Age-related colpitis in women treatment with folk remedies. Atrophic colpitis: symptoms and treatment

This disease is manifested by inflammation of the mucous membranes of the vagina against the background of a decrease in the level of sex hormones - estrogens, in a woman's body.

Despite the fact that vaginitis during menopause usually occurs accompanied by moderately severe symptoms, it still gives the patient a lot of discomfort. We will try to understand what age-related colpitis is and how to treat this condition with experienced gynecologists-endocrinologists of the NEOMED Medical Center.

Signs of colpitis in older women

Every postmenopausal woman knows about the characteristic manifestations of this condition - dryness, burning and itching of the genitals, as well as a whole range of hormonal symptoms. Against the background of general changes in the body, patients often do not even suspect that they have an inflammatory process of the vagina.

Characteristic signs of senile colpitis:

• discomfort in the genital area- the itching and burning mentioned above. They are also accompanied by dry mucous membranes and moderate soreness in the vaginal area;
• tissue hyperemia- the mucous membranes of the genital organs, including the external ones, become red, signaling the spread of inflammation;
• unusual discharge- the nature and consistency of the discharge depends on the infectious agent that caused vaginitis, however, abundant cheesy, putrefactive and mucous discharge mixed with blood is often noted;
• pain when urinating and during sex- pain causes any exercise stress and contact of the genitals with the liquid medium.

Age-related vaginitis also causes general weakness and irritability of the fair sex, but these signs are lost against the background of general menopausal manifestations.

Causes of age-related colpitis

If in young women the inflammatory process of the vagina develops mainly as a response to a pathogenic infectious agent, then age-related vaginitis is associated primarily with hormonal changes. Against the background of a sharp decrease in estrogen levels, there is a rapid depletion of the mucous membranes of the vagina. This process is accompanied by a significant change in the quantitative composition of the natural microflora of the vagina. First of all, the number of vaginal sticks and lactobacilli that produce lactic acid decreases. The acidity of the mucous membranes is lost and the pH of the medium almost doubles to pH 5.0-7.0.

The acidic reaction of the membranes of the genital organs serves as the main deterrent for the development of the conditionally pathogenic flora of the vagina - the yeast fungus Candida, Escherichia, Escherichia coli, etc. When this defense mechanism and the mucous membranes begin to deplete, all these normal inhabitants of the vagina begin to actively grow and multiply, causing inflammation. In some cases, pathogenic microorganisms - trichomonas, ureaplasma, chlamydia, etc., can also serve as the root cause of the infectious and inflammatory process.

It is important to note that the described form of vaginitis sometimes affects young women, if they have the following risk factors:

1. immunodeficiency states;
2. endocrine pathologies- diabetes mellitus, obesity, thyroid disorders;
3. patients who survived the removal of the ovaries;
4. women who have undergone radiation and radiotherapy.

Non-compliance with the rules of intimate hygiene and wearing tight synthetic underwear are also factors provoking a violation of the composition of the vaginal microflora.

Diagnosis and treatment of age-related colpitis in women

A gynecologist can make a diagnosis already on the basis of a standard examination and determination of the pH level of the vaginal environment. Bacterioscopic and bacteriological examination of the smear helps to determine the specific pathogen and its sensitivity to antibacterial drugs. An extended colposcopy of the vagina is considered an additional diagnostic measure.

The main direction of treatment of colpitis in older women is hormone therapy. Gynecologists prefer the appointment of natural estrogens. Local application of antibacterial ointments and gels is also prescribed, which are selected individually, taking into account the sensitivity of the identified pathogen. A positive effect is shown by baths with decoctions and infusions of herbs that have anti-inflammatory and antibacterial effects. Additionally, a set of measures for general strengthening therapy is being formed, which includes taking multivitamin preparations and normalizing the diet.

Experienced gynecologists of the multidisciplinary medical center of the European level of service NEOMED will help diagnose and treat age-related colpitis in women.

Senile colpitis is a specific type of inflammation of the vaginal mucosa associated with systemic hormonal changes in a woman's body. The term "senile" is equivalent to the definition of "senile", and the nature of inflammation in this disease is such that degenerative processes occur in the mucosa, therefore senile colpitis is also called atrophic.

