Vulvitis is an inflammatory process that affects the external female genitalia.

This disease is characterized by very unpleasant symptoms (see photo), namely profuse vaginal discharge, itching and burning, swelling and redness of the labia, pain during urination and during sexual intercourse. This pathology may be associated with poor hygiene, various diseases of the genital area, hormonal disorders, etc.

In adult women, primary and secondary inflammation of the vulva, with timely treatment, rarely causes the development of dangerous complications, but in little girls, a disease that occurs at an early age can provoke the development of synechiae - fusion of the labia minora.

Causes

Why does vulvitis occur, and what is it? According to the nature of the causative agent, vulvitis is divided into:

1. Specific - gonorrhea, trichomonas, candidiasis, herpesvirus;
2. Nonspecific– caused by opportunistic microflora (Escherichia, staphylococci, Klebsiella, Proteus).

In addition to infectious agents, the appearance of vulvitis can be caused by the following reasons:

1. Neglect of personal hygiene rules. This is especially acceptable during menstruation periods.
2. Wearing uncomfortable clothes and using sanitary pads for long periods of time.
3. Long-term antibacterial therapy.
4. Presence of intestinal and genitourinary fistulas.
5. Disruption of the endocrine system (overweight, diabetes).
6. Allergic conditions.
7. Urinary incontinence.
8. , increased sweating, etc.

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

Classification

According to the mechanism of occurrence:

1. Primary – penetration of infection through the mucous membrane. Most often it manifests itself during pregnancy, hormonal imbalance, and immunodeficiency. During reproductive age, it is a rare occurrence, affecting mainly girls and women after menopause.
2. Secondary – develops against the background of inflammatory diseases of the internal genital organs or concomitant diseases. Occurs in women of reproductive age.

According to the nature of the flow:

1. Chronic – develops as a result of an untreated or undertreated acute form, lasts for years, passing through stages of remission and exacerbation. During a lull, there are no manifestations or they are minimal.
2. Acute vulvitis. The duration of the disease is a week. Symptoms are pronounced and occur suddenly.
3. Atrophic vulvitis– most often formed in women. Excess weight and... contribute to it.

Depending on the type of pathogen, it is customary to distinguish between bacterial and candidal vulvitis, and depending on the nature of the pathological transformations of the mucous membrane of the external genitalia, vulvitis is divided into atrophic, ulcerative and adhesive.

Symptoms of vulvitis

Acute vulvitis is characterized by the following symptoms:

• swelling and redness, or redness, of the vulvar area;
• the presence of ulcers or erosions in the vulva area;
• discomfort, itching, burning in the vulva area;
• pain that becomes stronger when urinating or defecating;
• discharge from the genitals, usually with purulent or serous-purulent contents;
• in more severe cases, enlarged lymph nodes in the groin area can be detected;
• An increase in body temperature is also characteristic.

Vulvitis with untimely and improper treatment can become chronic with frequent relapses. The chronic form of vulvitis is characterized by moderate manifestations of swelling, pain and hyperemia in certain areas of the vulvar mucosa, hypertrophy of the sebaceous glands, itching, burning, and scanty discharge.

Sometimes with vulvitis, after healing of erosions and ulcers, the genitals can become deformed, making sexual life difficult in the future. In girls, adhesions in the labia area - synechia - may occur.

Diagnostics

Effective diagnosis of the disease is based on the characteristic symptoms of vulvitis, as well as the patient’s life history and illness (recent illnesses, antibiotic treatment, allergies, etc.).

In addition, the doctor must examine the external genitalia, perform a two-handed examination, and take smears for microscopy, microbiological and cytological studies. If necessary, the vulva is examined using a colposcope, a special type of magnifying glass. Girls are required to undergo a stool test for helminth infections.

Vulvitis: photo

What inflammation of the female genital organs looks like is shown in the photo below.

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How to treat vulvitis in women?

If symptoms of vulvitis occur, treatment consists of eliminating the cause that caused it and/or treating concomitant diseases (diabetes mellitus, helminthiases, etc.). In the acute stage, bed rest and abstinence from sexual activity are recommended. Treatment of vulvitis in women or girls is carried out strictly individually.

