The aging of the female body begins with the extinction of ovarian function. This leads to a natural decrease in estrogens - sex hormones that govern many processes in a woman's body. Atrophic colpitis (vaginitis) in menopausal women is a consequence of these regular processes. But this state is not pleasant. Are there ways to influence it?

Estrogen deficiency diseases include neuroendocrine disorders, osteoporosis, urogenital problems, and pathology of the cardiovascular system. Everything is explained by the presence of estrogen receptors in many tissues: bone, epithelial, fat. Estrogen deficiency can occur naturally - with aging. There is also an artificial menopause, when the work of the ovaries is stopped by medication or surgery. In this case, the symptoms of menopause manifest themselves in the same way as with its natural onset.

Hormonal affairs: what happens to the body after 50

Estrogens in the blood are represented by several fractions with varying degrees of activity. Their disappearance with age occurs in a certain order. Body aging is a natural programmed process. Approximately five years before the onset of menopause, mechanisms are activated that lead to a decrease in estradiol. With the onset of menopause, its concentration is almost zero. In postmenopausal women, another fraction, estrone, remains circulating in the blood, but its effect on receptors is minimal, which means that the necessary effects are unattainable.

The hypothalamus tries to stimulate the ovaries by artificially increasing follicle-stimulating and luteinizing hormones, which during menopause exceed the norm of reproductive age. But the function of the ovaries fades, they do not respond to stimulation of the hypothalamus. The formation of the main estrogen hormone occurs due to the adrenal cortex or by converting androgens into it in the tissues of the ovaries. Also, its amount can be affected by obesity, liver dysfunction and ovarian tumors.

Estrogen deficiency affects the entire body. In this case, the following pathologies are observed:

  • neurotic disorders;
  • urogenital problems;
  • high risk of developing atherosclerosis;
  • dystrophic processes in the skin;
  • osteoporosis;
  • psychological changes.

But all these symptoms do not appear at the same time. There is a clear sequence. The sexual organs are the first to feel the lack of estrogen. Therefore, atrophic vaginitis develops in women after about 50 years. After that, skin problems appear, urinary incontinence torments. Closer to 60 years, the problem of osteoporosis arises, and after - atherosclerosis.

Atrophic colpitis in menopausal women: why a problem arises

The period of menopause is characterized by the occurrence of a complex of urogenital disorders, which include the following conditions:

  • atrophy of the vaginal mucosa;
  • urinary incontinence;
  • prolapse of the pelvic organs.

The causes of these conditions are atrophic changes in tissues that are sensitive to estrogens:

  • epithelium of the vagina;
  • lower third of the urinary tract;
  • pelvic floor muscles;
  • connection device.

Rarely do changes occur in isolation, usually a combination of several problems. Moreover, the frequency of their occurrence is associated with age. If at 50 urogenital disorders occur in 10% of cases, then after 55 years - in 50%. For women 75 years old, this figure reaches 80%.

According to ICD-10, the code for atrophic colpitis is N59.2, but if the menopause is caused by surgery, then it is assigned the code N59.3.

How the norm turns into pathology

In women of reproductive age, the pH of the vagina is maintained at a level of 3.5-5.5 due to the metabolism of lactobacilli. They convert glucose into lactic acid. The nutrient medium for their life activity is formed from the desquamated epithelium, in which a large amount of glycogen has been accumulated. In addition to lactic acid, lactobacilli produce many other useful substances, including even hydrogen peroxide. The normal microflora of the mucosa is maintained by the following mechanisms.

  • Glycogen. Its amount in desquamated cells determines how many microorganisms are able to survive.
  • Acidity. Normal pH affects not only the beneficial flora, but also does not allow the opportunistic pathogen to multiply.
  • Estrogens. Their concentration is the determining factor. Under the influence of hormones, the epithelium is intensively stored with glucose, and glycogen is formed.
  • Sex life. Full sex increases the extravasation of fluid into the vagina if the woman is aroused, and contributes to the desquamation of the epithelium. Sufficient humidity allows lactobacilli to feel good.

But it is worth developing an estrogen deficiency, the amount of glycogen in the epithelial cells will significantly decrease. This means that lactobacilli will not receive a nutrient medium for themselves. Their number gradually decreases until it disappears completely. The disappearance of lactobacilli leads to a decrease in the production of lactic acid, a change in pH to the alkaline side. This creates favorable conditions for conditionally pathogenic and pathogenic flora. The protective properties of the vagina are significantly reduced.

Then there are such symptoms of atrophic colpitis as dryness, thinning of the epithelium.

The main manifestations of the condition: complaints and diagnosis

The first signs of a decrease in proliferative processes in the vagina are the appearance of a feeling of discomfort, which turns into itching and burning. Women also complain of the following symptoms:

  • dyspareunia - painful intercourse due to dryness in the vagina;
  • discharge - may be associated with inflammation;
  • bleeding - contact, often after intercourse, associated with thinning of the mucosa;
  • prolapse of the vaginal walls- a consequence of estrogen deficiency.

Atrophic colpitis rarely occurs as an independent disease, in 78% of cases it is combined with urination disorders:

  • cystalgia - pain in the bladder;
  • nocturia - frequent nightly trips to the toilet;
  • pollakiuria - frequent daytime urination;
  • urinary incontinence- stress and non-stress form;
  • imperative urges- requiring immediate emptying.

Complications in the absence of treatment can manifest themselves in the form of microtrauma of the mucous membrane, the attachment of the inflammatory process and its spread to other parts of the genitourinary tract, cystitis, urethritis may develop.

Establishing diagnosis

Diagnosis requires a seated examination. The doctor notes that the mucous membrane of the vulva and vagina is thinned, it bleeds easily when touched. For analysis, a smear is taken from the vagina. The cytogram reflects the following indicators.

  • KPI. The karyopyknotic index is the ratio of the number of surface cells with pyknotic nuclei to the total number of all cells. With the development of atrophic changes, the KPI decreases to less than 15-20.
  • maturation index. It is determined by the ratio of parabasal, intermediate and superficial cells per 100 counted. Changes are determined by formula shift. If more parabasal cells appear, then this is a sign of atrophy.

Identification of cells with signs of atypia indicates a possible precancerous process. This condition requires further diagnosis.

Vaginal discharge is also taken for examination of the flora. A large number of leukocytes in a smear simultaneously with the microbial flora speak in favor of inflammation.

To confirm this, a colposcopy is performed. This is a special method of examining the vagina and cervix using a magnifying device - a colposcope. During the study, the doctor conducts small additional tests.

Schiller's test allows you to determine the condition of the epithelium of the vagina and cervix. The technique is based on the fact that in the normal epithelium there is a large amount of glycogen, which can react with iodine. If there is no glycogen, the reaction will not occur. The sampling procedure consists of five steps.

