Symptoms of vulvitis in girls and women. Local and general treatment

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Vulvitis is an inflammation of the vulva, the mucous membrane that lines the labia minora, as well as the vestibule of the vagina. The disease is accompanied by pain, discomfort and burning when urinating. Without timely treatment, it leads to serious complications, including infertility.

Gynecology is one of the main areas of work of the MedEx clinic. We use a personalized approach: when making a diagnosis and selecting a treatment regimen, we take into account the patient’s age, lifestyle, and individual characteristics. The clinic is equipped with modern equipment that allows diagnostics to be carried out accurately, quickly and safely.

Symptoms of inflammation of the labia

The inflammatory process in the area of ​​a woman’s external genitalia (vulva) is referred to in gynecology as “vulvitis.” This condition has characteristic symptoms, such as redness, itching, swelling of the labia, painful symptoms when urinating, and copious natural female discharge. A woman may also experience a number of additional symptoms:

• the appearance of roughness of the labia minora, which is nodules of enlarged sebaceous glands;
• the appearance of a whitish coating, plaques reminiscent of psoriasis rashes;
• feeling of general malaise and fever.

Like any other inflammatory process, vaginitis is divided into acute and chronic. The acute form is characterized by pronounced symptoms, while the chronic process is more sluggish and unnoticeable.

Expert opinion

You should be especially careful about the development of vulvitis in little girls, since children tend to hush up problems associated with discomfort in the intimate area. For this reason, it is necessary to make it clear to the child that if he experiences any unpleasant sensations, he must inform his elders about their occurrence.

Obstetrician-gynecologist of the highest category Oksana Anatolyevna Gartleb

Gynecologist appointment

Types and forms of the disease

According to the course of the disease, the following forms are distinguished:

• Acute vulvitis. It develops rapidly, with a sudden onset. The acute form lasts up to a month.
• Subacute vulvitis. Intermediate form: compared to the acute form, it has mild symptoms, but lasts less than chronic vulvitis - up to 90 days.
• Chronic vulvitis. It is distinguished by a protracted and long-lasting course with mild symptoms, as in the subacute form.

Depending on the cause of occurrence, bacterial, herpetic, allergic and candidal (fungal) vulvitis are distinguished. Bacterial vulvitis is considered nonspecific if it is caused by staphylococci, streptococci, enterococci, E. coli, and specific if it is caused by chlamydia, trichomonas, gonococci.

Fungal or candidal vulvitis is caused by the activity of Candida fungi, herpetic vulvitis is caused by the herpes virus. The allergic form of the disease develops as a result of allergies.

Depending on the pathomorphological changes, vulvitis is divided into three types:

• Sticky. This form of the disease occurs in girls of preschool age. Characterized by fusion of the labia minora.
• Atrophic vulvitis. Accompanied by the appearance of small erosions. The atrophic form occurs in women during menopause.
• Ulcerative. Characterized by the appearance of erosive changes and ulcers. Most common among women of reproductive age.

In the absence of timely treatment, purulent vulvitis may develop. It is accompanied by an increase in the size of the external genitalia, intoxication, and the appearance of purulent foci.

Important!

When the first symptoms of the disease appear, consult a doctor! Self-medication increases the risk of complications!

Causes of vulvitis

In order to clearly understand the causes of vulvitis, it is worth dividing this disease into 2 types: primary and secondary. Primary vulvitis develops in the case of:

• Failure to comply with the rules of intimate hygiene (irregular washing, rarely changing tampons and pads during menstruation, rarely changing underwear, wearing tight and synthetic underwear).
• Sudden hypothermia or overheating of the body.
• Mechanical damage to the vulvar mucosa during sexual intercourse, constant use of tight clothing made of coarse fabrics, removal of hair, and combing.
• Chemical exposure to various drugs.
• Hormonal imbalance and metabolic disorders (obesity, diabetes, insufficient ovarian function, lack of vitamins and minerals in the body);
• Allergic reactions.

