How long is vulvitis treated. Signs and consequences of vulvitis. Vulvit - gels and creams for local use

Vulvitis is called inflammation of the vulva, namely the mucous membrane of the external genital organs in women, which include the small and large labia, pubis, the vestibule of the vagina, the clitoris, and sometimes the mucous membrane of the vagina itself. disease in severe cases affects the entire perineum and passes to the skin of the inner thighs. How to treat vulvitis in women, read further in the article.

Symptoms of the development of vulvitis

The main symptoms of the disease are itching and burning in the genital area, swelling of the vulva, redness of the mucous membrane of the labia, an increase in the clitoris, swelling, purulent deposits and discharge, an increase in inguinal lymph nodes.

Often the disease causes pain when urinating, walking and washing.

Sometimes there are such signs of the disease in women as: general weakness, headaches, malaise, fever.

If vulvitis is caused by Escherichia coli, then there may be watery discharge, yellow-green with bad smell.

If staphylococcus aureus became the cause of vulvitis in a woman, then the discharge is thick, yellow-white in consistency.

With a fungal disease, symptoms of white plaque may appear.

If the vulvitis has passed into chronic stage, then there are periodically burning and itching, discomfort when running and walking, during intercourse.

Types of vulvitis and its manifestations in women

There are serous and serous-purulent, as well as acute and chronic vulvitis.

Patients with symptoms acute vulvitis note a burning sensation in the vulva, and sometimes pain in the perineum during movement, and subsequently itching becomes the leading symptom. Acute vulvitis is also manifested by swelling of the tissues of the genital organs, redness inguinal folds, purulent discharge, sometimes an increase in inguinal lymph nodes. Often, vulvitis is combined with acute condylomas located in the genital area and anus(pointed skin formations). Patients are concerned about itching and burning of the external genital organs, purulent discharge, pain in the genitals when moving.

Chronic vulvitis characterized by itching, burning, redness, but all these manifestations are less pronounced than in the acute process. In chronic vulvitis, the main symptom is itching, diffuse hyperemia is replaced by spotting, and hyperemia persists only in the Bartholin or Skene glands. Sometimes the mucous membrane becomes rough, strewn with small yellow nodules, which are hyperplastic sebaceous glands.

There are also primary and secondary vulvitis. Primary vulvitis occurs as a result of trauma, followed by infection of the injured areas. The occurrence of injury may be due to itching of the external genital organs, which accompanies various kinds diseases (diabetes, helminthiases, urinary incontinence).

Secondary vulvitis in a woman occurs when there is inflammatory process in the internal genital organs. Pathological discharge from the vagina, cervix violate the epithelial cover of the vulva and thereby create favorable conditions for the penetration of microbes.

Manifestations of chronic vulvitis

Chronic vulvitis develops in case of untimely or incorrect treatment and is accompanied by frequent relapses. Patients present with complaints associated with burning and itching in the vulva, especially during and after urination, purulent discharge and pain during movement. In case of damage to the vulva by Escherichia coli liquid discharge acquire an unpleasant odor, a yellowish-green tint, and if staphylococcus is affected, the discharge is in the form of thick whites, with a yellow-white tint.

The diagnosis of "chronic vulvitis" is made taking into account the data of the anamnesis, the analysis of complaints, the result of a gynecological examination, the data of bacteriological, bacterioscopic examination of the vulva. The diagnosis is also confirmed during colposcopy.

Acute female vulvitis and its symptoms

In addition to chronic vulvitis, there is an acute form of the disease. Acute process accompanied

• diffuse hyperemia,
• tissue swelling,
• purulent secretions,
• hyperemia in the inguinal folds or inner thighs,
• groin may be enlarged The lymph nodes,
• swelling of the lymph.

Vulvitis can be combined with acute warts, which are located in the anus and genital slit.

In case of untimely or inadequate treatment of the disease, acute vulvitis can become chronic. Chronic vulvitis responsibly proceeds with frequent relapses. In the case of acute vulvitis in girls in early age, after its transfer, adhesions of the labia minora may form.

Most often, secondary acute vulvitis is observed, which occurs against the background of pathological discharge from the vagina and cervix, in case of inflammation. Primary vulvitis in women occurs quite rarely, but in childhood this form of the disease is predominant.

How to treat traditional methods of vulvitis in women?

Treatment of vulvitis is complex. It includes the use of local antiseptics, as well as general strengthening drugs. It is advisable to treat concomitant diseases (diabetes, helminthiases).

Treatment of this inflammatory disease of the external female genital organs is carried out antibacterial agents(antibiotics, sulfonamides, Metronidazole, antifungal drugs), desensitizing agents (Suprastin, Tavegil, Pipolfen, Ketotifen, etc.), vitamins (A, groups B, E, C), which are catalysts for metabolic processes in the body; biogenic stimulants (Biosed, Peat, Peloid distillate, etc.), which increase nonspecific resistance. In combination with general treatment, such methods of treating vulvitis as vaginal douching, local irrigation with antiseptics (Furacilin, Rivanol, Potassium permanganate, Dioxidin, Dimexide), intravaginal tampons with Konkov's ointment, Levosin, etc. are also prescribed.

Physical Methods treatment of vulvitis is aimed at reducing bacterial or fungal intoxication (bactericidal and mycocidal methods of treatment), stopping inflammation (anti-exudative methods), itching (antipruritic methods) and stimulating the immune system (immunostimulating methods for treating vulvitis).

Principles drug therapy vulvitis

Special baths and treatment with a 0.5% solution of decamethoxin or chlorhexidine for the external genitalia will help treat vulvitis.

Treatment of the vulva and vagina with ointment: Vokadin, Betadine, Tsiteal, Instillagel, Miramistin.

