Update: December 2018
One of the most common female “sores” is
colpit This disease mainly affects women.
the weaker sex of childbearing age, but it does not bypass it
attention, both girls and postmenopausal women. To not
miss the development of colpitis, every woman should know him
symptoms, in order to start treatment immediately. But it is important to remember
that any disease, especially of an infectious nature, is the same
Colpitis, do not try to treat yourself, you need
consult a doctor.
Definition of “colpit”
When the vaginal mucosa is inflamed due to its
infection by pathogenic microorganisms, talk about the occurrence
kolpita. Another name for colpitis is vaginitis, from Latin.
the words “vagina”, which means the vagina. Frequency of occurrence
disease accounts for 60 – 65%.
Classification of colpitis
Depending on the type of pathogen that provoked
disease, colpitis is divided into specific and nonspecific.
Specific vaginitis is caused by gonococci, trichomonads,
fungi and other infections.
On localization of the initial infectious lesion colpitis
are divided into:
- primary, when the process immediately develops in the vagina;
- secondary, in case of ingestion of infectious agents in the vagina
from other places (ascending – from the surface of the vulva and descending – from
The course of the disease causes the following forms:
- acute colpitis;
- подacute colpitis;
- chronic colpitis;
- sluggish vaginitis;
- latent (hidden) vaginitis;
- бессимптомный colpit
Separately distinguished senile colpitis or atrophic
Vaginal microflora is normal
Normal in a healthy woman of childbearing age microflora
95 – 98% of the vagina consists of lactobacilli or sticks
Doderlein. Doderlein sticks break down glycogen, which
�”Receive” from desquamated epithelial cells of the surface layer
vaginal mucosa. The breakdown of glycogen is formed
lactic acid, due to which the pH of the vaginal environment is shifted to
acidic side (4.5 and less). Sour vaginal environment is
a kind of protection against pathogenic microbes, so many of them do not
able to grow and multiply in such conditions. Also
lactobacilli form hydrogen peroxide and a number of antibiotic-like
substances that strengthens the protection and prevents the vagina from settling
In addition to lactobacilli, there are bifidobacteria in the vagina, which
also protect it from infection. Vital activity and
the amount of lactobacilli depends on the production of estrogen. Therefore, with
the onset of premenopause when estrogen production decreases,
vaginal mucosa becomes thinner and the amount decreases
lactic acid bacteria that leads to the development of age
Similarly, under various other conditions leading to a decrease in
lactobacilli in a healthy and young woman, the vagina is very fast
inhabited by “invaders” – pathogenic microorganisms.
In addition to lacto-and bifidobacteria in the vagina in a small
other microorganisms are also present:
- fungi of the genus Candida and others.
Causes of colpitis
As already noted, the disease is caused by the colonization of the vagina
pathogenic microorganisms or the activation of conditionally pathogenic
pathogenic flora. Conditionally pathogenic flora is represented by microbes,
which in the normal state of immunity are in balance
with the usual flora, but the balance is very fragile. Worth loosen
immunity and this flora goes into the category of pathogenic.
The causative agents of vaginitis can be the following types
- fungi of the genus Candida;
- myco-and ureaplasmas;
- numerous intestinal flora;
- tubercle bacillus and others.
In girls, vaginitis may be caused by pathogens of children’s
infections that enter the vagina with the blood stream (secondary
vaginitis). These may be causative agents of measles, diphtheria, scarlet fever and
But in order for the disease to begin to develop,
certain conditions or predisposing factors:
- noncompliance or, on the contrary, excessive intimate infatuation
- hidden genital infections;
- promiscuous sex life;
- endocrine pathology (thyroid disease, sugar
- genital trauma (gross sex, deprivation
- cramped synthetic;
- pregnancy and menstruation (hormonal changes and
weakening of immunity);
- menopausal age;
- oncological diseases and their treatment (chemotherapy,
- acquired and congenital immunodeficiency states;
- lack of vitamins;
- allergic reactions;
- antibiotic treatment, especially uncontrolled;
- taking hormones;
- anomalies of the genital organs (gaping genital slit or omission
- mucosal damage during childbirth;
- ovarian hypofunction;
- use of intrauterine spirals;
- improper and poor nutrition;
- diseases of the digestive tract;
- spontaneous and artificial termination of pregnancy;
- scraping the uterus.
