Understanding Vaginitis: Symptoms, Types, and Implications
Vaginitis is an inflammation of the vaginal mucosa and submucosal connective tissue, recognized as a prevalent condition in gynecological clinics. Healthy women possess a natural defense mechanism that prevents the invasion of pathogens into the vagina due to their anatomical and biochemical characteristics. However, when this natural defense is compromised, pathogens can easily intrude, leading to vaginitis. This condition is more common among prepubescent girls and postmenopausal women, as a lack of estrogen makes the vaginal epithelium thinner, decreases the glycogen content in cells, and raises the vaginal pH to approximately 7, reducing resistance to infections.
Clinically, vaginitis is characterized by changes in the characteristics of vaginal discharge and the presence of itching and burning sensations in the vulva. Pain during intercourse is also frequently reported. If the infection spreads to the urethra, it may result in symptoms such as painful urination and urges to urinate frequently.
Types of Vaginitis
The most common types of vaginitis include bacterial vaginosis, trichomoniasis, yeast infections, and atrophic vaginitis. A study by Gardner et al. involving 1,181 cases of vaginitis revealed that 41% were bacterial, 27% fungal, and 24% caused by trichomonas. Atrophic vaginitis occurs mainly after menopause, following oophorectomy, or after pelvic radiation therapy, with reported incidence rates as high as 98.5%.
1. Trichomoniasis
Symptoms: This condition often presents with increased vaginal discharge that may be milk-white or yellow, sometimes purulent, and typically foamy with a foul odor. In severe cases, there may be blood-stained discharge, accompanied by painful and frequent urination.
Risks: Complications can include trichomonas urethritis, cystitis, and pyelonephritis. Since trichomonas can engulf sperm, this infection can also lead to infertility and adversely affect sexual relations.
2. Candidiasis (Yeast Infection)
Symptoms: Patients may experience intense itching of the vulva, burning sensations in the vulva and vagina, and an increase in white discharge that resembles cottage cheese. This condition can also lead to frequent urination, painful urination, and discomfort during sexual intercourse. A gynecological examination may reveal white patches on the inner labia and vaginal mucosa, which, when removed, expose a reddened and swollen mucosal surface. In acute cases, one might observe erosive lesions or superficial ulcers.
Risks: Yeast infections are notoriously difficult to eradicate and are prone to recurrence. They can lead to complications such as preterm labor and fetal infections or malformations.
Final Thoughts
It is essential for women to be aware of the signs and symptoms of vaginitis, as well as its potential complications. Early diagnosis and treatment can help in managing the symptoms effectively and preventing further health issues.