Main aspects of therapy:

1. Washing the vulva and vagina with antiseptic solutions(Chlorhexidine, Miramistin®, etc.), infusions of herbs (chamomile, sage, calendula, etc.). It is better to do douching once a day, at night, not forgetting to wash the labia majora and minora with the solution.
2. Antibacterial drugs in the form of vaginal suppositories, for example Terzhinan, Neo-Penotran, Macmiror, etc. They are usually administered after washing, at night, for 7-10 days.
3. For severe itching, use (Tavegil®, Claritin®, etc.).
4. For pain and burning, use additionally anesthetic ointments.

Effective treatment of vulvitis, regardless of its form, is only possible by prescribing complex therapy, which includes local and systemic measures. It is necessary to treat concomitant diseases and eliminate factors that provoke inflammation of the external genitalia.

Preventive measures

Prevention of vulvitis includes the following principles:

• promptly contact a gynecologist if signs of genital diseases are detected;
• maintain personal hygiene;
• strengthen the immune system and adhere to a healthy diet;
• you should eat fermented milk products containing live cultures;
• avoid casual sexual contacts;
• stop using synthetic underwear;
• take antibiotics as prescribed by your doctor.

Proper hygiene of girls is the key to their future female health. Untreated vulvitis in childhood can provoke serious gynecological problems in the future, the main of which is infertility.

Irritation in the genital area in the form of itching and burning in women in most cases indicates vulvitis. This is a fairly common inflammation of the external genitalia, expressed by redness of the vulva, itching, and burning. The symptoms of this disease cause severe discomfort to the fair sex. Timely and correct treatment completely eliminates it.

Vulvitis in a woman, the symptoms and treatment of which are largely determined by the cause of its occurrence, can develop due to many factors. The key is a general weakening of the body's immunity.

Causes of vulvitis:

Correctly determining the cause of vulvitis is the key to effective treatment.

Classification of pathology

Vulvitis is classified according to several criteria.

According to the clinical course, they are distinguished:

• Acute vulvitis. Duration – up to 1 month.
• Subacute vulvitis. Exacerbation alternates with phases of remission and lasts up to 3 months.
• Chronic vulvitis. Usually occurs during menopause. It is observed in women and girls who suffer from excess weight and diabetes.

Due to the development of vulvitis, they are classified:

• Primary. It usually appears in childhood and adolescence. The reason is injury to the mucous membrane.
• Secondary. It appears in women of reproductive age. Accompanies infectious, endocrine and other diseases.

According to the etiology of the disease, vulvitis is distinguished:

According to the nature of the pathology of the external genitalia, they are distinguished:

• Atrophic vulvitis. Characterized by thinning of the vulvar mucosa.
• Ulcerative vulvitis. There are ulcers on the external genitalia. Characteristic of the chronic form.
• Adhesive vulvitis. Usually develops in children. The main symptom is the fusion of the labia with each other.

First signs and symptoms

Vulvitis in women, the symptoms and treatment of which are interrelated, causes enormous discomfort. The manifestations of this disease depend on the clinical course.

Type of vulvitis	Main symptoms
Spicy	Signs: severe itching and burning in the perineum, significant redness of the vulva, swelling of the labia. There is pain during sexual intercourse, walking, and urination. Tiny plaque blisters may appear on the vulva, as well as ulcers and plaques.
Chronic	The signs are mild. Slight itching and slight redness of the vulva may bother you. Often women do not attach much importance to these symptoms.
Atrophic	The main manifestation of the disease is thinning of the mucous membrane of the clitoris, labia, and vulva. Possibly cracking of the skin and dryness.

Diagnostics

At the first manifestations of vulvitis (itching or burning in the genital area), you should go to the doctor. Delayed treatment leads to serious consequences.

To diagnose the etiology of the disease, the following manipulations are performed:

• Vaginal smear to determine bacterial cultures. Using this method, the pathogen is determined, as well as its sensitivity to antibiotics.
• Stool analysis. Required to determine the presence of worms.
• General urine analysis. Allows you to detect the presence of cystitis.
• Polymerase chain reaction (PCR). Infections that are sexually transmitted are detected.
• Smear for cytology. Allows you to detect the presence of malignant cells.
• Colposcopy.

Treatment of primary and secondary vulvitis

Treatment of vulvitis in women is prescribed by a doctor according to the type of disease.

