Features of diagnosis and treatment of atrophic colpitis

The diagnosis of “colpitis” in gynecology is made when the doctor sees inflammation in the woman’s vagina - visually or based on test results (leukocytes in the smear are increased from 30-40 to 100 or more). It can be of bacterial or fungal origin. If the infection is localized in the area of ​​the labia and clitoris, women are diagnosed with vulvitis. Inflammation of the mucous membrane of the vagina and external genitalia is called vulvovaginitis.

If you are concerned about signs of inflammation in the vagina, a gynecologist at our clinic will help solve this delicate problem. After passing the tests and confirming the diagnosis, the specialist will recommend an effective treatment regimen for colpitis with the best drugs. They are selected taking into account its causes and the presence of concomitant gynecological diseases.

general information

Vaginitis, vulvovaginitis and colpitis occur in sexually active adult women, virgins, adolescents and children, as well as in menopausal and elderly women. And in general, it is not so easy for a woman to have a beautiful and clean vagina. Let's be honest. It requires much more money than most other organs. Unfortunately, some of the well-intentioned efforts we put into making him look good and healthy, such as deep bikini waxing, crotch shaving, "scented soap washes," etc. In the end, it only aggravates everything and causes colpitis. The reasons, acting individually or together, lead to the appearance of bad, sometimes purulent vaginal discharge, significant irritation, rash, terrible itching...

Sometimes the question arises: “Does colpitis occur in men and what is it?” This formulation is incorrect - a man does not have a vagina, and therefore there cannot be inflammation. Therefore, if representatives of the stronger sex end up on this page from a search, then this is clearly happening by mistake - there is nothing here and cannot be!

Causes of colpitis

Girls' vaginas can become inflamed for the following most common reasons:

1. STDs (trichomoniasis, thrush, gonorrhea, mycoureaplasmosis, etc.)
2. Endocrine disorders (ovarian diseases, obesity, diabetes).
3. Hormonal changes during puberty, pregnancy, menopause.
4. Uncontrolled or prolonged use of antibiotics.
5. Poor intimate hygiene.
6. Weakening of the immune system.
7. Injuries to the vaginal mucosa.
8. Allergic reactions to anything.
9. Vascular pathologies that impair the nutrition of the mucous membrane.
10. Senile atrophy of the vaginal mucosa.

The consequence of these reasons is a disruption of the natural microflora - vaginal dysbiosis, with its further colonization by atypical microorganisms, which cause an inflammatory reaction in the genital tract.

How inflammation develops

Problems are inevitable if the number of pathogens entering the reproductive tract is too large. Inflammation in the vagina can be caused by E. coli, staphylococci, gardnerella, and streptococci. Disruption of the normal vaginal microflora can occur due to the above reasons, as well as excessive sexual activity.

Depending on the location of the primary source of infection, the following are distinguished:

1. primary colpitis - it immediately develops in the vagina, and
2. secondary colpitis: • ascending - the infection comes from the external genitalia, urethra, anus; • and descending - during the transition of inflammation from the uterine cavity.

Recently, specific colpitis caused by mycoplasmas and chlamydia has become increasingly common, which can occur in mixed forms, often in virgin girls. If bacterial vaginitis is not treated, complications can occur. Inflammation can spread to the cervical canal, cavity and appendages. The consequence of an ascending infection can be cervical erosion, cervicitis, endometritis, and in advanced cases - adhesions and infertility. The likelihood of infection increases with sexual intercourse during menstruation.

Symptoms of colpitis

Signs of the disease in women depend on the cause of inflammation in the vagina. The course of colpitis can be acute, subacute, sluggish, chronic, latent and asymptomatic. All its forms are characterized by one important symptom - the inflammatory nature of vaginal discharge, the so-called. "leucorrhoea". Their character is determined by their origin (tubal, uterine and vaginal leucorrhoea is liquid, cervical leucorrhoea is mucous). An admixture of pus in the discharge usually indicates an inflammatory process, while blood often indicates the development of a tumor.

