Vaginitis

Vaginitis

Vaginitis refers to the inflammation of the vagina, which can occur due to both infectious and non-infectious causes. The female reproductive system is complex and delicate, making it prone to inflammation. In some cases, vaginitis may present with additional symptoms such as itching or abnormal vaginal discharge.

Causes of Vaginitis
Vaginal inflammation can arise from various factors, including bacteria, yeast, viruses, chemicals in creams or sprays, as well as infections transmitted during sexual intercourse.

Candida Infections: This is a common cause of vaginal inflammation. The most frequently encountered yeast is Candida albicans, followed by Candida glabrata, which adheres well to vaginal epithelial cells. Normally, yeast is present in the vagina in a balanced state. However, factors such as antibiotic use, infections, or inflammation can disrupt this balance, causing yeast overgrowth. Other contributing factors include a weakened immune system, pregnancy, and diabetes.
Bacterial Infections: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge. It occurs due to an imbalance in vaginal bacteria, allowing opportunistic microorganisms to proliferate. Besides inflammation, BV often produces a fishy, unpleasant odor.
Other Factors: Additional causes of vaginal inflammation include douching, intrauterine devices (IUDs), pregnancy, having multiple sexual partners, frequent changes of sexual partners, and unprotected sexual intercourse. Vaginitis can increase the risk of other vaginal conditions, particularly sexually transmitted infections (STIs).

Symptoms of Vaginitis
Increased vaginal discharge, often with an abnormal color
Abnormal discharge color, such as yellow, green, or blood-tinged
Foul, fishy odor from vaginal discharge
Itching and redness around the vaginal area
Pain or discomfort during urination or sexual intercourse
A burning sensation during urination

Risk Factors for Vaginal Infections
Pregnancy
Uncontrolled diabetes
HIV infection
Immunosuppressive medication
Hormonal contraceptives with high estrogen levels
Corticosteroid treatment, which weakens the immune system
Prevention and Management Tips
Avoid wearing tight-fitting pants.
Do not wear damp or non-breathable underwear.
Refrain from douching.
Practice safe sex with condoms.
Avoid prolonged antibiotic use unless prescribed.
Limit the use of sanitary pads to only during menstruation to prevent moisture buildup.
Treatment Options
Medications

Topical Treatments: Creams and vaginal suppositories, such as Metronidazole, may cause irritation or burning sensations.
Oral Medications: Drugs like Clindamycin, Tinidazole, or Secnidazole can sometimes cause nausea, vomiting, abdominal pain, or headaches. There are also reports of elevated liver enzymes with certain medications.
Dietary Supplements
Probiotics are an emerging option for the prevention and treatment of vaginitis. Vaginal inflammation often results from fungal and bacterial infections caused by an imbalance in the vaginal microbiota, allowing opportunistic pathogens to proliferate.
Research has shown that certain probiotic strains can help restore balance:

Lactobacillus johnsonii enhances immune responses by increasing IL-10 expression and reducing inflammatory markers such as TNF-α, IL-6, and IL-12.
Lactobacillus paracasei MSMC 39-1 significantly inhibits pro-inflammatory cytokines TNF-α and IL-1.
Lactobacillus rhamnosus BMX 54, when administered to patients with concurrent vaginal infections and HPV, reduces HPV levels and improves the vaginal microbiome by increasing beneficial microorganisms. Long-term probiotic use shows significant reductions in HPV, fungal, and bacterial infections compared to short-term use.
Probiotics can, therefore, help reduce vaginal inflammation and restore microbiota balance in both the vagina and gastrointestinal system.

Reference:
Palma E, Recine N, Domenici L, Giorgini M, Pierangeli A, Panici PB. Long-term Lactobacillus rhamnosus BMX 54 application to restore a balanced vaginal ecosystem: a promising solution against HPV-infection. BMC Infect Dis. 2018 Jan 5;18(1):13.