Age-related colpitis symptoms and treatment. Colpitis during menopause and after menopause: symptoms, diagnosis and treatment. Treatment of vaginal dysbiosis

Women of reproductive age, for one reason or another, often encounter gynecological problems. Medical statistics say that at least once every second woman has encountered a disease such as colpitis. Let's consider the causes of its occurrence, symptoms of colpitis, diagnostic methods and treatment regimens, and also find out what impact this pathology can have on the bodies of a pregnant woman and unborn child.

Colpitis, what is it?

Colpitis in women is an inflammatory process that develops on the vaginal mucosa. Only in isolated cases is colpitis a single isolated inflammatory process. In most cases, this pathological condition occurs simultaneously with inflammation of the mucous membranes of the external genitalia (with vulvitis), the canal of the uterine cervix (with endocervicitis) and/or the upper membranes of the urethra (with urethritis). In fact, colpitis can be considered one global problem consisting of many smaller problems. Colpitis includes not only the notorious vaginal candidiasis (typical thrush), but also more dangerous STDs (which are sexually transmitted) that affect the mucous layers of the vagina, thereby provoking the development of inflammatory processes of various sizes in them.

Causes of colpitis in women

The development of the disease occurs due to the entry of various pathogenic microorganisms into the vagina (pinworms, gonococci, trichomonas, ureaplasma, Proteus, Gardnerella, E. coli, staphylococci, streptococci, chlamydia, fungi of the genus Candida. Various viruses, such as papillomavirus, cytomegalovirus, can also cause colpitis or herpes virus.

Microorganisms can get onto the mucous membrane in various ways: with unwashed hands, with insufficiently thorough hygiene of the genital organs, with stale underwear. Also, the inflammatory process can be triggered by prolonged mechanical irritation of the mucous layers of the vagina. This often occurs among women whose doctor has prescribed them to wear rings, which protect the vaginal walls from falling out. Interestingly, colpitis can be diagnosed not only in adult women and girls. This pathology often occurs in childhood in girls aged 4-12 years. The cause is most often the flow of blood in the genitals during diseases such as measles, influenza and scarlet fever.

But you need to keep in mind that a woman is never in completely sterile conditions, so the entry of pathogenic bacteria into the body is normal and natural. A healthy female body is able to independently get rid of pathogenic microbes without any negative consequences. In view of this, several factors predisposing to infection with colpitis can be named:

Decreased functional activity (hypofunction) of the ovaries.

Diseases with a chronic course of various systems and organs.

Abnormal structure of the organs of the reproductive system (this may include prolapse of the vaginal walls, displacement to the side of the genital organs, wide gaping of the genital slit, etc.).

Sluggish vaginosis of bacterial origin (can occur as a result of improper douching, the use of potent antiseptic drugs, illiterate use of intrauterine contraceptives, as well as due to the natural physiological thinning of the vaginal mucosa in the postmenopausal period).

At risk are women who have a history of various diseases of the genitourinary system and those who regularly use intrauterine devices. The risk of catching colpitis is also high in women who have several sexual partners.

Doctors know cases of senile colpitis. In older women, the vaginal mucosa, due to age-related hormonal changes, becomes dry and “shrinks,” which can trigger the onset of an inflammatory process.

Symptoms of colpitis in women

Symptoms of the disease vary depending on the type of pathology. Colpitis can be acute and chronic. Let us consider in detail the characteristic symptoms for each type of colpitis.

Acute colpitis

Symptoms of acute colpitis occur unexpectedly. Suddenly, the woman begins to feel characteristic pain, itching and burning in the vaginal area. Intense discharge appears, the nature of which can be different: from mucopurulent to pronounced purulent with an admixture of blood. The lower abdomen may feel a little tight. Often during urination the intensity of unpleasant sensations increases. The mucous membranes of the vagina change their normal pinkish color to bright red, and visible swelling appears. Even the slightest mechanical impact can cause bleeding of the vaginal mucosa. Often the inflammatory process spreads to the cervix and other female genital organs. The symptoms of colpitis development are strictly individual and depend on what pathogen caused the disease. For example, colpitis caused by Trichomonas is manifested by purulent discharge from yellow to green; it can be foamy and have a strong unpleasant odor. At the same time, fungal colpitis is characterized by discharge of a light shade, even closer to white, with a cheesy consistency.

Often, colpitis is characterized by symptoms of vulvovaginitis, the development of which is very rapid: irritation from the vagina quickly spreads to the genitals and soon even affects the surface of the thighs and buttocks. The unpleasant symptoms of colpitis always suppress a woman’s sexual desire. Sexual intercourse becomes painful and can cause bleeding due to mechanical damage to the inflamed vaginal walls.

Chronic colpitis

The transition from the acute form of the disease to the chronic one occurs for only one reason: the woman did not take measures to treat the acute course of the pathology or self-medicated. The last option, like the first, is absolutely unacceptable, because the activity of the infection is suppressed, but its presence is not excluded. That is, the inflammatory process remains. Symptoms of chronic colpitis are most often erased, not clearly expressed, but exacerbations periodically occur. The signs of chronic colpitis are the same as those of the acute form of the inflammatory process, but they are sluggish. The main danger of this form of pathology is that inflammation gradually moves from the vagina to the fallopian tubes, ovaries and directly to the uterus itself. This can lead to problems with conception, that is, infertility.

I would also like to dwell on the peculiarities of colpitis in female representatives of non-reproductive age.

Colpitis in childhood

Doctors officially call childhood colpitis vaginitis. According to statistics, every fifth girl aged 4-12 years has been diagnosed with an inflammatory process in the vagina at least once. In the vast majority of cases, vaginitis in childhood is provoked by an infection of bacterial origin on the vaginal mucosa. Rarely, the inflammatory process develops as a result of allergic reactions to foods or hygiene products intolerable to the child's body. Most often, the disease occurs in a chronic form, which in this case is characterized by not too abundant purulent-mucosal discharge. Acute vaginitis in girls is quite rare; it can be triggered by diseases of infectious origin and foreign bodies entering the vagina.

