Vaginal Infections
1. What is Vaginal Infection (Vaginitis)?
Vaginitis is an inflammation of the vaginal mucosa and one of the most common causes of gynecologists. Vaginitis affects 90% of adolescent women and two or more infections occur together in 30% of cases1,2,3.
Vaginal discharge is a clear, egg-like secretion that keeps the vagina environment moist under normal conditions. Vagina secretion may increase in natural conditions such as pregnancy, sexual stimulation and ovulation, but this is not a normal condition and does not cause any complaints. Therefore, the increase in vaginal discharge does not always indicate a symptom of the disease.
If the amount of vaginal discharge, itching, burning and bad smell are felt with the change of color and consistency, these symptoms may indicate a problem of vaginal discharge, especially if it lasts more than 2-3 days.
Vaginitis is not usually a life-threatening disease. However, it can lead to more serious health problems if not treated in a timely and correct manner.
2. How does vaginitis occur?
Three factors are often responsible for the formation of vaginitis (90%):
- Fungi (Candida albicans)
- Bacteria (Gardnerella vaginalis)
- Parasites (Trichomonas vaginalis)
In addition, Chlamydia and Micoplasma bacteria, Neisseria gonorrhoea, Escherichia coli, Giardia lamblia, Balantidum coli, Entamoeba histolytica and Ureaplasma urealiticum are responsible for the vaginitis picture of microorganisms4.
The main factors that play a role in the formation of vaginitis is the deterioration of normal vaginal environment (flora) and the change in pH.
Mixed (mixed) vaginal infections are sometimes mentioned when two or all of these factors coexist.
3. What are the most common types of vaginitis?
The most common types of vaginitis are candidal vulvovaginitis caused by fungi, bacterial vaginosis caused by bacteria and trichomonal vaginitis caused by parasites.
What is Candidal Vulvovaginitis (Vaginal Fungal Infection)?
A common type of vaginitis, candidal vulvovaginitis is mostly caused by yeast fungi called Candida albicans. Candida albicans is the most important fungus that causes infection due to the deterioration of the natural resistance of the organism in the normal flora of the skin and mucous membranes of healthy individuals. This type of vaginitis occurs at least once in their lifetime in approximately 75% of adult women, and occurs two or more times in 40-50% of them1.
What are the Symptoms of Candidal Vulvovaginitis?
The main symptom is severe itching and irritation around the vagina. Consequently, redness and swelling of the external genitalia and intense and small amount of cheesy discharge are also present2.
What Causes Candidal Vulvovaginitis?
Normally found in the mouth, throat, intestinal (colon) and vagina flora, this fungus changes the balance of the body in pregnancy, diabetes (diabetes), obesity cases, birth control products, sperm killers (spermicide), intrauterine device (IUD) and intensive antibiotics 5. It causes disease in use5.
How is Kandidal Vulvovaginitis Treated?
In the treatment of these infections, antifungal products which are used orally or vaginally used against fungi are used.
What Is Bacterial Vaginal Infection (Bacterial Vaginosis)?
Bacterial vaginosis, also known as Gardnerella vaginalis or non-specific vaginitis, is the most common bacterial vaginal infection observed in women of childbearing age. In this disease, normal vaginal flora changes, the beneficial bacteria called Lactobacillus, which should be present in healthy flora, disappear and other bacteria (Peptococcus sp., Prevotela sp., G. Vaginalis and Mobiluncus sp.) Are increasing6.
Since bacterial vaginosis is asymptomatic at a rate of 50%, the incidence rate cannot be determined exactly. However, it is possible to say that bacterial vaginosis is detected in 15% -19% of patients presenting to outpatient clinics with gynecological disorders, 10% -30% of pregnant women and 24% -40% of people with sexually transmitted diseases1.
What are the symptoms of bacterial vaginosis?
Bacterial vaginosis does not show any symptoms. The most important symptom is fish-smelling vaginal discharge. In the eyebrow and irritation may be observed in some cases.
What Causes Bacterial Vaginosis?
Risk factors include IUD use, vaginal showers, and pregnancy.
How is Bacterial Vaginosis Treated?
Various antibiotics are used orally or vaginally against bacteria.
What is Trichomonal Vaginitis?
Trichomonal vaginitis is caused by Trichomonas vaginalis, a sexually transmitted parasite.
Trichomonas vaginalis affects approximately 180 million people worldwide annually7
What are the Symptoms of Trichomonal Vaginitis?
Symptoms are especially severe after menstruation and during pregnancy. The most common symptom is malodorous excessive discharge. The discharge can usually be observed in yellow-green color. Other symptoms include pain during sexual intercourse, burning during urination, and pain in the lower abdomen in some patients.
What Causes Trichomonal Vaginitis?
Since trichomonal vaginitis is a sexually transmitted disease, it may occur as a result of sexual intercourse with an individual who has this disease.
How is Trichomonal Vaginitis Treated?
Antiprotozoal or oral medications against parasites are used in its treatment. These medicines include products.
Because it is a sexually transmitted disease, the sexual partner must also be treated in order to minimize the success rate and recurrence rate. Sexual intercourse should be prohibited during the treatment period8.
What are the effects that facilitate the formation of vaginitis?
- Use of tight and tight synthetic garments
- Pregnancy (changes in hormonal balance)
- Diabetes
- Use of birth control pills
- Wrong cleaning habits
- Causes such as lack of immune system facilitates the formation of vaginitis.
What are the precautions to be taken to prevent vaginitis?
Cleaning is the main factor in disease prevention. It is useful to change underwear every day, boiling and ironing.
Frequent washing of the vagina with soap or intim showers disrupts the protective layer of the vagina, causing inflammatory diseases to settle. Prolonged use of tampons and pads is also a negative factor.
General bathrooms and excessive chlorinated pools should not be entered, public toilets and shared toilet cleaning materials should not be used.
In external genitalia, washing and drying should be done from front to back. With this method, it is possible to prevent the transmission of microbes from the anus, which is rich in microbes, to the vagina.
The choice of clothing is an important factor in preventing disease. Very tight and tight clothes such as synthetic fiber underwear and trousers are the factors that increase the fungus growth especially because they take less air and increase the heat and moisture around the vagina. Clothing that are carried wet for long periods, such as swimwear, are also harmful. Therefore, comfortable clothes and cotton underwear should be preferred.
Chemical contact can lead to vaginitis by changing the vaginal environment as a result of local allergy and hypersensitivity. Therefore, the use of perfumed toilet paper should be avoided.
Since prolonged and uncontrolled antibiotic use is one of the common causes of vaginitis, antibiotics should only be used under the supervision of a doctor.
Nutritional habits can also be preparative for vaginitis. Especially as a result of nutrition with abundant sugary foods, blood sugar will increase and disease formation may be easier.
How Should Sexual Life Be During Vaginitis Treatment?
Sexual intercourse should be avoided during treatment in other types of vaginitis, since irritation, which may occur as a result of sexual intercourse, may facilitate the development of infections and pain is a common finding in all types of vaginitis.
7AXX
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