  1. The neck is exposed in the mirrors.
  2. The neck is cleaned with a cotton ball from mucus and secretions.
  3. Enter 10-15 ml of Lugol's solution.
  4. After a minute, the solution is blotted with a swab.
  5. Conduct an inspection.

With atrophic colpitis, the walls of the vagina, the neck are stained very weakly and unevenly. But sometimes a negative result can be a sign of leukoplakia. The test strips also check the pH of the vagina. With atrophic changes, it can reach six to seven.

How to fix the situation

Treatment of age-related atrophic colpitis should be carried out after examination by a gynecologist. The basis is hormone replacement therapy. Only this method will help with atrophic colpitis in women, because it is the only one aimed at the cause of the pathology.

In the absence of other signs of an approaching menopause, topical preparations can be used. With atrophic colpitis, Ovestin candles are taken. It is also available in gel and tablet form.

The composition of the drug includes estriol - a hormone that disappears from the body when the function of the ovaries is weakened. Estriol normalizes the microflora of the vagina, restores pH. The hormone has a positive effect on urinary problems, eliminates dyspareunia, and makes sexual life possible.

Contraindications for the use of hormonal suppositories:

  • pregnancy;
  • estrogen-dependent tumor;
  • bleeding of unknown origin;
  • allergy;
  • liver dysfunction.

Use "Ovestin" start with a large dose - 0.5 g daily two to three times a day. This treatment lasts for two weeks. Then they switch to maintenance doses of 0.5 g twice a week. Candles are produced in the indicated dosage.

Non-hormonal treatment for atrophic colpitis is ineffective. Despite the reviews on the network, folk remedies, homeopathy, douching with herbs, the use of sea buckthorn oil can only reduce the severity of inflammation, slightly softening the dry mucous membrane.

Alternative treatment of atrophic colpitis leads to a long-term absence of pathogenetic and etiological treatment. Therefore, signs of urinary incontinence, nocturia, pollakiuria, as well as the prolapse of the walls of the vagina will be the consequences of neglecting high-quality therapy.

It is necessary to treat atrophic colpitis only after visiting a gynecologist, although preparations for local hormonal treatment can be purchased without a prescription. Atrophic vaginitis is dangerous because it can be a background for the development of oncological pathologies. A prolapse of the pelvic organs can lead to their prolapse and the need for surgical care in the future.

  • Atrophic colpitis, also called "atrophic vaginitis", "vaginal atrophy", "vulvovaginal atrophy" or "urogenital atrophy", is an inflammation of the vagina caused by thinning and shrinkage of tissues, as well as a sharp decrease in vaginal lubrication.
  • The disease is largely due to a decrease in the level of estrogen in the body of a woman and can develop not only in women during menopause, but also in women who have just entered the pre-menopausal period - the time when estrogen deficiency in the body begins.
  • Low hormonal levels of estrogen increase the susceptibility of the urogenital and vaginal area to many secondary infections and lead to loss of vitality and mechanical strength of the vaginal walls (hence the atrophy).
All patients can be conditionally divided into two main groups:
  1. Up to 75% of cases of atrophic vaginitis involve postmenopausal women due to reduced estrogen production.
  2. Women who experience decreased production of the hormone estrogen, such as breastfeeding mothers, oophorectomy patients (who have their ovaries removed), women undergoing chemotherapy, etc.

Risk factors for the development of atrophic colpitis

Because estrogen levels begin to decline during menopause, most people tend to think that menopause itself causes this condition. However, a decrease in estrogen can also occur in other cases.

All of the factors that can lead to low estrogen levels in women are potential risk factors for developing atrophic colitis and may include:

The primary causative factor for atrophic colpitis is a lower level of estrogen production. Estrogen is an important hormone that maintains the physical vitality of the urinary (epithelial) and vaginal walls and maintains the correct acidity (pH). The absence of estrogen increases acidity, making the body susceptible to vaginal/urinary infections, and the vaginal walls lose their firmness and moisture.

  • The perimenopausal period is the period immediately before and after menopause.
  • Breastfeeding period (observed in breastfeeding mothers)
  • Surgical removal of the ovaries
  • Cancer Treatment - Like Radiation Therapy and Chemotherapy
  • Side effects of certain medications that are designed to lower hormone levels in the body as part of the treatment for another disease or disorder (eg, infertility, breast cancer, fibroids)
  • Extreme stress and depression

Symptoms of postmenopausal atrophic colitis

Vaginal itching, trouble urinating, and pain during sex are the most common symptoms, but they are often accompanied by:
  • Pain during intercourse: This is often caused by the fact that the vagina is smaller, much drier, and less lubricated than it was before menopause. As the tissue becomes more fragile as the disease progresses, this can make intercourse even less comfortable.
  • Discomfort: occurs as a result of inflammation of the vulva.
  • Itching: Atrophic colpitis makes the skin around the vagina more sensitive and easily susceptible to infections. This can cause the vaginal skin to itch very often.
  • Vaginal Discharge: If you notice white or yellow discharge on your underwear, this may be a sign of atrophic vaginitis. However, if the discharge has a distinct, foul odor, it is most likely an infection.
  • Vaginal infections: Atrophic colpitis raises the pH level of the vagina, thereby making it easier for harmful microbes such as yeast and bacteria to grow in it, which in turn causes vaginal infections. The loss of estrogen also reduces the overall immunity of the vaginal walls, leaving your vagina unable to resist pathogenic infectious bacteria.
  • Urinary problems: Atrophic colpitis can also lead to urinary problems. As the urinary tract or bladder tissues become thin and weak, the passage of urine becomes more painful.
  • Urinary tract infections (UTIs): The disease also increases the risk of urinary tract atrophy. Urinary tract infections associated with atrophy usually present with frequent or more urgent urination and/or a burning sensation during it.

Diagnosis of postmenopausal atrophic colpitis

The doctor will perform a thorough examination and ask for details about the medical history. Questions will also be asked regarding the use of certain hygiene products, such as soaps and perfumes, as these can further irritate the inflamed areas of the vagina and cause or worsen symptoms.

A thorough diagnosis will then be made to look for physical signs of atrophic vaginitis, such as:

  • Lack of vaginal elasticity
  • Pubic hair is less common than usual.
  • The vaginal lining is shiny and smooth and pale in color.
  • thinning of external genitalia
  • There are protrusions in the walls of the vagina
  • A vaginal pH or acidity test will be done. Under normal conditions, the vagina should have a pH of 4.5 or less. The indicator of atrophic vaginitis is pH 4.6 or higher.
The doctor may also request screening for infections by performing a vaginal smear and urine tests,
Examples of infections that may be present are endometritis, candidiasis, and bacterial vaginosis. Because atrophic colpitis can make the vaginal area more susceptible to infections, it can also occur along with an infection.
To rule out the possibility of diabetes, the doctor will also do a blood test along with diabetes.

