In the course of the disease vaginal epithelium is no longer produced and updated, which leads to a thinning and dryness of mucous membranes. The vagina becomes hypersensitive to a variety of mechanical damage and disorders, as well as susceptible to defeat pathogens.
What it is?
Atrophic coleitis - is an inflammatory process, actively flowing in the vaginal mucosa, which is the result of thinning of the epithelium and reducing blood estrogen concentration. Most often, the disease can be found in older women, but sometimes it occurs in women of childbearing age. The incidence of such diseases is 35-40%.
The main cause of vaginitis is the lack of female sex hormones - estrogen. Their deficiency leads to the following events:
- microflora is disturbed, resulting in increase in pH;
- increased vulnerability of the vaginal walls;
- there is a significant vaginal dryness;
- slows down and then stops the proliferation (growth) of the vaginal epithelium;
- It thins the mucous membrane;
- reduced secretion of glands located in the vagina;
- reduces the number of lactobacilli;
- activated inner conditionally pathogenic flora;
- the conditions for the penetration of pathogenic bacteria from the outside.
Most affected by the following categories of women:
- past radiotherapy any organs located in the pelvis;
- bearer of the human immunodeficiency virus;
- have reached menopause or early menopause;
- had undergone surgery to remove the ovaries;
- suffer from hypothyroidism (low thyroid function), diabetes, and other diseases of the endocrine system;
- having a weak immune system.
Mucosa injury that may occur during a pelvic exam, other medical procedures, with intimate contact, create conditions for unimpeded penetration infection. Weakening the body's defenses and ekstragenital'nye disease with chronic lead to the development of non-specific inflammatory reaction vaginal mucosa. In this senile coleitis passes in relapsing forms.
The symptoms of atrophic vaginitis in women
The first signs of atrophic vaginitis occur in about 5 years after the onset of the last menstrual period. As a rule, the disease is sluggish, slabovyrazheny symptoms (see. Photo).
Amplification of clinical manifestations associated with joining a secondary infection and activation of opportunistic bacteria, which contribute microtraumas mucosa because of its easy vulnerability (e.g., after a gynecological examination, or coitus caving / syringing).
To the main symptoms include such clinical manifestations:
- Pain during sexual intercourse and after it is due to the depletion of stratified squamous vaginal epithelial denudation nerve endings and decreased production of vaginal secretion glands, the so-called lubrication.
- It manifested as a feeling of dryness, tightness of the vagina, in some cases, pain. Upon accession, the pathogenic microflora appear significant itching and burning.
- Senile vaginitis is always accompanied by thinning of the walls of the bladder and pelvic relaxation of muscles. These processes are accompanied by increased frequency of urination, although the amount of urine per day does not change (does not increase). Furthermore, weakened pelvic floor muscles contribute to the development of urinary incontinence (coughing, laughing, sneezing).
- They are modest, mucous or closer to the watery. In the case of infection leucorrhea acquire quality characteristic for a certain type of bacteria (curdled, greenish foam), and have an unpleasant odor. Also for atrophic vaginitis is characterized by bleeding. They usually insignificant, in the form of several drops of blood and mucous are caused traumatization (sex, physical examination, douching). The appearance of any bleeding (both minor and heavy) in postmenopausal women is a cause for immediate treatment to the doctor.
Vaginal mucosa pale pink, with numerous punctate hemorrhages. Upon contact with medical instruments mucosa bleeds easily. In the event of the accession of secondary infection observed swelling and redness of the vagina, or grayish pus.
To diagnose coleitis certainly needed:
- traditional gynecological examination using mirrors;
- microscopic examination;
- assessment of acid-base balance of the vaginal environment.
Even during a normal checkup doctor may notice an unnatural pallor and excessive thinning of the mucosa. Use speculum easily visible areas of mucous coated microcrack and devoid of epithelium. For reinfection characteristic greyish plaque isolation and containing pus.
Microscopic analysis during vaginitis shows:
- analizprevyshayuschy microscopic leukocyte count rate;
- the presence or absence of potentially harmful micro-organisms;
- insufficient vaginal sticks.
When colpocytologic examination revealed pH-level change in a big way, when the sample Schiller - weak staining in most cases non-uniform. To exclude oncology, additionally appointed PCR, biopsy and research secretions. Appoint a doctor may also cytogram.
How to treat atrophic coleitis
In women, the treatment of the inflammatory process has several objectives, including:
- Vaginal tissue regeneration processes for food preservation of their structure;
- Removal of existing inflammatory process and, if necessary, joined bacterial infection;
- Prevent possible recurrence of vaginitis.
Most often, women with atrophic vaginitis prescribe hormone replacement therapy.
For the treatment of the disease locally in the vagina introduced candles and ointments, including estriol and ovestin. Also prescribed tibolone hormone, estradiol, kliogest, Angelica, which is used systemically in tablet form or in patches. It's worth noting that the hormones will have to take a long time period, up to 5 years without interruption.
If the inflammation is accompanied by the addition of the bacterial flora, the patient was prescribed antibiotics. When coleitis atrophic form causes urinary incontinence, doctors recommend uroseptikov reception.
To evaluate the effectiveness of the therapy, the woman will have to undergo regular studies, which were implemented in the diagnostic phase.
If a woman is contraindicated treatment with preparations containing estrogen, it is prescribed for therapeutic purposes local irrigation with antiseptic properties. This allows you to alleviate some of the woman's condition and reduce the severity of symptoms.
As for the forecast, that with respect to the life of the patient it is favorable. However, even with the passage of a full therapeutic course of the disease may recur and bring the woman some discomfort, reducing its quality of life.
The main preventive measures to prevent the development of atrophic vaginitis are regularly monitored by a doctor-gynecologist and timely prescription of hormone therapy. Such drugs are not only able to reduce menopausal symptoms and affect the state vaginal epithelium, prevent the occurrence of some cardiovascular diseases, osteoporosis, etc.
Nonspecific prophylaxis of atrophic vaginitis comes to observing the following guidelines:
- engage in exercise stress;
- stop smoking;
- try to avoid stressful situations;
- adhere to the rules of healthy eating;
- closely monitor the personal hygiene;
- wear cotton underwear;
- strengthen the immune system.
As to the forecast, the flow atrophic vaginitis is favorable, with the exception of recurrent relapses which impair quality of life.