Colpitis in postmenopausal age

Women of non-reproductive age after menopause also experience colpitis. Doctors usually call this disease atrophic colpitis in older women. The development of this pathology is due to the fact that with the onset of menopause, the level of sex hormones in the body decreases, accordingly, the activity of the ovaries becomes less and less active, and the vaginal mucosa dries out, atrophic changes appear. At the beginning of the development of the inflammatory process, the symptoms are not pronounced, but gradually they increase: characteristic pain and pain in the vagina appear, the area of ​​the external genital organs itches, and there may be purulent discharge, sometimes with blood.

Diagnosis of colpitis

Usually, it is not difficult for an experienced gynecologist to diagnose colpitis. The patient is examined on the chair using standard gynecological speculums. The acute course of colpitis is always visually noticeable: the vaginal mucosa has a bright, uncharacteristic shade for a healthy person. The folds of the vagina are quite loose, thick, and there is swelling. Serous or purulent plaques are often observed. If the doctor tries to scrape off the plaque, the integrity of the tissue will easily be damaged and begin to bleed. Particularly severe, advanced cases of colpitis are manifested by erosion of the epithelium upon visual examination.

The chronic form of colpitis is somewhat more difficult to diagnose due to the fact that the defectiveness of the vaginal mucosa in this case will be much less pronounced.

But in order to make an accurate diagnosis, one examination in the mirror is not enough. At the moment, to make a correct diagnosis, and, therefore, to prescribe adequate, effective treatment, doctors use a diagnostic method such as colposcopy. The procedure is carried out using a special device - a colposcope, which looks very similar to a laboratory microscope. With its help, the doctor is able to perform a thorough examination of the vagina and cervix under multiple magnification. Modern colposcopes make it possible not only to display a clear picture on the screen, but even to record a video, which almost completely eliminates the possibility of making an incorrect diagnosis in the patient. During diagnosis with a colposcope, the woman does not experience any pain.

In addition to colposcopy, every woman with suspected colpitis must undergo microscopy of smears from the urethra, vagina and cervical canal. The result of these tests reveals the number of leukocytes in the smear. Nonspecific colpitis is characterized by a large number of them (30-60 or even more in the field of view), as well as an increased content of cells of sagging epithelial tissue. In the conclusion to this laboratory analysis, the number of lactobacilli will also be indicated (with colpitis it invariably decreases) and the presence of “foreign” microflora.

The patient is also prescribed bacterial culture and bacterioscopic examination of smears. These tests make it possible to identify pathogenic microorganisms (to establish their grammatical identity, types, nuances of morphology). In acute colpitis, large associations of a wide variety of bacteria are most often found.

If there is a suspicion of concomitant gynecological pathologies, the specialist prescribes an ultrasound diagnosis of the pelvic organs to the patient.

Modern gynecology offers patients with colpitis general and local therapy. The tactics and treatment regimen in each clinical case are selected by a specialist on a strictly individual basis. The type of pathology, the presence of concomitant gynecological problems, the woman’s age, as well as her medical history are taken into account.

Local treatment of colpitis involves sanitation (douching/washing) of the vagina and external genitalia with special solutions of certain medications. Most often this is a solution of potassium permanganate (the notorious potassium permanganate), zinc sulfate, chlorophyllipt or a solution of rivanol. As a supplement, it is recommended to use decoctions of herbs that have antiseptic properties (for example, chamomile or sage).

General therapy includes restorative treatment, the purpose of which is to increase immunity. After all, as mentioned above, the low protective ability of the female body is the right path to health problems, including colpitis.

During diagnosis, the doctor determines the type of bacteria in order to treat them with antibacterial drugs during the treatment process. Antibiotics can be prescribed either topically or orally, and in some cases, both.

The patient is required to adhere to a special diet. The diet excludes dairy and fermented milk products and dishes, and also minimizes the amount of salty, fatty and spicy foods consumed. Also, during treatment, alcoholic and sweet carbonated drinks are completely excluded.

To reliably assess the effectiveness of the prescribed treatment, vaginal smears are taken from the patient at regular intervals for analysis. In patients of childbearing age, a smear is taken on the fifth day of the cycle; in young patients, as well as in the elderly, a control smear is taken after completing the full course of therapy for colpitis.

Treatment of atrophic colpitis

Since the reason for the development of colpitis in the postmenopausal period is a hormonal imbalance, gynecologists use hormone therapy to treat this problem in mature women. Treatment with hormone-containing drugs is carried out in two ways. The first treatment option is local therapy. Tablets and vaginal suppositories are used. The second method is systemic, that is, taking tablets (orally, of course) and injections. The most effective and widely used drugs for the treatment of colpitis are considered to be Gynodian Depot, Ovestin and some others.

The following methods are used as auxiliary therapy:

Physiotherapeutic procedures (most often this is a magnetic laser effect on the external genitalia).

Treatment of the vagina and labia with soda solution.

The use of vaginal suppositories with sea buckthorn oil.

Treatment of both acute and chronic colpitis involves complete abstinence from sexual intercourse until the tests return to normal and the symptoms of the disease disappear.

Treatment regimen for colpitis

Specific treatment

Etiotropic treatment depends on the pathogen that caused colpitis. Drugs and treatment regimens for colpitis are presented in the table.

Treatment of vaginal dysbiosis

After specific treatment, it is necessary to restore the normal microflora of the vagina, for this purpose the following drugs are used:

- (lyophilisate of living bifidobacteria) vaginally 5-6 doses diluted with boiled water, 1 time a day for 5-8 days or 1 vaginal suppository 2 times a day for 5-10 days;

- (lyophilized microbial mass of active strains of bifidobacteria and Escherichia coli) - vaginally 5-6 doses 1 time per day for 7-10 days;

- lactobacterin(lyophilisate of live lactobacilli) - vaginally 5-6 doses, diluted with boiled water 1 time per day, 5-10 days;

- colibacterin dry(lyophilisate of living bacteria) - vaginally 5-6 doses 1 time per day for 5-10 days;

- Vagilak(Lactobacillus acidofilus - 18 mg, Lactobacillus bifidus - 10 mg, yogurt culture - 40 mg, whey powder - 230 mg, lactose - 153.15 mg) - 1 capsule in the vagina 2 times a day for 10 days;

- acylac- 1 vaginal suppository at night for 10 days;

- "Simbiter-2"(one dose contains 1000 billion living cells of microorganisms of a 25-strain probiotic culture) - the contents of the bottle, previously diluted with boiled water (1:2), are administered intravaginally for 10-15 days.