Secondary vulvitis, vulvovaginitis (Vulvovaginitis) occurs due to infection of the external genitalia by pathogenic microorganisms contained in vaginal discharge.

Vulvitis - causes

Irritation of the labia can be caused by thrush, colpitis (Vaginitis), endometritis (Endometritis) and other diseases of various organs, not necessarily directly related to the mucous membranes and skin of the genitals. It is worth noting that long-term or frequent use of antibiotics can cause disruption of the vaginal microflora and subsequent vulvitis.

Inflammation of the labia - vulvitis

As medical statistics show, secondary vulvitis most often occurs in women of reproductive age, while primary inflammation is more often diagnosed in childhood. This is facilitated by the tendency of children to diathesis, helminthiasis (Helminthosis) (pinworms with improper hygiene can get into the labia area, causing an inflammatory process).

In this case, vulvitis in girls can be complicated by the appearance of synechiae, which are adhesions connecting the labia minora.

Vulvitis can occur during pregnancy, especially if a woman does not follow the rules of intimate hygiene or wears inappropriate underwear. Vulvitis can occur after childbirth. As the fetus passes, the vagina and labia are injured, which can cause subsequent inflammation.

Vulvitis - symptoms and treatment

Success in the treatment of vulvovaginitis depends on an accurate diagnosis based on a thorough analysis of the anamnesis, clinical and laboratory data. Only after receiving the results of bacteriological, virological and histological studies confirming the diagnosis can therapy begin.

First of all, an anti-infective drug , taking into account the sensitivity and type of microorganism.

• For candidiasis - antimycotic drugs, such as Diflucan, fluconazole, nystatin, levorin, clotrimazole, ketoconazole, etc.
• For herpes - antiviral drugs: acyclovir, Valtrex, Famvir.
• For STDs - antibacterial drugs depending on the type of pathogen.
• For bacterial vaginosis - local antiseptics, Clindacin.
• For aerobic vulvovaginitis - local antiseptics, antibiotics taking into account culture indicators.

Treatment of patients with prolonged vulvitis is carried out jointly with dermatologists. In such cases, you can prescribe the combined local drug Tetraderm. It includes:

• Mometasone is the most powerful glucocorticosteroid (GCS) safe for local use. Has anti-inflammatory, antipruritic and anti-exudative effect.
• Econazole is a modern effective antifungal component with a bactericidal effect. Reduces the synthesis of ergosterol, which regulates the permeability of the cell wall of microorganisms.
• Gentamicin is a broad-spectrum antibacterial component used for topical treatment of primary and secondary bacterial skin infections.
• Dexpanthenol (vitamin B5) is a regenerating component with a metabolic effect. It has a local anti-inflammatory and immune effect, is included in the metabolism of skin cells and restores the damaged stratum corneum.

"Makmiror complex" is an antimicrobial combination agent containing nifuratel and nystatin. The drug does not suppress the growth of lactobacilli, so after a course of therapy, normal vaginal flora is quickly restored.

Antimicrobial therapy destroys not only pathogenic, but also beneficial microflora. As a result, more virulent infections invade and colonize the vagina, which again manifests itself as pathological vaginal discharge and vulvar irritation. To break this vicious circle, after antimicrobial therapy it is necessary to restore the flora with eubiotics - preparations containing live cultures of beneficial microorganisms. For example, you can use Laktozhinal. This drug helps normalize the pH of the vaginal microflora due to the production of lactic acid. It consists of :

• Lactobacilli LCR 35 - form a protective film, normalize the pH of the vagina, and prevent the attachment of pathogens. As a result, the stability of the microflora is restored until the moment when the biotope is filled with its own lactobacilli.
• Lactose monohydrate is a nutrient medium for lactobacilli LCR 35. Secreted metabolites by LCR 35 enhance the antibacterial effect.

Application:

• 1 drop per day (No. 21) for vulvovaginal candidiasis;
• 2 drops per day (No. 7) for bacterial vaginosis;
• 1 drop per day (No. 14) as an alternative therapy [10].

