Vulvitis signs. Alternative methods of treatment of vulvitis at home. Home treatment for vulvitis

Vulvitis is called inflammatory process vulva. The vulva (external genitalia) includes the pubis; large and small labia; clitoris; hymen (or its remains); the vestibule of the vagina, as well as its two (right and left) large (Bartholin) glands and the bulb (horseshoe-shaped venous plexus, covering the urethra and spreading in the thickness of the small and large labia). outer hole urethra located under the clitoris in the vestibule of the vagina.

Natural factors contributing to the occurrence of vulvitis:

constant humidity and warm conditions containing the external genitalia

Tenderness of integument, abundant amount nerve endings, vessels and their plexuses, the presence of folds

Causes of vulvitis:

Infectious agents: streptococci, staphylococci, E. coli, enterococci, fungi, etc. cause non-specific vulvitis, and gonococci, diphtheria bacilli, chlamydia, Trichomonas, viruses, tuberculosis mycobacteria - specific;

Oral sex (due to infection);

Irrational or long-term use antibiotics, hormonal drugs and immunosuppressants (depress the immune system); these drugs kill normal flora and causes dysbacteriosis, the manifestation of which may be, including candidal vulvitis;

common diseases ( diabetes; leukemia and malignant tumors);

Malignant tumors of the genital organs (vagina, cervix and body of the uterus, ovaries) in a state of necrosis and decay;

Other inflammatory diseases of the female genital organs: vaginitis, endocervicitis (inflammation cervical canal cervix), endometritis (inflammation of the uterine mucosa), pyosalpix (accumulation of pus in fallopian tubes, which can be emptied through the uterus);

Inflammation of the urethra (urethritis), bladder (cystitis);

Continuous leakage (incontinence) of urine;

The presence of urogenital fistulas (there is a message between bladder or ureter with vagina);

Helminthiases (worms);

Allergic reactions to certain substances contained in hygienic, perfumery and cosmetics(soaps, shampoos, bubble baths, deodorants, sanitary napkins, colored or scented toilet paper, use of synthetic underwear, washing powders, spermicides, disinfectants in pool water, etc.);

Chemical factors (douching concentrated solutions antiseptics, irritation of the external genital organs chemicals, in particular, gases and dust in hazardous production);

Mechanical factors (horse riding, cycling, masturbation);

Thermal factors (hot baths and douching of the vagina with hot solutions);

Insufficient observance of the rules of personal hygiene (especially obese women who are prone to diaper rash);

Wet conditions for a long time ( prolonged wear swimsuit on the beach, swimming);

The development of vulvitis is favored by conditions accompanied by a low content of estrogen in the body, which is observed in childhood and adolescence, as well as in postmenopause.

Symptoms of vulvitis:

Redness;

puffiness;

Soreness, aggravated by walking, urinating, lifting weights, sexual intercourse;

Burning in the vulva;

Roughness of the inner surface of the labia minora due to nodules (enlarged sebaceous glands);

Fluid-filled vesicles (in herpetic vulvitis), which, after opening, ulcerate and then crust;

Plaques (especially with diphtheria), sometimes ulcers; psoriasiform (as in psoriasis) plaques (often with candidal or fungal vulvitis);

Sometimes fever and malaise;

Itching in diabetes mellitus is the first and very characteristic symptom vulvitis.

Depending on the cause, there are primary and secondary vulvitis. In women in reproductive age more often secondary vulvitis is observed due to other diseases of the genital organs and common diseases(see above), and in children - primary due to the tendency to exudative diathesis, helminths (in particular, pinworms that can penetrate the vagina), etc. According to the clinical course, they distinguish sharp and chronic vulvitis. In a chronic disease, the symptoms are less intense, but they increase with relapses (exacerbations). In young girls, vulvitis can be complicated by the formation of adhesions (synechia) between the labia minora.

In the presence of symptoms of vulvitis, especially itching, you should not scratch the affected areas, as this can worsen the course of the disease and additional infection. Before seeking medical help, you can take a warm, but not hot, sitz bath with a decoction of comfrey, chamomile, string, calendula. It is important to remember that the external genitalia should be dried from front to back (preferably with a waffle towel, as if getting wet, but not rubbing), they should be kept dry and clean. If signs of vulvitis appear, you should immediately consult a gynecologist, since delay in treatment can lead to the spread of infection to the vagina (vaginitis), and then to the internal genital organs (uterus and its appendages).

Diagnosis of vulvitis based on the patient's complaints, information about the onset of the disease, previous and concomitant diseases, drug tolerance. The doctor, in good (preferably daylight) lighting, will examine the external genitalia (sometimes using a hand magnifier), perform a two-handed vaginal-anteroabdominal (vaginal-abdominal, or bimanual) and rectal (rectal) digital examination, performs smear collection for cytological examination on atypical (malignant) cells and discharge for bacterioscopic (microscopy) and bacteriological (inoculation) studies in order to identify the pathogen and its sensitivity to antibacterial agents. Special attention given to the state of peripheral lymph nodes. If necessary, the surface of the vulva (vulvoscopy) will be examined using a colposcope (a special mono- or binocular loupe). Be sure to prescribe a fecal analysis for helminths.