Vitamin therapy for colpitis

Multivitamins in courses (Vitrum, Centrum, Uni-cap, Multitabs);

Riboflavin 0.005 g 2 times a day;

Ascorbic acid 200 mg with tocopherol acetate 100 mg 3 times a day.

Colpitis and pregnancy

During pregnancy, the female body experiences very serious stress, so the immune system often malfunctions. A pregnant woman is always more vulnerable than a woman who is not carrying a child. Colpitis in itself cannot become an obstacle to successful conception. And in fact, this disease in itself is not scary for a pregnant woman. But not everything is so simple. The consequences that may occur can be very dangerous for the unborn child. For example, with colpitis there is a very high risk of developing an ascending infection, when the fetus from the mother can be infected during its intrauterine life. Natural childbirth is also dangerous, when the child becomes infected from the mother as it passes through her birth canal. Pregnant women experiencing colpitis should keep in mind that the inflammatory process in the vaginal mucosa can cause miscarriage. Often, amniotic fluid also becomes infected, which can lead to the development of a variety of pregnancy complications, ranging from polyhydramnios to premature birth of a not always healthy child.

Despite the fact that a large number of medications for the treatment of colpitis are prohibited for use during pregnancy, this problem must not be ignored under any circumstances! At the first manifestation of unpleasant symptoms of colpitis, you need to seek help from your local gynecologist. Usually the problem is quickly resolved with the help of immunomodulating drugs and local antibacterial agents. It is also recommended to resort to traditional medicine recipes - douching and washing with decoctions of medicinal herbs. A specialist will tell you which ones exactly.

Inflammation of the vaginal mucosa. In women who have entered the postmenopausal period, the likelihood of developing atrophic colpitis increases many times over. The pathology is mainly associated with a significant decrease in the production of the hormone estrogen. The disease may also be referred to in medical documentation as atrophic postmenopausal vaginitis, senile, age-related or senile colpitis.

Causes

Senile colpitis most often occurs in old age. Approximately 10 years after the complete cessation of menstruation, signs of atrophic changes are detected in almost half of women, and the likelihood of the disease increases every year. The risk of development also occurs in young women who experience artificial menopause after removal of the ovaries or their irradiation.

The main reason is hypoestrogenism, that is, low estrogen levels. The lack of these sex hormones leads to the following changes in the vaginal mucosa:

• Slowing down and gradual complete cessation of epithelial proliferation.
• Thinning of the mucous layer.
• Reduced secretion production by the glands.
• Reducing the number of lactobacilli, disrupting microflora and the occurrence of bacterial vaginosis.
• Increased dryness and vulnerability of the inner walls of the vagina.
• Activation of opportunistic flora.

Injury from gynecological instruments during an examination, microtraumas received during sex, contribute to the penetration of infection deeper, and then an inflammatory reaction develops.

The risk group includes patients with diabetes mellitus, hyperthyroidism and other endocrine pathologies, with a weakened immune system and HIV infection.

Frequent use of scented gels and soaps for intimate hygiene, wearing underwear made of synthetic fabrics, insufficient hygiene of the genital organs, and frequent sexual intercourse contribute to the occurrence of senile colpitis.

Symptoms

The disease develops slowly and at the very beginning there are no obvious signs of senile colpitis. A woman may periodically pay attention to itching and pain in the vagina, which sometimes increases after intimate hygiene with soap. As pathological changes intensify, more pronounced signs of the disease begin to appear, these include:

If even one symptom is observed for a long time, it is necessary to undergo an examination by a gynecologist.

Diagnostics

A gynecologist can make a diagnosis based on a combination of complaints and factors predisposing to the development of senile vaginitis. To confirm the diagnosis, a number of examinations are prescribed:

To exclude the development of vaginitis under the influence of specific pathogens (trichomoniasis, candidiasis), it is necessary to take tests to detect infection.

Treatment

The main treatment for atrophic colpitis is replacement therapy with hormonal agents. Its main goal is to restore the trophism of the vaginal mucous layer and prevent exacerbations of inflammation. Estrogens are prescribed up to 5 years.

• When prescribing hormone replacement therapy, drugs such as Angeliq, Estradiol, Climodein, Tibolone and a number of others are chosen.
• To eliminate the inflammatory reaction, suppositories or ointments are prescribed - Estriol, Ovestin.
• If there are a large number of injured areas of the mucous membrane, Methyluracil suppositories are prescribed for better healing.
• Phytoestrogens – hormones of plant origin – are recommended for use.
• If contraindications to the use of hormones are identified, baths made from a decoction of chamomile, St. John's wort, and calendula are prescribed. Douching can also be done with these decoctions. You can read more about treatment with folk remedies at the link.

In a video clip from a popular program, you can learn in detail about the causes, symptoms and treatment of atrophic vaginitis:

Prognosis and possible complications

The course of atrophic colpitis is generally favorable, but during relapses the quality of life suffers greatly. The atrophic process can spread to the cervix and its body. An unpleasant consequence of senile vaginitis is urinary incontinence, which increases as the pathology progresses.

Prevention

Prevention involves taking special hormones at the onset of menopause. Nonspecific preventive measures also include good physical activity, the absence of bad habits and extra pounds, and a rational and healthy diet. Compliance with all hygiene rules and wearing underwear made from natural fabrics.

Wavebreakmedia/depositphotos.com, lanakhvorostova/depositphotos.com, edesignua/depositphotos.com

About 40% of women after menopause begin to suffer from signs of atrophic colpitis (burning and itching, vaginal dryness and pain during intimacy). It is also characteristic that the longer the period of menopause, the higher the chances of developing this pathology. Thus, the percentage of patients with this disease increases to 75 10 years after the cessation of menstruation.

Since atrophic changes in the vaginal epithelium are usually associated with the physiological completion of hormone production by the ovaries, atrophic colpitis is considered as a pathology only if there are pronounced clinical manifestations (significant discomfort).

Definition of the term and types of disease

Atrophic colpitis is a change in the vaginal epithelium that is associated with functional and structural changes, against which the vaginal epithelium becomes thinner, which ultimately causes the development of characteristic symptoms (repeated inflammation, itching, dyspareunia, dryness). This condition is provoked by a significant decrease in estrogen levels, which can be associated with both physiological reasons (physiological menopause) and artificial cessation of the secretion of female sex hormones (atrophic colpitis during reproductive age or artificial menopause).