Acute colpitis

In the acute stage of the disease, the amount of leucorrhoea increases sharply. They may have an unusual consistency, color, pungent odor, and are often accompanied by burning and itching in the intimate area, pain during sexual intercourse. Based on the nature of the discharge, one can assume the most likely cause of inflammation. Often the symptoms of colpitis are accompanied by urinary disorders in the form of cystitis and pain in the lower abdomen or back.

The temperature usually does not increase in acute colpitis of a nonspecific nature, or slightly in case of deep damage to the vaginal walls. As a rule, a high temperature is typical for the clinic of colpitis of gonorrheal or trichomonas origin. Very often it is accompanied by copious, foul-smelling discharge that contains pus or even blood. Flowing down the inner surface of the thighs, in advanced cases, such secretions cause severe irritation of the skin, which makes it difficult to walk. A woman experiences a burning sensation and painful itching in the vagina, in the area of ​​the external genitalia.

When the inflammatory process becomes chronic, the symptoms become mild. But the most stable symptom is itching in the genital area, which does not stop even with a decrease in the amount of discharge.

Chronic colpitis

At this stage, the main complaints are about discharge from the genital tract, and less often, itching and discomfort in the vaginal area. The disease is characterized by a long course and a tendency to relapse.

In chronic colpitis, the symptoms are erased, swelling and hyperemia are not expressed, there may be multiple or focal dilatations of blood vessels. The vaginal epithelium with significant structural changes may disappear in one area or another. Pus appears to be released directly from the vaginal walls, which become thick and rough.

The chronic form of colpitis has the following symptoms:

• Burning and itching in the vagina;
• Pain during sexual intercourse;
• Heaviness in the lower abdomen;
• Bloody discharge from the genital tract;
• Purulent discharge, often with an unpleasant odor;
• Redness of the vaginal mucosa.

Atrophic colpitis

During menopause and menopause, with an inevitable reduction in the amount of estrogen produced by the ovaries, women may develop age-related colpitis. Due to a decrease in the number of lactobacilli, which perform a protective function, during the menopausal period, opportunistic microorganisms actively multiply in the vagina, which provoke local inflammatory reactions and increased discharge.

In senile (senile) colpitis, the mucous membrane is atrophic, has a pale yellow color, and hemorrhagic spots and granulating tissue defects are located on its surface. Wrinkling of the submucosal tissue occurs. This leads to narrowing of the lumen and atrophy of the vagina or even fusion of its walls. This leads to the activation of pathogenic microflora of the vagina, as well as the creation of favorable conditions for the penetration of pathogenic bacteria from the outside.

With atrophic colpitis, symptoms in older women are practically absent. The disease progresses indolently, patients may have no complaints. The most common symptoms are burning and itching, a feeling of “tightness” in the vagina and dryness. Intimacy is painful, followed by bloody discharge or even minor bleeding. When examined in the speculum, a pale pink, thinned mucosa with many pinpoint hemorrhages is revealed. Often, due to vaginal dryness in atrophic colpitis, insertion of gynecological speculum is difficult.

Tormented by atrophic menopausal colpitis?

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Prevention

There are no vaccines to prevent the development of colpitis. To reduce the risk of infection, you need to:

• see a gynecologist once a year (during a standard examination in a gynecological chair, the doctor can easily identify the first symptoms of the inflammatory process and immediately prescribe effective therapy);
• strictly observe the rules of personal hygiene (wash the external genitalia twice a day with warm water and soap or intimate hygiene product from front to back);
• strengthen the immune system, eat well, take vitamins and minerals;
• do not self-medicate with antibiotics;
• have one regular sexual partner.

At the first symptoms of colpitis, you should immediately make an appointment with a gynecologist.

. A disease detected at an early stage is much more treatable. If you do not visit a doctor on time, colpitis can become chronic or cause complications (abscess, fistula). Also, if left to chance, the infection can spread to the uterine cavity and lead to infertility.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

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?