Eubiotics also include suppositories “Acilact”, “Lactonorm”, “Triozhinal”, etc.

Proteolytic enzymes enhance the effect of antibiotics . They help accelerate proliferative processes in tissues, activate cellular reactions, enhance the phagocytic activity of leukocytes, and reduce relapses of the disease. Proteolytic enzymes are contained in the Wobenzym preparation. It is resistant to gastric juice. This product contains: bromelain, papain, pancreatin, chymotrypsin, amylase, lipase, rutin. Prescribe 3 tablets 3 times a day for 1-2 months [6]. (The drug should be regarded as a dietary supplement, the effectiveness of which has not been fully proven. - Ed.)

, vitamin therapy, immunostimulants, and interferon inducers are also used [7] .

Due to the fact that prolonged itching is associated with excessive production of histamine, it is recommended to prescribe antihistamines : Suprastin, Tavegil, Diazolin, Zodak, etc. [7]. Some patients with prolonged itching do not consult doctors for a long time and try to treat themselves. As a rule, this does not help, and women go to the doctor with an already formed “vicious circle”. Such patients are recommended to be prescribed sedatives that have a calming effect [2].

Local application of estrogens restores vaginal acidity and neutralizes microbiological changes, especially during menopause, when the level of female sex hormones drops. Also helps prevent recurrences of urinary tract infections.

Vaginal use of estriol preparations reduces vaginal dryness, itching and dyspareunia (pain during sexual intercourse), and significantly improves cytological data. Estriol is a natural estrogen. He is the safest. Has no effect on the endometrium and mammary glands. Estriol contains drugs such as “Ovestin” (cream and suppositories), “Orniona” (cream), etc. For the treatment of vulvar dystrophy, estriol is used in a single dose for 2-3 weeks daily, then a maintenance dose is recommended 1-2 times a week. Moreover, only a small part of a single dose is applied directly to the vulva, and the rest must be inserted into the vagina.

It is important to understand that local estrogen deficiency is possible not only in postmenopausal women, but also in young patients with regular menstruation, therefore, with dyspareunia and recurrent vulvovaginitis, it is important to pay attention to the cytological conclusion, the results of colposcopy and keep in mind possible estrogen deficiency.

Local use of glucocorticosteroids is especially indicated for autoimmune inflammatory dermatosis. Corticosteroids have an anti-inflammatory effect and an antihyperplastic effect on the proliferating superficial layers of the skin. They have antiallergic, local analgesic, antipruritic effects. Because of the risk of scar tissue, corticosteroids are not used long-term, but may be prescribed for a short period to quickly relieve severe itching and pain in the vulva. Corticosteroids are especially effective in cases of severe inflammatory reaction and mainly in patients with lichen sclerosus [5].

Local application of androgens. It is a promising method for the treatment of vulvitis against the background of lichen sclerosus. 2% testosterone propionate in a small amount should be rubbed into the skin 2-3 times a day for 6-8 weeks. Maintenance course - 1 time every other day. However, the drug may cause side effects, the patient must be warned about this. Long-term use of testosterone can lead to clitoromegaly (abnormal enlargement of the outer part of the clitoris), increased sexual desire and facial hair growth [5].

The following surgical treatments are used: cryodestruction, radiofrequency and laser coagulation, vulvectomy. However, due to frequent postoperative complications and relapses, unsatisfactory cosmetic and functional results, these methods are abandoned in favor of less traumatic ones.

Photodynamic therapy is a high-tech method for treating vulvar dystrophy [11]. PDT is an organ-preserving treatment method. A photosensitizer is first introduced into the patient's body, which subsequently accumulates in pathological tissues (malignant, inflammatory, infected with viruses). Further, under the influence of radiation of a certain wavelength, these altered tissues are destroyed. In this case, there is minimal damage to healthy tissue, an antiviral effect, rapid tissue healing and good cosmetic results.

