

When diagnosing colpitis, the doctor’s task is not only to identify the disease, but also to determine the factor that provoked its appearance. Usually, already at the first appointment, a gynecologist can suspect the disease based on the patient’s complaints and examination in the gynecological chair.

For a more accurate diagnosis, colposcopy, ultrasound of the pelvic organs, and rectal examination are performed to detect various neoplasms in the rectum. A vaginal smear for cytology will determine the nature of the inflammatory process, and with the help of bacteriological analysis, a specific type of microorganism can be identified.

If necessary, the doctor also prescribes a general blood and urine test and a blood test for hormones.

Importance of Therapy

Treatment of colpitis is mandatory at any age and with any severity of symptoms. This disease almost never goes away on its own, especially when local or general immunity is reduced.

The main complications of the inflammatory disease include high risks of infection spreading to the pelvic organs, genitourinary system, structural changes in the cervix, infertility or inability to carry a pregnancy, synechiae, etc.

Even if the acute symptoms go away on their own without medical intervention, it is necessary to visit a doctor: weakening of the symptoms may be due to the fact that the disease has become sluggish or chronic. As soon as factors that provoke and weaken the body appear (hypothermia, intimate contact, infectious disease, vitamin deficiency, etc.), pathogenic organisms become active again - recurrent colpitis is observed. If you have any alarming symptoms, you should make an appointment with a gynecologist.

Prevention

To prevent colpitis, a number of rules should be followed:

● Regular examinations by a gynecologist to identify disorders in the initial stages of their occurrence.

● Caring for the vaginal lining, including maintaining personal hygiene, frequent changes of underwear, and proper use of toilet paper.

● Taking antibacterial agents exclusively as prescribed by a doctor and, if necessary, combining them with taking medications that will maintain the microflora of the mucous membrane in a normal state.

● Strengthening the immune system.

How to treat colpitis

In the treatment of inflammation of the vaginal mucosa in modern gynecology, general and local methods are used. The treatment is usually prescribed in a complex manner and is selected depending on the type of colpitis, the woman’s age, the presence of contraindications and concomitant diseases, etc. An effective regimen usually combines the administration of the following drugs and techniques:

• Antibiotics,
• Anti-inflammatory drugs,
• General restorative therapy,
• Local procedures
• Candles.

Ascending infection during colpitis in pregnant women can lead to infection of the fetus and cause recurrent miscarriage, as well as infertility. Treatment of colpitis during pregnancy is carried out within certain periods as prescribed by the observing obstetrician-gynecologist!

WHERE IS THE BEST WHERE TO GO IN MOSCOW

Do you want to get advice from an experienced and competent specialist on the diagnosis and treatment of pain and discharge caused by inflammation of the vaginal mucosa? We invite you to register at our clinic. The combination of the high professionalism of our doctors and the most modern methods allows us to cure colpitis and vaginitis in women and young girls quickly and with excellent results!

Treatment of colpitis

Proper treatment should include not only eliminating disturbing symptoms, but also getting rid of the cause of the pathology. The latter falls within the purview of etiotropic therapy. It is based on the use of antifungal, antibacterial or antiviral drugs.

To treat nonspecific colpitis, combination medications are prescribed to kill several types of infections. Local therapy consists of the external use of various antiseptics and other medications in the form of douching or moistened vaginal tampons.

Do not forget that if vaginitis is associated with the acquisition of an infectious agent through sexual contact with an infected partner, both partners must be treated at the same time.

It is recommended to abstain from sexual intercourse during therapy until complete recovery.

Leading specialists in the treatment of colpitis, vaginitis in the Southern Federal District

Ermolaeva Elvira Kadirovna is a well-known and recognized specialist in the North Caucasus in the treatment of colpitis, vaginitis in girls, adolescents and girls who have not been sexually active. Gynecologist, ultrasound doctor, physiotherapist-health resort specialist. Suffering women and women who want to improve aesthetics turn to Elvira Kadirovna genitals, shrink the vagina and refresh intimate relationships from all regions of Russia and foreign countries.

Ermolaev Oleg Yurievich Candidate of Medical Sciences, pediatric gynecologist with 25 years of successful experience in the treatment of colpitis and vaginitis. Able to see relationships that elude others.

Shchepkin Petr Sergeevich Gynecologist, specialist in the treatment of colpitis, vaginitis. Experienced ultrasound doctor.