Methods for the treatment of atrophic colpitis in postmenopause

Treatment for postmenopausal atrophic colpitis usually varies from case to case depending on the most disturbing symptoms and usually involves one or more of the following:
  1. Estrogen creams, pills, rings
    Because atrophic vaginitis is caused primarily by a lack of estrogen in the body, replacing estrogen in the tissues can often help relieve many of the symptoms. This can be done by topical application of an estrogen ointment or cream, or by inserting an estrogen tablet into the vagina. This may be a soft, flexible ring (such as an Estring. Estring) inserted into the vagina by a physician that releases the hormone estrogen at a slow, controlled rate. The estrogen ring is usually used for up to three months, after which it needs to be changed. The disadvantage of this method of treatment is an increased risk of endometrial cancer.

    Note: Estrogen creams should not be used as a lubricant during intercourse if you are using latex contraceptives such as condoms and a diaphragm. This is due to the fact that the cream can damage the latex, which nullifies all the safety of contraception. Therefore, when using condoms or diaphragms, or any method of contraception that is made of latex, it is better to use vaginal estrogen tablets or vaginal estrogen rings. Gels are another great option.

  2. Hormone Replacement Therapy (HRT)
    This is taking estrogen in the form of gels, tablets or patches. Since this treatment provides the necessary levels of estrogen throughout the body, it is often the best treatment for symptoms of atrophic colpitis, especially if other typical menopausal symptoms are present.
    The disadvantage of this type of treatment is a certain set of complications in some cases. Therefore, it is recommended to consult a doctor before starting treatment.
  3. Vaginal lubricants and moisturizers
    Sometimes vaginal dryness is the only problem with this disease. In cases where hormonal creams are not recommended due to the risk of other medical problems, lubricating moisturizers or gels are used. Lubricants can make the condition less painful, while vaginal moisturizers can help restore the moisture content of the vagina, thereby relieving vaginal irritation and dryness.

Depending on the severity of the symptoms and the method used, doctors recommend adhering to the prescribed treatment time. Each treatment works well in most cases, but if it is interrupted, the symptoms may return.

Check with your doctor if symptoms do not improve after treatment or return after treatment is completed, as these may sometimes be symptoms of other illnesses.

Prevention of atrophic colpitis in postmenopausal women

While it is not possible to completely prevent atrophic vaginitis, certain lifestyle changes can be made that can reduce the risk of infection:
  • Wear comfortable underwear: Cotton underwear improves air circulation in the genital area.
  • Be sexually active: Sexual activity will not have any effect on estrogen levels, but it will improve blood circulation.
  • Exercise Regularly: Exercise also boosts circulation and immunity, as well as providing protection against infection-causing bacteria.

Prognosis for atrophic colpitis

  • Atrophic colpitis can be cured completely. Proper treatment leads to a complete recovery from symptoms, bringing significant relief.
  • However, if there are other risk factors or developed opportunistic infections, treatment may be prolonged and intensive.

About 40% of women after the onset of menopause begin to suffer from signs of atrophic colpitis (burning and itching, vaginal dryness and pain during intimacy). It is also characteristic that the longer the period of menopause, the higher the chances of developing this pathology. Thus, the percentage of patients with this disease increases to 75 after 10 years from the moment of cessation of menstruation.

Since atrophic changes in the vaginal epithelium are usually associated with the physiological completion of hormone production by the ovaries, atrophic colpitis is considered as a pathology only if there are pronounced clinical manifestations (significant discomfort).

Definition of the term and types of disease

Atrophic colpitis is a change in the vaginal epithelium, which is associated with functional and structural changes, against which the vaginal epithelium becomes thinner, which ultimately causes the development of characteristic symptoms (repeated inflammation, itching, dyspareunia, dryness). This condition is provoked by a significant decrease in estrogen levels, which can be associated with both physiological causes (physiological menopause) and artificial cessation of the secretion of female sex hormones (atrophic colpitis in reproductive age or artificial menopause).

The very name of the pathology "vaginitis", or "colpitis", arose from the Greek word "colpos" and the Latin "vagina", which literally translates as "vagina". The suffix "it" indicates inflammation of the organ. Other synonyms of this disease are senile, or senile colpitis, atrophic vaginitis.

A little about the physiology and pathogenesis of the disease

The female vagina is lined with stratified squamous epithelium, which performs a significant number of functions that are required to protect the genital organs from various infectious diseases. The vaginal epithelium, due to its multi-layered nature, is constantly updated, the upper cells begin to die and slough off, taking pathogenic microorganisms and toxins with them, which are replaced by new cells.

In addition, the vaginal epithelium maintains a constant pH level of the environment. Normally, in women of reproductive age, the environment in the vagina is always acidic (pH 3.8-4.5), while the microflora is 98% composed of lactic acid bacteria. Lactobacilli prevent the attachment of pathogenic pathogens and the activation of opportunistic microorganisms by maintaining a constant acidic environment in the vagina. Such lactic acid bacteria feed on glycogen present in large quantities in the desquamated epithelium.

With the onset of menopause, the cyclic renewal of the vaginal ball of the epithelium begins to stop, which is associated with a decrease in the amount of synthesized estrogen and the completion of menstrual activity. Epithelial cells are able to exfoliate only in small quantities, which leads to the development of glycogen deficiency and, accordingly, causes a decrease in the number of lactobacilli. In connection with such processes, the pH of the vagina begins to shift towards alkalization, which ultimately leads to its contamination with opportunistic microflora and the penetration of pathogenic pathogens into the mucosa. All of these changes provoke the development of a local inflammatory reaction, namely colpitis.

The thinning of the epithelium and a decrease in the production of secretion by the glands of the vagina lead to slight vulnerability and fragility of the vaginal mucosa, which only contributes to the activation of opportunistic microorganisms and leads to a narrowing of the vaginal lumen.

Causes

The formation of this pathology is based on hypoestrogenism, which can be both physiological after the cessation of menstruation, and artificial (surgery and other manipulations on the ovaries). In girls of reproductive age, hypoestrogenism is possible under the following circumstances:

After childbirth, especially when breastfeeding

In the postpartum period, there is a gradual restoration of hormonal balance, especially in those women who breastfeed their babies (prolactin is synthesized), which ultimately leads to a long-term estrogen deficiency and often eventually causes the development of atrophic colpitis.

Hormonal ovarian dysfunction

A long-term hormonal imbalance provokes persistent hypoestrogenism and the formation of pathology.

    Endocrine pathology.

    Strong psycho-emotional experiences (hormonal imbalance occurs).

Women who suffer from thyroid diseases, adrenal pathologies, diabetes mellitus are prone to developing atrophic vaginitis.

Other reasons

    Weakened immunity (negatively affects the hormone-forming function of the ovaries).

    Carriers of HIV infection or patients with AIDS.

    Radiation therapy of the pelvic organs. When the pelvic region is irradiated, the female gonads are also involved in the process, which provokes a violation of the secretion of hormones, including estrogens.