The very name of the pathology “vaginitis”, or “colpitis”, arose from the Greek word “colpos” and the Latin “vagina”, which literally translates as “vagina”. The suffix “itis” indicates inflammation of the organ. Other synonyms for this disease are senile, or senile colpitis, atrophic vaginitis.

A little about the physiology and pathogenesis of the disease

A woman’s vagina is lined with stratified squamous epithelium, which performs a significant number of functions that are required to protect the genital organs from various infectious diseases. Due to its multilayered nature, the vaginal epithelium is constantly renewed; the upper cells begin to die and slough off, taking with them pathogenic microorganisms and toxins, which are replaced by new cells.

In addition, the vaginal epithelium maintains a constant pH level. Normally, in women of reproductive age, the environment in the vagina is always acidic (pH 3.8-4.5), while the microflora is 98% lactic acid bacteria. Lactobacilli prevent the addition of pathogenic pathogens and the activation of opportunistic microorganisms by maintaining a constant acidic environment in the vagina. Such lactic acid bacteria feed on glycogen present in large quantities in the desquamated epithelium.

With the onset of menopause, the cyclic renewal of the vaginal epithelium begins to cease, which is associated with a decrease in the amount of synthesized estrogen and the end of menstrual activity. Epithelial cells are able to exfoliate only in small quantities, which leads to the development of glycogen deficiency and, accordingly, causes a decrease in the number of lactobacilli. In connection with such processes, the pH of the vagina begins to shift towards alkalization, which ultimately leads to its contamination with opportunistic microflora and the penetration of pathogenic pathogens into the mucosa. All of these changes provoke the development of a local inflammatory reaction, namely colpitis.

Thinning of the epithelium and a decrease in the production of secretions by the vaginal glands lead to slight vulnerability and fragility of the vaginal mucosa, which only contributes to the activation of opportunistic microorganisms and leads to a narrowing of the vaginal lumen.

Causes

The formation of this pathology is based on hypoestrogenism, which can be either physiological after the cessation of menstruation or artificial (surgeries and other manipulations on the ovaries). In girls of reproductive age, hypoestrogenism is possible under the following circumstances:

After labor, especially during breastfeeding

In the postpartum period, there is a gradual restoration of hormonal balance, especially in those women who breastfeed their babies (prolactin is synthesized), which ultimately leads to a long-term estrogen deficiency and often ultimately becomes the cause of the development of atrophic colpitis.

Hormonal ovarian dysfunction

Long-term hormonal imbalance provokes persistent hypoestrogenism and the formation of pathology.

Endocrine pathology.

Strong psycho-emotional experiences (hormonal imbalance occurs).

Women who suffer from thyroid diseases, adrenal gland pathologies, and diabetes are prone to developing atrophic vaginitis.

Other reasons

Weakened immunity (negatively affects the hormone-forming function of the ovaries).

Carriers of HIV infection or patients with AIDS.

Radiation therapy of the pelvic organs. When the pelvic area is irradiated, the female reproductive glands are also involved in the process, which provokes a disruption in the secretion of hormones, including estrogens.

Removal of the ovaries (oophorectomy). The ovaries synthesize estrogens, whereas in their absence, the secretion of these sex hormones automatically stops.

Predisposing factors

Among the many predisposing factors, it is especially worth noting:

unprotected, frequent and promiscuous sexual intercourse;

incorrect intimate hygiene;

use of aromatic products for hygiene of intimate places, lubricants, antibacterial soap, fragrances;

wearing tight synthetic underwear (obstructs oxygen access and promotes the development of anaerobic flora);

common chronic diseases;

chronic inflammatory diseases of the genital organs;

errors in the diet (lack of fermented milk products, drinking poor-quality water, eating unwashed fruits and vegetables).

Clinical picture of the disease

The first signs of the development of atrophic colpitis appear approximately 5 years after the end of menstruation. Usually the pathology is characterized by a sluggish course, the symptoms are mild. An increase in clinical signs is associated with the attachment of a secondary infection to the focus and the activation of opportunistic microflora, which is only facilitated by microtrauma of the mucous membrane due to its slight vulnerability (for example, after douching, washing, coitus, gynecological examination). Among the main features are:

Vaginal discomfort

It occurs as a feeling of dryness and tightness in the vagina, sometimes painful sensations may be present. If pathogenic vaginal microflora is attached, severe burning and itching occurs.

Dyspareunia

Pain during or immediately after sexual intercourse is caused by depletion of the stratified epithelium of the vagina, exposure of nerve endings and a decrease in the secretion of vaginal gland products, which are usually called lubrication.

Vaginal discharge

With this pathology, vaginal leucorrhoea is moderate in nature, mucous and tends to be watery. In case of infection, the discharge acquires qualities that are characteristic of a certain type of microorganism (foamy, greenish, cheesy) and is accompanied by an unpleasant odor. Also, atrophic colpitis is characterized by the presence of bloody discharge. Usually they are insignificant in the form of a few drops of blood and are caused by trauma to the mucous membrane (douching, medical examination, sexual contact). The occurrence of any bleeding (both heavy and minor) during the postmenopausal period is a reason to immediately visit a doctor.

Frequent urination

Senile vaginitis is always characterized by thinning of the walls of the bladder with weakening of the tone of the pelvic floor muscles. These processes are accompanied by frequent urination, in which the amount of urine released remains unchanged. In addition, when the pelvic floor muscles weaken, urinary incontinence begins to appear (when sneezing, laughing, coughing).

Examination data in gynecological speculum

The vagina, and specifically its mucous membrane, has a pale pink color with the presence of numerous pinpoint hemorrhages. When contacting medical instruments, new areas begin to bleed. If a secondary infection occurs, vaginal hyperemia and swelling, purulent or grayish discharge appear.

Diagnostics

Diagnosis of this disease should be comprehensive and include:

examination of the mucous membrane of the cervix and vaginal walls in the speculum;

collection of smears for microbiological examination.

A large number of leukocytes are determined (in the case of a secondary infection), which indicates inflammation, lactic acid bacteria are almost completely absent, a high content of opportunistic microorganisms is observed, and it is possible to identify specific pathogens (Gardnerella, fungi, Trichomonas).