If the result is not satisfactory, the procedure can be repeated. At the end of treatment, the doctor can see a good cosmetic effect, an improvement in the cytological and morphological picture. The woman herself, as a rule, notes a decrease in itching, burning, soreness, dryness, increased tissue elasticity, and an improved quality of sexual life.

When performing photodynamic therapy, the patient must:

• During the day, observe the light regime - avoid exposure to direct sunlight.
• Treat the external genitalia with an antiseptic solution after each act of urination.
• If pain occurs, apply a local anesthetic (for example, Acriol Pro) to the vulvar tissue.
• Apply Tetraderm cream in a thin layer to the vulva from the second day until the tissue is completely epithelized.
• Apply Orniona cream daily at night for a long time.
• See a specialist [11].

Diagnosis of vulvitis

To diagnose vulvitis, in most cases, a simple manual examination by a doctor is sufficient, as well as taking a smear for bacteriological, bacterioscopic and cytological examination. The results obtained allow us not only to determine the presence of inflammation, but also to exclude malignant tumors and identify the causative agent of the infection. Additionally, the doctor may prescribe a stool test to detect helminthiasis.

Appointment with a doctor for the treatment of vulvitis

A detailed description of the symptoms and the initial stage of the disease will also have diagnostic value for the doctor. This will simplify the diagnosis and make it possible to exclude any concomitant infections. After all, the itching that vulvitis causes leads (especially often in girls) to the appearance of scratching in the area of ​​the external genitalia, which may also indicate the presence of diseases such as pediculosis, dermatitis or lichen. Also, the cause of itching in the labia area can be any sexually transmitted disease, which sometimes may require consultation with a dermatovenerologist or additional diagnostics.

Possible complications and danger of the disease

Untimely or improper treatment of vulvitis/vulvovaginitis can cause the disease to become chronic. It is characterized by periodic exacerbations, difficulty in therapy, and hypertrophy of the sebaceous glands may occur. Girls may experience synechiae, which sometimes requires surgical intervention.

Vulvovaginitis can cause diseases of the urinary system, cervix, pelvic organs - adnexitis, endometritis, etc., as well as associated infertility.

Treatment of vulvitis

If you notice any alarming symptoms, you should immediately consult a doctor. Only a specialist can diagnose the cause and prescribe correct and quick treatment, including a set of measures: relieving inflammation, eliminating factors that are catalysts for the process.

The basis of treatment for vulvitis is the elimination of the causes of the inflammatory process and treatment of concomitant diseases, which may include diabetes mellitus (Diabetes mellītus), gonorrhea (Gonorrhoea), diphtheria (Diphtheria), helminthiasis. After receiving smear test data and checking the sensitivity of the infectious agent, the doctor can prescribe medication, most often antibacterial drugs. Vulvitis responds well to treatment with local remedies, which include all kinds of ointments, gels and suppositories.

In parallel, in the course of treatment of vaginitis, vitamin complexes can be prescribed, including vitamin A to effectively protect the epithelial layer, as well as vitamins E and C, known for their antioxidant properties.

To combat severe symptoms, other drugs may be prescribed:

• Antihistamines that help relieve itching.
• Hormonal, occurring in atrophic vulvitis in the postmenopausal period.
• Anesthetics that relieve pain.

In addition to the medications prescribed by your doctor, you can use Gynocomfort Restoring Gel. This product was created by specialists from the pharmaceutical company VERTEX and underwent clinical trials at the Department of Dermatovenerology with the clinic of the St. Petersburg State Medical University. During testing of the gel, it was proven that it is a very effective additional agent as part of the complex therapy of inflammatory processes of the female genital tract.

As additional therapeutic measures that can be used at home, it is worth mentioning warm baths with herbal infusion.

Chamomile, calendula, string, and comfrey have excellent anti-inflammatory properties.

Baths will help not only reduce inflammation, but also relieve symptoms such as itching, burning and pain.