    Removal of the ovaries (ovariectomy). The ovaries synthesize estrogens, while in their absence, the secretion of these sex hormones automatically stops.

Predisposing factors

Among the many predisposing factors, it is especially worth noting:

    unprotected, frequent and indiscriminate sexual intercourse;

    incorrect intimate hygiene;

    the use of aromatic products for the hygiene of intimate places, lubricants, antibacterial soaps, fragrances;

    wearing tight synthetic underwear (obstruction of oxygen access and promotes the development of anaerobic flora);

    general chronic diseases;

    chronic inflammatory diseases of the genital organs;

    errors in the diet (lack of sour-milk products, drinking low-quality water, eating unwashed fruits and vegetables).

Clinical picture of the disease

The first signs of the development of atrophic colpitis appear approximately 5 years after the end of menstruation. Usually, the pathology is characterized by a sluggish course, the symptoms are mild. An increase in clinical signs is associated with the addition of a secondary infection to the focus and the activation of opportunistic microflora, which is only facilitated by microtrauma of the mucosa due to its mild vulnerability (for example, after douching, washing, coitus, gynecological examination). Among the main features are:

Vaginal discomfort

It occurs as a feeling of dryness and tightness in the vagina, sometimes painful sensations may be present. In the case of accession of pathogenic vaginal microflora, severe burning and itching occurs.

Dyspareunia

Pain during or immediately after intercourse is due to depletion of the stratified epithelium of the vagina, exposure of nerve endings, and decreased secretion of vaginal gland products commonly referred to as lubrication.

Vaginal discharge

With this pathology, vaginal leucorrhea is moderate in nature, are mucous and tend to be watery. In the case of infection, the discharge acquires qualities that are characteristic of a certain type of microorganisms (foamy, greenish, curdled) and are accompanied by an unpleasant odor. Also, for atrophic colpitis, the presence of bloody discharge is characteristic. Usually they are insignificant in the form of a few drops of blood and are caused by trauma to the mucous membrane (douching, medical examination, sexual contact). The occurrence of any spotting (both profuse and insignificant) in the postmenopausal period is a reason for an immediate visit to the doctor.

Frequent urination

Senile vaginitis is always characterized by thinning of the walls of the bladder with a weakening of the tone of the muscles of the pelvic floor. These processes are accompanied by frequent urination, in which the amount of urine separated remains unchanged. In addition, with the weakening of the muscles of the pelvic floor, urinary incontinence begins to appear (when sneezing, laughing, coughing).

Examination data in gynecological mirrors

The vagina, and specifically its mucous membrane, has a pale pink color with numerous petechial hemorrhages. Upon contact with medical instruments, bleeding of new areas appears. In the case of a secondary infection, there is hyperemia and swelling of the vagina, purulent or grayish discharge.

Diagnostics

Diagnosis of this disease should be complex and implies:

    examination of the mucous membrane of the cervix and the walls of the vagina in the mirrors;

    collection of smears for microbiological examination.

A large number of leukocytes is determined (in the case of a secondary infection), which indicates inflammation, lactic acid bacteria are almost completely absent, a high content of opportunistic microorganisms is observed, specific pathogens (gardnerella, fungi, Trichomonas) can be identified.

PCR

In the presence of an obvious inflammatory process in the vaginal mucosa and obtaining questionable results of microbiological examination of smears, the patient is sent for PCR (blood, urine, gynecological smears) to determine hidden sexual infectious diseases. It is possible to detect human papillomavirus and herpes, cytomegalovirus, myco- and uroplasmas, chlamydia, and other pathogens.

Determination of acidity of the vagina

It is performed using a special test strip. Normally, the pH should correspond to the readings of 3.5-5.5. In the presence of atrophic colpitis, the pH increases to 5.5-7 or even goes into alkali (more than 7).

Colposcopy

Examination of the vaginal walls and cervix with magnification using a colposcope. Pallor and atrophy of the mucous membranes of the cervix and vagina, small cracks, a mild vascular pattern are determined, foci of dysplasia on the cervix and vaginal walls may be present. When performing the Schiller test (staining with Lugol), uneven staining or a weakly positive test is observed (depletion of the epithelium layer is an indirect sign of the development of dysplasia).

Taking a smear from the posterior fornix of the vagina and cervix for cytology

The cervical mucosa is represented by several types of cells:

    basal (mature and turn into parabasal, then into intermediate, and keratinizing);

    parabasal;

    intermediate (made in two layers and located under the keratinizing cells, as a result replacing them);

    keratinizing (they are directly exfoliated and are the upper layer of the mucosa).

Thus, with this pathology, the epithelial layer is depleted (not only on the walls of the vagina, but also on the cervix itself), respectively, in the cytogram in the presence of atrophic vaginitis, parabasal and basal cells prevail.

Classification of cytology of smears:

    the first type - atypical cells are absent, the cytological picture is normal;

    the second type - the structure of epithelial cells is slightly changed as a result of the presence of an inflammatory process in the neck or vagina;

    the third type - there are cells with a modified nucleus, but only in a single amount (repeated cytological examination is required) and colposcopy;

    the fourth type - there are individual epithelial cells with obvious signs of malignancy - histology and colposcopy are necessary;

    the fifth type is the multiple presence of atypical cells.

In the presence of atrophic vaginitis, a cytogram of the inflammatory process is usually diagnosed, which does not imply the appointment of anti-inflammatory therapy.

Treatment

What and how to treat in the presence of atrophic colpitis can only be determined by a gynecologist. The most effective and main method of treating atrophic colpitis in women both in the postmenopausal period and in childbearing age is the appointment of HRT (hormone replacement therapy). It is the intake of hormonal drugs that allows misleading the vaginal mucosa and forcing the epithelium to be renewed cyclically, which improves the trophism of the mucosa, reduces the severity of atrophy and prevents the formation of microtraumas.

Hormone replacement therapy can be carried out in two ways: systemic administration of hormones in the form of injections, tablets or hormonal patches, local creams, ointments, suppositories. Hormone therapy should continue for a long time, at least 1.5-3 years, although it is worth noting that a positive effect is observed already after 3-6 months from the start of therapy. However, if the course of hormonal therapy is stopped, the symptoms of atrophic vaginitis return and are quite often complicated by the addition of a secondary infection.

Local treatment

Candles that are prescribed in the presence of atrophic colpitis:

    Estriol.

Suppositories contain the main active ingredient - estriol (directly the estrogenic component) and as an additional substance - dimethyl sulfoxide. Release this drug without a prescription. Scheme of therapy: the first month intravaginal administration once a day, then twice a week. The drug can reduce the severity of vaginal itching, eliminates dyspareunia, excessive dryness. Candles are also effective in case of urination disorders, as well as urinary incontinence, which are provoked by atrophic processes in the vaginal mucosa.

