Vaginitis
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Vaginal infections are among the most common reasons that women seek
gynecological care. There are a variety of organisms that are frequently
associated with vaginal infection. Some of these include /Trichomonas
vaginalis, Candida albicans/, and /Gardnerella vaginalis/ (formerly
/Haemophilas vaginalis/), in association with other organisms, primarily
anaerobes. /G. vaginalis/, with other organisms, causes a bacterial
vaginosis (also referred to as nonspecific vaginitis). /Chlamydia
trachomatis/, and /Mycoplasma hominis/ may also be associated with
vaginitis.(1 <#fn108702>)
While some vaginal infections are simple and require minimal care,
others have a more serious side and warrant careful evaluation and
appropriate therapy that is specific for the specific site and type of
infection. For example, vaginal trichomoniasis and bacterial vaginosis
early in pregnancy may be predictors of premature onset of labor.(2
<#fn108703>) Bacterial vaginosis may also be a risk factor in developing
upper genital tract infection. Vaginitis also may be an early sign of
toxic shock syndrome. Vaginal discharge may be the presenting symptom of
genital herpes, or may occasionally reflect cervicitis or pelvic
inflammatory disease (PID) caused by chlamydial or gonococcal
infections. All of these are reasons why it is important to have any
type of vaginal infection checked out early.
It is important to remember that there are several reasons not related
to infection that a woman might have a vaginal discharge. A normal
vaginal discharge is generally nonodorous, white, highly viscous, and
acidic. Discharges may become heavier at mid-cycle because of increased
cervical mucous or increased vaginal cells.(3 <#fn108704>, 4
<#fn113286>) Other conditions resulting in excessive vaginal discharges
include retention of foreign bodies (e.g., tampons), allergic reactions
to vaginal spermicidal agents or products used for douching, or the
presence of cervicitis.(5 <#fn108705>)
*Bacterial vaginosis* is the most common cause of vulvovaginal symptoms
in most clinical settings; it is closely followed in frequency by
*vulvovaginal candidiasis*.(2 <#fn108703>) *Trichomoniasis* is a
sexually transmitted disease (STD) that is much less common in most
settings in developed countries.
Factors that may lead to the development of *bacterial vaginosis* are
not established, but it may be linked to sexual activity.(6 <#fn108706>)
The syndrome is associated with STD factors, such as multiple sex
partners or recent intercourse with a new partner; however, no single
sexually transmitted pathogen has been identified as the cause. One
difference routinely found is that the hydrogen peroxide-producing
/Lactobacillus/ sp., which constitutes most of the bacterial flora of
healthy women, is usually absent in women with bacterial vaginosis. This
situation may be at least partly responsible for the overgrowth of
anaerobic bacteria.
Women of all ages are susceptible to *vaginal candidiasis*. Some of the
factors that lead to candidiasis may include pregnancy and diabetes
mellitus, thought to be due in part to elevated glucose levels in urine.
The use of broad-spectrum antibiotics, cytotoxic drugs, or
corticosteroids are thought to alter the normal bacterial flora,
allowing yeast overgrowth. Finally, dietary intake (e.g., high calorie
or high carbohydrate diets) may influence the incidence of
candidiasis.(7 <#fn108707>)
*Atrophic vaginitis* is most commonly associated with postmenopausal
women and is due, at least in part, to the lessening of tissues which
were formerly dependent upon high estrogen concentrations. Large numbers
of estrogen receptors are located in the vagina, vulva, urethra, and
trigone of the bladder.(8 <#fn108708>) The vulva undergoes shrinkage,
and there is also shrinkage of the labia minora. A decrease in the
subcutaneous fat and elasticity of the tissue causes the labia majora to
flatten. Sometimes changes of the vulva (Kraurosis vulvae) lead to
pruritis and pain.(9 <#fn108709>, 10 <#fn108710>) Additionally, the
vaginal cell wall becomes thin and pale, leading to reduced secretion
and diminished elasticity; the tissue becomes easily traumatized and may
bleed. The normal premenopausal pH of 4.5 to 5 rises to an alkaline 6 to
8, creating a favorable environment for growth of pathogens.
For nutritional support, visit www.vitaminaid.net
Additional Links Back to Top <#top>
* Statistics <HC2.asp?objID=100638&cType=hc> about Vaginitis
* Signs and Symptoms <HC2.asp?objID=100638&cType=hc> of Vaginitis
Footnotes Back to Top <#top>
^1 Sagraves R, Letassy NA. Gynecologic disorders. In: Koda-Kimble MA,
Young LY, eds. Applied Therapeutics, the Clinical Use of Drugs, 5th ed.
Vancouver, WA: Applied Therapeutics Inc; 1992:70-75.
^2 Holmes KK, Handsfield HH. Sexually transmitted diseases: Overview and
clinical approach, In: Fauci AS, Braunwald E, Isselbacher KJ, et al,
eds. Harrison?s Principles of Internal Medicine, 14th ed. New York:
McGraw-Hill; 1998:805-807.
^3 Eschenbach DA. Vaginal Infection. Clin Obstet Gynecol. 1983;26:186.
^4 Gipson IK, Moccia R, Spurr-Michaud S, et al. The Amount of MUC5B
mucin in cervical mucus peaks at midcycle. J Clin Endocrinol Metab.
Feb2001;86(2):594-600.
View Abstract </SHK/view-abs.asp?fnid=113286&absid=106200>
^5 Eschenbach DA. Pelvic infections and sexually transmitted diseases.
In: Scott JR, et al eds. Danforth?s Obstetrics and Gynecology.
Philadelphia: J.B. Lippincott; 1986:972.
^6 Reed BD, et al. Differentiation of Gardnerella vaginalis, Candida
albicans, and Trichomonas vaginalis infections of the vagina. J Fam
Pract. 1989;28:673.
View Abstract </SHK/view-abs.asp?fnid=108706&absid=102994>
^7 Reed BD, et al. The association between dietary intake and reported
history of Candida vulvovaginitis. J Fam Pract. 1989;29:509.
View Abstract </SHK/view-abs.asp?fnid=108707&absid=102995>
^8 Pugh MC, Moynahan-Mullins P. Hormone Replacement Therapy. In: DiPiro
JT, Talbert RL, Ye GC, et al, eds. Pharmacotherapy, A Pathophysiologic
Approach, 4th ed. Stamford, CT: Appleton & Lange; 1999:1356-1357.
^9 Mishell DR. Estrogen replacement therapy: An overview. Am J Obstet
Gynecol. 1989;161:1825-1827.
View Abstract </SHK/view-abs.asp?fnid=108709&absid=102996>
^10 London SN, Hammond CB. The climacteric. In: Danforth DN, Scott JR
eds. Obstetrics and Gynecology, 5th ed. Philadelphia: Lippincott; 1986:905.
About Vaginitis
? Introduction <HC1.asp?objID=100638&cType=hc>
? Statistics <HC2.asp?objID=100638&cType=hc>
? Signs & Symptoms <HC2.asp?objID=100638&cType=hc#sign>
*Treatment Options* <HC3.asp?objID=100638&cType=hc>
Click to View additional treatment options for Vaginitis
<HC3.asp?objID=100638&cType=hc>
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