PCR

If there is an obvious inflammatory process in the vaginal mucosa and questionable results of microbiological examination of smears are obtained, the patient is referred for a PCR test (blood, urine, gynecological smears) to determine hidden sexually transmitted infectious diseases. It is possible to detect human papillomavirus and herpes, cytomegalovirus, myco- and uroplasmas, chlamydia, as well as other pathogens.

Determination of vaginal acidity

This is done using a special test strip. Normally, the pH should correspond to the reading of 3.5-5.5. In the presence of atrophic colpitis, the pH increases to 5.5-7 or even becomes alkaline (more than 7).

Colposcopy

Examination of the vaginal walls and cervix with magnification using a colposcope. Pallor and atrophy of the mucous membranes of the cervix and vagina, small cracks, a weak vascular pattern are determined; there may be foci of dysplasia on the cervix and vaginal walls. When performing the Schiller test (Lugol staining), uneven staining or a weakly positive test is observed (depletion of the epithelial layer is an indirect sign of the development of dysplasia).

Taking a smear from the posterior vaginal vault and cervix for cytology

The cervical mucosa is represented by several types of cells:

basal (ripe and turn into parabasal, then intermediate, and keratinizing);

parabasal;

intermediate (made in two layers and located under the keratinizing cells, as a result replacing them);

keratinizing (they are directly exfoliated and are the top layer of the mucosa).

Thus, with this pathology, the epithelial layer is depleted (not only on the walls of the vagina, but also on the cervix itself); accordingly, in the cytogram in the presence of atrophic vaginitis, parabasal and basal cells prevail.

Classification of smear cytology:

first type – there are no atypical cells, the cytological picture is normal;

the second type - the structure of epithelial cells is slightly changed as a result of the presence of an inflammatory process in the cervix or vagina;

third type - cells with an altered nucleus are present, but only in a single quantity (repeated cytological examination is required) and colposcopy;

fourth type - there are individual epithelial cells with obvious signs of malignancy - histology and colposcopy are necessary;

the fifth type is the multiple presence of atypical cells.

In the presence of atrophic vaginitis, a cytogram of the inflammatory process is usually diagnosed, which does not imply the prescription of anti-inflammatory therapy.

Treatment

What and how to treat in the presence of atrophic colpitis can only be determined by a gynecologist. The most effective and main method of treating atrophic colpitis in women both during the postmenopausal period and during childbearing age is the prescription of HRT (hormone replacement therapy). It is the use of hormonal drugs that makes it possible to mislead the vaginal mucosa and force the epithelium to renew itself cyclically, which improves the trophism of the mucosa, reduces the severity of atrophy and prevents the formation of microtraumas.

Hormone replacement therapy can be carried out in two ways: systemic administration of hormones in the form of injections, tablets or hormonal patches, local creams, ointments, suppositories. Hormonal therapy should continue for a long time, at least 1.5-3 years, although it is worth noting that a positive effect is observed after 3-6 months from the start of therapy. However, if the course of hormonal therapy is stopped, the symptoms of atrophic vaginitis return and are quite often complicated by the addition of a secondary infection.

Local treatment

Suppositories that are prescribed in the presence of atrophic colpitis:

"Estriol."

Suppositories contain the main active ingredient - estriol (directly estrogenic component) and as an additional substance - dimethyl sulfoxide. This drug is available without a prescription. Treatment regimen: intravaginal administration once a day for the first month, then twice a week. The drug can reduce the severity of vaginal itching, eliminate dyspareunia, and excessive dryness. Suppositories are also effective in cases of urinary disorders, as well as urinary incontinence, which are provoked by atrophic processes in the vaginal mucosa.

"Ovestin".

Available in the form of suppositories, tablets and vaginal cream. The active ingredient is estriol, additionally: lactic acid, acetyl palmitate, potato starch. The drug has properties similar to estriol. The treatment regimen is also similar (first, intravaginal administration of suppositories daily for 4 weeks, after which, if the general condition improves, the dosage is reduced to 2 suppositories per week). Available in pharmacies without a prescription.

"Gynoflor E".

It is produced in the form of tablets for insertion into the vagina. The drug contains lyophilisate of lactobacilli acidophilus with a dosage of 50 mg, as well as estriol - 0.03 mg. Effectively restores the vaginal microflora (the action of lactobacilli acidophilus), and also improves the nutrition of the vaginal epithelium, stimulates its growth due to glycogen, which is present in the drug, supports the growth and formation of its own lactic acid bacteria on the vaginal mucosa. Treatment regimen: intravaginal administration of one tablet for 6-12 days daily, after which one tablet is administered twice a week. Available in pharmacies without a prescription.

"Elvagin."

Available in the form of cream and suppositories. The main active ingredient is estriol. Injected into the vagina every day for 2-3 weeks, after which the dose is reduced to twice a week. Sold without a prescription.

"Ortho-ginest."

Available in the form of tablets, suppositories and vaginal cream. The drug contains estriol. Course of therapy: administration of the drug (regardless of the form) at a dosage of 0.5-1 mg daily for 20 days, after which a week-long break is taken; if symptoms weaken, treatment is continued for 7 days a month. The course of treatment should be at least six months.

"Ovipol Clio" (suppositories).

"Estrovagin" (vaginal suppositories, cream).

"Estrocard" (suppositories and cream).

Systemic treatment

Drugs prescribed for systemic therapy:

"Climodien."

Available in the form of tablets for oral administration. One package contains 28 tablets. The drug contains dienogest and estradiol. The drug is taken one tablet every day, it is advisable to take the drug at the same time. After finishing the package, start taking a new one. Climodien is prescribed to women who have severe menopausal symptoms (increased sweating, disturbed sleep, hot flashes) and signs of atrophic vaginitis, but not earlier than a year after menopause. The drug is available at the pharmacy without a prescription.

"Cliogest".

One blister of the drug contains 28 tablets. Reception can be started on any day, but not earlier than a year after the last menstruation. The drug contains norethisterone acetate and estradiol propionate. The drug is prescribed as hormone replacement therapy after 55 years of age to prevent the development of osteoporosis and for the treatment of atrophic colpitis. The drug is available in pharmacies without a prescription.

"Davina."