Clinical picture заболевания довольно разнообразная и во
largely determined by the type of pathogen and the shape of the flow. Main
signs of vaginitis are:
- burning, itching in the vagina;
- the amount of vaginal discharge increases significantly
the nature of which is different (cheesy, pussy, homogeneous
milk, foamy, blood or mixed with blood);
- discharge has an unpleasant smell
- redness and swelling of the labia may occur;
- aching or nagging pain in the abdomen;
- pain during coitus;
- dysuric disorders (rapid and painful
- temperature rise.
In the case of acute colpitis, all manifestations are pronounced: burning
and itching significant, heaviness in the lower abdomen suggests
problems with internal organs, allocation abundant. With severe
the course of the disease may have a significant rise in temperature, up to
38 degrees and above. As a rule, such a pattern is characteristic of
specific colpitis (gonorrheal or trichomonas).
In chronic colpitis, the picture is less bright, symptoms
erased. The disease flows for a long time, with periodic exacerbations.
Discharge becomes moderate, serous or
When viewed on a chair in the mirrors, edema, hyperemia and
�”Loose” vaginal mucosa. On the mucous membrane petechial and
dot hemorrhages, reddish nodules may appear
(infiltrates) and erosive sites. In advanced cases in
the inflammatory process involves the cervix, which leads to
cervicitis or pseudo-erosion.
This form of the disease is caused by Trichomonas, which
sexually transmitted. Household way of infection with trichomonads, as
some patients prefer to think impossible because
The pathogen quickly dies in the environment. Symptomatology
Trichomonas vaginitis so pronounced that the diagnosis is not
presents difficulties. Characterized by significant whites, wearing
very unpleasant smell. The excreta are usually frothy and have
yellowish tint. In the case of joining non-specific
microflora secretions turn green. Infection is very fast
spreading, affecting the cervix, the uterus itself and the urethra, which
manifested by dysuric disorders and lower abdominal pain.
Sexual acts are unpleasant and even painful, accompanied by
secretions mixed with blood.
With atrophic vaginitis, the symptoms are practically absent.
The disease is sluggish, patients may or may not
make complaints. Most often worried about burning and itching, feeling
�”Tightness” in the vagina and its dryness. Sexual intercourse is painful,
after it there is discharge with blood or even arises
slight bleeding. Due to a decrease in the number
lactobacilli that perform a protective function in the vagina actively
conditionally pathogenic microorganisms that provoke
local inflammatory processes and increased secretions. Such
watery discharge, there is a mixture of blood after
some procedures (washing and douching the vagina,
gynecological examination). When viewed in the mirrors revealed
pale pink thinned mucosa with multiple points
hemorrhage. In many cases, due to the vaginal dryness, the introduction of
gynecological mirrors difficult.
After collecting anamnesis and complaints, an objective examination is carried out.
patient, which includes:
- examination of the mucous membrane of the vaginal walls and cervix in
gynecological mirrors (the discharge, their consistency and
odor, ulceration on the vaginal walls and pseudo-erosion or
cervicitis on the cervix) – inspection is carried out without prior
preparation (do not wash off);
- bimanual palpation of the uterus and appendages to identify
complications of vaginitis (endometritis and / or adnexitis);
- examination of the labia, urethra, clitoris and internal surfaces
thighs for swelling and ulceration, maceration and cracks
(resulting discharge may annoy the listed
From laboratory tests are required:
- microscopy of secretions obtained from the cervical canal, posterior
vault of the vagina and urethra (allows you to define
bacterial flora, including trichomonads and fungi, gardnerella and
- bacteriological seeding of vaginal secretions for
identifying the pathogen and identifying its sensitivity to
antibiotics (if possible, after a 3-week course
- PCR diagnostics of the main genital infections (Trichomonas,
gonokokki, herpes, cytomegalovirus, chlamydia and ureaplasma).
According to the indications, colposcopy is prescribed and performed.
Additionally, general blood and urine tests are prescribed;
syphilis and HIV infection.
Treatment кольпита у женщин подразумевает ликвидацию возбудителей,
caused the disease, the restoration of normal vaginal flora and
immunity stimulation. Self-medication is not allowed vaginitis.