This disease occurs in postmenopausal women when the balance between male and female sex hormones changes. The immediate cause of thinning and atrophy of the uterine epithelium is a significant decrease in estrogen levels.

Reasons for the development of atrophic colpitis

Key point: almost all cases of atrophic colpitis occur in women during menopause. Almost 45% of all women over 40 have senile colpitis. (cm. " ")

However, age and the associated menopause are not the only reason for the development of colpitis, although the most significant. There is a number of factors that significantly affect the likelihood of developing colpitis:

• the presence of chronic diseases in decompensation that deplete the body (diabetes, for example);
• HIV infection or AIDS;
• insufficient hygiene of the external genitalia or, conversely, too frequent washing with soap;
• removal of the ovaries, regardless of the reason for the operation;
• thyroid diseases, which are accompanied by a decrease in hormone production;
• wearing underwear made of low-quality synthetic fabric;
• radiation or chemotherapy;
• venereal infections.

Symptoms of senile colpitis

Atrophic colpitis is a disease that in any case has chronic course. Atrophy of the mucosa, its thinning with loss of function always occurs gradually. Traditionally, all inflammatory diseases (with rare exceptions) are called chronic if their duration is more than 3 months. Senile colpitis can develop for years.

There can be no acute, obvious manifestations of chronic colpitis. The mucosa, changing, loses its properties, and the glands, which normally should produce a mucous secret (mucous membranes are not in vain called mucous membranes), cease to function. The mucous membrane of the inner lining of the vagina dries up, normal acidity is disturbed, all the characteristics necessary for the normal operation of all local defense systems and the vital activity of “healthy”, beneficial microorganisms change.

The main manifestations of senile colpitis are associated precisely with these two factors: with the drying of the mucous membrane and the change in the microflora of the vagina.

How can atrophic colpitis manifest itself? Of course, there are symptoms of this disease. But they are not even always noticed! We will now consider theoretically possible manifestations that are sometimes found in practice (usually atrophic colpitis does not particularly bother a woman). So, what can be observed with senile colpitis:

• and in the vulva, perineum. As a rule, itching is not very pronounced (for comparison, we give in which this symptom can even cause insomnia) and is especially noticeable after intercourse, washing or long-term wearing of tight, uncomfortable underwear made of synthetic fabric.
• Moderately expressed feeling burning sensation in the perineum (less often this sensation is clearly localized, and a woman may indicate a burning sensation in the vagina).
• . Urine has a rather aggressive environment, therefore, when it enters an atrophied, vulnerable mucous membrane, irritation occurs, which is accompanied by pain. In addition, there may be frequent urge to urinate, urinary incontinence.
• Often appear, which have a watery consistency and a strong, unpleasant odor. The secretions also cause irritation of the mucous membrane of the vagina and external genitalia.

Atrophic changes in the mucosa lead to the fact that local protective factors cannot perform a protective function. This leads to the development of secondary bacterial infections. In this case, all signs of an acute inflammatory process (fever, intoxication, pain syndrome, etc.) are also added to the clinical picture from the genital tract.

Diagnosis of the disease

The diagnostic process begins with a bimanual examination and examination in the mirrors. As a rule, these manipulations are combined with extended colposcopy - examination of the mucous membrane of the vagina and cervix, probing of the cervical canal.

Gynecological examination allows you to determine the secretory function of the mucosa (with senile colpitis, the mucosa becomes dry, may be covered with erosion), the degree of the atrophic process, the presence of secondary infections or concomitant diseases.

It is important to measure the acidity (pH) of the vaginal environment. This indicator is an indicator not only of the loss of mucosal functionality, but also of the risk of developing bacterial vaginosis(dysbacteriosis) and secondary infections.

Treatment of senile colpitis

Since senile colpitis is a disease that is caused by a systemic disorder, a disorder of the endocrine glands, treatment should also be systemic (first of all!). Atrophic colpitis always has a chronic course, so treatment should be long and regular to ensure long-term remission.

