Vaginal infections ( vaginitis ) are the most frequent reason for gynecological consultation in adult women. According to statistics, they affect each woman at least once in a lifetime.
Vaginal infections are inflammations of the vagina ( vaginitis ), sometimes also extended to the uterine cervix, that is, the cervix, caused by one or more infectious agents, identifiable in pathogenic microorganisms of different kinds and species. Under normal conditions, the vagina already hosts some harmless or only potentially pathogenic microorganisms inside it, but normally inactive. The germs that colonize the vaginal mucosa making up the normal vaginal flora are:
- Lactobacillus acidophilus, commonly called lactobacillus, a very important bacterium in regulating the degree of vaginal acidity;
- Diphtheroids, also bacteria;
- Staphylococcus epidermidis;
- Streptococci of various species;
- Escherichia coli (typical intestinal bacterium);
- various anaerobic bacteria;
- Candida albicans, a fungus (or rather a yeast) present in the vagina of 25% of asymptomatic women.
Vaginal health depends on the physiological balance between all the microorganisms present. The rather acid environment, with pH 4, is the result of this good balance and prevents the excessive growth of pathogenic germs.
When pathogenic germs intervene in high quantities or when there are diseases (diabetes, general debilitating diseases) or therapies (antibiotics, immunosuppressants) that alter the balance of the vaginal environment, infection arises caused by one or more agents. The forms of infection most recurrent, almost 90% of vaginitis, are bacterial vaginosis and vaginitis fungal infection. The vaginitis caused by trichomonas alone accounts for about 10% of all infections.
The basic symptoms of a vaginal infection are itching, vaginal discharge, burning, dyspareunia ( pain in sexual intercourse).
The first diagnostic step is the gynecological examination with the observation of the mucous membranes of the vagina and of the cervix through the speculum. Then a vaginal swab is usually recommended to identify with certainty the germs responsible for the infection.
It accounts for approximately 60% of all vulvovaginal infections. The term ” vaginosis ” does not indicate a real infection, but a modification or imbalance of the vaginal ecosystem with the replacement of the normal lactobacillus flora by a pathogenic flora.
Normally the vagina contains several bacteria including Doderlein’s lactobacillus, which locally maintains the necessary acidity to avoid the multiplication of undesirable organisms. In the case of bacterial vaginosis, the lactobacilli decrease, and harmful bacteria proliferate abnormally with a bacterial concentration that increases approximately 100 times. One of the bacteria most frequently responsible for bacterial vaginosis is Gardnerella vaginalis.
The symptoms, in this case, are: moderate white-gray vaginal discharge with an unpleasant odor (fishy or moldy), presence of air bubbles in the secretions, vaginal pH greater than 4.7, sometimes itching.
Almost half of women with bacterial vaginosis, however, do not perceive any symptoms, and the infection is discovered by chance during a routine examination; in fact, unlike other types of vaginitis, vaginosis does not usually involve vaginal disturbances or irritations. Therapy is oral or vaginal antibiotics.
WHAT IS CANDIDOSIS OR MYCOTIC VULVOVAGINITIS?
Three out of four women suffer from candidiasis or fungal vulvovaginitis at least once in their life, and half of them have one or more relapses. As its name indicates, this type of vaginitis is caused, in most cases, by a fungus called Candida Albicans, which is present in the oral cavity, gastrointestinal tract, and vagina.
The candidiasis vaginal is in fact an infection of endogenous origin rather than exogenous infection by contact.
The disease manifests itself with intense vulvar itching, burning (particularly frequent during urination), small white, odorless and dense vaginal discharge (similar to cottage cheese), sometimes liquid and foamy, absence of air bubbles in secretions, presence of erythema, edema, and occasionally blisters on the vagina.
The risk factors for the development of fungal vaginitis are pregnancy, oral contraceptives, steroids, antibiotics, certain diseases such as diabetes, excessive use of douching and intimate deodorants, and finally the use of underwear. synthetic or too tight underwear. Treatment is based on oral or vaginal medications.
VAGINITIS FROM TRICHOMONAS
It is a sexually transmitted disease that accounts for about 10% of all vaginitis. Trichomonas can be found on wet wipes or bathing suits, toilet seats, or washcloths, although transmission by these non-sexual routes is extremely rare. Symptoms include profuse greenish-yellow loss of unpleasant (fishy) odor, air bubbles in secretions, reddening of the vulva and irritation of the vaginal mucosa, vaginal itching, and burning particularly when urinating.
Requires a specific antibacterial treatment on medical prescriptions. Treatment typically consists of taking oral antibiotics.
ALSO, CARE FOR THE PARTNER?
While trichomonas vaginitis is transmitted sexually and therefore necessarily involves treatment of the partner, it is not so evident that bacterial vaginosis or fungal vaginitis are transmitted in the same way. That is why you generally don’t even cure your partner in this type of infection. However, if you have repeated vaginitis or if your partner is experiencing symptoms, you would do well to talk to your doctor who will determine whether or not it is essential to treat the partner as well.
HOW ARE VAGINAL INFECTIONS PREVENTED?
The use of condoms is the most effective method to avoid trichomonas vaginitis, unlike spermicides which have no effect in this sense, and therefore should not be used as a means of prevention.
In the case of bacterial vaginosis and fungal vaginitis, which tend to recur regularly, a few simple precautions can help reduce the risks:
- wear only pure cotton underwear, avoid tight tights and pants because they create a humid area conducive to the proliferation of fungi. Prefer skirts, especially in summer. Change your underwear at least once a day;
- when you go to the bathroom, use toilet paper from the front to the back to prevent the transport of bacteria from the rectum to the vagina;
- do not wear a damp or wet swimsuit for too long, change as soon as possible, and do not wear the same swimsuit again before it is completely dry;
- avoid any contact between the vaginal mucosa and deodorants or perfumes, paying particular attention to hygienic wipes, toilet paper, soaps, and bath products;
- use a condom with each new partner, and if you have symptoms of infection, avoid sexual intercourse with penetration;
- prefer internal tampons to external absorbents, make sure they are not scented, and never wear them for more than four consecutive hours;
- carefully rinse your linen, and if possible iron it with the steam iron to get rid of any fungus.