It should be remembered that other diseases can occur under the mask of vulvitis. Therefore, often the doctor has to exclude them. Scratching in the vulva, as well as other symptoms, including those mentioned above, may indicate pediculosis and scabies, psoriasis, limited neurodermatitis, lichen sclerosus (kraurosis), seborrheic dermatitis. We must not forget about the precancerous condition of the outer integument of the vulva (epithelial dysplasia) and. Rarely, plasmacellular vulvitis occurs in the form of shiny hyperemic (red) plaques. In situations where the prescribed treatment of vulvitis does not help within 6 weeks. or the diagnosis is unclear primary examination sick, the doctor must perform a biopsy. Thus, despite the fact that vulvitis belongs to the group of so-called visual diseases, its diagnosis can be extremely difficult and require the efforts of not only a gynecologist, but also related specialists - a dermatovenereologist and a therapist. If one of the sexually transmitted diseases (STDs) is identified, diagnostic tests may be required to identify other infections from this group.

Treatment of vulvitis consists in eliminating the cause that caused it (see above) and / or treating concomitant diseases (diabetes mellitus, helminthiases, diphtheria, gonorrhea, etc.). AT acute stage recommend bed rest and abstinence from sexual activity. Treatment of vulvitis is carried out strictly individually. The external genital organs are washed up to 3 times a day with warm (up to 38 C) infusions of herbs (see above), a solution of potassium permanganate, a 2% solution boric acid, miramistin, dioxidine, chlorhexidine. Use according to indications antibacterial drugs on the surface of the external genitalia (vagitsin, Macmiror cream) or injected into the vagina (polygynax, terzhinan. ginalgin). Treatment is carried out until the symptoms of vulvitis are completely eliminated. Vitamins A (protects the epithelium), E and C are also prescribed as antioxidants. Sea buckthorn or rosehip oil, solcoseryl can accelerate the recovery process, especially with ulceration. With itching of the vulva, anesthesin ointment and antihistamines (diphenhydramine, suprastin, tavegil, etc.) are locally prescribed for oral administration. With atrophic vulvitis and vaginitis, which occur mainly in postmenopausal women, hormonal drugs (estrogens) are prescribed for local, and sometimes for systemic use. With specific vulvitis (see above), special treatment is prescribed.

Prevention of vulvitis consists in observing the rules of general hygiene and hygiene of the genital organs and sexual life. It is necessary to avoid those causes that can lead to this disease(see above).

Vulvitis in women is a disease in which the inflammatory process affects the external genitalia. The disease causes discomfort and can lead to complications, among which are the appearance of ulcers, as well as the spread of the pathological process to the vagina and cervix.

Causes

According to what reasons contributed to the development of pathology, vulvitis can be:

1. Primary - the cause of this type of pathology is improper intimate hygiene, malfunctions of the endocrine system, burns and injuries in inguinal region, cystitis, allergic reactions; less often, this form of vulvitis can form while taking antibiotics and hormonal drugs for quite a long time;
2. Secondary - outward manifestation violations of the internal genital organs; vaginitis, herpes and other pathologies - all these are provocateurs of the occurrence of this form of the disease.

One of the main causes of vulvitis, especially in women under 45, is a weakening defensive forces organism. Decreased immunity may be due to systemic bacterial or viral disease, long-term use certain drugs (glucocorticoids, cytostatics), deficiency in the diet essential vitamins. The risk of inflammation of the external genitalia increases with alcohol abuse, drug use.

Other causes of vulvitis are:

• diaper rash due to the peculiarities of the constitution of a woman (for example, the formation of skin folds on the external genital organs with excess weight);
• injuries, scratches, scratching;
• dermatological diseases (psoriasis, eczema);
• allergic reaction to pads and products for intimate hygiene, latex;
• wearing tight synthetic underwear;
• non-compliance with the rules of intimate hygiene;
• untimely replacement of tampons and pads during menstruation.

The risk of inflammation increases in the presence of concomitant diseases of the reproductive and endocrine systems (colpitis, vaginitis, diabetes mellitus). The occurrence of chronic or acute vulvitis contributes to the violation of the microflora of the vagina. Similar situation may occur during pregnancy long-term treatment antibiotics, taking improperly selected oral contraceptives, gynecological diseases accompanied by a decrease in estrogen production. Depending on the cause of the onset of symptoms of vulvitis in women in gynecology, the following forms of the disease are distinguished:

1. Atopic vulvitis occurs in response to a specific reaction to an allergen that has fallen on the external genitalia.
2. Atrophic vulvitis is mainly found in old age or in diabetes mellitus due to a violation of the structure of the mucous membrane.
3. Candidiasis vulvitis is a consequence of the pathological reproduction of fungi of the genus Candida.

A bacterial form of inflammation, which occurs under the influence of pathogenic microflora, is also isolated. It may also be caused by internal infections excretory system (cystitis, urethritis), fistulas between the bladder and vagina.

Symptoms of vulvitis in women

The disease can manifest itself in two forms - acute and chronic. In women, symptoms of vulvitis (see photo) acute type such:

1. Burning and itching, soreness in the groin, especially when moving, touching and urinating;
2. Severe swelling and hyperemia of the labia and clitoris, the appearance of erosions and ulcers. It also affects inguinal folds and inner part hips;
3. Enlarged inguinal lymph nodes;
4. Increased body temperature (in some cases);
5. Sanctuary or serous-purulent discharge(with Escherichia coli - a watery consistency of yellow-green color with an unpleasant odor, with staphylococcus - a thick consistency, yellow tint, with candida - a cheesy appearance).

If the disease is not cured in time, then it goes into chronic form. Symptoms of vulvitis in this case characterized by moderate swelling of the mucosa, redness and soreness of certain parts of the vulva, burning and itching, and slight discharge.

Complications can be manifested by deformation of the genitals, as well as fusion of the labia, which disrupts the normal sexual life in adulthood and reproductive function basically.