Since the root cause of the disease is endocrine disorders, the basis of treatment is the use of hormonal preparations containing natural estrogens. In addition to the systemic use of hormonal drugs, often used local preparations with estriol - ointments and vaginal suppositories.

Changes in senile colpitis are associated with a decrease in local immunity, and the appearance of bacterial complications. This is the reason why antibacterial drugs are used in the treatment of atrophic colpitis. Most often, these are vaginal baths with antibiotics, but there may also be drugs for systemic administration.

Prevention

The main factor leading to the occurrence of atrophic colpitis is hormonal disorders associated with age-related changes. This is a factor that, alas, cannot be influenced. But, in addition to this, there are other factors that can be influenced.

Prevention of senile colpitis includes the following aspects:

• adequate and regular intimate hygiene;
• wearing high-quality underwear that does not cause inconvenience;
• timely treatment of inflammatory and non-inflammatory diseases of the genital organs - "neglected" diseases can lead to various complications, which may be the reason for an operation to remove the ovaries;
• prevention of sexually transmitted diseases and their timely treatment.

Content

In reproductive age, the occurrence of a pathology called "atrophic colpitis" is not excluded - a disease in the vagina that requires treatment. The atrophic type of vaginitis develops over several years due to a lack of estrogen in a woman's body. The disease delivers a lot of unpleasant symptoms with painful sensations. The only method of treatment is hormonal therapy, but in order to accelerate the improvement of the woman's health, the doctor prescribes additional therapeutic measures.

What is atrophic colpitis

The inflammatory process of the vaginal mucosa during menopause is called atrophic vaginitis. The disease is caused by a low amount of the female hormone (estrogen) produced by the ovaries. In medicine, there are other synonyms for the term - senile or senile colpitis. This name comes from Greek word"colpos", which translates as the vagina. With atrophic vaginitis, thinning of the stratified epithelial layer of the vagina occurs. The pathological process is considered only when a woman experiences discomfort and other signs are expressed.

ICD-10 code

Atrophic or senile vaginitis is one of the most common diseases and can be of 3 types: acute, chronic and secondary. After 8 years of the climatic period, every 2 patient suffers from colpitis. Every 10 years, the risk of developing the disease increases. Among women, about 80% suffer from colpitis during the menopausal period. Senile colpitis has a code according to the International Classification of Diseases (ICD-10) - 95.2.

Symptoms

Physiological and structural changes in the body, in which atrophic vaginitis is formed, cause significant inconvenience to a woman. The initial stage of senile colpitis is asymptomatic, after years the woman experiences vaginal discomfort, frequent urination due to changes in the pelvic floor and dyspareunia (painful sexual intercourse). Vaginal discharge may be unusually white or bloody and accompanied by an unpleasant odor. Atrophy of the vaginal mucosa or colpitis is accompanied by:

• dryness in the vagina;
• pain when urinating;
• itching of the external genitalia;
• atopic dermatitis (with allergic colpitis);
• urinary incontinence;
• redness of the mucous membrane of the vagina.

Cytogram of atrophic colpitis

A procedure called "cytology" is performed to identify the infection of colpitis and the condition of the female cells. To pass the analysis, you must make an appointment with a gynecologist and ask to take a vaginal smear for analysis for microflora studies. This is done during a visual inspection. Annual cytology will help detect colpitis at the initial stage before the onset of unpleasant symptoms. The interpretation of the results of a smear taken during cytology is called a "cytogram". The main points of deciphering the cytogram:

1. CBO - cytogram without features.
2. NILM - without malignant cells.
3. Endocervix - the outer part of the cervix, normally should contain cells of glandular (cylindrical) or squamous stratified epithelium.
4. Ecdozervix - cervical canal, MPE cells, superficial, parabasal, intermediate layer can be detected.
5. Leukocyte infiltration - an increase in the number of leukocytes.
6. Proliferation is an increased rate of cell division.

The reasons

The only cause of senile colpitis is the pathogenic microflora in the vagina, in which harmful microorganisms develop. The basis of colpitis is hypoestrogenism. With a normal indicator of hormones, the inner walls of the vagina are covered with a squamous epithelium in many layers. When the level of hormones decreases, which occurs during menopause, the thinning of the epithelium begins layer by layer. Further, there is a significant decrease in cells containing the main nutrient for lactobacilli, glycogen.