Treatment of the disease

Treatment of vulvitis is complex. It is important not only to eliminate the clinical manifestations of the disease, but also the root cause. Adult patients are advised to abstain from sexual activity until the inflammatory process subsides.

Medicines are selected taking into account the etiology of the disease. For allergic vulvitis, histamines are prescribed to reduce the severity of the reaction. It is recommended to use new generation products that do not cause drowsiness. To relieve itching, an ointment or cream with a soothing effect is prescribed.

Bacterial vulvitis is treated with antibiotics. Drugs for external use are prescribed, including miramistin, chlorhexidine, povidone-iodine. For local treatment, lotions with solutions of eucalyptus or furatsilin, medicinal baths with a decoction of calendula, chamomile, and string can also be used. Some doctors recommend antibacterial suppositories and douching with antiseptic drugs.

For candidal vulvitis, antimicrobial agents are prescribed. During treatment, it is advisable to avoid using soap that is aggressive to the mucous membrane: it is better to choose soft gels for intimate hygiene. Candidiasis vulvitis during pregnancy requires mandatory consultation with a personal gynecologist.

For atrophic vulvitis, pills and other means of hormone replacement therapy are used. They are prescribed in a short course. Tablets are not taken chronically.

In the ulcerative form, treatment of vulvitis often requires surgical intervention. During the operation, the pathological focus is removed and plastic surgery is performed.

There is a myth that vulvitis occurs not only in women, but also in men. This is an incorrect name: most often the inflammatory process is confused with candidiasis. This is the name for a fungal disease transmitted through sexual intercourse (which is why in some literature you can find the term “marital” candidiasis). Vulvitis is not sexually transmitted. But if the spouse is diagnosed with candidiasis, there is a risk of infecting the partner.

Prevention of inflammation of the labia

To prevent vulvitis, it is necessary, first of all, to maintain intimate hygiene. It is recommended to use products designed specifically for caring for intimate areas. Ginocomfort washing gels for intimate hygiene, which were developed by specialists of the pharmaceutical company VERTEX, taking into account the characteristics of the microflora of the genital organs, are well suited for this purpose. They do not dry out the mucous membrane and do not disturb the acid-base balance. These products have a package of necessary documents and quality certificates.

Other measures to prevent inflammatory processes in the labia area include the following:

• Proper drying of the genitals after hygiene procedures. It should be carried out with a clean towel or napkin in the direction from front to back or with gentle blotting movements.
• Careful selection of underwear. It is optimal if it is underwear made of natural and soft material that will not squeeze or rub the perineum.
• General maintenance of immunity, which will allow the body to independently fight infection and suppress the proliferation of pathogens.

Prevention of vulvitis

Prevention of vulvitis includes the following principles:

• compliance with the rules of personal, intimate and sexual hygiene;
• casual sexual intercourse should be avoided;
• it is necessary to treat all diseases in a timely manner, regularly visit a gynecologist for preventive examinations;
• You should not use cosmetics and hygiene products with a strong odor; give preference to hypoallergenic products that have been clinically tested;
• wear underwear made of natural fabric;
• make choices in favor of a healthy lifestyle and nutrition.

Inflammation of the labia in women, video

Gynecologist Irina Vladimirovna Garyaeva about vulvitis in women.
Source - KVD - dermatovenerological dispensary Sources:

1. ROLE OF INFECTIONS IN THE GENESIS OF VULVA DISEASES. Reutskaya M.A., Kulinich S.I. // Siberian Medical Journal (Irkutsk). – 2010. – No. 6. – pp. 239-242.
2. CLINICAL AND MORPHOLOGICAL PRINCIPLES OF TREATMENT OF CHRONIC VULVITIS. Kulinich S.I., Reutskaya M.A., Pokinchereda T.V., Ezhova I.V. // Acta Biomedica Scientifica. – 2013. – No. 5 (93). – P.42-48.
3. Diseases of the cervix, vagina and vulva: Clinical lectures. Ed. V.N. Prilepskaya. // M.: MEDpress. - 1999. - P. 432.
4. Recurrent vulvovaginal candidiasis: etiology, pathogenesis, treatment. Levonchuk E.A. // Med. news. - 2001. - No. 4. — P. 40-43.
5. Dystrophic diseases of the vulva. Diseases of the cervix, vagina and vulva. Ed. V.N. Prilepskaya. // M.: MEDpress. - 1999. - pp. 326-336.
6. https://simptom-lechenie.ru/en/vulvit-u-zhenshhin-i-devochek-simptomy-i-lechenie.html
7. https://www.thenakedscientists.com/science-articles
8. https://woman-centre.com/vlagalische-i-vulva/vulvit/vulvit-u-zhenshhin.html
9. https://simptomer.ru/bolezni/zhenskie-zabolevaniya/864-vulvit-simptomy

Forms of the disease

Inflammation is classified according to several criteria. According to the nature of the flow, they are divided into the following types:

• Spicy. In this form of vulvitis, the symptoms are quite pronounced. The disease lasts 7 days and occurs completely unexpectedly.
• Chronic. The duration of the disease is difficult to determine, since inflammation goes through a stage of exacerbation and remission, which can bother the patient for several years. Symptoms are practically absent and are not observed during the calm period. A chronic form of the disease develops against the background of an untreated acute form.

According to the type of pathogen, inflammatory processes of the external genital organs are divided into candidiasis (caused by fungi of the genus Candida) and bacterial.

Candidiasis vulvitis - features of the disease

Inflammations caused by the growth and active development of fungi are characterized by the following symptoms:

• the presence of pain when urinating;
• redness and swelling of the external genitalia;
• burning and itching on the genitals;
• discomfort during sexual intercourse;
• pain radiating to the lumbar region in the lower abdomen;
• the presence of white, cheesy vaginal discharge with an unpleasant odor;
• rash in the form of small blisters on the mucous membranes.

Having opened, the papules leave erosion on the soft tissues of the genital organs. Candidiasis vulvitis is often accompanied by a secondary infection. As a result, ulcers appear, wounds fester and inflammatory elements become crusted.

There are several types of this disease:

• Carriage. It is characterized by an increased level of fungi in the body's microflora, but at this stage of vulvitis there are no symptoms.
• Spicy. At this stage, symptoms are well expressed.
• Recurrent. If the acute stage is not treated for more than two months, the disease becomes chronic. With a decrease in the body's protective functions, the inflammatory process worsens. There is also a period of calm when the disease does not bother you at all.

Atrophic vulvitis

With this disease, the vulva becomes inflamed, and at the same time the mucous membranes of the genital organs become thinner. With this form of vulvitis, treatment is prescribed by a qualified doctor who will conduct diagnostics and make the correct diagnosis. The main cause of the disease is a lack of the female hormone (estrogen).

The form of the disease is diagnosed in patients undergoing artificial or natural menopause. Vulvitis in women after 45 years of age can develop due to metabolic disorders and the appearance of extra pounds, as well as increased blood glucose levels.

According to statistics, the number of patients who complain of symptoms characteristic of this disease increases every year. Atrophic vulvitis is often diagnosed in regions where hormone replacement therapy is not used after surgery to remove the ovaries.

Popular questions

I suspect inflammation and cysts.
The doctor prescribed IV thiosulfate, IM ceftriaxone, and Diclovit suppositories. I just didn’t explain, is it necessary to apply everything at the same time or what? Hello! Most often, this complex of treatment is carried out simultaneously, but it is better to check with your doctor.

Hello. My labia and clitoris are swollen, there is a burning sensation and a cheesy discharge with something in it, the color is unclear. What could it be and how to treat it? Before that I had inflammation and treatment, and after that it all started. Hello! This is how vulvovaginitis manifests itself. I recommend that you contact an obstetrician-gynecologist and conduct an examination to find out the cause of the inflammation. This will allow you to correctly prescribe therapy. At this stage, you can use Gynocomfort gel with tea tree oil, 1 dose once a day, which will limit the spread of inflammation and improve your well-being.