Diagnostics

Examination for suspected vulvitis includes the following:

• collection of complaints. The patient is asked what worries him, how long ago the symptoms appeared, with what the person associates their appearance, etc .;
• inspection;
• analysis of a gynecological smear for flora. The study helps to identify the inflammatory process, as well as the presence of bacteria - the direct cause of the pathological process;
• bacteriological culture of a gynecological smear;
• a general urine test reveals the presence of cystitis, which can be both the cause of vulvitis and its complication.

Treatment of vulvitis in women

For a comprehensive and adequate approach to the treatment of vulvitis in a woman, it is customary to use two main areas:

1. Pathogenetic impact directly on the focus of infection, that is, on the inflammatory process in the active phase.
2. Treatment (both etiotropic and symptomatic) of a primary or concomitant disease that directly or indirectly contributes to the onset and progression of vulvitis. It can be diabetes mellitus, and inflammatory diseases of the pelvic organs, such as adnexitis, cystitis.

It makes no sense to consider how to treat vulvitis by eliminating a concomitant disease due to the fact that each disease has its own aspects of therapy and patterns of prevention. But let's dwell on the etio-pathogenetic effect on the focus of inflammation in more detail.

1. First of all, the patient needs bed rest, of course, complete sexual rest, as well as enhanced measures for the hygiene of the external genital organs. It is recommended to either douche or take sitz baths with various herbs with soothing and anti-inflammatory effects (chamomile, St. John's wort, plantain).
2. Baths with antibacterial solutions have also proven themselves well: chlorhexidine, furatsilin and others. Medicines for vulvitis are also widely represented by local antiseptics, such as Miramistin, potassium permanganate and boric acid. However, you also need to be careful with them, because you should not forget that these drugs can have an irritating effect, which can aggravate the disease.

In case of severe itching and burning, ointments are actively used for vulvitis in women, containing anti-inflammatory, analgesic components and antihistamines. For example, hydrocortisone ointment, Inflorax, Suprastin, Tavegil, and so on. These medicines can effectively relieve itching for quite a long time.

1. In the event that a patient is diagnosed with allergic vulvitis, she is prescribed a diet that excludes sweet, spicy and salty foods, and is also treated with antihistamines.
2. When diagnosing seborrheic dermatitis, which provoked the development of vulvitis, a woman is prescribed local treatment with hydrocortisone ointment, and, if necessary, systemic hormonal anti-inflammatory therapy.
3. Purulent hydradenitis also requires local treatment. For this, steroid hormones and antibiotics are used. Note: with a long course of the disease without positive dynamics, it is indicated surgical excision affected areas of the skin in the vulva.
4. With the atrophic nature of vulvitis, a general or local replacement therapy estrogen.

AT without fail it is necessary to treat pathologies associated with vulvitis, as well as take drugs that strengthen the immune system (vitamins and immunostimulants).

Ointments for vulvitis

Consider effective ointments prescribed for the treatment of vulvitis:

1. Nystatin ointment. It is used for candidal form of vulvitis. Active substance ointment contributes to the destruction of the protective shell of the pathogen and their further death.
2. Instillagel. Used in the treatment of women and girls. The agent affects many groups of pathogens, including fungi. Instillagel quickly eliminates itching, burning and pain due to the presence of lidocaine in the composition.
3. Radevit. This ointment promotes tissue healing. It contains vitamins that relieve inflammation and eliminate irritation. natural composition makes it possible to use in young girls.
4. Tetracycline ointment. Its composition includes antibacterial component a wide range actions. Helps to stop the growth and reproduction of pathogenic microflora.
5. Levomekol. it combined remedy with regenerating and anti-inflammatory properties. Levomekol contains methyluracil and chloramphenicol.
6. Actovegin. The ointment saturates tissues with oxygen, and also improves blood flow and metabolism. You can use the tool almost from birth.

Ointment is easy to use dosage form, which quickly eliminates the symptoms of vulvitis. Local funds rarely cause side effects, and if this happens, then they wear local character and pass quickly.

The ointment is applied carefully to pre-washed dry genitals. The product starts working within a few minutes. Prolonged use of the ointment is not recommended. If there is no effect, you should consult a doctor to adjust the treatment.

Prevention

Prevention of vulvitis is the most common, well-known recommendations. Nevertheless, if you adhere to these measures, you can avoid such an unpleasant disease in all respects as vulvitis.

Personal hygiene rules:

• use special gels for intimate hygiene that support acid - alkaline balance, do not have irritating and allergic action, often contain herbal ingredients with anti-inflammatory action;
• can't use antibacterial agents, since it is possible to upset the balance of conditionally pathogenic and beneficial flora in the body;
• refuse tight synthetic underwear, wear loose underwear.

In addition, it is worth:

• strengthen immunity, take courses of multivitamins, treat chronic diseases.
• fight obesity, treat diabetes.
• lead a mobile lifestyle, give up bad habits.

The main thing is not to be afraid of the gynecologist and visit with preventive purpose Twice a year.

- inflammation of the vulva (external female genital organs). It is characterized by the appearance of itching, burning, profuse discharge, hyperemia and swelling of the labia, pain after urination. May be the result of poor hygiene or injury to the external genital organs (primary vulvitis), genital or extragenital diseases, endocrine disorders(secondary vulvitis). Dangerous transition of infection to the internal genital organs; in girls of early childhood, vulvitis can cause fusion of the labia minora. Vulvitis can occur in acute and chronic form. For the diagnosis of vulvitis, a consultation with a gynecologist is necessary.