Vaginal balls, tablets and tampons with ointments containing drugs of etiotropic action.

Drying agents.

Means antipruritic.

General treatment vulvitis includes:

the whole complex of drugs for genitourinary infections.

Immunotherapy, in case of reduced immunity.

Vitamin therapy.

Treatment different forms female vulvitis

At acute vulvitis it is necessary to observe a semi-bed rest, refrain from sexual activity, 2-3 times a day to toilet the external genitalia with a warm, slightly pink solution (36-37 С) of potassium permanganate, warm infusion of chamomile (1 tablespoon of chamomile, pour 1 cup of boiling water ), lotions with a solution of Furacillin (1: 5 thousand) 3-4 times during the day.

With intense itching manifestations, it is advisable to use psychotherapy, hypnosis, sometimes X-ray therapy, and ultrasound. However, the treatment of vulvitis with neurogenic itching presents great difficulties. effective method treatment for this pathology is acupuncture, which is carried out according to inhibitory techniques in the following biologically active points: V25–30, T4, 12–4, R11–13, RP6, F2, 5, T28–30, etc. Especially pronounced therapeutic effect gives acupuncture or cauterization of point 11. On the ear, points of the external genitalia are used, urethra, point of endocrine glands.

Treatment of the chronic form of vulvitis carried out comprehensively. It includes the use of general strengthening and local funds. The treatment of diseases associated with chronic vulvitis that could cause secondary chronic vulvitis is also carried out.

In the morning and evening, for the treatment of vulvitis, it is necessary to carry out the toilet of the external genitalia with a warm solution of potassium permanganate, warm infusion of chamomile, 3% solution of boric acid. You can also use lotions with a solution of furacilin for vulvitis up to four times a day.

If the disease develops against the background allergic manifestations, desensitizing agents are prescribed, and special diet. With acute vulvitis, which is caused

• chlamydia,
• gonococci,
• Trichomonas,
• fungi genus Candida,
• Mycobacterium tuberculosis

specific treatment is given.

Causes and prevention of vulvitis

The most common causative agents of vulvitis in women are opportunistic pathogens such as E. coli, staphylococci, streptococci, and yeast fungi, less often gonococci, chlamydia, Trichomonas, viruses, etc. In some cases, the development of vulvitis can be triggered by tuberculosis or diphtheria pathogens. The conditions for the development of infection is the result of a violation skin, vulvar mucosa or reduced immunity.

Disposing factors of vulvitis in women:

inadequate personal hygiene. Especially on menstrual days.

injury to the mucosa of the external genital organs, by wearing rough and tight clothing, or with prolonged use of sanitary pads, as well as during sexual intercourse.

maceration and irritation of the mucous secretions from cervical canal and vagina, with existing infections of the genitals, with urinary incontinence or chemicals.

misuse and overuse medicines, radiation therapy.

metabolic disorders in the body, hormonal disruptions and allergic reactions.

the presence of pathological fistulas urinary tract and intestines.

scratching with vegetative neurosis, excessive sweating, helminths, external genital organs.

Also, the cause of vulvitis in women may be the presence of pinworms in a child. The mucous membrane of the genital organs is injured during scratching, which in turn facilitates the penetration of the infection.

Causes of acute vulvitis

Most often, the causes of the disease by pathogens of the inflammatory process are staphylococcus aureus, enterococcus, streptococcus, E. coli, gonococcus, diphtheria bacillus.

The occurrence of acute vulvitis in early childhood may be associated with exudative diathesis or changes in the body, against the background of tonsillitis. The development of vulvitis is also promoted common diseases, such as

• ovarian hypofunction,
• diabetes,
• obesity, etc.
• as well as the mechanical effect
• pinworms,
• the presence of cystitis
• and urinary fistulas
• exposure to chemicals in the workplace,
• unreasonable use of antibiotics and other drugs.

Causes of chronic vulvitis

The chronic form of the disease is inflammation of the external female genital organs, which is characterized by burning and itching. By itself, chronic vulvitis is divided into primary and secondary. Primary vulvitis occurs as a result of trauma followed by infection.

Secondary chronic vulvitis occurs in women with an inflammatory process in the internal genital organs. Pathological discharge from the vagina and cervix, in turn, violates the cover of the vulvar epithelium, which creates favorable conditions for the penetration and reproduction of microbes such as E. coli, staphylococci, streptococci, etc. Ovarian hypofunction is a predisposing factor to the development of the disease.

Prevention of vulvitis in women

In order to prevent vulvitis, it is necessary to observe the rules of personal hygiene as well as the hygiene of sexual relations. It is necessary to avoid the use of products that can cause an allergic reaction of the vulvar mucosa. It is also important to treat concomitant chronic diseases. Increase immunity, eat properly fortified, and make sure that physical activity is moderate.

From early childhood, mothers should instill in girls the rules of hygiene of the external genital organs, namely, wearing clean and comfortable underwear, timely washing.

Also, to prevent vulvitis in women, it is necessary to regularly, independently examine the genitals. When the first symptoms appear, such as redness, itching or burning, you should consult a doctor. Give up bad habits, as they contribute to the weakening of the immune system, and visit the fresh air more often.

Vulvitis is an inflammation of the external genital organs of a woman, caused by pathogenic bacteria or fungi. Large and small lips, mucous membranes of the vestibule of the vagina, clitoris, hymen, Bartholin's glands are infected.

With localized inflammation of the labia, local treatment with ointments is prescribed. Select drugs depending on the cause of the disease. If the pathology provoked fungal infection, then prescribe ointments with fungicidal action, in case of bacterial infection, the treatment of the genitals is carried out with antibacterial agents. Hormonal and wound healing ointments relieve the inflammatory process, swelling, accelerate the regeneration of mucous membranes, normalize the work of the Bartholin glands.