The function of the main waste product of lactobacilli (lactic acid) is to maintain a normal vaginal environment - control over the internal acidity of the environment. When there is a decrease in glycogen, the colony of beneficial bacteria is exterminated, which provokes the development of pathogenic microorganisms due to an increase in the acidity of the vagina. Unpleasant symptoms of atrophic vaginitis are caused by local inflammation of the mucous membrane, which is facilitated by improper intimate hygiene.

Diagnostics

The result of treatment of atrophic vaginitis depends on the diagnosis. Diagnosis is prescribed comprehensively and includes taking smears for microbiological studies, examining the vaginal walls, cervix with the help of mirrors. In the presence of atrophic vaginitis, changes are detected: a large accumulation of leukocytes, the absence of beneficial lactic acid bacteria, the content of opportunistic flora. It is not excluded the definition of specific pathogens (gardnerella, fungi, Trichomonas and others). Other diagnostic methods:

• colposcopy;
• testing by PCR;
• a special test strip for determining the acidity of the vagina.

Treatment of atrophic colpitis

In gynecology, the technique is based on the regeneration of the epithelial lining and the prevention of relapses. With colpitis, the doctor prescribes local and systemic hormone replacement therapy (HRT) to produce estrogen and stabilize hormone levels. Under the influence of estrogens, epithelial cells will begin to renew themselves, which will improve the nutrition of the mucous membrane, prevent the formation of microtraumas, and reduce the degree of atrophy. Hormone therapy for atrophic vaginitis is carried out for a long time from 1.5 to 3 years. The woman will feel the first relief after 3 months of treatment.

Preparations

Self-administration of treatment for colpitis is dangerous to health. After the examinations, the doctor will prescribe a set of suitable medications, based on the history of atrophic vaginitis. In addition to hormone therapy, local treatment (creams, ointments, suppositories, vaginal tablets), phytohormone therapy, uroseptics, and drugs for systemic action are indicated. The last group of drugs for atrophic vaginitis is aimed at restoring not only the layers of the vagina, but the whole organism as a whole. These medicines include:

• Cliogest;
• Angelique;
• Estradiol;
• Tibolone;
• Indivina.

Herbal preparations

Phytohormonotherapy for senile colpitis is carried out with medicinal syrups, elixirs, tablets and creams with natural ingredients. Kliofit helps perfectly, which contains only natural ingredients: rose hips, hawthorn, cedar and coriander seeds, pharmacy chamomile, and other components. The price of Kliofit in Moscow is 168 rubles. A remedy for colpitis can be bought in the form of an elixir and taken according to the scheme: 3 times a day 15 minutes before meals, a week. Among other herbal preparations for atrophic vaginitis, there are:

• Klimadinon;
• Qi-clim;
• Lephem;
• Feminal;
• Bonisan.

Candles

The use of medicinal suppositories helps very well with the symptoms of atrophic vaginitis, acting locally on the inflamed area of ​​​​the vagina. Candles from colpitis called "Estriol" are supplemented with an estrogen component, reduce itching, remove excessive dryness, dyspareunia. The drug for atrophic vaginitis is administered intravaginally, also for problems with urinary incontinence, painful urination caused by atrophic problems of the vagina. The following suppositories for colpitis have proven themselves well:

• Ovestin;
• Elvagin;
• Ortho-gynest;
• Ovipol Clio;
• Estrocad.

Methyluracil

The drug is produced in the form of suppositories for injection into the rectum, but with colpitis, gynecologists recommend inserting it into the vagina. A remedy for atrophic vaginitis accelerates the repair (recovery) of the cervix. The course of treatment for colpitis with Methyluracil ranges from a week to 4 months. The drug for atrophic vaginitis stimulates tissue immunity, regenerates cellular structures, heals wounds, improves the process of maturation of erythrocytes and leukocytes. Before using Methyluracil for the treatment of colpitis, douching with soda, herbal infusions is carried out.