General information

The inflammatory process of the external genitalia in women (vulvitis) develops due to a number of local and general. With vulvitis, infection of the clitoris, small and large labia, the vestibule of the vagina and its glands occurs, hymen. The most common causative agents of vulvitis are opportunistic pathogens(E. coli, streptococci, staphylococci, yeast fungi), less often pathogenic STD pathogens (gonococci, Trichomonas, chlamydia, viruses, etc.). Sometimes the development of vulvitis is provoked by pathogens of tuberculosis, diphtheria. Conditions for the development of infection are created as a result of a violation of the integrity of the skin and vulvar mucosa and a decrease in local immunity.

Vulvitis and its causes

The reasons for vulvitis may be:

• non-compliance with the rules of personal hygiene (especially during menstruation);
• mechanical injury to the vulvar mucosa when wearing tight and rough clothes, prolonged use of sanitary pads, during sexual intercourse;
• irritation and maceration of the mucosa with secretions from the vagina, cervical canal with an existing infection of the genitals, with urinary incontinence, chemicals;
• excessive intake medicines(antibiotics), radiation therapy;
• hormonal and metabolic disorders in the body (ovarian hypofunction, obesity, diabetes mellitus, lack of vitamins and minerals), allergic reactions;
• the presence of pathological passages (fistulas) from the intestines, urinary tract;
• scratching of the external genitalia with vegetative neurosis, helminths, excessive sweating.

There are primary vulvitis, when the infection develops as a result of trauma or non-compliance with the cleanliness of the genitals, and secondary, if other organs are the source of infection (vagina, uterus, tonsils, bladder, kidneys). Primary vulvitis develops more often in girls and in postmenopausal women, which is associated with the characteristics of the genital organs in these age periods. In healthy adult women, the mucous epithelium of the vulva (due to the predominance of lactic microflora, acidic secretion pH, hormonal levels) is more resistant to infection. Primary vulvitis is rare in them and occurs in the form of vulvovaginitis.

Primary vulvitis is more common in girls, as their skin and the mucosa of the vulva is thin, delicate, easily injured. The microflora of the genital organs is dominated by coccal forms, there are no Doderlein sticks, the secretion medium is alkaline, local immunity is still imperfect. Also, the presence of pinworms in a child contributes to the occurrence of vulvitis - the mucous membrane of the external genital organs is injured during scratching, facilitating the penetration of the infection. Sometimes newborn girls may have vaginal discharge, provoked by maternal estrogen hormones that came to them before childbirth. Usually these phenomena go away on their own.

In the postmenopausal period, with a decrease in estrogen levels, cessation menstrual cycle, occur atrophic changes mucous membrane of the genital organs. Quantity vaginal discharge decreases, the mucosa "dries out", becomes thinner, easily damaged and infected, which leads to the development of vulvitis. The development of secondary vulvitis occurs against the background of existing inflammatory diseases internal genital organs (colpitis, cervicitis, endocervicitis) of a specific and non-specific nature.

Signs and consequences of vulvitis

Vulvitis can occur in acute and chronic form. The following symptoms are characteristic of the acute form of vulvitis:

• severe swelling and redness of the labia, clitoris, ulcers and erosion may form, inguinal folds may be affected and inner surface hips;
• itching and burning, soreness (when urinating, moving, touching increases);
• serous-purulent or sanious secretions. When infected coli- leucorrhea of ​​a watery nature, yellow-green with a bad smell; staphylococcus - thick, yellowish; candida - "curdled" leucorrhoea and raids;
• sometimes an increase in inguinal lymph nodes, fever.

In girls with acute vulvitis, there are signs of nervous excitability, sleep disturbance.

Vulvitis with untimely and improper treatment can become chronic with frequent relapses. The chronic form of vulvitis is characterized by moderate manifestations of edema, soreness and hyperemia in certain areas of the vulvar mucosa, hypertrophy sebaceous glands, itching, burning, meager secretions. Sometimes with vulvitis, after healing of erosions and ulcers, the genitals can be deformed, making it difficult to have sex in the future. Girls may experience adhesions in the area of ​​the labia - synechia.

Diagnosis of vulvitis

For the diagnosis of vulvitis, consultation with a gynecologist is necessary. Diagnostic measures include the collection of anamnesis data, patient complaints, gynecological examination data, colposcopy (if necessary) and results laboratory tests. To isolate the causative agent of inflammation, bacterioscopy of smears and culture with the determination of sensitivity to antibiotics are performed. In addition, diseases associated with vulvitis are detected, which may be a source of infection or reduce immune status organism.

Treatment of vulvitis

In the treatment of vulvitis, modern gynecology uses complex therapy local and overall impact. Treatment of vulvitis should include the elimination of not only the inflammatory process of the external genital organs, but also the factors contributing to its occurrence. With acute vulvitis, the girl needs bed rest. For the period of treatment of vulvitis, women should refrain from sexual activity.

Antibacterial treatment is prescribed taking into account the identified pathogen and its sensitivity to antibiotics. With vulvitis of a specific nature (gonorrheal, trichomonas, chlamydial, tuberculosis), a special treatment corresponding to the pathogen is necessary. With candidal vulvitis, the main ones are antifungal drugs. In girls, vulvitis is more often caused by opportunistic microflora, in connection with this, antibiotics are prescribed topically (ointments, creams).

With vulvitis, local treatment of the external genital organs is necessary:

• lotions, cold compresses from lead water, with a solution of furacilin, infusion of eucalyptus;
• sitz baths with a warm solution of potassium permanganate, herbal infusions (calendula, chamomile, string, eucalyptus);
• toilet of the external genital organs with a solution of boric acid, potassium permanganate, chamomile infusion;
• douching with antiseptic solutions, anti-inflammatory suppositories.