The advantage of using external preparations is the effect directly on the lesion. This method of treatment is less likely to cause the development side effects, makes it possible to carry out therapy in girls, pregnant and breastfeeding women.

Antifungal ointments

Candidiasis vulvitis is caused by yeast fungi of the genus Candida. Women are concerned about itching, burning in the genital area, whitish discharge of a curdled consistency appears. Formed on mucous membranes small rash, erosion.

How to treat vulvitis with ointments - the gynecologist will explain after the examination and laboratory research detachable vagina. Sexually active women are usually prescribed vaginal suppositories, but this method of treatment is not suitable for virgins.

An alternative option is the use of external ointments with antimycotics.

• Clotrimazole cream is applied to the affected areas 2-3 times a day, the course of treatment for vulvitis is 1-2 weeks. The drug can be injected deep into the vagina, 5 mg 1 time per day, this therapy gives results within 3 days. pharmachologic effect Clotrimazole is based on the destruction of fungal cells, the drug is active against yeast and molds, gram-positive and gram-negative bacteria. When administered intravaginally, the cream may cause irritation, swelling, itching and mucous discharge from the vagina.

• Pimafucin ointment is applied to previously cleaned genitals 4 times a day, the duration of therapy for vulvitis depends on the severity of the disease, external processing continue for another 4 days after disappearance clinical symptoms candidiasis. Active ingredient Pumafucin is natamycin is an antibiotic a wide range actions, fungi of the genus Candida are especially sensitive to it. Ointment rarely causes side effects, it is allowed to be used by pregnant and lactating mothers.

• Candide is an ointment for vulvitis for women, which has a fungicidal, antibacterial and antiprotozoal effect. The drug is applied to washed, dry skin of the genital organs 2-3 times a day for 10-14 days. The cream can not be used during menstruation, in the first trimester of pregnancy, with individual intolerance.

• Nystatin ointment effective against Candida fungi, causing symptoms thrush. The drug is recommended for use in order to prevent prolonged use of antibiotics, chronic mycotic infections. The cream is applied to the external genitalia or administered intravaginally. The duration of treatment for vulvitis is 7-10 days, with chronic forms of the disease - 20-30 days.

Before applying ointments, the skin of the genital organs is washed with gels for intimate hygiene or treated with antiseptic solutions (Furacilin, Chlorhexidine) and dried. The medicine is evenly distributed on the affected areas and gently rubbed. If symptoms of irritation, swelling and severe itching stop using this drug.

Hormonal ointments

Treatment of vulvitis in adolescents, during menopause and with an allergic nature of the pathology, is carried out with ointments with corticosteroids. During puberty, hormonal changes occur in the girl's body, against this background, the work of the Bartholin glands may be disrupted, vaginal dryness, microflora disturbance, and vulvitis develops.

• Hydrocortisone ointment is prescribed for allergic reactions, inflammation of non-bacterial etiology, mechanical injuries vulva. The drug relieves swelling, reduces itching and redness, inhibits the synthesis of inflammatory mediators. The duration of treatment depends on the form of the disease, on average it is 6-14 days.

• Ovestin therapeutic cream contains the hormone estriol, lactic acid and chlorhexidine. The drug compensates for estrogen deficiency in women during menopause, eliminates dry mucous membranes, normalizes the functioning of the reproductive organs, and relieves inflammation symptoms.

Treatment of vulvitis in women with ointments with glucocorticosteroids should be prescribed by a doctor after an examination and testing for estrogen levels in the blood. Independent application such drugs can lead to the development of uterine bleeding, impaired menstrual cycle and other complications.

Antibacterial ointments

Infectious vulvitis is treated after determining the causative agent of the disease. There are specific and nonspecific forms of the disease. The first type includes Trichomonas, gonococcal infections, chlamydia and mycobacterium tuberculosis. A nonspecific form of pathology develops against the background of infection with Escherichia coli, staphylococci, streptococci.

To antibacterial ointments applies to:

• Synthomycin ointment inhibits growth pathogenic microorganisms, removes pain syndrome quickly reduces inflammation. The duration of use for vulvitis is 7-10 days.

• Cream Triderm has anti-inflammatory, fungicidal, antibacterial action, active substances drugs - clotrimazole, gentamicin and betamethasone. The duration of treatment is determined by the doctor, the ointment is used in combination with systemic antibiotics. It is contraindicated to treat the genitals for pregnant women in the first trimester, children under 2 years of age and with individual intolerance.

• Ointment Levosin has anti-inflammatory, analgesic, antimicrobial action. This remedy even cures purulent forms vulvitis. How to use the ointment correctly, the gynecologist will explain.

• Erythromycin ointment contains a bacteriostatic macrolide antibiotic - erythromycin. The drug is active against gram-positive and gram-negative bacteria, and also destroys strains resistant to other classes of antibiotics. The course of therapy is from 3 to 14 days, depending on the form of the disease.

Treatment of vulvitis of bacterial etiology is carried out in a complex manner, local treatment of the genital organs with ointments, oral administration of antibiotics, vitamins, bifidobacteria is required.

Healing ointments

• Vaginorm C accelerates the healing of the mucous membrane, normalizes the microflora, pH level, increases local immunity, protects reproductive organs from the penetration of pathogenic microorganisms and viruses. The drug can be used to prevent recurrence of chronic vulvitis.

• Cream Actovegin is made from the blood of cattle, used in gynecology for recovery acid-base balance vagina, accelerate the regeneration of damaged tissues, improve trophism.