    "Ovestin".

Produced in the form of suppositories, tablets and vaginal cream. The active ingredient is estriol, additionally: lactic acid, acetyl palmitate, potato starch. The drug has properties similar to estriol. The treatment regimen is also similar (first, intravaginal administration of suppositories daily for 4 weeks, after which, if the general condition improves, the dosage is reduced to 2 suppositories per week). It is released in a pharmacy without a prescription.

    "Gynoflor E".

Produced in the form of tablets for insertion into the vagina. The drug contains a lyophilisate of acidophilic lactobacilli with a dosage of 50 mg, as well as estriol - 0.03 mg. Effectively restores the vaginal microflora (the action of acidophilic lactobacilli), and also improves the nutrition of the vaginal epithelium, stimulates its growth due to glycogen, which is present in the preparation, supports the growth and formation of its own lactic acid bacteria on the vaginal mucosa. Scheme of therapy: the introduction of intravaginally one tablet for 6-12 days daily, after which one tablet is administered twice a week. Available in pharmacies without a prescription.

    "Elvagin".

Produced in the form of cream and suppositories. The main active ingredient is estriol. Enter into the vagina every day for 2-3 weeks, after which the dose is reduced to twice a week. Sold without a prescription.

    "Ortho-gynest".

Available in the form of tablets, suppositories and vaginal cream. The composition of the drug contains estriol. The course of therapy: the introduction of the drug (regardless of the form) at a dosage of 0.5-1 mg daily for 20 days, after which a week-long break is taken, with the weakening of symptoms, treatment is continued for 7 days a month. The course of treatment should be at least six months.

    "Ovipol Clio" (suppositories).

    "Estrovagin" (vaginal suppositories, cream).

    "Estrocard" (suppositories and cream).

Systemic treatment

Drugs that are prescribed for systemic therapy:

    "Climodien".

Produced in the form of tablets for oral administration. One package contains 28 tablets. The drug contains dienogest and estradiol. The drug is taken on a tablet every day, it is advisable to take the drug at the same time. After the end of the package, start taking a new one. Klimodien is prescribed to women who have pronounced menopausal symptoms (increased sweating, disturbed sleep, hot flashes) and signs of atrophic vaginitis, but not earlier than a year after the onset of menopause. In the pharmacy, the drug is dispensed without a prescription.

    "Cliogest".

One blister contains 28 tablets. Reception can be started on any day, but not earlier than one year after the last menstruation. The composition of the drug includes norethisterone acetate and estradiol propionate. A remedy is prescribed as hormone replacement therapy after 55 years for the prevention of the development of osteoporosis and for the treatment of atrophic colpitis. The drug is dispensed in a pharmacy without a prescription.

    "Davina".

Produced in the form of tablets of blue (10 pieces each) or white (11 pieces each) color. The package contains 21 tablets. The white tablets contain estradiol, while the blue tablets contain methoxyprogesterone and estradiol. They are taken every day for 3 weeks at the same time, after this period a week break is made, which is accompanied by the development of menstrual bleeding. The drug is prescribed in the presence of estrogen deficiency, for the prevention of postmenopausal osteoporosis and in menopausal syndrome. The pharmacy is released without a prescription.

    "Pausegest".

The composition of the drug includes norethisterone and estradiol. The package contains 28 tablets. The drug is taken daily, one tablet for four weeks. Upon completion of the packaging, they immediately begin taking a new one. "Pauzogest" is appointed no earlier than one year after the cessation of menstruation. In the pharmacy, the drug is dispensed without a prescription.

    Eviana.

    "Revmelid".

    "Active".

Herbal preparations (use of phytohormone therapy)

    "Kliofit".

Released in the form of an elixir or syrup. The composition of the product includes: chamomile, chaga, coriander seeds, hawthorn, cedar seeds, wild rose and other components of plant origin. Scheme of therapy: 10-15 ml of the product is diluted with 100 ml of water and taken three times a day 15 minutes before meals for 2-3 weeks. If necessary, the course of therapy is repeated after 1-2 weeks. The tool is released without a prescription.

    "Klimadinon".

The composition of the drug includes rhizomes of cimicifuga - a plant that has anti-menopausal and estrogen-like effects. The blister contains 15 tablets, the usual package contains 4 or 6 of these blisters. The drug is taken twice a day, one tablet at a time, the duration of therapy is determined by the doctor. The drug is dispensed in a pharmacy without a prescription.

    Qi-clim.

The basis of the drug contains an extract of cimicifuga roots, produced in the form of tablets, cream for the body and face. Reception is performed daily, 1-2 tablets for a month. The duration of the course is adjusted by the attending physician.

  • "Inoklim".

    "Estrovel".

    Tribestan.

    "Bonisan".

    Menopace Plus (vegetable component).

    Menopace (minerals and multivitamins).

    "Remens" (in the form of drops).

    "Feminal".

    "Climaxan".

    Klimadinon Uno.

Frequently asked Questions

Can alternative treatment be used in the presence of atrophic vaginitis?

Yes, the use of folk remedies is allowed, but only in the form of an addition to the main therapy with hormonal drugs. Folk remedies are usually used in the presence of a pronounced inflammatory reaction of the vaginal mucosa to eliminate itching and redness, relieve swelling, and better heal microcracks in the mucosa. They use warm baths with decoctions of Rhodiola rosea, juniper fruits, sage, calendula, chamomile and other medicinal preparations. You can also intravaginally introduce tampons moistened with aloe juice, take an infusion from a mixture of rose hips, sweet clover, nettle, sage, mint or celandine herb. It is also allowed to drink tea from raspberry leaf, chamomile and willow leaves.

I am 35 years old, and about a year ago I had an ovaries removed for endometriosis, and hormonal contraceptives were prescribed. Approximately 2 weeks ago, itching and burning in the vagina appeared, while there are yellowish discharges that have an unpleasant odor. Are such symptoms a manifestation of atrophic colpitis?

In this case, it is necessary to visit a gynecologist as soon as possible and perform smears on the vaginal microflora. In all likelihood, not atrophic, but nonspecific vaginitis is present, and the development of candidiasis is also possible. This disease requires at least a year since the operation, while it was said that the patient is taking hormonal drugs. The doctor will evaluate the results of smears and, when determining the pathogen, will prescribe an anti-inflammatory treatment appropriate to the situation. With regard to hormone replacement therapy, it is worth a little time.

Is it possible to prevent the development of atrophic vaginitis, and how to do it?

Yes, as a preventive measure, you need to regularly visit a gynecologist, give up addictions, wear synthetic and tight underwear, adhere to proper nutrition, and take multivitamin complexes (only if there is a doctor's recommendation). It is also worth excluding the use of flavored products as intimate hygiene, abandoning unprotected sexual intercourse and doing physical general strengthening exercises and Kegel exercises (for local strengthening of the muscles of the pelvic floor), it is better to replace the bath with a shower.