Therapeutic measures are prescribed to all patients regardless of their
age and form of the disease, the presence of comorbidity.
For the period of the disease the patient is recommended to observe sexual
peace Sex acts not only aggravate the discomfort, but also
promote infection and re-infection. Also
need to adhere to a certain diet. Should abandon
spicy and salty foods (in case of candidal vaginitis and from
sweets), alcohol is prohibited. In the diet should
predominate fresh vegetables and fruits, and lactic acid products.
When a specific pathogen is identified (for example, Trichomonas,
gonococci), treatment is prescribed and sexual partner. With severe
the course of the disease (significant fever and
выраженный дискомфорт во влагалище) назначается половой peace
Be sure to respect intimate hygiene. No need to wash
less than twice a day, in the case of menstruation after each replacement
pads. When vaginitis occurs in a girl, it is washed away after
every visit to the toilet.
Vaginal douche or douching prescribed for a period of 3 – 4
day, so a longer course of procedures promotes desquamation
epithelial cells of the superficial mucosal layer and disrupts
healing process. For douching use solutions
- a solution of potassium permanganate in the ratio of 1/5000 – 1/8000;
- 0.5% solution of rivanol;
- decoction of sage or chamomile;
- solution hlorfillipta;
- soda solution (dilute 2 teaspoons per liter of boiled
water) is effective for viscous purulent white hair.
Douching is carried out three times a day. Parallel assigned
sessile trays with decoctions of herbs or antiseptics.
Vaginal suppositories and tablets
Candles for colpitis and vaginal tablets are used in
as a local therapy:
- polygynax (polymyxin, neomycin and nystatin are included) –
has anti-inflammatory, antibacterial and anti-fungal
effects, appointed course for 7 – 14 days, twice a day;
- terzhinan (composition: ternidazole, neomycin, nystatin and prednisone)
– a similar effect, the course of treatment is 10 days, is introduced
1 candle per day;
- vocals (composition: wine-iodine) therapy course 1 – 2 weeks,
1 suppository is administered per day;
- mikozhinaks (composition: metronidazole, chloramphenicol, nystatin and
dexamethasone) – appointed for 1 – 2 weeks for 1 – 2 suppositories in
- Dalatsin ointment (consists of tinidazole, sinestrol, vitamin C and
lactic acid) – a course of treatment for 7 – 10 days, tampons with ointment
introduced in the morning and before bedtime in the vagina;
- ginalgin (consists of metronidazole and chlorochinaldol) –
duration of therapy 10 days, 1 suppository per day;
- Klion-D (composition: metronidazole and miconazole) – antimicrobial and
antifungal effect, injected 1 vaginal tablet once a
day for 10 days.
- metronidazole in the form of vaginal suppositories (ginalgin and
Klion, flagelil and Trichopolus) – a course of treatment for 10 days, 1 candle each
- tinidazole (active substance fazizhin) – a course of treatment
- Hexicon – candles are introduced 3 times a day for 7–20
- neo-penotran (consists of metronidazole and miconazole) – course 1 –
2 weeks, 1 suppository twice a day.
Courses of trichomoniasis therapy are conducted three times, after each
- nystatin – in the form of suppositories for 1 to 2 weeks;
- clotrimazole – vaginal tablet is administered daily on
over 6 days;
- Kanesten (0.5 gr.) – a single injection of tablets in
- pimafucin (natamycin) 1 suppository twice a day for
throughout the week;
- Pimafukort (composition: natamycin, neomycin and hydrocortisone) –
is administered as an ointment on swabs in the vagina twice a day in
for 2 weeks.
- acyclovir (analogs: zovirax, herpevir) – vaginal tampons with
кремом вводятся до 4 – 5 раз в день, курс около 10 days;
- 0.5% bonafton ointment – treatment duration 10 days, applied
on tampons and is administered intravaginally 4-6 times a day;
- viferon – suppositories are administered intravaginally in the morning and
in the evening, the course of 5 – 7 days;
- a-interferon – suppositories are administered twice a day, course 1
Read more about the treatment of genital herpes.