• Ointment Radevit has healing, anti-inflammatory and antipruritic properties. Softens and moisturizes the skin, enhances its protective properties.

Ointments that accelerate the regeneration of mucous membranes are used for 3-4 weeks, until full recovery soft tissues of the external genitalia.

Local treatment of vulvitis in women with ointments as monotherapy is effective only on initial stages. Advanced forms of bacterial or fungal infection are treated with oral antibiotics, antimycotics, and topical vaginal creams. Treatment should be carried out under the supervision of a physician.

Vulvitis is an inflammatory process of the external genital organs.

Allocate: primary vulvitis (reasons - non-compliance with hygiene; diaper rash with obesity; genitourinary fistulas; cystitis, helminthiasis, endocrine diseases; chemical, thermal and mechanical influences; irrational use of antibiotics and other drugs); secondary vulvitis (a consequence of inflammatory processes of the internal genital organs - colpitis, endocervicitis, etc.).

Etiology of vulvitis: nonspecific opportunistic microflora, Trichomonas, yeast-like fungi, viruses ( herpes simplex, human papillomas, molluscum contagiosum).

Clinically distinguished: Acute vulvitis and chronic vulvitis

Symptoms of vulvitis

Symptoms of acute vulvitis: Complaints of pain, burning sensation and itching in the vulva, aggravated by walking and urinating; copious discharge; general malaise; increase in body temperature.
Objectively: swelling of the external genitalia; hyperemia of the small and large labia of a diffuse nature or in the form of separate sections; small erosions of the external genitalia with purulent discharge; general malaise, fever; sometimes the inguinal lymph nodes may be enlarged.

Chronic vulvitis - these symptoms are less pronounced.

Examination for vulvitis

1. General analysis blood.
2. General analysis of urine.
3. Blood test for RW, HIV.
4. A smear of vaginal secretions for flora.
5. Sowing vaginal discharge for microflora and sensitivity to antibiotics.
6. Examination for human papillomavirus, molluscum contagiosum virus, Trichomonas, Candida albicans (if necessary).
7. Sowing on gonococcus (if necessary).

Treatment of vulvitis

I. Abstinence from sexual life.

P. Local treatment of vulvitis (described in detail in the "Colpitis" section):

1. Vaginal baths and treatment of the external genitalia with a 0.5% solution of chlorhexidine or decamethoxine.
2. Treatment of the vagina and vulva with betadine, vocadine, citeal, miramistin, instillagel.
3. The introduction of vaginal balls, tablets and tampons with ointments containing etiotropic drugs:
a) with non-specific coccal flora - terms, polygynax, meratin-combi, mycogynax, betadine;
b) with gardnellers - Ung. Dalacini 2%, metronidazole (flagyl, trichopol, efloran, nidazole), ginalgin, meratincombi, terzhinan, klion - D;
c) with trichomoniasis (general and local treatment should be carried out 10 days after menstruation for 3 cycles) - tablets of trichopolum, tinidazole (fazizhina); klion D, meratin-combi, terzhinan, trichomonacid, neo-penotran, hexicon;
d) at yeast-like fungi- preparations of the polyene series: nystatin, levorin, natamycin, pimafucort; imidazole preparations: ketoconazole, clotrimazole, kanesten, miconazole, bifonazole, ginezol, ginalgin, isoconazole, econazole, batrafen; complex preparations: cecamin, complex of polygynax and clotrimazole, terzhinan;
e) for genital herpes - drugs of direct antiviral action: ointments with acyclovir (Zovirax, Virolex, Gerpevir); balls with interferons: a-interferon, viferon; ointments with antiviral drugs plant origin: alpizarin, megosin.
4. Drying agents:
Rp.: Camphorae 0.5
Zinci oxydi 2.5
Talci 47.0
M.D.S. Sprinkle on the surface of the vulva.
5. Antipruritics:
Rp.:Mentholil,0
Anaesthesini 3.0
Folliculini 300 000 IU
Streptocidi alba 4.0
M.D.S. Wipe itchy surfaces. Rp.: Sol. Dicaini 3% - 2 ml D.S. To lubricate the vulva.

III. General treatment of vulvitis

General treatment should be carried out with severe clinical manifestations of vulvitis, depending on the type of pathogen (section genitourinary infections.).

IV. Immunotherapy for vulvitis (application)

V. Vitamin therapy for vulvitis:

Thiamine chloride - 0.002 g 3 times / day, 30-40 days;
- riboflavin - 0.005 g 2 times / day;
- vitamin C(200 mg) with tocopherol acetate (100 mg) - 1 capsule 3 times / day.
- aevit - 1 caps. 2-3 times / day.

VI. Phytotherapy for vulvitis

Decoctions and infusions medicinal herbs for sitz baths and douching with vulvitis and vulvovaginitis

VII. Physiotherapy for vulvitis

1. UVI of the external genital organs.
2. Electrophoresis with 1% novocaine solution or 10% calcium chloride solution on the vulva area.

Vulvitis is a pathology of the vulva associated with the inflammatory process in it. It can be chronic, acute, atrophic, and each of these types threatens with its own complications and has a separate treatment method.

Atrophic vulvitis - inflammation of the vulva, which is accompanied by thinning of the mucous membranes of the vagina. The disease is most often found in menopause which is characterized by a decrease in the concentration of estrogen in the blood.

Atrophy makes the mucous membranes of the vagina thin, which leads to their trauma and frequent infection. The cause of the disease may be clinical stage obesity and pathology of glucose metabolism.

Causes of the disease

The most serious cause of atrophic vulvitis is a decrease in the concentration of estrogen during menopause, or during artificial menopause, for example, after surgery on the pelvic organs or during radiation therapy.