How is the effectiveness of therapy for atrophic colpitis determined?

To determine the negative or positive dynamics of the pathology, regular colposcopy (once every 3-6 months), cytological examination of smears of the vaginal microflora, and measurement of the pH of the vagina are required.

Atrophic colpitis is considered a fairly common disease among female patients. In most cases, it is age-related, that is, it is associated with natural physiological processes in the body. The treatment of the disease is quite complicated and lengthy, so it is important to consult a specialist in a timely manner to prevent complications.

Atrophic colpitis is a disease characterized by a change in the epithelium of the inner walls of the vagina, a gradual thinning of tissues and the appearance of concomitant symptoms that greatly complicate a woman's life. According to statistics, about 40% of patients after the appearance of the first signs of menopause note the symptoms of colpitis.

The most likely causes of the disease are the following:

Despite the fact that specialists almost always know for sure the cause of the development of the disease, determining the exact factor is considered extremely important.

Causing factors for the onset of the disease

Age-related atrophic colpitis, which is treated only after the true cause of the disorder has been identified, can be aggravated by other factors. Experts note that even with a decrease in the level of estrogen in the blood, not every woman has signs of the disease.

Diabetes mellitus, long-term use of antibacterial drugs, mechanical damage - these factors can also become provoking. In addition, colpitis often develops in patients who do not adhere to the rules of personal hygiene, or vice versa, observe it too diligently using aggressive means.

This will certainly violate the microflora or exacerbate the situation if such symptoms are already present. Another factor can be the wrong choice of underwear. Synthetic materials that do not allow air to pass through can greatly worsen the situation, even in the absence of other reasons.

Additionally, in patients who use tampons during menstruation, the risk of developing vaginitis or colpitis increases, especially when such products are made from low-quality raw materials.

It is worth noting that trichomonas, triponema and gonococci worsen the course of colpitis or become a provoking factor in the absence of other reasons.

At-risk groups

The risk group includes patients who are sexually active, do not have a permanent partner and neglect barrier contraceptives. Regular contact with a new partner can provoke acute colpitis, since the microflora of the vagina is disturbed.

In addition, an active sex life increases the risk of injury to the vaginal mucosa, which also aggravates the condition. The risk group also includes women with chronic diseases of the genitourinary system, as well as those who have undergone chemotherapy. Such factors significantly increase the likelihood of developing the disease.

Patients with weakened immunity, diseases of the endocrine system are much more likely to suffer from an atrophic form of colpitis. The age factor also matters, as women over 50 are more prone to thinning of the walls of the vagina.

Symptoms

Age-related atrophic colpitis (treatment is prescribed only after a diagnostic examination) is quite difficult to detect at the initial stage, since it almost does not manifest itself. As the disease progresses, symptoms appear.

The first sign will be an increase in the amount of discharge and a change in their smell. It becomes unpleasant, sometimes a small amount of blood is present in the discharge, which indicates damage to the mucous membrane and the formation of microcracks.

When urinating or performing hygiene procedures, the patient feels a burning sensation of varying degrees of intensity. In the advanced stages, it is quite strong, long-lasting.

In most women, colpitis is accompanied by a feeling of dryness in the vagina, discomfort and itching in the vulva. This indicates the progression of the disease, a decrease in the amount of lubrication and a violation of the microflora.

During sexual intercourse, the patient feels discomfort or even severe pain, which also indicates thinning of the epithelium and the formation of multiple areas of damage.

At the same time, sensations persist for a long time, even after the end of intimacy. Visual examination of the external mucous membranes marks their swelling and redness. At advanced stages, the color turns from red to burgundy or cyanotic, which indicates the severity of the condition.

Puffiness is observed not only during a visual examination of the external genital organs. When examining the vagina with the help of gynecological mirrors, such manifestations are almost always present.

At the advanced stage, other symptoms join. The patient talks about frequent urination and pain in the lower abdomen. Her general condition is deteriorating, possibly an increase in body temperature, weakness.

With a long course of the disease, the woman's appetite worsens, body weight decreases. The patient becomes irritable, performance decreases, signs of depression appear. General immunity also deteriorates, which can lead to complications.

Forms of the disease

Atrophic colpitis can occur in two forms - acute and chronic. The age-related type of the disease is most often chronic, so the treatment is long and complicated.

Acute colpitis occurs with severe symptoms, is often complicated and greatly worsens the general condition of the woman. All signs are aggravated for several days, and complications appear within a week. At the same time, all the classic manifestations of the disease are present in the clinical picture.

The chronic type of the disease develops much more often. Symptoms are mild, which is dangerous, because the woman does not notice the aggravation of the condition.

Itching and dryness of the vagina is present, burning during urination is insignificant. Often the patient considers the symptoms to be a sign of bladder or urethral disease. In any form of the disease, a complete diagnostic examination is required to identify the cause and degree of neglect of the condition.

Diagnostics

The first stage of the diagnostic examination will be a patient interview and a gynecological examination using mirrors. The survey allows you to determine the severity of symptoms and the presumptive cause of the disease.

On examination, the doctor observes visual signs in the form of swelling and redness of the mucous membranes, as well as microcracks. Sometimes there is some bleeding.

A mandatory stage of diagnosis is a clinical and biochemical blood test. The result allows you to assess the general condition of the patient and identify possible concomitant deviations.

PCR

The method is the definition of a polymerase chain reaction to identify hidden pathogens of genital infections. To do this, specialists take a sample of vaginal discharge. The biological material is sent to the laboratory, where it is placed in a special solution.

Diagnosis is very accurate, gives almost 100% guarantee of detection of pathogens, if they are present in the body in a latent form. The duration of the study is from 1 to 2 days, depending on the reagent used.

Determination of acidity of the vagina

Normally, the acid-base balance of the vagina is 3.5 - 5.5. With colpitis, the indicator rises to 7, which provokes discomfort.

Acidity is determined using a special test strip. The whole procedure takes several minutes. Based on the results, the doctor prescribes further examination.

Colposcopy

The technique is a study of the vaginal mucosa using a special colposcope device. This device magnifies the image several times, which allows you to see even minor damage and microcracks.

The procedure is performed on an outpatient basis, takes no more than 40 minutes, but allows you to get more accurate information.

Manipulation takes place in several stages:

  1. The patient is located on the gynecological chair.
  2. The specialist treats the external genital organs with antiseptic solutions.
  3. After that, a special tube is inserted into the vagina, at the tip of which there is a camera. She transmits the image to the monitor, and the doctor evaluates the result.
  4. After a thorough examination of the walls of the vagina and cervix, the colposcope is removed, and the external genital organs are re-treated with antiseptic solutions.

During colposcopy, the specialist usually takes an additional smear for cytological examination.

