The term “vulva” includes the female external genital organs, which include the labia minora and labia vulva, the eve of the vagina, the external opening of the urethra, and the clitoris.
About vulvitis say when the inflammation of the mucous vulva, that is, all of the listed anatomical structures.
Women of premenopausal and menopausal age often suffer from Vulvitis and girls, as a rule, up to 10 years.
- acute vulvitis, which lasts for one month,
- subacute vulvitis lasting up to three months
- chronic process lasting more than three months.
Also, the disease can be infectious, that is, due to pathogenic microorganisms, and non-infectious (allergic, atopic, traumatic vulvitis ). In turn, an infectious vulvitis may be nonspecific and specific ( trichomonas, gonorrhea, candidal ).
In addition, vulvitis is classified into primary and secondary. Primary vulvitis is talked about when the process has evolved against the background of non-compliance with intimate hygiene, injuries and other factors. Secondary vulvitis is a disease that appears on the background of any other (helminthiasis, endometritis, diabetes mellitus ).
The causes of vulvitis in girls and women are very similar. These include:
- failure to comply with the rules of intimate hygiene (frequent, using soap washing, neglect of hygiene);
- diseases of the internal genital organs (vulvar irritation, pathological leucorrhoea);
- genital infections;
- allergic reactions (diaper dermatitis, the use of nappies with fragrances, the use of pads and deodorizing personal care products);
- endocrine pathology (diabetes, hypothyroidism );
- wearing tight linen and tight pants;
- genital trauma (masturbation, foreign bodies, rough sexual intercourse);
- lack of vitamins;
- hormonal adjustment (during pregnancy and menopause );
- weakened immunity;
- improper feeding (in infants);
- long-term antibiotic treatment;
- urinary tract infections;
- urinary incontinence;
- anatomical features: lack of posterior commissure, gaping genital slit (in girls);
- childhood infections;
- vegetoneuroses (vulva scratching).
Infectious pathogens of the disease can be E. coli, fungi, viruses, and specific microorganisms ( chlamydia , gonococci, trichomonads).
The clinical picture of the disease is similar in both girls and women.
On examination, there is swelling of the labia and clitoris, their color changes to bright red. Older girls and women often have a sore clitoris that interferes with walking and causes pain. Permanent combing of the vulva (in girls) leads to ulceration. In some cases, the process extends to the skin of the pubis and internal labia.
Girls become restless, capricious, their sleep is disturbed. In children under one year, there is anxiety, crying, especially during urination, and rejection of the breast. Sometimes the process is so pronounced that the girl’s temperature rises and the inguinal lymph nodes increase. Women, in addition to itching and burning in the vulva, complain of pain during intimacy, urination, and when walking.
Another characteristic sign of vulvitis is whiter. In girls, they are usually abundant, transparent or watery, but can change their color and character depending on the pathogen.
Differential diagnosis of vulvitis should be carried out with herpes infection, diabetes mellitus, diseases of the internal genital organs, children’s infections ( measles, scarlet fever ), sexually transmitted infections.
The diagnosis is established on the basis of characteristic complaints and the clinical picture.
Mandatory microscopy of vaginal (in girls) and cervical smear, smear from the urethra.
In addition, it is shown to conduct bacteriological examination of whiter to identify the pathogen and determine its sensitivity to antibiotics.
PCR diagnostics for genital infections, complete blood and urine analysis, feces for helminth eggs and blood sugar.
The treatment of vulvitis in girls is carried out by a pediatric gynecologist, in women a gynecologist.
First of all, before starting treatment, it is necessary to establish and eliminate the cause that led to the disease. For example, changing diapers, refusal of intimate hygiene products, revision of complementary foods, removal of a foreign body from the vagina and so on. This stage is crucial in the treatment of the disease.
Further, treatment is prescribed depending on the identified pathogen (in the case of the fungal etiology of vulvitis, antifungal agents are indicated, in the infectious nature of the disease antibiotics are prescribed).
Children, as a rule, are not prescribed antibiotics, but if the course of the disease is severe, and even more so if vulvitis is caused by a specific microflora, antibiotic therapy is necessary.
Warm baths with decoction of medicinal herbs (calendula, chamomile, and St. John’s wort) and antiseptic solutions ( furacilin, chlorhexidine, boric acid) are shown as symptomatic therapy.
With severe itching, ointments are prescribed. for external use with anesthesin, painkillers.
In case of restless sleep, sleeping pills are prescribed.
For the time of treatment, girls are shown bed rest, women are banned from sex.
The treatment of acute vulvitis takes 7-10 days, while the treatment of chronic can take a month or more.
One of the consequences of the disease is the chronization of the process (with poor quality or incomplete treatment).
In girls, acute vulvitis is dangerous in the development of synechiae (adhesions) labia, narrowing of the vagina, deformation of the external genital organs, which impede the intimate life in the future, urethritis, erosion of the cervix .
In women, an infection from the vulva can penetrate higher into the cervix, uterus and appendages with the development of inflammatory diseases.
The prognosis for the timely treatment of vulvitis favorable.