Available in the form of blue (10 pieces) or white (11 pieces) tablets. The package contains 21 tablets. White tablets contain estradiol, while blue tablets contain methoxyprogesterone and estradiol. They are taken every day for 3 weeks at the same time, after this period a week break is taken, which is accompanied by the development of menstrual-like bleeding. The drug is prescribed in the presence of estrogen deficiency, for the prevention of postmenopausal osteoporosis and menopausal syndrome. Available at the pharmacy without a prescription.

"Pauzogest."

The product contains norethisterone and estradiol. The package contains 28 tablets. The drug is taken daily, one tablet for four weeks. Upon completion of the package, they immediately begin to receive a new one. Pauzogest is prescribed no earlier than one year after the cessation of menstruation. The drug is available at the pharmacy without a prescription.

"Eviana".

"Revmelid".

"Activel".

Herbal preparations (use of phytohormone therapy)

"Cliophyte".

Available in the form of an elixir or syrup. The composition of the product includes: chamomile, chaga, coriander seeds, hawthorn, cedar seeds, rose hips and other components of plant origin. Treatment regimen: 10-15 ml of the product is diluted with 100 ml of water and taken three times a day 15 minutes before meals for 2-3 weeks. If necessary, the course of therapy is repeated after 1-2 weeks. The product is available without a prescription.

"Klimadinon".

The drug contains cohosh rhizomes, a plant that has anti-menopausal and estrogen-like effects. The blister contains 15 tablets; a regular package contains 4 or 6 such blisters. The drug is taken twice a day, one tablet at a time, the duration of therapy is determined by the doctor. The product is available in pharmacies without a prescription.

"Qi-klim."

The drug is based on black cohosh root extract and is produced in the form of tablets, body and face cream. Take 1-2 tablets daily for a month. The duration of the course is adjusted by the attending physician.

• "Inoklim".

  "Estrovel".

  "Tribestan".

  "Bonisan."

  "Menopace Plus" (herbal component).

  "Menopace" (minerals and multivitamins).

  "Remens" (in the form of drops).

  "Feminal"

  "Climaxan".

  "Klimadinon Uno".

FAQ

Is it possible to use alternative treatment in the presence of atrophic vaginitis?

Yes, the use of folk remedies is allowed, but only in the form of an addition to the main therapy with hormonal drugs. Folk remedies are usually used in the presence of a pronounced inflammatory reaction of the vaginal mucosa to eliminate itching and redness, relieve swelling, and better heal microcracks in the mucosa. Use warm baths with decoctions of Rhodiola rosea, juniper fruits, sage, calendula, chamomile and other medicines. You can also insert tampons soaked in aloe juice intravaginally, take an infusion of a mixture of rose hips, sweet clover, nettle, sage, mint or celandine herb. You can also drink tea from raspberry leaf, chamomile and willow leaves.

I am 35 years old, and about a year ago I had my ovaries removed for endometriosis and was prescribed hormonal contraceptives. About 2 weeks ago, itching and burning appeared in the vagina, with yellowish discharge that had an unpleasant odor. Are such symptoms a manifestation of atrophic colpitis?

In this case, it is necessary to visit a gynecologist as soon as possible and take smears for the vaginal microflora. In all likelihood, it is not atrophic, but nonspecific vaginitis, and the development of candidiasis is also possible. This disease requires at least a year from the date of surgery, and it was said that the patient is taking hormonal medications. The doctor will evaluate the results of the smears and, when determining the pathogen, will prescribe anti-inflammatory treatment appropriate to the situation. Regarding hormone replacement therapy, you should wait a little.

Is it possible to prevent the development of atrophic vaginitis, and how to do it?

Yes, as a preventive measure, you need to regularly visit a gynecologist, give up bad habits, wear synthetic and tight underwear, adhere to proper nutrition, and take multivitamin complexes (only if you have doctor’s recommendations). It is also worth excluding the use of scented products for intimate hygiene, avoiding unprotected sexual intercourse and engaging in physical restorative exercises and Kegel exercises (for local strengthening of the pelvic floor muscles); it is better to replace taking a bath with a shower.

How is the effectiveness of therapy for atrophic colpitis determined?

To determine the negative or positive dynamics of the pathology, regular colposcopy (once every 3-6 months), cytological examination of smears of vaginal microflora, and measurement of vaginal pH are required.

Senile colpitis is a specific type of inflammation of the vaginal mucosa associated with systemic hormonal changes in a woman’s body. The term “senile” is equivalent to the definition of “senile”, and the nature of inflammation in this disease is such that degenerative processes occur in the mucous membrane, therefore senile colpitis is also called atrophic.

This disease occurs in postmenopausal women, when the balance between male and female sex hormones changes. The immediate cause of thinning and atrophy of the uterine epithelium is a significant decrease in estrogen levels.

Reasons for the development of atrophic colpitis

The main point: almost all cases of the development of atrophic colpitis occur in women during menopause. Almost 45% of all women over 40 years old have senile colpitis. (cm. " ")

However, age and the associated menopause are not the only reason for the development of colpitis, although it is the most significant. Eat a number of factors that reliably influence the likelihood of developing colpitis:

• the presence of chronic diseases in decompensation that deplete the body (diabetes mellitus, for example);
• HIV infection or AIDS;
• insufficient hygiene of the external genitalia or, on the contrary, too frequent washing with soap;
• removal of the ovaries, regardless of the reason for the operation;
• diseases of the thyroid gland, which are accompanied by a decrease in hormone production;
• wearing underwear made of low-quality synthetic fabric;
• radiation or chemotherapy;
• venereal infections.

Symptoms of senile colpitis

Atrophic colpitis is a disease that in any case has a chronic course. Atrophy of the mucosa, its thinning with loss of function always occurs gradually. Traditionally, all inflammatory diseases (with rare exceptions) are called chronic if their duration is more than 3 months. Senile colpitis can take years to develop.

There cannot be acute, obvious manifestations of chronic colpitis. The mucous membrane, changing, loses its properties, and the glands, which normally should produce mucous secretion (it is not for nothing that the mucous membranes are called mucous membranes), cease to function. The mucous membrane of the inner lining of the vagina dries out, normal acidity is disrupted, and all the characteristics necessary for the normal functioning of all local protective systems and the functioning of “healthy”, beneficial microorganisms change.

The main manifestations of senile colpitis are associated precisely with these two factors: drying out of the mucous membrane and a change in the microflora of the vagina.

