Vaginitis - Vaginitis

Japanese: 腟炎 - ちつえん（英語表記）Vaginitis

What kind of infection is it?

This is a general term for infectious diseases that occur in the vagina. The most common causative microorganisms are Trichomonas vaginalis, mold, and Escherichia coli, but recently, the bacteria that normally reside in the vagina and are necessary for keeping the vagina clean have been identified. Lactobacillus ( New patient ) However, we have now discovered the existence of a disease called bacterial vaginosis, which occurs as a result of being overwhelmed by multiple bacteria.

Sometimes the cause is a foreign object, such as a forgotten tampon.

In addition, as women age, the secretion of ovarian hormones decreases, which weakens the vaginal cleansing function and allows the growth of various bacteria, which can lead to vaginitis (atrophic vaginitis).

How symptoms manifest

Symptoms Leucorrhea ( Taige ) This is an increase in vaginal discharge, which is yellowish and sometimes foul-smelling. This type of discharge irritates the mucous membrane of the vulva (the outer part of the genitals), causing vulvitis, which causes itching and pain. The mucous membrane of the vagina also becomes red, and in severe cases, bleeding may occur.

Testing and diagnosis

Vaginal secretions are examined under a microscope to detect and sometimes culture the inflammatory response (increased white blood cells) and the causative pathogen.

Treatment methods

First, find the cause and remove it. For example, in the case of vaginal trichomoniasis, a type of vaginitis, if a tiny protozoan called Trichomonas is found under a microscope, a drug that is effective against vaginal trichomoniasis is administered into the vagina or taken orally. Fortunately, there is an effective drug for vaginal trichomoniasis, but since it is transmitted between partners, it is better for two people to treat it to reduce the frequency of recurrence.

For vaginitis caused by fungi, antifungal drugs are administered into the vagina and an ointment containing an antifungal drug is applied to the vulva. For atrophic vaginitis, hormone drugs are administered to kill bacteria in the vagina and to strengthen the vaginal mucosa.

A foreign body that is sometimes found is a forgotten tampon, which causes persistent foul-smelling vaginal discharge that quickly resolves if removed.

What to do if you notice an illness

Increased vaginal discharge can also occur due to malignant conditions such as uterine cancer, so if you have colored vaginal discharge, please visit an obstetrician-gynecologist.

On the other hand, one of the causes of vaginal discharge is mucus secretion from the cervix. This changes with the rise and fall of hormones. Clear vaginal discharge may increase between menstruation, but this is nothing to worry about as it is caused by the action of hormones.

Takashi Kawana

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな感染症か

　腟に起こる感染症の総称です。原因微生物としては、腟トリコモナス原虫、カビ、大腸菌などが比較的多いのですが、最近、腟に常在していて腟を清浄に保つために必要な乳酸桿菌(にゅうさんかんきん)が、複数の菌に追いやられた結果発症する、細菌性腟症という病気の存在がわかってきました。

　時には異物、たとえば生理用タンポンの取り忘れなどが原因になっていることもあります。

　また、高齢で卵巣ホルモンの分泌が低下するため、腟の清浄作用が低下し、いろいろな菌の増殖を許してしまって腟炎（萎縮性腟炎）を発症する場合もあります。

症状の現れ方

　症状は帯下(たいげ)（おりもの）の増加で、黄色っぽく、時に悪臭を伴います。このような帯下は、外陰（性器の外側の部分）の粘膜を刺激して外陰炎を発症し、かゆみや痛みをもたらします。腟の粘膜も発赤し、ひどくなると出血してきます。

検査と診断

　腟の分泌物を顕微鏡で観察し、炎症反応（白血球が多く出現する）やその原因となった病原体を検出したり、時には培養したりして特定します。

治療の方法

　まず原因を探し、これを取り除きます。たとえば、腟炎のひとつ腟トリコモナス症では、顕微鏡で小さい原虫であるトリコモナスが発見されたら、腟トリコモナス症に有効な薬剤を腟内に投与したり、経口薬を服用します。幸い、腟トリコモナス症には有効な薬剤がありますが、パートナー間で感染するので、治療は2人で行ったほうが再発する頻度が少なくなります。

　カビによる腟炎は、抗カビ薬の腟内投与を行い、外陰部には抗カビ薬の入った軟膏を塗ります。萎縮性腟炎の場合は、腟内の菌を殺す一方、腟の粘膜を強化するため、ホルモン薬を投与します。

　異物として時々みられるのが、生理用タンポンの取り忘れです。悪臭のある帯下が持続しますが、これを除けばすぐに治ります。