Fluomizin

The drug Fluomizin with an antiseptic in the composition is effective tool against senile colpitis. Substances in tablets affect the pathogenic flora: dequalinium chloride (10 mg), lactose monohydrate, microcrystalline cellulose and magnesium stearate. The active ingredient eliminates Candida fungi and has a wide spectrum of action against colpitis. The action is based on a decrease in the activity of cellular enzymes and further destruction of microorganisms. Fluomizin for atrophic vaginitis has little side effects, available in 6 pcs. costs about 700 rubles in a pharmacy.

Treatment with folk remedies

With age-related colpitis are very popular folk methods treatments that, compared with medications, have fewer contraindications for admission and the possibility of long-term treatment. Gynecologists have a different opinion: folk remedies useful for atrophic vaginitis, but they should only be used in combination with the main treatment - hormonal therapy. To eliminate itching and heal small cracks, calendula, chamomile, St. John's wort and plantain are recommended. According to recipes, infusions and decoctions are prepared from herbs. Among the folk remedies are:

• sitz baths with the addition of soda;
• douching with tea tree oil;
• a drink made from chamomile and willow leaves;
• alcohol tincture on lily of the valley;
• tampons or aloe.

Prevention

There are 2 types of preventive measures for atrophic vaginitis: non-specific and specific. The first type of prevention contains general recommendations for inflammation of the vaginal mucosa: daily hygiene, avoiding casual sex and wearing comfortable underwear. To specific prevention colpitis includes taking drugs, special substances, serums, vaccines and hormonal pills. All medicines for atrophic vaginitis contain estrogens, protect a woman not only from colpitis, but also osteoporosis.

Video

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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. Normal in women reproductive age in the vagina, the environment 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.

Thinning of the epithelium and a decrease in secretion production by the glands of the vagina lead to mild 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.

The reasons

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 becomes the cause 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 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;

use of aromatic products for hygiene 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 fermented milk products, drinking poor-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 attachment to the focus of a secondary infection 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 case of accession of pathogenic vaginal microflora there is severe burning and itching.

Dyspareunia

Pain during intercourse or immediately after it is due to depletion of the stratified epithelium of the vagina, exposure of nerve endings and a decrease in the secretion of products of the vaginal glands, which are 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, atrophic colpitis is characterized by the presence of spotting. 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

For senile vaginitis, thinning of the walls is always characteristic 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 made, 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. Taken every day for 3 weeks at the same time, after this period a week-long break is made, which is accompanied by the development of menstrual-like 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 others. medicines. 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. For this disease, a minimum of a year is required from the moment of operation, while it was said that the patient takes hormonal preparations. 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, 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 engaging in 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.

How to live and deal with senile colpitis? This question worries many. Some information about what senile colpitis is, symptoms and treatment are probably known to many. The female body, especially the genitals, is prone to all sorts of diseases. These are inflammatory processes, and allergic manifestations, and all kinds of fungal infections.

To prevent complications in gynecological diseases, it is necessary to visit a doctor regularly. Systematic examinations and observation by a gynecologist should occur twice a year.

The main signs of colpitis

Age-related colpitis is one of the gynecological diseases. This is an inflammatory process of the genital organs of a woman. During menopause, a woman may feel some discomfort, itching and burning in the vagina. Colpitis in older women is caused by atrophic changes in the mucous membrane of the vagina and genital organs. The functionality of the ovaries decreases, the acidity of the vaginal microflora can drop to a catastrophic level. When especially severe cases in the secret liquid, it is no longer an acidic, but an alkaline environment. Pathological flora begins to develop.

Colpitis can go unnoticed, without causing concern and without giving itself away. Sometimes there are mucous discharges, bloody, with clear signs pus. But a woman usually associates these symptoms with other diseases. To more frequent signs relate:

• burning;
• swelling of the labia;
• strong mucous discharge, which may be milky or cheesy, with obvious signs of blood or pus;
• disgusting smell;
• pain in the lower abdomen;
• frequent urine output;
• lethargy;
• fast fatiguability;
• in severe cases, fever.