In the case of primary vulvitis, treatment is aimed at eliminating the symptoms:

For secondary vulvitis, therapy is aimed at eliminating the cause of the disease:

1. If worms are detected, anthelmintic drugs are prescribed.
2. When opportunistic organisms are detected, antibacterial therapy using drugs and ointments is prescribed.
3. If sexually transmitted diseases are confirmed, antiviral drugs are prescribed.
4. When identifying candidiasis vulvitis, antifungal agents are effective.

When treating secondary vulvitis, in addition to eliminating the cause of the disease, you should get rid of the symptoms. To do this, you should apply all of the above recommendations for primary vulvitis.

Treatment methods depending on the cause of the disease

Vulvitis in women, the symptoms and treatment of which are directly related to the cause of its occurrence, the so-called secondary vulvitis, is not difficult to heal.

To do this, you need to get rid of the accompanying illness.

Ointments for vulvitis

Ointment therapy is an integral part of the treatment of vulvitis. It is especially effective in the initial stage. The advantage of ointments is their speed of action due to direct contact with inflamed areas. They must be applied strictly according to the instructions on skin pre-treated with an antiseptic.

The following ointments are used:

1. Antibacterial:

2. Fungicidal (antifungal):

• Pimafucin. Lubricate the skin 4 times a day until symptoms disappear and for another 4 days after. Suitable for pregnant and breastfeeding women. Has no side effects. The main active ingredient is natamycin. It is effective against fungi of the Candida family.
• Nystatin ointment. The duration of the course is 7 – 10 days, for chronic vulvitis – up to 1 month.
• Clotrimazole. Treatment continues for up to 2 weeks.
• Candide. Apply to the skin 2 – 3 times a day for 2 weeks. It has side effects and is therefore contraindicated for pregnant women.

3. Hormonal:

4. Healing:

• Actovegin. The ointment is based on cattle blood. Has regenerating properties.
• Vaginorm WITH. It has immunomodulatory and protective properties. Balances microflora and pH levels. Prescribed for chronic vulvitis for prevention.
• Radevit. Anti-inflammatory and protective agent.

Candles

Suppositories are a good remedy for secondary vulvitis. They are inserted into the vagina, thus directly affecting the mucous membrane of the internal genital organs. Suppositories, like ointments, are selected depending on the etiology of the disease.

They can be:

Candles can only be used strictly as prescribed by a doctor. If itching and irritation of the mucous membrane occurs, treatment should be stopped.

Suppositories are contraindicated during menstruation, pregnant, breastfeeding women and people with individual intolerance.

Antibiotic drugs

Antibiotics are prescribed only for vulvitis caused by opportunistic organisms. They are not effective against diseases that are transmitted through sexual intercourse, such as candidiasis. Antibiotic drugs are selected depending on the pathogenic microorganisms, which are determined by laboratory analysis vaginal smear for microflora:

• If gonococci are present, cephalosporin antibiotics are prescribed.
• In the presence of trichomonas, use Metronidazole, Tinidazole, Ornidazole.
• For mycoplasma, ureaplasma, and chlamydia, broad-spectrum antibiotics are prescribed.
• Terzhinan helps a lot with mixed vulvitis.

Treatment of vulvitis using folk remedies

Vulvitis in women, the symptoms and drug treatment of which are described above, can be alleviated with folk remedies. In the case of primary vulvitis, using folk recipes you can completely get rid of this disease. They are also effective for preventive purposes and at the initial stage.

Various treatment methods are used:

The advantage of treatment with folk remedies is that the risk of complications is low compared to drug therapy.

When carrying out treatment procedures, you should pay attention to some nuances:

Drink

The strongest factor in the occurrence of vulvitis is a decrease in a woman’s immunity.

To strengthen it, various herbal teas and decoctions are used:

1. Chamomile tea. It has immunomodulatory and anti-inflammatory properties. To prepare it, 1 tsp. dried flowers must be brewed in a glass of boiling water. Take 3 times a day, 50 ml.
2. White acacia decoction. 1 tbsp. The dried plant must be boiled for 5 minutes. over low heat in 0.5 liters of water. The maximum dose per day is 3 glasses.
3. A decoction of coltsfoot, sweet clover, and wintergreen. 1 tbsp. The dried mixture should be poured with a glass of boiling water, kept on low heat for 15 minutes, and left for a couple of hours. Take 3 times a day, 1 tbsp. after eating for 14 days.