After water procedures the genitals should be dried with a towel and powdered with streptocid powder. For severe itching, sleeping pills and lubrication of the vulva at night with anesthetic ointment. In some cases, hydrocortisone ointment, physiotherapy (UVI) are used. Allergic vulvitis is treated with antihistamines, a diet with the exclusion of sweet, spicy and salty foods.

Diseases associated with vulvitis (hormonal and metabolic disorders, chronic infections - tonsillitis, pyelonephritis) are subject to treatment, which also helps to strengthen the immune system. Reception of fortifying preparations is shown: vitamins, immunostimulants, dietary supplements.

Prevention of vulvitis

Prevention of the development of vulvitis implies: timely treatment of common diseases and elimination of foci chronic infection; compliance with the rules of personal hygiene (cleanliness of the genitals, wearing loose hygienic underwear); healthy lifestyle life and strengthening of immunity (cessation of smoking, alcohol, absence of casual sex, proper nutrition, sports). Proper hygiene of girls is the key to their future women's health. Untreated vulvitis in childhood can provoke serious complications in the future. gynecological problems, the main of which is infertility .

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The mucous membranes of the labia and vagina have a special flora that protects the female body from the penetration of infections and the reproduction of pathogens. The consistency of this flora is maintained by the level of estrogen, but it is stable only during the childbearing period.

In girls and women after 40 years of age, estradiol is reduced, therefore, the flora loses its ability to protect the body from infections, which often causes vulvitis affecting the mucous membranes of the genital organs. What it is? Vulvitis is an inflammatory process that is localized on the vulva and has pronounced symptoms that make a woman seek help from a hospital.

The main causes of vulvitis:

• Fungal infections;
• Staphylococci, streptococci;
• Diabetes;
• Oncological diseases (especially during and after chemotherapy);
• The presence of fistulas in the genitourinary system;
• Frequent douching with antimicrobial solutions that wash out the flora from the vagina;
• Failure to observe daily personal hygiene.

Symptoms of vulvitis in women and girls, photo

Inflammation affects the mucous membranes of the vagina, which means that the disease cannot proceed latently. It will show itself pretty quickly, because pathological processes spread to the urethra and bladder advanced cases).

They are as follows:

• Burning in the labia minora and labia majora, in the vagina.
• Severe itching, not accompanied by the appearance of a curdled plaque, as with thrush.
• Abundant watery discharge having a grayish or yellowish tint.
• The mucous membranes of the vulva are bright red, while normally they should be red-pink.
• Swelling of small and large labia.
• Pain at the beginning of the act of urination.
• Drawing pains in the lower abdomen.
• The presence of bleeding microcracks on the mucous membranes.
• Pain during intercourse.

photo of symptoms of vulvitis in women (atrophic and atopic forms)

Symptoms of vulvitis in girls about the same, the only differences are the involvement of the hymen in the inflammatory process, as well as the fact that the disease in childhood can have relapses, since opportunistic flora before puberty is neutral and does not contain lactobacilli. Therefore, the girl's vagina is not protected from infection.

Forms of vulvitis

Depending on the nature of the disease, three forms of vulvitis are distinguished: acute, subacute and chronic. They differ from each other in the degree of intensity of the inflammatory process, as well as the duration of its course.

Acute vulvitis– can last up to 30 days, has bright severe symptoms. Discomfort is felt not only in the vaginal area, but also when walking, sitting, touching underwear. Often this form of vulvitis is accompanied by inflammation of the urethra and copious purulent discharge with an unpleasant odor.

Subacute vulvitis– lasts about 3 months. Periods of exacerbation and improvement are clearly separated. However, the complete disappearance of pain and symptoms of the disease is not observed. The inflammatory process takes on a protracted nature, and if the course of treatment is not carried out in time, it will turn into a chronic form.

Chronic vulvitis- difficult to treat, has periods of exacerbation and remission. During periods of exacerbation, the symptoms are not as pronounced as in acute vulvitis, so a woman often does not go to the doctor, and the disease remains without qualified therapy for years.

In all cases of acute and subacute vulvitis in women, the symptoms noticeably worsen the quality of life, so they try to get treatment from a doctor. But the chronic form does not cause such severe inconvenience, and most patients, if they go to the doctor, then already when the disease has developed for several years and began to affect the urinary system.

Types of vulvitis, characteristic signs

Depending on what caused the disease, gynecologists distinguish several types of it:

Atrophic vulvitis- characterized by the appearance of small erosions that are difficult to heal. It is observed in women in menopause and is often associated with insufficient moisture in the vaginal mucosa (see photo above).

Fungal vulvitis- occurs due to an excessive amount of Candida fungi in the flora. May be acute or take a chronic form. Most often, this type of vulvitis is observed in adolescent girls. Treatment of the disease is quite complicated and requires the participation of a competent specialist.

Atopic vulvitis- an inflammatory process that begins due to the influence of various allergens on the girl's body. The reason is not fully ripe the immune system. The atopic form causes severe swelling of the vagina. The treatment plan should be developed in cooperation with the immunologist-allergist (see photo 2).

Adhesive vulvitis- affects girls of preschool age and is expressed in the fact that the labia minora is gradually fused due to problems with endocrine system. On the early stages the disease can be cured with medication, in more advanced cases - only with the help of surgery.