Hello! Severe itching on the labia, irritation. There is nothing to worry about in the vagina itself. What could it be?

Hello! This may result in an allergic reaction or inflammation. I recommend using Ginocomfort gel with mallow extract, applying it once a day to the discomfort zone for 7 days. If you do not notice relief, consult a doctor.

Good morning, I have vulvitis on my labia minora, I don’t know what to do or how to treat it.

Hello!
If inflammation occurs in the labia minora area, you can use Gynocomfort gel with tea tree oil. The gel is applied in a thin layer once a day for 1 week. If complaints persist, you should consult a specialist. For an accurate diagnosis, contact a specialist

Causes of vulvovaginitis development

The main factors that can cause the development of the disease are as follows:

• Constant stress and nervous tension.
• Presence of diabetes mellitus.
• Acute allergic reactions.
• Hormonal changes in the body.
• Poor personal hygiene.
• Weakened immunity.
• Taking antibiotics and a number of drugs.
• Prolapse and prolapse of the uterus.
• Presence of hemorrhoids and anal fissures.
• Skin diseases (psoriasis, eczema, etc.).
• Dysfunctional ovarian disorder.

To determine the causes of the pathology, the patient is prescribed laboratory tests: PCR to detect sexually transmitted diseases, microbiological examination of a gynecological smear, bacterial culture.

Reviews

Author, 06/24/2016

Hello! The story is like this. Candidiasis, that is, thrush, has been tormenting me for a long time. Flucostat is effective for two days for a maximum of a week. I contacted doctors. The last doctor prescribed a diet and a long course of treatment. Apply clotrimazole externally for 21 days, Viferon suppositories, then a one-time application, five Revita tablets taken internally for a month (so that ascorbic acid restores the microflora). And in the end, two weeks after the end of treatment, the finish is complete again. Everyone stupidly advises using soda the old fashioned way, but I’m afraid of experiments. Who was in such a situation and won this byaku? Please share your experience.

Irina, 08/15/2016

Oh, how familiar this problem is to me, nothing helps. There are probably no medications that I haven’t tried. I took smears and culture tests 100 times. I did everything as prescribed by the doctor. After treatment with antifungal drugs, I took probiotics and put on suppositories. I also tried folk remedies. I donated blood. It seemed like the norm was the last time (albeit a year ago). I’ve been suffering from this infection for about 15 years. At first there were relapses once every six months, then after a month or two, now a week after the end of treatment. I don’t know what to do. I’ll go to the doctor again. But I don’t believe it anymore. All this time I did what they told me. How much money I spent, I’m generally silent. And I tried expensive medications and their analogues. They brought it to me from abroad. I constantly deal with this garbage. I don’t believe that anything will help. More like a cry from the heart. I finished another course of treatment a week ago. Here we go again...

Alena, 35 years old, September 20, 2016

I had thrush for about 9 years. I read medical articles about this, itraconazole helped me, but I took it for about a week at the same time as Terzhinan suppositories for 10 days, after that Vaginorm for 6 days along with ecofemin in tablets, and don’t expect to be cured in one month, further 3 months, fluconazole once a week, and do not stop repeating Vaginorm and Ecofemin after menstruation, and then depending on the situation, as soon as I feel that something is starting again, terzhinan suppositories and Ecofemin lactobacilli, constant monitoring, but for almost a year there have been no fungus in tests)!

Causes of vesiculitis

The causes of vesiculitis in men are infectious and stagnant.

Vesiculitis in men may appear due to the following factors:

• interruption of sexual intercourse;
• masturbation;
• no regularity of sexual activity;
• abstinence;
• defective ejaculations;
• alcohol and nicotine;
• hypothermia often occurs;
• sedentary lifestyle;
• expansion of hemorrhoidal veins and other pelvic inflammations.

D.S. Markaryan, N.B. Morzhakova, N.T. Dzhabieva.