Products for baths, douching, irrigation

Baths and douching perfectly soothe the skin and mucous membranes of the genital organs in women.

In addition, they have antiseptic, antibacterial, anti-inflammatory properties:

Therapeutic tampons

Tampons are used for treatment:

Herbs for internal use

Helps against illness:

Forecast

With proper and timely treatment, vulvitis goes away without complications or consequences.

But if a woman does not immediately consult a doctor, but begins self-medication, serious consequences are possible:

1. Formation of cysts and abscesses.
2. Chronic ulcers of the vulva.
3. Fusion of the labia.
4. Deformation of the vulva.
5. The appearance of scars on the mucous membrane.
6. The inflammatory process can spread to the internal genital organs and cause:

• endometritis;
• vaginitis;
• infertility;
• cervicitis and other diseases.

7. On the psychological side, a woman can be negatively affected by a lack of sex life.

Vulvitis in women can be either a consequence of a certain disease or can occur on its own due to injury to the mucous membrane of the external genitalia. Based on the symptoms, it is possible to suggest the cause of the disease, but for an accurate determination, you should undergo a full examination by a doctor. Under no circumstances should you self-medicate.

Wrongly chosen drugs can only harm the body. At the initial stage of the development of the disease, as well as for prevention purposes, you can use folk remedies. They perfectly relieve irritation and itching of the vulva and do not cause complications. But you shouldn’t put off going to the doctor.

Article format: Mila Friedan

Video about vulvitis

About vulvitis in detail:

The female genital organs are divided into external and internal. The pubis, two pairs of labia majora and minora, the clitoris, the vestibule of the vagina and the hymen form the first group. They are also called the vulva.

The labia minora are two folds of mucous membrane that cover the clitoris in front. In most women, they are in a closed state and cover the genital opening.

The space between them forms the vestibule of the vagina. The opening of the urethra is located in it slightly below the clitoris, and the ducts of the Bartholin glands open there.

Between these folds is the entrance to the vagina. This entire area has a large number of vessels and increased innervation.

Vulvitis is a disease that is characterized by an inflammatory process in the vulva area, most often the vestibule of the vagina and labia minora. It can be infectious or non-infectious.

Causes of vulvitis

The disease can occur on its own or be a consequence of an infection of the overlying parts of the reproductive system.

Factors that contribute to infection are folding and vulnerability of the mucous membrane, increased blood supply and high humidity.

The causes of primary vulvitis can be:

1. 1 Poor hygiene of the external genitalia (especially in children under one year old and preschool age).
2. 2 Obesity and diaper rash.
3. 3 Exposure to chemicals (panty liners, hygiene products), physical factors (temperature) and mechanical injuries (scratching, friction).
4. 4 Endocrine diseases, in particular diabetes.
5. 5 Inflammatory diseases of the perineal area, hemorrhoids.
6. 6 Psoriasis and eczema.

Inflammation of the vulva often develops against the background of cervicitis. The following factors can provoke vulvitis:

1. 1 Pregnancy.
2. 2 Long-term treatment with antibiotics or their improper use.
3. 3 Use of oral contraceptives with a high content of estrogen.
4. 4 Treatment with cytostatics, glucocorticoids, radiation therapy.
5. 5 Diseases of the endocrine system.
6. 6 Ovarian dysfunction.
7. 7 Immune disorders after serious illness or injury.
8. 8 Helminthic infestations.
9. 9 Scleroderma or vulvar dystrophy.

According to the clinical course, three forms of vulvitis are distinguished:

1. 1 Acute – lasts no more than 1 month.
2. 2 Subacute – up to 3 months.
3. 3 Chronic – more than 3-6 months.

In practice, specific and nonspecific vulvitis are conventionally distinguished. The first group includes inflammatory processes, the cause of which is (most often, genital herpes).

If bacteriological examination reveals staphylococci, Escherichia coli, enterococci, Proteus, bacteroides or other representatives of normal microflora, then such vulvitis is called nonspecific.

Most often, inflammation is provoked by mixed flora. - not uncommon in women with hormonal disorders and immunodeficiencies.