But the lack of estrogen only thins the membranes. For them to be struck by vulvitis, one or more factors are needed, including:

• Microcracks and injuries of the mucous membranes, for example, with unsuccessful depilation;
• Frequent washing and douching;
• promiscuous sex life;
• Frequent antibiotic treatment;
• Wearing tight underwear made of synthetic fabrics;
• irritation of the vulva;
• Diseases of the central nervous system;
• Weakening of the body's immune response.

These factors contribute to the development of not only vulvitis, but also concomitant genital infections, which can only aggravate the situation.

Symptoms

Symptoms depend on the form of vulvitis. The form can be acute and chronic. In acute atrophic vulvitis, one feels severe burning and itching, especially at the entrance to the vagina. Burning sensation during urination cutting pain, the pain syndrome also intensifies during sexual contact, physical activity.

Often there is a combination of atrophic vulvitis with thrush and vaginitis, therefore white coating on the mucous membranes of the vagina, as well as abundant white discharge with a curdled consistency. Bacterial vaginitis manifests itself in grayish and greenish discharge with a strong smell of ammonia.

Chronic vulvitis is manifested only by slight itching, which increases with urination, sexual contact, walking, and physical activity. With a combination of exacerbation factors, vulvitis passes into an acute phase.

Diagnostics

Diagnosis is primarily gynecological examination. The doctor will ask what color and what kind of discharge is present, whether the patient has undergone childbirth, abortion, or surgical interventions.

Among the methods laboratory diagnostics vulvitis:

• Blood test for estrogen, progesterone;
• Vaginal smear to determine the concentration of leukocytes;
• PCR to rule out STDs;
• Bacteriological culture of vaginal discharge to detect resistance to antibiotic therapy;
• General blood and urine tests to determine the pathogen in the urethra, as well as the inflammatory process in the body.

According to the results of laboratory diagnostics, a treatment regimen is prescribed, aimed at eliminating the root cause - correction hormonal background or fight infection.

Treatment

Treatment is carried out hormonal drugs systemic and local action. Washing is also carried out antiseptic preparations, general hormonal therapy to restore blood estrogen levels. If an infectious agent is detected, antiviral and antibacterial therapy is carried out.

• Washing the vagina and vulva is carried out with drugs: Miramistin, Chlorhexidine, decoctions of calendula, chamomile, sage. Douching of the vagina is carried out no more than once a day after the recommendation of a doctor. In acute atrophic vulvitis, douching can injure the thinned vulva.

• Vaginal suppositories with antibacterial effect: Macmirror, Terzhinan, Neo-penotran. Introduced the night after hygiene procedures and washes.

• With severe itching, anti-allergic drugs are prescribed: Tavergil, Claritin, or orally Diazolin.

• After the disappearance of bright symptoms, ointments are prescribed with sea ​​buckthorn oil and vitamin A, preparations Actovegin, Solcoseryl.

Concerning hormone therapy, it should be prescribed exclusively by a gynecologist or endocrinologist. The same applies to systemic therapy antibiotics, the dosage and type of which is prescribed by the doctor after receiving the results of the diagnosis.

Chronic form

If the treatment of acute vulvitis of any etiology is not started in time, the disease becomes chronic. In childhood, this is fraught with gluing of the labia minora - synechia, which is treated only with surgery.

In adult women, chronic vulvitis can cause permanent infection of the vagina due to the vulnerability of the mucous membranes and the presence of inflammatory focus. Accordingly, being infected with concomitant infections, a woman exposes the reproductive system to systemic diseases that end in spikes. fallopian tubes, obstruction of the egg and infertility.

Symptoms

Chronic form vulvitis manifests itself less pronounced than acute. Symptoms appear intermittently and can disappear just as suddenly. The clinical picture is as follows:

• Itching and burning, which appear periodically and do not bring severe discomfort;
• Pain during sexual contact;
• Vaginal discharge with an ammonia smell, especially noted in the evening and in the morning.

Under the influence of reduced immunity, hypothermia, contraceptives or mechanical damage to the vulva, the disease can become acute. At the same time, the treatment of chronic vulvitis is aggravated by the constant presence of infection in the vagina, which requires systemic treatment.

Treatment

At the time of treatment of chronic vulvitis, it is necessary to abandon sexual contact, since the disease can be transmitted sexually, although its manifestations are less pronounced in men.

• With the fungal nature of the disease, ointments with antimycotic action are prescribed: Pimafucin, Candide, Nystatin, Mirtoplex.

• Inflammatory processes are removed with non-steroidal anti-inflammatory drugs, which are prescribed by a doctor, the most popular of which are Nimesulide, Ibuprofen.

• For local treatment of affected areas, apply and antiseptic ointments: Hexicon, Betadine, Iodine Povidone.

• If the causative agent is Candida fungus, vaginal suppositories with antimycotic action are prescribed: Clotrimazole, Terzhinan, Nystatin, Pimafucin. Their use does not exclude the combination with ointments.

• At viral nature diseases are prescribed ointments Betadine, Vokadin, Instillagel.

• Vulvitis chronic type it is treated in combination with physiological procedures: electrophoresis with calcium chloride, novocaine, UVI.

• The patient is prescribed complex multivitamins with immunostimulating drugs.

Upon detection allergic reaction appointed antihistamines. The treatment regimen with oral medications, vaginal suppositories and antiseptic treatment in combination with vitamins.

acute form

Acute vulvitis can be secondary or primary. Secondary is called vulvitis, caused by infection from other organs - the kidneys, uterus, tonsils. Primary is often congenital, and manifests itself in girls up to a year, or in women during menopause.