Urogenital infections continue to be the dominant pathology in the practice of both gynecologists and urologists-andrologists. More than half of women’s visits to gynecologists are related to clinical manifestations of vaginitis, vulvovaginitis and bacterial vaginosis. The causative agents are most often mixed infections represented by standard flora of the oral cavity and intestines - staphylo-streptococci, E. coli, enterococci, grdnerella, fungi of the genus Candida, ureamicoplasmas, etc. At the same time, about half of men with preserved foreskin suffer from clinical and subclinical forms of balanitis and balanoposthitis with the same spectrum of infections. Their relationship seems so obvious that paired treatment of partners - a woman by a gynecologist, a man by a urologist-andrologist should have long ago become the “gold standard”. However, in practice, everything looks the other way around - each partner is treated (or not treated) independently of the other, with all the resulting negative consequences. It’s even worse when the gynecologist, instead of limiting sex and referring the partner to a urologist-andrologist, recommends the same treatment regimens for the partner as for the partner, forgetting about the fundamental difference in anatomy and physiology between men and women. Therefore, in this work, we made an attempt to once again answer two questions: 1. How often the above-mentioned pathology is combined and present in partners at the same time 2. Assess the immediate and long-term consequences of parallel treatment - a woman with a gynecologist, a man with a urologist-andrologist. This work was carried out on 21 married couples in collaboration with a gynecologist and a urologist-andrologist. If the above-mentioned pathology was detected in a woman, the partner was invited to the urologist-androlgist and vice versa. Only men with uncircumcised foreskin were included in the analysis. In 20 out of 21 cases with the above-mentioned pathology in women. clinical and subclinical forms of balanitis, balanoposthitis were found in their partners. Microflora was often clearly visible on smears of the foreskin. Men with circumcision, urethritis, urethro-prostatitis, and STDs are not included in this analysis. Next, parallel treatment was carried out for the female partners by a gynecologist, and the male partners by a urologist-andrologist. Men used topical, cutaneous medications with antimicrobial, antifungal and sometimes antiviral effects (Clindacin cream, Levomekol, Clotrimazole, Cycloferon, etc.). Most often, we used a powdered drug we developed with the code name "Macrosept" - a mixture of several pharmaceutical drugs , which had many advantages over creams - minimal consumption, reliable adhesion to the skin of the foreskin for up to 24-48 hours, the absence of any inconvenience and complications (I powdered the foreskin and forgot).

Women were treated according to known regimens with the obligatory restoration of normal microcenosis of the vagina and intestines. The indicators of cure in women were the restoration of normal vaginal biocenosis (Lctobacillus - Doderlein bacilli more than 80% in the biotope), pH less than 4.6, absence of a clinic. The criteria for cure for men are the absence of a clinic, the absence of visible flora on the epithelium of the foreskin. After this, the couples were allowed to restore the usual rhythm of intimate life. Preventive advice was given. The duration of observation of the couples ranged from 4 to 12 months. Recurrences of the above diseases have not yet been detected.

Conclusions. Taking into account the male factor provides great additional opportunities for reducing the level and prevention of vaginitis, vulvovagtinitis and bacterial vaginosis in women; it requires parallel examination and treatment of both partners and close cooperation of gynecologists and urologists-andrologists.

Causes of the disease

Inflammation of the vulva and vagina appears due to the influence of such factors:

• violation of intimate hygiene rules, wearing underwear made of low-quality synthetics
• frequent change of sexual partners without the use of barrier contraception
• diseases of the metabolic system that can affect the vaginal microflora (diabetes mellitus, thyroid problems)
• hormonal imbalances characteristic of puberty and menopause
• taking antibacterial drugs (while taking antibiotics, a fungus like Candida is activated)
• chemotherapy and radiation therapy
• intoxication due to chronic infectious diseases
• mechanical injuries of the vulva and vagina, especially regular ones

The presence of more than two risk factors increases the likelihood of the occurrence of pathology several times.

Allergic vaginitis is also possible. Pathology is diagnosed in the presence of helminths.