2. Symptoms of the disease

• Hexicon (chlorhexidine);
• Betadine (povidone-iodine);
• Fluomizin (dequalinium chloride);
• Ginalgin.
• Terzhinan.
• Polygynax.

A feature of the use of the last two drugs is the possibility of continuous use during menstruation.

After the course of basic treatment, your doctor may recommend suppositories with lactobacilli to restore the balance of vaginal microflora.

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

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

The main causes of vulvitis:

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

Symptoms of vulvitis in women and girls, photos

Inflammation affects the mucous membranes of the vagina, which means that the disease cannot be latent. It will manifest itself quite quickly, because pathological processes will spread to the urethra and bladder (in advanced cases).

Are as follows:

• Burning in the area of ​​the labia minora and majora, in the vagina.
• Severe itching, not accompanied by the appearance of a cheesy coating, as with thrush.
• Copious watery discharge with a grayish or yellowish tint.
• The mucous membranes of the vulva are bright red, whereas normally they should be red-pink.
• Swelling of the labia minora and majora.
• Pain when starting to urinate.
• Nagging pain in the lower abdomen.
• The presence of bleeding microcracks in the mucous membranes.
• Pain during sexual intercourse.

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

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

Forms of vulvitis

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

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

Subacute vulvitis– lasts about 3 months. Periods of exacerbation and improvement of the condition are clearly distinguished. However, complete disappearance of pain and symptoms of the disease is not observed. The inflammatory process becomes protracted and if treatment is not carried out in time, it will become chronic.

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

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

Types of vulvitis, characteristic signs

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

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

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

Atopic vulvitis– an inflammatory process that begins due to the influence of various allergens on the girl’s body. The reason is an incompletely matured immune system. The atopic form causes severe swelling of the vagina. The treatment plan should be developed together with an immunologist-allergist (see photo 2).

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

Treatment of vulvitis in women, drugs

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

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

• Doctors usually prescribe Miramistin, furatsilin solution or potassium permanganate solution (pale pink, not concentrated).

Ointments and gels– unlike solutions, they not only fight bacteria, but also have a moisturizing effect on the mucous membranes, almost immediately significantly alleviating the burning sensation and itching. Ointment for vulvitis has a quick soothing effect, but the course of such treatment requires wearing panty liners to avoid stains on underwear and clothes.

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

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

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

Taking antibiotics– prescribed along with the use of topical medications. Antibacterial therapy should not be prescribed as the only treatment for vulvitis. It will effectively fight pathogens, but will not at all ease the patient’s well-being in the first days of treatment - the woman will still feel severe itching and burning. Therefore, antibiotics are prescribed together with ointments, gels and external solutions.

If you consult a doctor in a timely manner, the prognosis for treatment of vulvitis in girls and women is favorable; acute and subacute forms do not have relapses if therapy is carried out correctly. With chronic vulvitis, the prognosis is less favorable. Usually, the doctor can only achieve a result in which exacerbations become rare, and periods of remission become more stable and longer.

Vulvitis in women is a common inflammation of the external genitalia. The disease is unpleasant and, moreover, very common. Quite often, patients do not pay attention to it, believing that these are signs of hypothermia, although the causes of vulvitis in women are much more complex. And, indeed, vulvitis in women cannot be classified as a fatal disease, but this pathology should not be completely ignored either due to its possible complications. In addition, if the course of vulvitis becomes chronic, you will have to spend a lot of time visiting a gynecologist and a lot of money for treatment, in addition to the discomfort that the disease will cause. And one more argument in favor of a more attentive and careful attitude towards yourself: in the early stages, the symptoms of vulvitis in women resemble nonspecific inflammation, so you can miss the onset of the disease, when treatment is most effective, simple and gentle, if you do not consult a doctor in time.

There is an opinion that vulvitis in women is not a separate independent disease and is considered as a manifestation of other infectious inflammatory processes of the genital organs - vaginitis, genital herpes. This does not make women’s suffering any less, so timely diagnosis and treatment of vulvitis by a specialist is necessary.