Taking a smear from the cervix and from the posterior fornix of the vagina for cytological examination

Age-related atrophic colpitis, the treatment of which begins after receiving the results of the examination, can be detected by examining biological material taken from the posterior fornix and cervix.

Usually, a specialist takes a sample immediately during a gynecological examination using a special tool. This allows you to reduce the time of the examination and get the most accurate results. Usually taking a smear is not difficult, but in some cases the mucous membranes are so thin and dry that the procedure is complicated.

After sampling, the material is sent to the laboratory. After 1-2 days, a specialist can examine the result. In most cases, pathogens are found in the analysis, which provoke complications.

Treatment of atrophic colpitis

To eliminate the symptoms of the disease at different stages, medicines and folk remedies are used. In addition, in the most advanced cases, surgical intervention is indicated.

In each case, the doctor selects an individual scheme that helps to achieve the effect in a short time.

Medical treatment

Drug treatment involves the appointment of local and systemic agents that have a complex effect on the body.

A drug Application features
EstriolVaginal suppositories that improve the general condition of the vaginal mucosa, eliminate itching and dryness. The medication contains hormonal components. Candles are administered daily for a month before bedtime. After that, for the next 4 weeks, the drug is administered 2 times a week, 1 suppository. After the course, the specialist evaluates the result, prolongs or cancels the treatment
OvestinHormonal topical drug, which is available in the form of vaginal tablets, cream and suppositories. It is used according to the scheme, which involves the daily administration of suppositories or tablets for 4 weeks. The cream is used for severe itching of the external genitalia
ElvaginVaginal suppositories with a hormonal component. The tool is highly effective, for 3 weeks quickly eliminates the signs of colpitis. It is necessary to enter 1 suppository daily, preferably at bedtime

In addition to local remedies, doctors prescribe systemic hormonal medications that enhance the effect. Hormonal preparations containing estradiol are usually used, for example, Climodien, Kliogest. A feature of these funds will be that they are only allowed to be prescribed to women whose last menstruation was at least 12 months ago.

After taking for 2-3 months, the symptoms of colpitis are weakened or disappear. The funds are available in the form of tablets or dragees, they are usually taken according to the scheme, like birth control pills, that is, 1 pc. per day. There are usually 28 tablets in a plate. The duration of the course is determined individually.

Surgical intervention

Surgical operation is required only in the case when colpitis is complicated by other diseases. For example, when an infection is attached, an inflammatory process develops in one or more walls of the vagina, the tissues swell, and a purulent focus may form.

In this case, an operation is indicated in which the specialist clears the focus of purulent masses, which prevents the further spread of inflammation. However, such cases are quite rare. The operation is performed under general anesthesia, the recovery period is individual.

Folk remedies

Alternative medicine recipes are used as a way to alleviate the condition, but cannot serve as the only method of treatment.

Sitz baths with chamomile

Chamomile officinalis is the best natural antiseptic, so it is often used in gynecology for baths.

Preparing a healing decoction is simple:

  1. Separate 20 g of raw materials.
  2. Boil in 2 liters of water for 5 minutes.
  3. Filter after 1 hour of infusion.
  4. Pour the broth into a basin and add 3 liters of ordinary warm water.
  5. Take a bath for at least 20 minutes.

Repeat the manipulation daily for 2 weeks.

Candles and tampons with sea buckthorn

Sea buckthorn vaginal suppositories can be purchased at a pharmacy and inserted into the vagina for 10 consecutive days at bedtime. An alternative to this method would be the introduction of homemade sea buckthorn oil tampons.

To do this, you need to chop 200 g of berries and pour a glass of sunflower oil. After a week of infusion, the product is ready for use. It is necessary to soak a cotton swab in oil and insert it into the vagina at night. Repeat the manipulation for 10-14 days.

Mud swabs and applications

Dirt for soaking tampons can be purchased at a pharmacy. After that, the mixture is heated to body temperature, tampons are moistened and inserted into the vagina for 40 minutes. The procedure is recommended to be combined with mud applications on the lumbar region. You just need to treat the skin with mud and apply gauze folded in several layers on top.

The procedure is carried out daily for a week. If necessary, the course can be repeated after 10 days of break.

Baths with coltsfoot

Treatment with sitz baths from coltsfoot decoction is carried out for a month. The tool can be prepared from 100 g of dry grass and 1 liter of water. Cook composition for at least 10 minutes. After insisting for 2 hours, combine the decoction with 3-4 liters of water, take sitz baths for 20 minutes a day.

When the degree of the disease is advanced, it is allowed to extend the procedure time by 10 minutes.

Herbal douching

The combination of chamomile, sage and oak bark is considered a good remedy for various gynecological pathologies. Each ingredient must be taken in equal amounts, pour 1 liter of boiling water.

Infusion time - at least 30 minutes. Use the filtered composition for douching with a rubber bulb. The procedure is carried out at bedtime every day for 2-3 weeks.

Any of the recipes has contraindications, so it is important to consult a specialist before starting the course.

Exercises

Age-related atrophic colpitis, the treatment of which is often carried out with a combination of several means, brings a woman significant discomfort. That is why experts recommend not only taking medications and using folk remedies, but also doing special exercises that train the muscles of the vagina and prevent complete tissue atrophy.

There is one exercise that replaces the whole complex. It is necessary to lie on your back and bend your knees, slightly spread them. After that, maximally strain and relax the internal muscles of the vagina for 1-2 minutes. Gradually, the duration of gymnastics can be increased to 3-5 minutes.

To understand which muscles need to be compressed, a woman should try to delay the process during urination. At this moment, she will feel the tension of precisely those internal vaginal muscles that are responsible for maintaining the vaginal arches and their elasticity.

Complications without treatment

The most common complication if left untreated is urinary incontinence. This occurs as a result of atrophy of not only epithelial, but also muscle tissue.

In addition, the patient may develop inflammatory diseases of the bladder, urethra. In advanced cases, the uterus, tubes and ovaries are involved in the process, which is dangerous not only for health, but also for the life of a woman.

Forecast

With timely treatment, the prognosis is quite favorable. After hormone therapy, exercise and the use of folk remedies, the condition of the mucous membrane improves, the tissues are partially restored.

Only in some cases, treatment does not work, and the prognosis is poor. Usually this situation is observed when the infection is attached and complications develop.

Atrophic colpitis is a serious and dangerous disease, especially when it is age-related. The patient should undergo a course of treatment, which will alleviate the condition and prevent complications.

Article formatting: Mila Fridan

Video about colpitis (vaginitis)

Elena Malysheva will tell about atrophic vaginitis:

Atrophic colpitis - symptoms and treatment regimen in women

Atrophic colpitis (senile) is a gynecological disease associated with the inflammatory process of the vagina, which occurs due to estrogen deficiency. Almost every third or fourth woman of the older age group is faced with such a problem.