Treatment of vulvitis in women, drugs

Vulvitis can be treated different ways, it all depends on the degree of neglect of the disease and on the cause of its occurrence. Some remedies are not suitable for a certain category of patients, for example, vulvitis in infants cannot be treated with suppositories and intravaginal tablets.

Solutions- they process the vagina and mucous membranes of the labia. They have an antimicrobial effect, but dry the skin, so they are best used in conjunction with ointments.

• Usually, doctors prescribe Miramistin, a solution of furatsilina or a solution of potassium permanganate (pale pink, not concentrated).

Ointments and gels- unlike solutions, they not only fight bacteria, but also have a moisturizing effect on the mucous membranes, almost immediately greatly alleviate the burning sensation and itching. Ointment for vulvitis has a quick calming effect, however, the course of such treatment requires the wearing of daily pads to avoid stains on linen and clothing.

• Most often, Levomekol, Lactagel and their more expensive counterpart, Triderm, are prescribed.

Candles and intravaginal tablets- they fight the disease inside the vagina, but do not immediately alleviate the condition of the mucous membranes of the labia, so suppositories are best used for vulvitis in conjunction with ointment treatment. Candles not only fight pathogenic microbes, but also restore the natural flora in the vagina.

• The most popular drugs are Terzhinan, Hexicon, Polygynax, Klion-D.

Taking antibiotics- is prescribed along with the use of drugs local action. Antibacterial therapy should not be written as the only treatment from vulvitis. It will effectively fight pathogens, but it will not at all alleviate the patient's well-being in the first days of treatment - the woman will still feel severe itching and burning. Therefore, antibiotics are prescribed together with ointments, gels and solutions for external use.

At timely handling to the doctor, the prognosis for the treatment of vulvitis in girls and women is favorable, acute and subacute forms do not have relapses if the therapy is carried out correctly. In chronic vulvitis, the prognosis is less favorable. Usually, the doctor manages to achieve only such a result, in which exacerbations become rare, and periods of remission become more persistent and longer.

Vulvitis is a disease characterized by inflammation of the vulva - the external genitalia in women. Vulvitis is most common in girls under the age of 10 and in older women. Illness is the result insufficient hygiene genital organs, injuries, genital and extragenital diseases, endocrine disorders.

In older patients, the mucosa of the vagina is often also involved in the inflammatory process, in which case vulvovaginitis is diagnosed. In adult patients, primary and secondary inflammation of the vulva, with timely treatment started, rarely causes the development dangerous complications, but in young girls, a disease that occurs in early age, can provoke the development of synechia - fusion of the labia minora.

For women childbearing age, mainly characterized by secondary vulvitis (infectious), which occurs against the background of inflammation of the internal genital organs. Complications of vulvitis can cause infertility.

Symptoms of vulvitis

The main symptoms that appear with vulvitis:

• itching and burning of the external genital organs;
• pain in the vestibule;
• swelling and redness of the labia;
• enlarged inguinal lymph nodes;
• irritability;
• deterioration in general well-being;
• sleep disorders.

In addition, allocation various colors and density, serous or purulent nature, which accumulate in the folds between the labia; with a prolonged course of the disease in girls - the formation of adhesions (sinechia) between the labia minora.

The nature of whites may be different. For example, candidal vulvitis is characterized by thick curdled secretions milky, upon removal of which a finely eroded hyperemic surface of the epithelium is exposed.

With the staphylococcal nature of the disease, leucorrhoea is purulent, yellowish color. And when affected by Escherichia coli, they are yellow-green, watery, with an unpleasant odor.

The severity of symptoms depends on the ethology and severity of the inflammatory process. Acute vulvitis is accompanied by severe physical discomfort with the following symptoms:

• pain;
• edema;
• hyperemia;
• erosion;
• burning.

A chronic inflammatory process in the vulva is usually manifested by such signs:

• periodically increasing itching;
• discomfort during urination and sexual intercourse;
• redness in the depth of the folds and around the existing defects of the epithelium;
• inconspicuous discharge.

Which doctors to contact with vulvitis

Treatment of vulvitis

Treatment of vulvitis includes local and general therapy. It is carried out on an outpatient basis, a disability certificate is usually not issued. At the time of treatment, a woman is recommended to have sexual rest; if an STI is detected, her partner must also undergo a course of antibiotic therapy. In case of secondary vulvitis successful treatment implies the elimination of the underlying disease.

At acute form illness or exacerbation of a chronic disease with severe inflammation and deterioration of health, you should follow a diet with the exception of

• spicy food;
• smoked meats;
• marinades;
• alcohol.

Drink plenty of warm liquids, preferably with high content vitamin C:

• dried fruits compote;
• currant juice;
• cranberry juice;
• cranberry juice.

During treatment, the toilet of the external genital organs should be carefully carried out at least 3 times a day. To do this, use a weak solution of manganese, an infusion of medicinal herbs:

• chamomile;
• hypericum;
• calendula.

After the procedure, it is necessary to thoroughly dry the perineum: moisture prevents the healing of tissues. You can not rub the genitals with a towel, it is better to make blotting movements in the direction from front to back.

Treatment of microbial vulvitis necessarily includes antimicrobials, which are administered orally in the form of tablets.

Preference is given to broad-spectrum antibiotics:

• metranidazole;
• amoxiclav.

Fungal lesions are treated locally with fungicidal preparations:

• nystatin;
• flucostat;
• mycosyst.

With vulvitis, they are not prescribed orally due to a large number side effects.

With allergic vulvitis, the appointment of antihistamines is required:

• diazolin;
• tavegil;
• zodak.