With severe течении кольпита или в случае хронизации процесса
medications are prescribed, applied orally or
intramuscularly. In the case of specific obesity caused by
gonococci, intramuscular antibiotics indicated
cephalosporins (ceftriaxone, cefixime) or tetracycline series.
When vaginitis, which caused Trichomonas, are appointed
nitroimidazoles (trichopol, tinidazole, metronidazole). Heavy current
nonspecific obesity requires the appointment of broad antibiotics
spectrum of action – amoxiclav (penicillins) or azithromycin
(macrolides). In the treatment of colpitis of fungal origin
drugs used: fluconazole, orungal, pimafucin, ketoconazole
In the case of senile vaginitis, as rule assigned
hormone replacement therapy. Treatment гормонами может быть как
local and systemic. For local therapy used
estrogen preparations in the form of vaginal tablets or ointments
(ovestin, estriol). The course of treatment lasts 2 weeks, if necessary.
repeats. As systemic hormone therapy prescribed
cliogest, klimodien, angelik and other drugs (tablets,
patches). Treatment длительное и непрерывное (5 лет). If a
joins a secondary infection, the treatment is carried out according to the principles
treatment of acute obesity with the appointment of etiotropic drugs locally,
and, if necessary, inside.
Restoration of vaginal microflora
Restoration of the natural flora of the vagina refers to the second
stage of vaginitis treatment:
- bifidumbacterin – intravaginal 5 – 6 doses, which are diluted
boiled water and administered daily or 1 suppository twice a day.
day – a course of treatment 10 days;
- bifikol – intravaginal administration of 5 doses daily up to 7
- Lactobacterin – intravaginal administration of 5 doses in a course of 10
- acylact – 1 suppository daily for 10
Parallel assigned поливитамины и иммуномодуляторы.
Do not lose their relevance in the treatment of diseases and folk
facilities. Folk methods применяются как дополнение к основному
(медикаментозному) лечению kolpita. For douching use
decoctions and infusions of medicinal herbs:
- chamomile (2 tablespoons boiled in 1 liter of water for
15 minutes, filter the broth and cool);
- coltsfoot (leaves), stinging nettle, St. John’s wort, thyme,
buckthorn bark – take in equal amounts of all herbs, mix and 2
tablespoons of the mixture pour 0.5 liters of boiling water, leave for 2 hours,
strain and cool;
- decoction of yarrow, sage, rosemary and oak bark;
- infusion of calendula;
- infusion of eucalyptus leaves;
- infusion series;
- отвар можжевельника и others.
To prevent the development of the disease, a number of
- do not forget about condoms during casual sexual intercourse;
- observe intimate hygiene (wash twice a day);
- give up narrow and tight underwear as well as underwear from
- lead a healthy lifestyle (giving up bad habits,
sports, multivitamins, especially in the winter-spring period);
- control weight (preventing obesity and excessive
- apply pads and tampons without fragrances;
- do not get involved in douching;
- use intimate hygiene products with neutral
medium and without flavors;
- strengthen the immune system;
- having one permanent sexual partner.
Вопрос: Применяются ли физиопроцедуры для лечения
Ответ: Да, для терапии заболевания широко
UHF and UV irradiation are used. With chronic vaginitis
zinc electrophoresis is prescribed in parallel with electrolyte
cauterization and SMV-therapy on the vaginal area.
Вопрос: Чем опасен вагинит?
Ответ: Во-первых, нелеченый острый кольпит
may turn into chronic. Secondly, the risk of ascending is high.
infections with the development of endometritis and adnexitis, which later
can lead to infertility. Also вагинит провоцирует возникновение
cervicitis, cervical pseudo-erosion, and in children of synechiae of the labia.
Possible damage to the urethra and bladder (cystitis and urethritis).
Вопрос: Может возникнуть кольпит после применения
spermicides and local contraceptives such as suppositories
Ответ: Да, спермициды, входящие в состав гелей
and creams affect the natural microflora of the vagina that
provokes the activation of conditionally pathogenic microbes. Therefore, this
type of contraception should not be major.
Вопрос: У меня в мазке обнаружены грибы. Worried
itching and burning. Is treatment necessary?
Ответ: Да, при обнаружении грибов и наличии
complaints the diagnosis of candidal colpitis is made and in compulsory
the order is assigned to his treatment.