The causes of the acute form of vulvitis may be as follows:

• Pathologies genitourinary system: endometritis, vaginitis, cystitis, endocervicitis;
• Hormonal disorders;
• Inadequate treatment with antibiotics and hormonal drugs;
• Helminths;
• Diseases of the endocrine system, diabetes, oncological diseases;
• mechanical or chemical damage vulva during hygiene procedures, depilation, sexual contact.

Since these factors can provoke other diseases reproductive system, pay attention to the level of estrogen, since under its influence acute vulvitis is often formed. The acute form is characterized by an increase in body temperature and fatigue.

Diagnostics

Diagnosis of acute vulvitis involves a number of activities:

• Bacteriological examination of vaginal discharge;
• A smear from the walls of the vagina and cervical canal;
• A smear from the urethra, diagnosis of the fungus;
• General analysis of feces for the presence of helminth eggs;
• Bacteriological culture to detect antibiotic resistance;
• A blood test for glucose concentration to rule out diabetes as the underlying cause.

An ultrasound of the pelvic organs may be needed if the doctor suspects cystitis or endometritis, including transvaginal studies.

Treatment

Acute vulvitis needs prompt and early treatment. It consists of the following recommendations:

• Local treatment of the labia with decamethoxin or chlorhexidine.
• Vaginal suppositories and tablets with a pronounced antimycotic, antiviral and anti-infectious effect, which are selected depending on the detected pathogen.
• Treatment with antiviral ointments-analogues of Betadine.
• The appointment of specific antibiotics orally in combination with drugs to restore the intestinal microflora.
• Reception vitamin complexes containing riboflavin, thiamine chloride, aevit.

To relieve itching, Claritin, Tavegil, Loratadin, Suprastin can be prescribed. The sooner treatment of any form of vulvitis is started, the less likely its transition to a chronic form. Diseases of the vulva are always a signal that an infection is multiplying in the body, or that a woman is not properly monitoring her reproductive health.

Vulvitis in women is inflammatory disease affecting the mucous membrane of the external genital organs. It can be caused by a number of factors, but the main causative agent pathological process is the bacterial flora. Symptoms and treatment of the disease is determined by the doctor, since self therapy fraught with complications. According to international classification ICD inflammation was assigned the code N76.1 and N76.2: subacute, acute and chronic vulvitis.

The mechanism of the development of the disease

According to statistics, similar pathology of the external genitalia in the vast majority of cases occurs in the elderly after menopause, in newborn girls and adolescents before the onset of menstruation. It is related to the level female hormones, estrogen. The fact is that under the influence of these biologically active substances in the mucous membrane covering the vagina and inner surface labia, lactobacilli develop, called Doderlein sticks. Their function is to convert glycogen (a substance formed under the influence of progesterone) into lactic acid.

Thus, a constant is maintained in the vagina. acidic environment destructive to many pathogenic microorganisms. In children and women after 45, these processes slow down due to a lower concentration of estrogen than in reproductive age. Therefore, their external genitalia are prone to the development of the inflammatory process. The causative agents of the disease can be mixed flora from staphylococci, streptococci, enterococci, Escherichia coli, fungi, etc. In this case we are talking about a nonspecific form of pathology of female external genital organs. Sometimes the cause is infections that are transmitted during sex (gonorrhea, chlamydia, trichomoniasis), mycobacterium tuberculosis, in gynecology this type of disease is called specific vaginitis.

With the development bacterial microflora on the mucous membrane, a response of the body occurs. It consists in the release of inflammatory mediators that act on cell receptors and cause itching, redness and other clinical signs of pathology. The disease can be primary, that is, it can occur on its own. If the symptoms develop against the background of other genital diseases, then doctors talk about secondary vulvitis.

Etiological factors

One of the main causes of vulvitis, especially in girls and 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 of essential vitamins. The risk of inflammation of the external genitalia increases with alcohol abuse, drug use. Other causes of vulvitis are:

• non-compliance with the rules of intimate hygiene;
• untimely replacement of tampons and pads during menstruation;
• 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;
• wearing tight synthetic underwear;
• dermatological diseases (psoriasis, eczema);
• allergic reaction to pads and intimate hygiene products, latex.

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 can occur against the background of pregnancy, long-term treatment with 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:

• Atopic vulvitis occurs in response to a specific reaction to an allergen that has fallen on the external genitalia.
• Candidiasis vulvitis is a consequence of the pathological reproduction of fungi of the genus Candida.
• Atrophic vulvitis is mainly found in old age or at diabetes due to disruption of the mucosal structure.

Also allocate bacterial form inflammation that occurs under the influence of pathogenic microflora. It may also be caused by internal infections excretory system (cystitis, urethritis), fistulas between bladder and vagina. Depending on the form of vaginitis in a woman, the gynecologist selects the appropriate treatment. It consists in the use of drugs for both local and systemic use.

Clinical picture

On the Internet, you can easily find a photo of what vulvitis looks like. First of all, redness and swelling of the labia and the vestibule of the vagina are noted. Also worried about severe itching and burning. In addition, doctors describe the following symptoms of vulvitis in women:

• sharp pain, aggravated by touch, walking, sexual intercourse;
• copious discharge from the vagina;
• purulent plaque on the mucous membrane of internal organs;
• areas of hyperemia and ulcerative lesions perineum;
• pain during urination and bowel movements.

Subacute vulvitis is somewhat different in symptoms. The signs are not so pronounced. The chronic form of the disease is accompanied by a blurred clinical picture. Itching, burning and pain may disappear for a while, and then, under the influence of any factors or against the background of a weakened immune system, reappear.