Causes of vulvitis

One of the main causes of vulvitis, especially in girls and women under 45 years of age, is the weakening of the body's defenses. Decreased immunity may be a consequence of a systemic bacterial or viral disease, long-term use of certain drugs (glucocorticoids, cytostatics), or a deficiency of essential vitamins in the diet. The risk of inflammation of the external genitalia increases with alcohol abuse and drug use. Other causes of vulvitis are:

• failure to comply with intimate hygiene rules;

• untimely replacement of tampons and pads during menstruation;

• diaper rash due to the characteristics of a woman’s constitution (for example, the formation of folds of skin on the external genitalia due to 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 developing 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 is facilitated by disruption of the vaginal microflora. A similar situation can occur during pregnancy, long-term treatment with antibiotics, taking incorrectly selected oral contraceptives, gynecological diseases accompanied by a decrease in estrogen production.

Types and forms of vulvitis

In clinical practice, a distinction is made between primary (isolated) and secondary vulvitis.

1. It should be noted that in adult women the primary form of the disease practically does not occur, since the mucous membrane, due to the predominance of fermented milk microflora, normal hormonal levels and an acidic pH environment, is more resistant to infection. However, primary vulvitis is quite often registered among old women and girls. This condition occurs due to the anatomical and physiological characteristics of the vulvar mucosa and changes occurring due to low levels of female sex hormones. In women of advanced years, during the postmenopausal period, atrophy of the mucous membrane of the urogenital organs is observed, the amount of vaginal discharge is significantly reduced, the mucous membranes become thinner and dry out. As a result, they are easily damaged and become extremely vulnerable to infection.

In childhood, the skin and mucous membranes of the vulva are thinner, and therefore they are easily injured. The vaginal microflora of girls, in contrast to the “adult” microflora, is predominantly coccal, the pH is alkaline, and local immunity is not fully formed. Also, very often, vulvitis in girls can occur due to the presence of pinworms. They cause severe itching; scratching causes injury to the mucous membrane and infection. Sometimes vaginal discharge occurs in newborn girls. They are provoked by maternal estrogens entering the child’s body before birth. This condition should not be considered a pathology, and it will soon go away on its own.

2. Secondary vulvitis is a pathological condition that is much more common. It occurs due to irritation of the external genitalia by infected vaginal and cervical discharge or infected urine (in case of urinary tract diseases).

Depending on the type of pathogen, it is customary to distinguish between bacterial and candidal vulvitis, and depending on the nature of the pathological transformations of the mucous membrane of the external genitalia, vulvitis is divided into atrophic, ulcerative and adhesive.

Candidiasis vulvitis

This is a disease caused by yeast-like fungi from the genus Candida. It affects the labia majora and minora, the clitoris and the vestibule of the vagina. As a result, severe itching and burning develops, which intensifies before the onset of menstruation and subsides slightly in the postmenstrual period. In patients with candidiasis vulvitis, the mucous membranes acquire a purple-bluish color, sometimes rashes in the form of small bubbles (vesicles) appear on the vulva, and a white cheesy film forms in the area located between the labia minora.

In women suffering from ovarian hypofunction, diabetes mellitus and myxedema, the pathological process sometimes spreads to the perianal region and to the femoral-inguinal folds.

Bacterial vulvitis

Bacterial vulvitis is a pathological condition provoked by opportunistic microflora or sexually transmitted infections (gonococci, trichomonas, chlamydia). Mycobacterium tuberculosis can provoke the disease much less often.

During pregnancy, bacterial vulvitis, as a rule, develops against the background of reduced immunity, due to the activation of staphylococcal microflora. Due to the significant functional and hormonal changes occurring in the body of the expectant mother, specific and nonspecific pathogens are much easier to penetrate into the thickness of the mucous membrane of the external genitalia.

Atrophic vulvitis

This form of pathology is characterized by thinning of the vulvar mucosa, which very often occurs in women after menopause. It should be emphasized that without hormone replacement therapy, atrophic vulvitis will steadily progress and, ultimately, lead to the formation of painful erosions.

Ulcerative vulvitis

Ulcerative vulvitis is a chronic form of the pathological process, which is characterized by the formation of plaque on the damaged mucous membrane of the external genitalia, in the place of which, after removal, ulcers remain. Most often, this pathology is found in patients of reproductive age.

Note: After the ulcers heal, there is often obvious deformation of the external genitalia.