How can atrophic colpitis manifest itself? Of course, this disease has symptoms. But they are not even always noticed! We will now look at theoretically possible manifestations that sometimes occur in practice (usually atrophic colpitis does not particularly bother a woman). So, what can be observed with senile colpitis:

• and in the area of ​​the external genitalia, perineum. As a rule, the itching is not very pronounced (for comparison, here is a symptom in which this symptom can even cause insomnia) and is especially noticeable after sexual intercourse, washing or prolonged wearing of tight, uncomfortable underwear made of synthetic fabric.
• Moderate burning sensation in the perineal area (less often, this sensation is clearly localized, and the woman can indicate a burning sensation in the vagina).
• . Urine has a fairly aggressive environment, so when it comes into contact with an atrophied, vulnerable mucous membrane, irritation occurs, which is accompanied by pain. In addition, there may be an increased urge to urinate and urinary incontinence.
• They often appear, which have a watery consistency and a strong, unpleasant odor. The discharge also causes irritation of the vaginal mucosa and external genitalia.

Atrophic changes in the mucosa lead to the fact that local protective factors cannot perform a protective function. This leads to the development of secondary bacterial infections. In this case, all signs of an acute inflammatory process (fever, intoxication, pain, etc.) are also added to the clinical picture from the genital tract.

Diagnosis of the disease

The diagnostic process begins with a bimanual examination and a speculum examination. As a rule, these manipulations are combined with extended colposcopy - examination of the mucous membrane of the vagina and cervix, and probing of the cervical canal.

A gynecological examination allows you to determine the secretory function of the mucous membrane (with senile colpitis, the mucous membrane becomes dry and may become covered with erosions), the degree of the atrophic process, the presence of secondary infections or concomitant diseases.

It is important to measure the acidity (pH) of the vaginal environment. This indicator is an indicator not only of the loss of the mucous membrane’s functionality, but also of the risk of developing bacterial vaginosis (dysbacteriosis) and secondary infections.

Treatment of senile colpitis

Since senile colpitis is a disease that is caused by a systemic disorder, a disorder of the endocrine glands, treatment should also be systemic in nature (first of all!). Atrophic colpitis always has a chronic course, so treatment must be long-term and regular to ensure long-term remission.

Since the root cause of the disease is endocrine disorders, the basis of treatment is taking hormonal medications containing natural estrogens. In addition to systemic administration of hormonal drugs, local preparations with estriol are often used - ointments and vaginal suppositories.

Changes in senile colpitis are associated with a decrease in local immunity and the appearance of bacterial complications. This is the reason why antibacterial drugs are used in the treatment of atrophic colpitis. Most often these are vaginal baths with antibiotics, but there may also be drugs for systemic use.

Prevention

The main factor leading to the occurrence of atrophic colpitis is hormonal disorders associated with age-related changes. This is a factor that, unfortunately, cannot be influenced. But besides this, there are other factors that can be influenced.

Prevention of senile colpitis includes the following aspects:

• adequate and regular intimate hygiene;
• wearing high-quality underwear that does not cause discomfort;
• timely treatment of inflammatory and non-inflammatory diseases of the genital organs - “advanced” diseases can lead to various complications, which may be the reason for surgery to remove the ovaries;
• prevention of sexually transmitted diseases and their timely treatment.

Throughout their lives, people have to deal with a whole bunch of infections and diseases. A considerable part of them are diseases of the genitourinary system. For example, a disease such as colpitis, the causes of which are very different, occurs equally often in women of all ages.

Colpitis - what kind of disease?

Colpitis is inflammation of the vaginal mucosa. The second name is vaginitis. Every third woman on the planet suffers from this disease. The disease affects people of absolutely any age and even children.

Colpitis in women can be caused by opportunistic microorganisms: staphylococci, streptococci, Proteus, E. coli, Trichomonas, chlamydia, Candida fungi and others that enter the body through sexual contact or through the rectum.

Vaginitis poses a health threat. It can cause inflammation in the uterus, fallopian tubes and ovary. The disease occurs in several forms.

Vaginitis: forms and types

Conventionally, the disease is divided into the following types:

1. Bacterial colpitis. It can be specific and non-specific. The first type is caused by opportunistic bacteria that appear under certain conditions, and the second is when intestinal infections enter the vaginal mucosa.
2. Non-infectious colpitis is the body's reaction to antibiotics. It could also be an allergy to underwear, ointments, creams, pads.

Vaginal colpitis develops:

1. In acute form. It is characterized by copious discharge, which has an unpleasant odor and is accompanied by painful sensations.
2. In the subacute form, there are no pronounced symptoms.
3. In chronic form. This is an untreated acute form. Rarely causes discomfort. Can cause ascending diseases of the uterus and appendages.

Causes of the disease

Colpitis appears in women due to a number of different reasons:

• Sexually transmitted diseases.
• Any infection that reduces the body's protective functions.
• Mechanical damage - abortion, childbirth.
• Hormonal disbalance.
• Antibiotic therapy.
• Allergy to ointments, creams, pads, underwear.
• Lack of personal hygiene.
• Bad habits.

Colpitis occurs most often among women of childbearing age, the causes of which lie in opportunistic flora. The causative agents of the disease are transmitted sexually. Therefore, it is necessary to carefully approach the choice of a partner. Or at least use a condom.

How to recognize the disease?

Timely diagnosis and treatment of vaginitis will save a woman from many problems in the future, including its consequences such as infertility.

Colpitis in women, symptoms:

• Mucus discharge that has an unpleasant odor. Sometimes the discharge takes on a cheesy appearance and resembles thrush.
• Itching, burning in the perineal area.
• The external genitalia have a slightly swollen, reddish appearance.
• Urination becomes painful.
• There is pain in the lower abdomen.

The disease may not always be accompanied by such symptoms. Subacute and chronic forms occur unnoticed and are detected only with a thorough gynecological examination. Therefore, visiting a gynecologist is a mandatory procedure that must be performed at least once a year.

Trichomonas colpitis in women

The disease is caused by an opportunistic bacterium - Trichomonas, which enters the healthy microflora only through sexual contact. The incubation period is one to two weeks, after which the first symptoms appear: mucous (foamy or curd-like) discharge, accompanied by itching and burning, as well as pain in the lower abdomen.