They will eliminate painful itching, reduce swelling and inflammation.

If the disease has developed against the background of insufficient estrogen production (ovarian disease, menopause), treatment is carried out hormonal drugs for local use:

• divigel;
• ovestin.

With herpesvirus infection, acyclovir is prescribed in the form of an ointment - it accelerates the healing of painful blisters.

The vulva is irrigated with antiseptics:

• chlorhexidine;
• miramistin.

To accelerate healing, an ointment is applied to the mucous membrane:

• solcoseryl;
• bepanthen;
• panthenol.

Folk remedies for the treatment of vulvitis at home

In the treatment of vulvitis itself in subacute or even chronic stage, as in the acute stage, it is necessary to carefully observe cleanliness and avoid injury and maceration of the vulva.

Therefore, lotions, compresses should not be used; clean water, but it is necessary to take disinfectant and astringent solutions; after a bath, washing or douching, it is necessary to thoroughly dry the vulva with cotton wool or a soft cloth, and then powder it, as indicated above. Here it is appropriate to use the same sitz baths as in the acute stage, washing the vulva with a solution of potassium permanganate (1: 1,000-5,000), mercury oxycyanide (1: 5,000-10,000), sublimate (1: 5,000-1O 000 ). The patient can do these procedures herself at home.

The lubrication of the affected areas with solutions of silver nitrate (2-5%), protargol (3-10%) is more intensive, but these lubrication should be performed by a doctor. Nitrate silver causes sharp pains, which, however, quickly pass; therefore, it should be resorted to only in those stubborn cases when the above treatment did not give within 10 - 15 days good results. During treatment nervous women sometimes you have to give it up.

Eliminate the symptoms of vulvitis, respectively, to alleviate the patient's condition will help herbal sessile baths, washing with decoctions of herbs and drinking them. There are several recipes suitable for all types of vulvitis:

Causes of vulvitis

The incidence of vulvitis is provoked by the following reasons:

• non-compliance with the rules of hygiene of the genital organs;
• obesity;
• mechanical injury to the mucous membrane of the vulva;
• inflammatory processes of the bladder;
• irritation of the vaginal mucosa;
• reduced immunity;
• radiation therapy;
• venereal diseases;
• excessive use of drugs;
• the presence of fistulas in the urinary tract and intestines;
• hormonal or metabolic disorders;
• allergic reactions;
• helminths;
• scratching of the genitals.

Vulvitis is primary and secondary. In the first case, inflammation is promoted by injuries and hygiene violations, which in most cases is typical for children. The fact is that children's skin is very delicate and thin, so the risk of damage to it is maximum. It has also been noticed that girls who often suffer from acute respiratory viral infections, tonsillitis and other viral diseases are susceptible to the disease.

Vulvitis in girls

Vulvitis in girls most often occurs from birth and worries them until about the age of ten. Children's vulvitis can often be accompanied by vaginitis.

The reasons

Vulvitis in the baby is associated with anatomical features newborn babies: the labia of the girl are open wide, and the pH level in the vagina exceeds the level adult woman, while the mucous membrane is very vulnerable, therefore protective functions vaginas are reduced.

Vulvitis in infants is associated not only with anatomical features, there are also chemical, mechanical and infectious causes the development of the disease. If the child is constantly in a diaper, then the greenhouse effect causes irritation and diaper rash, which become the cause of vulvitis.

Symptoms

Symptoms of vulvitis in children can be very different, depending on the cause of its occurrence. Very often, vulvitis in a child is accompanied by discomfort of the external genital organs, there is a burning sensation, itching, as well as pain when walking and urinating, an increase in inguinal lymph nodes.

Sometimes there are discharges of different colors and smells. When the vagina is affected by Escherichia coli, yellow-green discharge with an unpleasant odor appears; staph infection accompanied by thicker yellow-white discharge; with candidiasis, white patches appear.

Abundant discharge with a pungent odor and an admixture of blood appear when a foreign object enters the vagina. In advanced cases, untimely treatment ulcers and erosions can form on the mucous membranes.

In this way, pathological changes in tissues are accompanied adhesive process, which leads to the fusion of the labia minora (synechia). Often, children's vulvitis is caused by pinworms and manifests itself very sharply - the child wakes up in the middle of the night with complaints of pain, severe itching, burning of the external genital organs, grinding of teeth in a dream, etc.

Treatment

The most common cause of vulvitis in children is helminths, therefore, in addition to the main treatment, antihelminthic drugs are prescribed. For the treatment of vulvitis in children, drugs that have a desensitizing effect, such as calcium preparations and antiallergic drugs, are also used.

If the cause of vulvitis was reduced immunity, then immunostimulants and vitamins are prescribed. In the acute form of vulvitis, the child is shown bed rest. For patients of all ages, it is recommended to follow a diet that excludes flour products, spicy, smoked and salty food. Must be consumed dairy products, greens, fruits and vegetables.

Classification of vulvitis

Depending on the age category distinguish the following types of inflammation of the vulva and vagina:

• during infancy (from 0 to 12 months);
• in children's period(from 1 to 8 years);
• in prepubertal age (from 8 years to the onset of menarche);
• puberty (after menarche).

Depending on the duration of the disease, vulvitis is divided into:

• acute (leak up to 1 month);
• subacute (up to 3 months, alternating periods of exacerbation and remission);
• chronic.

Also this pathology may be infectious (caused by pathogenic and opportunistic microbes.) and non-infectious genesis (trauma, including the introduction foreign body into the vagina, burns, allergies or metabolic disorders).

