What happens and what forms it comes in
The skin and mucous membrane of the vulva are protected by natural microflora and a layer of secretion. When protection is compromised, microorganisms or irritating substances cause an inflammatory response: blood vessels dilate, swelling, redness and itching appear. Primary vulvitis develops due to injury, poor hygiene and irritation; secondary - when inflammation descends from the vagina or is associated with a general disease. According to the course, they distinguish between acute and chronic vulvitis, and according to the cause - infectious, allergic and atrophic.
- Acute vulvitis - vivid symptoms, clear onset
- Chronic - persistent itching and relapses
- Candidiasis - curdled discharge and severe itching
- Bacterial - discharge with odor
- Allergic contact - after changing hygiene products
- Atrophic - with estrogen deficiency in menopause
Causes and risk factors
Most often, vulvitis is caused by yeast-like fungi and opportunistic bacteria, the proliferation of which is facilitated by taking antibiotics, elevated blood sugar and decreased immunity. The second large group is non-infectious causes: allergies to scented pads, intimate hygiene gels, synthetic underwear, as well as excessive washing that washes away the protective flora. In girls before the onset of puberty, the mucous membrane is thin and easily inflamed; in women during menopause, a lack of estrogen plays a role. Sexually transmitted infections and helminthic infestations in children are considered separately.
- Candidiasis and bacterial infections
- Sexually transmitted infections
- Diabetes mellitus and other metabolic disorders
- Allergies to hygiene products, linen, washing powder
- Excessive or insufficient hygiene
- Estrogen deficiency in menopause
- Pinworms and urinary incontinence in children and the elderly
Symptoms
The main complaint is itching and burning, intensifying in the evening and at night. The mucous membrane and skin become red, swollen, painful when touched, and small cracks and scratches are possible. Urination is accompanied by pain if urine gets on the irritated mucous membrane, and sexual intercourse becomes painful. The nature of the discharge suggests the cause: curdled - with candidiasis, copious liquid with an odor - with a bacterial process. Girls often experience redness and complaints of burning when urinating.
- Itching and burning in the external genital area
- Redness and swelling of the labia
- Pain during urination and sexual intercourse
- Various types of vaginal discharge
- Cracks and scratches on the skin
- Discomfort when walking and sitting
Diagnostics
The gynecologist examines the external genitalia and performs a speculum examination, assessing whether the vagina and cervix are involved. A smear on the flora is required, and PCR studies and extended panels are used to clarify the pathogen. If there are frequent relapses, check blood glucose levels and rule out diabetes and thyroid problems. If the skin changes are persistent - there are whitish areas, thickening or thinning - you need to consult a dermatologist and have a biopsy of the vulva so as not to miss lichen sclerosus and precancerous changes.
- Examination of the vulva and speculum examination
- Flora smear and purity level
- PCR for sexually transmitted infections
- Extended study of microflora
- Blood glucose during relapses
- Vulvar biopsy for persistent skin changes
Treatment and prevention
Treatment is prescribed by the doctor based on the results of the examination: for candidiasis - antifungal agents locally or internally, for bacterial inflammation - appropriate antibacterial drugs, for an allergic nature - elimination of the irritant and anti-inflammatory external agents. Local estrogen therapy helps well during menopause. General measures are no less important: gentle hygiene without soap and fragrances, cotton underwear, avoidance of panty liners with fragrance, blood sugar control. Douching is not recommended: it destroys the protective flora.
- Antifungal or antibacterial agents as prescribed by a doctor
- Elimination of irritating hygiene products
- Local estrogens for atrophic vulvitis
- Cotton underwear, loose clothing
- Washing with warm water without aggressive soap
- Avoiding douching
- Treatment of diabetes and other underlying diseases