Secondary vulvitis is manifested by signs of concomitant diseases. If it is vaginitis or colpitis, then characteristic purulent discharge from the vagina with an unpleasant odor appears. When defeated upper structures reproductive system (uterus, fallopian tubes or ovaries) there are pains in the lower abdomen, painful and heavy periods, menstrual disorders, fever. According to the symptoms of specific vaginitis, its causative agent can also be assumed. For various venereal infections vaginal discharge, plaque on the mucous membrane are characteristic.

Methods for detecting a disease

With vulvitis, diagnosis begins with a survey of the patient. Diagnosis can be made on the basis of the clinical signs. Then follows mandatory inspection on the gynecological chair. The doctor notes reddened and swollen external genitalia, pays attention to the condition of the skin of the perineum, vaginal discharge, their color, texture and smell.

Further diagnosis of vulvitis is aimed at identifying its cause and possible concomitant diseases. For this purpose, women take a swab from the vagina and send it to the laboratory for culture and determination of the sensitivity of microorganisms to antibiotics. Urinalysis is also needed to rule out kidney damage. If the nature of the discharge indicates a venereal infection, you need to donate blood for research PCR method (polymerase chain reaction) to identify its causative agent.

Vulvitis, vulvovaginitis.

Inflammation in women, vulvitis, endometritis, colpitis, adnexitis, vaginitis

Women's diseases. Pelvic inflammatory disease

The main symptoms and causes of vulvitis in a child

In the presence of nonspecific vulvitis, it is necessary to examine the uterus, ovaries and fallopian tubes. For this, an ultrasound of the pelvic organs is prescribed. For greater information content, it is advisable to carry it out using a transvaginal sensor. If cancer is suspected or benign formations PET (positron emission tomography) MRI or CT should be done.

Also, depending on the severity of the symptoms of vulvitis, the doctor concludes that the inflammation is acute or chronic. It has great importance in determining tactics further treatment. If the patient is sexually active, an additional hCG test is performed ( chorionic gonadotropin person) to confirm or exclude possible pregnancy. The fact is that antibiotics are often needed to treat vulvitis, and many of them are toxic to the fetus.

Suppositories for local use

Treatment of vulvitis in women requires integrated approach. It's in without fail includes the use of antibiotics or fungicides, ointments, suppositories and antiseptic solutions. Medicines are shown to strengthen immune system, normalization of the vaginal microflora, various multivitamin complexes. In identifying sexually transmitted diseases, a similar therapy is necessary for a man. Doctors believe that it is advisable to use such suppositories for vulvitis:

• Polygynax, thanks to a combination of antibiotics and a fungicide, these vaginal capsules are used to treat non-specific and candidal forms of inflammation.
• Terzhinan. In composition, these suppositories are similar to Polygynax, however, they additionally contain prednisolone, which has an anti-inflammatory effect. Due to this, the drug effectively eliminates itching, swelling and redness of the labia.
• Betadine contains povidone-iodine. This compound has antimicrobial activity against gram-positive and gram-negative bacterial and fungal flora.
• Hexicon with chlorhexidine. vaginal tablets or suppositories are used for inflammation caused by pathogens sexually transmitted diseases(Trichomonas, gonococci, chlamydia, ureaplasma).
• Klion-D (Neo-Penotran) contains metronidazole and miconazole. Most often prescribed for trichomoniasis and candidiasis.
• Ginalgin. In addition to metronidazole, the composition of the product includes chlorquinaldol, which is active against resistant strains of staphylococci.

These medicines for vulvitis should be used 1 to 2 suppositories per day. The duration of therapy is determined by the doctor. dissolving active ingredient suppositories are evenly distributed along the mucous membrane of not only the vagina, but also the external genitalia. In addition, it is also the prevention of vaginitis.

Ointments and solutions

Creams used to treat vulvitis should be applied thin layer on the affected areas of the perineum. In addition to the antimicrobial effect, similar drugs also soften and moisturize the mucosa. Therefore, they are prescribed for the treatment of an atrophic form of inflammation. For the treatment of acute and chronic vulvitis, the following drugs are used:

• Synthomycin liniment is a broad-spectrum antibiotic cream. It is active against nonspecific microflora and gonococci.
• Levomekol is similar in effectiveness to synthomycin, but it also contains methyluracil, which contributes to quick recovery and tissue healing.
• Triderm is a cream with complex action. It contains the antibiotic gentamicin, the anti-inflammatory component betamethasone and the fungicidal agent clotrimazole. Thanks to this, the drug eliminates itching, swelling and other symptoms of inflammation, destroys bacterial and fungal flora. The only "minus" of the drug is its relatively high price(about 740 rubles).
• Lactagel is prescribed in parallel with the main treatment therapy. It restores the disturbed microflora of the mucous membrane of the vagina and external genital organs.

The advantage of the method of how to treat vulvitis with ointments is the rapid onset of the effect. The drug is applied directly to the site of the pathological process. In addition, this method of application minimizes the risk of systemic side effects. Contraindications to the appointment of ointments is hypersensitivity to the components of the drug.

Also, for rubbing and washing, doctors recommend Miramistin solution. This is a drug that is used to treat and prevent sexually transmitted diseases and exacerbations of chronic vulvitis, provoked by gram-positive and gram-negative flora. In addition, baths and lotions with a weak solution of potassium permanganate (potassium permanganate) are recommended. For this purpose, decoctions can also be used. medicinal plants.

Antibacterial and symptomatic therapy

Antibiotics for vulvitis are used for acute course inflammatory process and the risk of spreading the disease to the vagina and upper sections of the female reproductive system. In addition, these drugs are necessary for sexually transmitted infections. For treatment non-specific forms pathologies appoint Amoxiclav (Augmentin) at a dosage of 625 mg three times a day. It contains amoxicillin combined with clavulanic acid, which increases its effectiveness. The duration of therapy is up to 14 days.