Adhesive vulvitis

Adhesive vulvitis, or fusion (synechia) of the labia minora, is a disease of unknown etiology that occurs in girls under five years of age. It is characterized by sticking together of the labia, which is how it got its name. At an early stage of the pathological process, an epithelial bridge is formed between the labia minora, which almost completely covers the vulva. In some cases, children complain of slow urination, but at the same time, much more often, synechiae are detected completely by accident, during a thorough examination of the external genitalia. In this case, the labia minora are connected along the “edge” to the anterior edge, where a small hole remains from which urine comes out.

As a rule, this condition does not cause any subjective sensations, and with the onset of puberty it heals itself. However, with the development of a rough adhesive process, in some cases surgical intervention (dissection of the labia minora) is indicated.

Symptoms of vulvitis

Acute vulvitis is characterized by the following symptoms:

• swelling and redness, or redness, of the vulvar area;

• the presence of ulcers or erosions in the vulva area;

• discomfort, itching, burning in the vulva area;

• pain that becomes stronger when urinating or defecating;

• discharge from the genitals, usually with purulent or serous-purulent contents;

• in more severe cases, enlarged lymph nodes in the groin area can be detected;

• An increase in body temperature is also characteristic.

Vulvitis with untimely and improper treatment can become chronic with frequent relapses. The chronic form of vulvitis is characterized by moderate manifestations of swelling, pain and hyperemia in certain areas of the vulvar mucosa, hypertrophy of the sebaceous glands, itching, burning, and scanty discharge.

Sometimes with vulvitis, after healing of erosions and ulcers, the genitals can become deformed, making sexual life difficult in the future. Girls may experience adhesions in the labia area - synechiae.

Diagnosis of vulvitis

In many ways, the diagnosis of vulvitis is based on a thorough assessment of clinical manifestations, as well as on the results of a vaginal examination, which reveals characteristic signs of inflammation.

In addition, the diagnostic search includes other studies. Their goal is to determine the cause of the disease in order to carry out targeted treatment.

The main diagnostic tests that are used for vulvitis are:

• Microscopic examination of vaginal smears. It allows you to exclude or confirm trichomonas or gonococcal infection;

• Bacteriological examination for vulvitis is not very popular, since there is a wide variety of microorganisms in this anatomical area;

• To identify urogenital infection, which leads to frequent relapses of vulvitis, it is rational to use the polymerase chain reaction.

It determines the DNA or RNA sequences of microorganisms. Currently, this is the “gold” standard for diagnosing infectious and inflammatory processes.

Treatment of vulvitis

WITH Modern gynecologists are of the opinion that correct, effective and sufficient therapy for vulvitis should be exclusively comprehensive, and not symptomatic, when the doctor treats not the disease, but its external manifestations. Consequently, not only the inflammatory process in the external genitalia must be eliminated, but also the factors that caused it. If the gynecologist claims that in your case simple relief of symptoms is enough (and this is often the case with doctors in small commercial clinics), you should look for another specialist.

• If the disease is in an acute stage, doctors advise sticking to bed rest, even if you are used to an active, eventful life;

• During treatment, it is strictly not recommended to have sex, and even more so to change partners frequently;

• Specific antibacterial therapy is prescribed on the basis of clinical tests and only after a pathogenic pathogen (gonococci, trichomonas, chlamydia or tubercle bacilli) has been identified;

• You should not refuse antibiotics (if your doctor recommends them) and demand more gentle treatment: modern drugs are much safer than those that were used 20–30 years ago;

• Antifungal drugs show their effectiveness only if a diagnosis of candidal vulvitis is made;

• In case of severe and painful itching, the symptoms are first relieved (anasthesin or hydrocortisone ointment, physical therapy);

• If vulvitis is caused by allergies, special antihistamines and a diet excluding sweet, salty and spicy foods are indicated;

• Mandatory treatment is also subject to a variety of concomitant diseases (chronic infections, metabolic and hormonal disorders);

• Particular attention should be paid to strengthening the immune system, for which immunostimulants, vitamins and certified dietary supplements are great;

• Of course, you should not neglect local treatment of the external genitalia (which, by the way, can be done at home). Cold compresses of lead water and lotions, sitz baths with a warm weak solution of potassium permanganate and douching with antiseptics will significantly increase the likelihood of a successful outcome of treatment. At the end of each procedure, the genitals should be thoroughly dried with a towel and treated with streptocide powder;

• With regular care (washing) of the external genitalia, you can additionally use a solution of boric acid, chamomile infusion and potassium permanganate.