In the course of the disease, the vaginal epithelium ceases to be produced and updated, which leads to thinning and dryness of the mucosa. The vagina becomes hypersensitive to various mechanical damage and disorders, as well as susceptible to damage by pathogens.

What it is?

Atrophic colpitis is an inflammatory process that actively proceeds in the vaginal mucosa, which is the result of thinning of the epithelium and a decrease in the concentration of estrogen in the blood. Most often, the disease can be found in older women, but sometimes it occurs in women of childbearing age. The incidence of this disease is 35-40%.

Causes

The main cause of colpitis is the lack of female sex hormones - estrogens. Their deficiency leads to the following phenomena:

  • the microflora is disturbed, which is expressed in an increase in the pH level;
  • increased vulnerability of the vaginal walls;
  • there is significant dryness of the vagina;
  • slows down, and then stops the proliferation (growth) of the vaginal epithelium;
  • thinning of the mucous membrane;
  • the secretion of the glands located in the vagina is reduced;
  • the number of lactobacilli decreases;
  • the internal conditionally pathogenic flora is activated;
  • conditions are created for the penetration of pathogenic bacteria from the outside.

The following categories of women are most susceptible to the disease:

  • who have undergone radiation therapy of any organs located in the pelvic area;
  • carriers of the human immunodeficiency virus;
  • who have reached menopausal age or with an early menopause;
  • who underwent surgery to remove the ovaries;
  • suffering from hypothyroidism (low function of the thyroid gland), diabetes mellitus, other diseases of the endocrine system;
  • with weak immunity.

Injuries to the mucous membrane, which can occur during a gynecological examination, other medical procedures, with intimate contact, create conditions for the unimpeded penetration of infection. The weakening of the body's defenses, as well as extragenital diseases with a chronic course, lead to the development of a nonspecific inflammatory reaction of the vaginal mucosa. In this case, senile colpitis passes into a recurrent form.

Symptoms of atrophic colpitis in women

The first signs of atrophic vaginitis occur approximately 5 years after the onset of the last menstruation. As a rule, the disease proceeds sluggishly, the symptoms are mild (see photo).

An increase in clinical manifestations is associated with the addition of a secondary infection and the activation of opportunistic bacteria, which is facilitated by microtrauma of the mucosa due to its slight vulnerability (for example, after a gynecological examination, coition or washing / douching).

The main symptoms include the following clinical manifestations:

Dyspareunia:

  • Pain during and after sexual intercourse is due to depletion of the stratified squamous vaginal epithelium, exposure of nerve endings and a decrease in secretion production by the vaginal glands, the so-called lubrication.

Vaginal discomfort:

  • Manifested as a feeling of dryness, tightness of the vagina, in some cases, pain. When pathogenic microflora is attached, significant itching and burning appear.

Frequent urination:

  • Senile vaginitis is always accompanied by thinning of the bladder wall and weakening of the tone of the pelvic floor muscles. These processes are accompanied by an increase in urination, although the amount of urine excreted per day does not change (does not increase). In addition, weakened pelvic floor muscles contribute to the development of urinary incontinence (when coughing, laughing, sneezing).

Vaginal discharge:

  • They are moderate in nature, mucous or closer to watery. In the case of infection, whites acquire qualities characteristic of a certain type of bacteria (curdled, greenish, foamy) and have an unpleasant odor. Also for atrophic vaginitis is characterized by spotting. As a rule, they are insignificant, in the form of a few drops of blood and are caused by traumatization of the mucous membrane (sexual contact, medical examination, douching). The appearance of any spotting (both minor and profuse) in postmenopause is a reason for immediate medical attention.

The vaginal mucosa is pale pink, with numerous petechial hemorrhages. Upon contact with medical instruments, the mucous membrane bleeds easily. In the case of a secondary infection, swelling and redness of the vagina, grayish or purulent discharge are observed.

Diagnostics

In order to diagnose colpitis for sure, you need:

  • traditional examination by a gynecologist using a mirror;
  • colposcopy;
  • microscopic examination;
  • cytology;
  • assessment of the acid-base balance of the vaginal environment.

Even during a routine preventive examination, the doctor may notice unnatural pallor and excessive thinning of the mucosa. With the help of a gynecological mirror, it is easy to see areas of the mucosa covered with microcracks and devoid of epithelium. Re-infection is characterized by a grayish coating and discharge containing pus.

Microscopic analysis during colpitis shows:

  • microscopic analysis of an excess level of leukocytes;
  • the presence or absence of potentially dangerous microorganisms;
  • insufficient amount of vaginal stick.

A colpocytological study reveals a change in the pH level upwards, with a Schiller test - weak staining, in most cases uneven. To exclude oncology, PCR, a biopsy are additionally prescribed, and a study of secretions is carried out. A doctor can also prescribe a cytogram.

How to treat atrophic colpitis

In women, the treatment of the inflammatory process has several goals, including:

  1. Restoration of the processes of nutrition of vaginal tissues to ensure the safety of their structure;
  2. Elimination of the existing inflammatory process and, if necessary, the associated bacterial infection;
  3. Prevention of possible relapses of colpitis.

Most often, women with an atrophic form of colpitis are prescribed hormone replacement therapy.

For the treatment of the disease, suppositories and ointments are injected locally into the vagina, including estriol and ovestin. Hormone therapy is also prescribed tibolone, estradiol, kliogest, angelik, which is used systemically in tablet form or in the form of patches. It is worth considering that hormonal drugs will have to be taken for a long time period, up to 5 years, without a break.

If the inflammatory process is accompanied by the addition of bacterial flora, then the patient is prescribed antibacterial drugs. When atrophic colpitis causes urinary incontinence, doctors recommend taking uroseptics.

To evaluate the effectiveness of the therapy, a woman will need to regularly undergo studies that were implemented at the diagnostic stage.

If a woman is contraindicated in treatment with drugs containing estrogen, then local douching with antiseptic properties is prescribed for therapeutic purposes. This allows you to somewhat alleviate the condition of the woman and reduce the severity of symptoms.

As for the prognosis, it is favorable regarding the life of the patient. However, even if a full-fledged therapeutic course is completed, the disease can recur and cause a woman some discomfort, reducing her quality of life.

Prevention measures

The main preventive measures to prevent the development of atrophic colpitis are regular monitoring by a gynecologist and the timely appointment of hormone therapy. Such drugs can not only reduce menopausal manifestations and affect the condition of the vaginal epithelium, prevent the occurrence of certain cardiovascular diseases, osteoporosis, etc.

Nonspecific prevention of atrophic colpitis is reduced to the following recommendations:

  • engage in dosed physical activity;
  • stop smoking;
  • try to avoid stressful situations;
  • adhere to the rules of a healthy diet;
  • carefully monitor personal hygiene;
  • wear cotton underwear;
  • strengthen the immune system.

As for the prognosis, the course of atrophic colpitis is favorable, with the exception of recurrent relapses that worsen the quality of life.