About the doctors of the Clinic in detail...

We work seven days a week and on holidays:

Monday - Friday from 8.00 to 20.00, Saturday, Sunday, holidays from 8.00 to 17.00.

Treatment of colpitis, vaginitis by appointment by multi-line phone 8 (800) 500-52-74 (toll-free within Russia), or +7.

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We accept girls, young women and women from all cities of Russia, near and far abroad.

The spa clinic for women's health facilitates the accommodation and accommodation of women, women with children and couples during examination and treatment.

During the treatment period and after treatment of colpitis and vaginitis, contraception (protection) with a condom is necessary until “clean” results of a control smear examination are obtained for both spouses.

A control microscopic examination of a smear for vaginal flora is carried out 5 days after the end of local treatment. Service cost

With respect for the religion and different habits of our patients, we achieve high efficiency and comfort of treatment.

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Why is colpitis dangerous?

Colpitis is not a dangerous disease if treatment is started in a timely manner. If a woman neglects medical care, the disease can become chronic, which will significantly worsen the quality of life.

If vaginitis is not treated correctly, it can develop into endometritis, urethritis or cervical erosion. Also, bleeding microcracks on the walls of the vagina serve as open gates for the acquisition of new pathogenic microorganisms, complicating the treatment process.

Complications of colpitis, vaginitis

• a complication of colpitis is VULVIT (inflammation of the external genital organs);
• a complication of colpitis is CERVICITIS (inflammation of the cervix);
• a complication of colpitis is ENDOCERVICITIS (inflammation of the cervical canal);
• ENDOMETRITIS (inflammation of the mucous membrane of the uterine cavity) can become a complication of colpitis;
• a complication of colpitis can be SALPINGITIS, adnexitis, salpingoophoritis, oophoritis (inflammation of the uterine appendages);
• a complication of colpitis can be PARAMETRITIS (inflammation of the periuterine tissue);
• a complication of colpitis can be adhesions in the pelvis;
• a complication of colpitis may be a disruption of the patency of the fallopian tubes;
• Infertility can become a complication of colpitis;
• ectopic pregnancy can become a complication of colpitis.

Prevention of colpitis, vaginitis

1. A balanced diet enriched with fermented milk products and pectins (plant fiber). Maintaining rhythmic bowel function.
2. Refrain from self-prescribing antibiotics and antibacterial agents. When prescribing antibiotics, always discuss with your doctor the possibility of solving the current situation using alternative methods: homeopathic remedies, herbal medicine, physiotherapy.
3. Hygienic care should be carried out only for the external genitalia with water and baby soap without the use of antibacterial intimate hygiene products. About the rules of genital hygiene in detail...
4. Do not use vaginal tampons and sanitary pads if you experience at least one allergic reaction to them.
5. Limit wearing synthetic underwear. Preference should be given to underwear made of cotton and linen fabrics. In hot weather, avoid wearing clothes that are tight and tight around the buttocks and thighs (trousers, leggings, etc.).
6. When intimate with a partner who has not been tested for sexually transmitted infections, barrier contraception (condom) is preferable. The condom must be worn before intromission (insertion) of the penis. Contraception with a condom is also desirable for oral and anal-genital sex. A man’s intelligence and social status (education, profession, income level, etc.) do not guarantee a healthy oral cavity and genital area.
7. Mandatory full examination of the permanent sexual partner and the intended (future) spouse by a urologist before marriage and first sexual intercourse without a condom. Cost of examination
8. If sexual intercourse is unprotected with a condom, vaginal suppository (suppository), or cream, it is necessary to conduct a test for sexually transmitted infections. A smear of vaginal flora 12 hours after sexual intercourse can detect yeast (fungi, thrush), Trichomonas, gardnerella, gonococcus and the presence of an inflammatory reaction in the vagina (colpitis). Smears are collected for testing for chlamydia, ureaplasma, and mycoplasma using the PCR method 28 days after sexual intercourse. Blood tests for human immunodeficiency virus (HIV; AIDS) and syphilis are carried out after 3 and 6 months. Collecting smears from the cervical canal and cervix for testing for human papillomavirus using PCR is carried out after 6-9 months. Cost of examination

Doctors and midwives of the Women's Health Resort Clinic are ALWAYS READY for regular patients, if it is impossible to contact them in person, to comment remotely (by phone, on the Internet) on an existing or newly emerging situation and suggest ways to solve it.

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