Both partners should be tested for the presence of Trichomonas. Since the disease is very often not accompanied by characteristic signs, it is advisable to carry out bacteriological culture of the vaginal microflora.

Treatment is prescribed for both women and men. It includes antimicrobial agents and topical agents (creams, suppositories, gels). Don't forget about immunostimulating drugs.

After a course of treatment, re-diagnosis is required.

Traditional and non-traditional treatment of colpitis

Regardless of what form of colpitis was diagnosed, the treatment of the disease looks the same and consists of the use of antibacterial, antiviral and antifungal agents. It is also advisable to follow a light diet, excluding salty, spicy and sweet foods. Alcohol consumption is prohibited.

Folk remedies will help cure colpitis with great success. Of course, they are prescribed in combination with basic medications.

You can eliminate itching and burning with:

• Sea buckthorn oil, which is used to lubricate the vaginal mucosa.
• Douching with herbal decoctions (chamomile, rose hips, rosemary, sage, oak bark). Douching is carried out with warm, never hot, water.
• Tampons soaked in a solution of propolis and honey. Grind a small piece of propolis and melt it in a steam bath. When it cools down, add a little honey. Soak tampons in this liquid and place them in the vagina for two hours, twice a day.

If we talk about how to treat colpitis in women, we should mention herbal infusions that are taken orally:

• Pour boiling water over valerian, lemon balm and nettle at a ratio of 1:1:1, leave for one night, then drink a quarter of a glass before meals.
• Pour 20 grams of thigh meat with 300 ml of boiling water, boil for 10 - 15 minutes and leave. Drink the decoction every two to three hours. You can add honey.
• Pour one tablespoon of St. John's wort and millennium with water and bring to a boil. Drink 1 spoon before meals.

Colpitis in women is a rather insidious disease. Ignoring treatment can cause negative consequences. Therefore, you should always be on alert and immediately consult a doctor at the slightest symptoms.

Colpitis in men

Colpitis is a female disease, so it cannot develop in men with all its symptoms. However, representatives of the stronger sex are carriers of the pathogens of this disease. Most often, Trichomonas, chlamydia, ureaplasma and other pathogenic bacteria live in the urethra of men. They cause colpitis in women.

Symptoms of the disease may be absent or appear to a minor extent:

• Redness on the genitals, swelling.
• Painful urination.
• Curdled discharge.

Therefore, if colpitis is detected in women, treatment, as well as the diagnosis itself, is prescribed to both partners. The best way to identify pathogenic bacteria is bacterial culture of the microflora.

Vaginitis during pregnancy

Vaginitis is a side effect of infections such as chlamydia, trichomoniasis, ureoplasmosis, candidiasis, etc. Pathogenic bacteria displace healthy flora, causing inflammation of the mucous membranes. If the inflammation is not treated in time, it can spread to the uterus and appendages, which is especially dangerous during pregnancy.

Penetrating into the uterus, the infection affects the placenta, making it more vulnerable. The result is premature birth, miscarriages in the early stages and miscarriage in later stages. Sometimes the infection that develops along with vaginitis penetrates the placenta to the fetus. In this case, the child (if it is a girl) may become infected and various developmental pathologies may occur.

Treating the disease during pregnancy is quite difficult. Strong drugs are prohibited, and weak ones do not always give results. Therefore, traditional medicine methods will be effective.

Do not forget about proper and balanced nutrition, a complex of multivitamins and stimulation of the immune system. You should also lead a healthy lifestyle and avoid stressful situations.

Vaginitis in pregnant women can be identified by general symptoms - itching, discharge with an odor, pain in the lower abdomen. Of course, such signs can indicate many different diseases that gynecology deals with. Colpitis, however, is the most common. Therefore, any abnormal discharge should always alert a woman.

Age-related colpitis

Optionally, inflammation of the vagina can be caused by pathogenic microorganisms. Often the cause of the disease is hormonal imbalance, reduced immunity, or a course of antibiotics.

Women over forty are at risk. Due to the restructuring of the body and menopause, the vaginal flora also becomes vulnerable.

The main symptom of age-related colpitis is purulent discharge with an unpleasant odor. Heaviness and pain in the lower abdomen may also be observed.

Treatment of the disease is carried out with a course of antibiotics and immunostimulating drugs. Vitamins and medications are required to correct hormonal levels.

Vaginitis in children

Colpitis is an insidious disease that even children are susceptible to. Most often, the reasons for the appearance are the following:

• Lack of personal hygiene or improper washing of the child, in which intestinal bacteria enter the vaginal mucosa.
• Allergy to detergents, creams, linen.
• Long-term use of antibiotics and other strong drugs.
• In rare cases, vaginitis can be caused by worms.
• Foreign objects in the vagina.

The disease is often accompanied by inflammation of the external genitalia. In this case, a pediatric gynecologist can diagnose vulvovaginitis. The disease, in the absence of timely treatment, leads to infertility. At risk are girls who often suffer from sore throat, ARVI, cough, diseases of the genitourinary system, and dysbacteriosis. In a word, children with weakened immune systems.

Symptoms of colpitis in children:

• Redness and itching of the genitals.
• Discharge.
• Pain in the genital area.
• Painful urination.

In addition to medications, treatment of the disease necessarily includes immunostimulating agents, as well as topical antiseptics.

Prevention of colpitis

It is better to prevent any disease in a timely manner than to treat it. In addition to the fact that diseases can recur, causing complications, they also have a significant impact on finances.

The best prevention of infections of the reproductive system is a regular sexual partner and personal hygiene. You also need:

• Regularly undergo examination by a gynecologist and other specialists.
• For casual sex, use a condom.
• Use only proven intimate cosmetics, as well as high-quality natural lingerie.
• Lead a healthy lifestyle, take vitamins and maintain immunity.
• Do not self-medicate and consult a doctor promptly.

Conclusion

There is probably no person on earth who has not encountered some kind of disease at least once in his life. Sexually transmitted infections have become especially common lately. This is all due to the fact that teenagers begin to become sexually active too early and do not always think about its consequences.

One of the serious diseases is colpitis in women. Representatives of both sexes should know the symptoms and causes. Although the disease is female, the pathogen is also found in men. Timely consultation with a doctor will help to avoid many negative consequences, including infertility.