Traditional medicine recipes for the treatment of vulvitis

For the treatment of vulvitis and vulvovaginitis, traditional medicine recommends the use of special medicinal plants. In cases of acute vulvitis, decoctions of eucalyptus leaves (6.0 g per 1 liter of water), sage infusion (14.0 g per 1 liter of water) are used; These products are used for washing and irrigating the vagina.

Many authors involved in the classification of medicinal plants and the distribution of their therapeutic effect for a particular pathology recommend the use of certain medicinal plants in combination, in the form of collections. E. Shmerko and I. Mazan in their publication recommend collections from plants that have a therapeutic effect, infusions and decoctions of which are used internally, in the form of baths and douches, as well as herbal tampons for vulvitis and vulvovaginitis of various etiologies.

Collection No. 1
Required: leaves, flowers of mountain arnica - 2 tsp, leaves of great plantain - 1.5 tsp, herb of marsh grass - 2 tsp, flowers of chamomile - 2 tsp, flowers of calendula officinalis - 2 tsp, peppermint herb - 1.5 tsp; boiling water - 0.5 cups.
Preparation : 5 tbsp. l. Pour boiling water over the mixture, leave for 2 hours, then strain the infusion through cheesecloth.
Application: Douche the vagina with warm infusion before bedtime. And at night, if you have vulvovaginitis, you can use a gauze swab soaked in the infusion, which is placed in the vagina overnight.

Collection No. 2
Required: calendula officinalis flowers - 1 tsp, tansy flowers - 1 tsp, chamomile flowers - 1 tsp, greater celandine herb - 1.5 tsp, great plantain leaves - 1 tsp l., cinquefoil herb - 1 tsp, cudweed herb - 1.5 tsp; boiling water - 0.5 cups.

Application: Douche the vagina with warm infusion before bedtime. And at night, if you have vulvovaginitis, you can use a gauze swab soaked in the infusion, which is placed in the vagina overnight.

Collection No. 3
Required: black currant leaves - 1 tsp, tripartite herb - 1.5 tsp, marsh grass - 1 tsp, bird cherry flowers - 1 tsp, calendula officinalis flowers - 1, 5 tsp, chamomile flowers - 1.5 tsp, sticky alder leaves - 1 tsp, leaves, flowers of mountain arnica - 1 tsp; boiling water - 0.5 cups.
Preparation: 5-6 tbsp. l. Brew the mixture with boiling water and leave for 2 hours, then strain through cheesecloth.
Application: Douche the vagina with warm infusion before bedtime. And at night, if you have vulvovaginitis, you can use a gauze swab soaked in the infusion, which is placed in the vagina overnight.
Decoctions of the above mixtures can be used in the form of sitz baths, the water temperature is 32-33 ° C, and the duration of the bath is 15-20 minutes.

Collection No. 4
Required: chamomile flowers - 1 tsp, cinquefoil herb - 2 tsp, oak bark - 2 tsp, stinging nettle herb - 1 tsp, knotweed herb - 2 tsp. ; boiling water - 0.5 cups.
Preparation: 5-6 tbsp. l. Brew the mixture with boiling water and leave for 2-2.5 hours, after which strain the infusion through cheesecloth.

Collection No. 5
Required: rosemary leaves - 1 tsp, sage leaves - 1 tsp, yarrow herb - 2 tsp, oak bark - 2 tsp; boiling water - 0.5 cups.
Preparation : 5-6 tbsp. l. Brew the mixture with boiling water and leave for 2-2.5 hours, then strain through cheesecloth.
Application: Douche the vagina with warm infusion before bedtime. And at night, if you have vulvovaginitis, you can use a gauze swab soaked in the infusion, which is placed in the vagina overnight. This remedy can also be used orally, 0.5 cups, as a general anti-inflammatory agent.

Prevention of vulvitis

To reduce the risk of developing an inflammatory process, women at any age need:

• promptly contact a gynecologist if signs of genital diseases are detected;

• maintain personal hygiene;

• Strengthen your immune system and stick to a healthy diet. You should eat fermented milk products containing live cultures;

• avoid casual sexual contacts;

• stop using synthetic underwear;

• take antibiotics as prescribed by your doctor.