Infectious inflammation of the vulva is divided into non-specific, which causes opportunistic microflora and specific.

In addition, vulvitis is divided into primary, when infection of the vulva is caused by microbes from outside, and secondary, if there are other foci of infection in the girl's body ( carious teeth, tonsillitis, otitis, etc.).

Diagnosis of vulvitis

The examination of patients with complaints characteristic of vulvitis is carried out by a gynecologist, who, at the first visit, the patient must find out the history of the development of the disease, complaints, conduct gynecological examination and prescribe the necessary laboratory tests for the examination.

To clarify the type of pathogen and its sensitivity to drugs prescribed for antimicrobial therapy, it is necessary to take a smear from the mucous membrane with obligatory bacterioscopy and inoculation on nutrient media. Performing clinical and biochemical analyzes blood helps to identify accompanying illnesses, which can be a source of infection or inhibit the body's immunity.

Surveys

• analysis of urine and feces;
• general blood analysis;
• blood test for HIV/AIDS;
• a smear of vaginal discharge to determine the microflora;
• culture of vaginal discharge to determine sensitivity to drugs;
• if necessary: ​​screening for gonococcus and human papillomavirus.

Prevention of vulvitis

Prevention of vulvitis consists in observing the rules of hygiene of the body and genital area, treatment of various inflammatory diseases of the female genital area and any chronic diseases, especially metabolic-endocrine. It is also necessary to increase immunity, eat well and exercise, since all these criteria are an excellent prevention of vulvitis.

By following these simple rules, you can not encounter vulvitis at all. These measures are the key to women's health. Parents should pay special attention to their children. Vulvitis in girls, not cured in childhood, can cause infertility in the future.

Questions and answers on the topic "Vulvitis"

Question:Hello. I'm 24, had one pa without protection. After him - painful urination, I passed a urine test, the gynecologist said that there are bacteria and prescribed me an antibiotic. Also a smear (it seemed to me again a thrush), but I can’t drink an antibiotic - vomiting is strong. Then other symptoms appeared - itching, redness of the small lips and, as it seems to me, there is a whitish discharge. But the doctor said that according to the initial analysis, there is no thrush. Do I need to get another pap smear? I didn’t tell the doctor about pa, I forgot.

Answer: Hello! The doctor needs to be told everything. Contact your doctor again for examination and selection of an antibiotic. It should be noted that the diagnosis of STDs is always a complex of tests for sexually transmitted diseases. None of the methods is sufficient to establish an unambiguous diagnosis.

Question:Hello, I am 17 years old. Permanent partner, protection - condoms. Recently, my left labia majora has become very enlarged. I got to the gynecologist only on the third day after that (a long queue), the tumor was almost gone. Has handed over analyzes on Urs, sugar. The amount of sugar is increased, Urs is negative. They said that it could be bacterial vulvitis, they recommended Betadine suppositories. The swelling went down on its own, even before I could start using suppositories. Now I don't feel any discomfort, except for a few whites thick discharge. The left labia is now about 0.5 cm larger than the right. It does not go away regardless of whether I use candles or not. Tell me what is it? And now what i can do?

Answer: Hello! You should see a gynecologist and get tested for infections despite using a condom.

Question:Hello. My daughter is 10 years old, nothing bothers her, but I found her at the entrance to the vagina white coating, we are constantly monitoring hygiene, we went to the gynecologist, she took a swab and said that we had acute vulvitis, we had 10-12 leukocytes in the smear, the flora was rod, the rest was dashes, she prescribed us washing with malavit and hexicon D suppositories, we did everything , but nothing has changed with us, as there was a white coating, it is, at the second appointment we were prescribed spraying with miramistin, in the morning to lubricate the entrance to the vagina with tykveol oil, in the evening oil tea tree and suppositories genferon light, and at the second appointment the doctor said that she had vaginal prolapse, the question is what causes vaginal prolapse, the causes of vulvitis, and why it was not cured the first time, everything was done according to the scheme, maybe the treatment is not correct , and there is a sense will address to other expert?

Answer: Hello. 10-12 leukocytes in a smear in a 10-year-old girl is the norm. With vulvitis, there should be redness of the mucous membrane and itching, burning. Such aggressive treatment no need. The girl is not worried about anything. It is necessary to observe hygiene, wash the girl with plain running water without using soap. About the prolapse of the vagina, this is nonsense. Seek another pediatric gynecologist for a face-to-face examination.

Question:Hello, I am 13 years old, 2 months ago I started having a severe burning sensation and unpleasant feeling in the genital area. I thought I just caught a cold. Decided to wait a bit the cold will pass but no, every day kept getting stronger and stronger. And then I decided to tell my mother, she took me to the gynecologist. The gynecologist prescribed me an infusion of chamomile and a mixture of rotokan, as well as metrogil ointment. In addition, I bought oak bark and sage, and a solution of miramestin. I started to process everything, but nothing goes away. Tell me what should I do?

Answer: Hello. You've been given the right treatment. But you forgot to write how many days you were treated. If the treatment does not help, you will have to re-contact the gynecologist. You must have been swabbed. These are tests that help to find out the cause of the disease. But now they will also take the sowing from you. This analysis is taken as an ordinary smear. But it helps you figure out which drugs are right for you. Pay attention to digestion. Temporarily give up sweets. Eat more dairy products. If you have problems excess weight, and there were cases of diabetes in the family, you will have to contact an endocrinologist. During the examination, antifungal drugs (fluconazole), interferon preparations with vitamins (viferon) gel topically, as well as probiotics (bactistatin) can be used, but only as prescribed by your doctor.