Candida albicans and other forms of vaginitis: symptoms, causes and treatment

Vaginitis is an infection of the female genital apparatus, not necessarily linked to an inflammatory state

It is a rather common and unpleasant situation, for which women frequently visit their gynaecologist.

These infections are divided into four categories: bacterial vaginosis (Gardnerella), mycotic vulvo-vaginitis (Candida), Trichomonas vaginitis and allergic or iatrogenic vaginitis.

What are the symptoms of vaginitis?

Vaginitis is usually manifested by:

  • Itching
  • Intense burning
  • Leucorrhoea, i.e. loss of vaginal secretions
  • A bad smell

Symptoms can be intermittent, relapsing or chronic.

In the first case they recur following spontaneous healing, while in the second case they reappear after healing due to specific treatment.

What are the causes of vaginitis?

The vaginal ecosystem is an acidic environment (with a pH of 4-4.5), which is so hostile that it prevents the development of micro-organisms and therefore infection.

However, in some women, slight momentary changes in vaginal pH are enough to cause the proliferation of pathogenic microorganisms.

Certain conditions can favour a change in pH, such as:

  • The use of neutral, non-physiological intimate cleansers (with a pH of 7).
  • Wearing tight-fitting clothing or synthetic fabrics, which increase the temperature.
  • Inadequate use of tampons, which should be changed every three hours.

The menstrual cycle can also lower the vaginal pH.

However, sexual intercourse is the main cause, for two reasons: semen raises the vaginal pH and through intercourse infection with exogenous infectious pathogens (sexually transmitted diseases) is possible.

How is vaginitis diagnosed?

The first step in the diagnostic process is the gynaecological examination, together with the symptoms reported by the patient.

In the second stage, the vaginal swab allows biological material to be taken and analysed by microbiological research.

The material taken is cultured on specific media for each possible pathogen and examined.

What is bacterial vaginosis and how is it treated?

Bacterial vaginosis is a vaginal infection in which bacteria quickly replace the bacilli of Doderlein, the true inhabitants of the vagina with an antibacterial function.

The best known bacterium is Gardnerella vaginalis, the others being Bacteroides, Mycoplasma and Mobiluncus.

Transmission may occur sexually.

Particular attention should be paid to pregnant women: Gardnerella appears to increase the risk of premature birth.

In half of the cases, this type of infection has no specific symptoms and may result in grey, strongly smelling, fluid vaginal discharge and burning inside the vagina.

Systemic antibiotic treatment with Metronidazole or Clindamycin may help.

What are mycotic vaginitis and how are they treated?

According to data from the Italian Society of Sexually Transmitted Diseases, 10-15% of women of reproductive age have contracted Candida at least once.

This infection is due to the presence of certain yeasts that, reproducing by budding, colonise the vagina, adhering to the epithelium.

It is manifested by severe itching and very thick vaginal discharge, similar to curdled milk.

It is advisable not to wear synthetic and tight-fitting clothing and, in case of discomfort, to prefer skirts.

The first treatment is usually topical imidazole compounds with locally applied ova and creams.

However, Candida vaginitis tends to recur, even after specific therapy.

This is due to the high resistance of the spores and the easy sexual transmission, with a continuous “passing on” of infections between partners.

In the event of frequent recurrences, oral therapy can be used.

What is Trichomonas vaginitis and how is it treated?

Trichomonas is a single-celled microorganism that is often found in the genital tract (including the male genital tract). It is particularly at home when the vaginal pH exceeds normal acidity levels.

It is mainly contracted through sexual transmission, partly because Trichomonas has difficulty surviving outside the human body.

However, the infection can be contracted in the bathroom or through the shared use of clothing or towels.

This vaginitis is manifested by intense itching, burning in the vulva or vagina, and foamy, strongly smelling, yellow-green discharge.

Treatment involves taking metronidazole, also for the partner.

What are allergic vaginitis and how are they treated?

These vaginitis are related to immediate hypersensitivity or delayed reactions from contact with soaps, creams, perfumed toilet paper, lubricants, ova or components of vaginal douches.

They manifest as intense burning, itching, erythema, odourless discharge.

It is essential to trace the allergen in order to avoid new allergic manifestations.

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