Classification of acute vaginitis

Acute vaginitis is of the following types:

• specific, caused by STDs and tuberculosis. With a combined infection, there are several types of pathogens in the vagina, for example, Trichomonas and gonococcus. Therefore, the ICD-10 classification indicates that code N76.0 includes acute colpitis without further specification (NOS);
• nonspecific, caused by the activation of opportunistic flora: staphylococcus, Proteus, Escherichia coli and Pseudomonas aeruginosa, fungi of the genus Candida. This form of colpitis is caused by a violation of the vaginal microflora;
• non-infectious, occurring due to allergies, sexual intercourse without sufficient hydration, irritation of the mucous membrane with latex, tampons, douching solutions.

Treatment of colpitis in women

Direct treatment of vaginal inflammation consists of local and general, taking into account the cause of its occurrence and test results. The regimen uses drugs - antibiotics, various medications, physiotherapy, herbal decoctions, baths with an acidic environment, ointment applications. In case of ovarian hypofunction, it is necessary to correct their activity, aimed at replenishing the deficiency of their hormones in the body.

The next mandatory point that must be strictly observed when treating colpitis is the complete cessation of intimate life, that is, sexual rest for two weeks is needed if the disease is not advanced. If it occurs with complications, then the period of abstinence must be extended.

Drug therapy

The selection of medications and related products for the treatment of acute and chronic colpitis is carried out individually, taking into account the properties of the identified pathogen, the stage and form of the disease. Accordingly, an antibiotic is selected that destroys the pathogenic microbe. To do this, a preliminary culture of vaginal discharge is carried out to determine antibiotic sensitivity.

In case of severe symptoms of colpitis or in case of chronicity of the process, treatment agents are prescribed, used orally or intramuscularly. In the case of specific gonococcal colpitis, intramuscular administration of cephalosporin antibiotics in the recommended dosage is indicated. Nitroimidazoles are effective for trichomonas colpitis. The complicated course of nonspecific colpitis requires the prescription of broad-spectrum antibiotics. In the treatment of candidiasis, antimycotic drugs and suppositories are used.

Means for topical treatment

Local therapy consists of prescribing warm sitz baths with herbal infusions, douching, antimicrobial suppositories and ointments. But these remedies, including folk remedies, are used strictly as prescribed by a gynecologist. After all, even chamomile, the universal favorite of Russian women, can cause harm.

It is useful to complete the course of treatment for colpitis by douching with a weakly acidic solution. For this, lemon juice can be used (one tablespoon per liter of warm boiled water) or 6 - 9 percent vinegar (two tablespoons of table vinegar per 1 liter of water). In this way, the woman will help Dederlein’s wand gain strength to protect the mucous membrane, and only then will she, on her own, fight the alkaline environment and uninvited guests from the outside.

At the same time, general strengthening agents are used - vitamin-mineral complexes, physiotherapy, herbal medicine, immunomodulators. In case of insufficient effectiveness, the tendency of colpitis to relapse and with severe ovarian hypofunction, local use of estrogen hormones in the form of emulsions is recommended. After completing the course, control tests should be taken 7-10 days later.

How to treat atrophic colpitis

In cases of senile vaginitis, hormone replacement therapy is often prescribed. The development of this pathology is due to the fact that with the onset of menopause, the level of sex hormones in the body decreases, and accordingly, the activity of the ovaries becomes less and less active. Since this form of the disease is caused by similar age-related changes in hormonal levels, treatment of atrophic colpitis in menopause and in older women will be aimed primarily at equalizing the level of one or another hormone. Therapy is prescribed by a gynecologist and can be either local or systemic. For local therapy at this age, estrogen preparations are used in the form of vaginal suppositories or ointments.

Prevention

With timely and correct treatment, the disease does not pose a serious threat. To maintain women's health, it is important not only to prevent colpitis, but also to eliminate risk factors for the development and exacerbation of the inflammatory process in the vagina. Therefore, it is useful to follow the advice of a gynecologist and perform certain preventive measures:

• Visit your doctor regularly, incl. for medical examinations;
• Observe the rules of intimate hygiene;
• Antibiotics and drugs - only with a doctor's prescription;
• Use barrier contraception;
• At the first sign of colpitis, urgently visit a gynecologist;
• Maintain immunity, give up bad habits.

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.