With trichomoniasis, Metronidazole (Trichopolum) is indicated. It is also used in parallel with other antibiotics in the treatment of vulvitis. The scheme of application is different. The drug is prescribed at 250-500 mg twice a day for two weeks, or 2 g on the first and third days of therapy. With gonorrhea and ureaplasma lesions, Azithromycin (Sumamed) is effective. I drink it at a dosage of 500 mg once a day for three days.

Erythromycin is effective against infections caused by chlamydia. To achieve the desired result, it must be taken 500 mg 4 times a day. For gonorrhea, doxycycline is indicated. On the first day of treatment of vulvitis, it is drunk at a dosage of 200 mg, and then they switch to 100 mg per day.

Symptoms of vulvitis (itching, pain) often cause insomnia, irritability. Therefore, magnesium and B vitamins are shown. Medicines such as Magnesium - B6 are prescribed in the form of ampoules with drinking solution or tablets, Magnicum. Often inflammation of the mucosa is associated with a weakening of the immune system. To strengthen it, preparations with echinacea (for example, Immunal), Proteflazid, Immunoflazid are suitable, in severe cases Viferon is indicated. When taking antibiotics, additional medications are prescribed to restore the intestinal and vaginal microflora.

Alternative Medicine Recipes

Treatment of vulvitis folk remedies should only be done after consulting a doctor. The fact is that although medicinal plants have a certain antiseptic effect, they are not able to cope with a serious bacterial infection. Therefore, without the use of antibiotics, home treatment can lead to the development of chronic vulvitis. There are many on the forums positive feedback got these recipes folk methods fighting inflammation:

1. Pour a tablespoon of round-leaved wintergreen with a glass of boiling water and leave for several hours. Then strain and make lotions with the solution 2-3 times a day.
2. Prepare a cool decoction of chamomile at the rate of 20 g per 200 ml hot water, strain. Add to sitz bath solution.
3. Two tablespoons St. John's wort pour half a liter of boiling water and leave for 2 - 3 hours. After cooling, strain and use twice a day for washing.
4. You can make baths and lotions with a mixture of medicinal plants: 10 g of oak bark and chamomile flowers, 30 g of nettle leaves and 50 g of knotweed grass. Take 2 tbsp. mixture, brew a glass of hot water.

In the process of treating vulvitis, it is necessary to adjust the diet. To reduce itching, avoid spicy and salty foods. It is also recommended to exclude alcohol and sweets from the diet. Food should contain all the necessary vitamins and minerals, vegetables and fruits. It is necessary to adhere to the rules of hygiene and refrain from sexual intercourse until the inflammation is finally cured.

Features of symptoms and treatment of the disease in children

According to Dr. E.O. Komarovsky, the main causes of vulvitis in infants and young children are diaper dermatitis and inadequate hygiene. The development of inflammation is also facilitated by wearing uncomfortable synthetic underwear, especially when playing sports, scratching the perineum with enterobiasis. In most cases, girls develop nonspecific vulvitis. Infection with gonococci, Trichomonas and other similar flora can occur when using shared underwear or during childbirth.

Diagnosis of inflammation is carried out by a pediatric gynecologist. He examines the perineal area and takes smears using swabs soaked in saline. This manipulation must be done carefully, without affecting hymen. Treatment of vulvitis in babies up to a year and young children is carried out at home and is as follows:

• sitz baths with a decoction of chamomile, a weak solution of potassium permanganate or soda (for candidiasis);
• treatment of the perineum with peach, sea buckthorn oil or Vitaon Baby to relieve irritation;
• lotions with oak bark or zinc oxide;
• washing with the use of a solution of Tsiteal (diluted with water in a ratio of 1:10);
• treatment of the mucous membrane of the external genital organs with 1% ointment with hydrocortisone, Levomekol, Bepanten.

If after a week the symptoms of vulvitis do not disappear, in the future the disease is treated with antibiotics. Augmentin is prescribed at a dosage of 40 mg / kg, Erythromycin (from 30 to 50 mg / kg), Metronidazole (the amount is calculated individually). The course of therapy is from 5 to 10 days. In addition, it is necessary to pass a urine test to exclude inflammation of the urinary tract.

Vulvitis during pregnancy

In the process of bearing a child, a woman is more susceptible to various diseases. This is due increased load for all systems hormonal changes. Inflammation of the genital organs is dangerous because the focus of infection is located in close proximity to the uterus. Penetration of the bacterial flora into the bloodstream of the placenta can lead to the development of intrauterine pathologies and even death of the fetus.

For this reason, you cannot wait for the process to go by itself. To reduce the risk of complications, preference is given to agents for external use. The methods of treatment are similar to the treatment of inflammation in childhood, as described above. Concerning antibacterial drugs, in the instructions for many antibiotics, pregnancy is in the list of contraindications. Most often prescribed Augmentin.

If we are talking about the disease vulvitis, treatment, or rather its absence, can lead to serious consequences. This is the spread of the process to the secretion glands (bartholinitis), the vagina (vaginitis, colpitis, kraurosis), the cervix (cervicitis, endocervicitis) and further to the fallopian tubes and ovaries. It should be remembered that inflammation does not go away on its own, it only acquires chronic course. Prevention of vulvitis is the observance of intimate hygiene, the use of protection against sexually transmitted infections. It is worth remembering that in childhood the so-called adhesive vulvitis (or synechia) is dangerous - the fusion of the labia minora. Therefore, at an early age, thorough washing and timely replacement of the diaper and diapers is necessary.

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