With senile colpitis (colpitis during menopause), dryness in the genitals is most often observed. Sometimes the dryness is so progressive that it itches. With severe itching, purulent blood discharge and other symptoms, you should consult a doctor to check for the formation of malignant tumors.

Causes of the disease and diagnosis

A number of categories of older women are subject to senile colpitis:

• with untimely onset of menopause;
• with normal (age-related) menopause;
• who underwent chemical therapy of the pelvic organs;
• HIV-infected;
• patients with diabetes;
• with reduced immunity;
• with reduced thyroid function.

Disease-provoking actions can be added to these risk groups. During a medical examination, minor damage to the vaginal mucosa can be obtained. The infection can penetrate through sexual contact without the use of a contraceptive. These reasons can also provoke senile colpitis or aggravate the form of its course. With additional factors that worsen the course of the disease, colpitis can go into a form that will give constant relapses (repetitions) after the stages of remission (recovery).

Read also: Thrush in girls and women - causes and treatment

In order for the remission stage to last as long as possible, it is necessary to carry out treatment in a timely manner and observe personal hygiene. Unprotected sexual intercourse should be excluded, chemical flavored gels and bactericidal soaps should be abandoned. These funds contribute to the imbalance of the acid-base environment of the vagina. You should make an unambiguous choice in favor of underwear from natural materials. Synthetics do not allow air to circulate freely, thereby creating all the conditions for the viability of bad microbes.

To diagnose senile (senile) colpitis, the following manipulations are performed in the gynecological office: examination with a mirror, determination of the level of acidity, and other tests. If necessary, cervical and vaginal secretions are diagnosed. This is done if there is a suspicion of specific factors for the occurrence and development of colpitis, for example, sexually transmitted diseases.

Treatment with the use of folk remedies

Non-traditional methods of treating various women's diseases are always offered and used as more gentle. Natural components do not harm other organs and systems of the human body.

With senile colpitis, the use of cauterizing liquids and ointments is prohibited, and it is also forbidden to use tampons. Douching with infusion or decoction of chamomile is shown. In case of senile colpitis, the vagina must be moistened with vitamin ointments. These can be ointments containing aloe juice, rosehip oil, sea buckthorn extract. You can use baby cream.

Colpitis of old age is successfully treated with herbs:

1. Mix 50 g of knotweed herb, 50 g of nettle (leaves), 10 g of cinquefoil root, oak bark and 20 g of chamomile (inflorescences). Put the dry mixture in a hermetically sealed dish so that moisture does not get in. From this mixture you will need 2 tbsp. spoons, which must be poured with a liter of water, boil and continue to cook for 10 minutes. For douching, it is necessary to cool the resulting therapeutic liquid, then strain. Douching is always best done before going to bed.
2. Chopped marigold flowers (medicinal calendula) pour a glass of hot (100 ° C) water and soak for one hour. You need to take 2 tbsp. spoons of calendula. Cool and then strain. Such an infusion of calendula is suitable for douching. It is also indicated for oral use (2 tablespoons or 5 teaspoons 2-3 times a day).
3. Boiling drinking water place 20 g of immortelle (sandy), leave for one hour. You need to take 0.5 liters of water. This medicinal infusion used for douching.
4. It is necessary to take 1 tablespoon or 3 teaspoons (without top) of oak bark, grind well, pour a glass of boiling (100 ° C) water, hold in a water bath. Then insist the resulting liquid for 10-12 hours. Strain and douche. The duration of such procedures is 10 days.
5. A decoction of a mixture of such herbs and plants is very good: garden peony, creeping clover, white water lily, field cornflower, chamomile, willow (grass), cat's paws (flowers), garden rose petals, mountaineer. Everything is taken little by little and in equal amounts. A tablespoon is taken from this dry mass and poured with a liter of boiling water (100 ° C). It is boiled for 10 minutes, then allowed to brew and filtered. It is necessary to drink the received folk medicine before meals 3 times a day. Drink half a glass at the same time. You can also add honey or sugar. The course of treatment is 3 months, then a break is made for 2 weeks. After that, the treatment is repeated (3 months).