Patient's question:
How to treat vulvar itching?Doctor's answer:
Diagnosis:① For non-specific vaginitis, take secretions for smear preparation, perform Gram staining, and examine under a microscope to identify common pathogens without the presence of fungi or trichomonads.
② For candidal vaginitis, take secretions for smear preparation, perform Gram staining, and examine under a microscope to find clusters of Gram-positive, intensely stained oval-shaped spores, or pseudohyphae and budding cells connected in chains or branched patterns. The most reliable method is to conduct fungal culture testing.
③ For trichomonal vaginitis, mix secretions with a small amount of warm physiological saline dripped onto a glass slide and examine under a microscope. Active vaginal trichomonads can be observed. If trichomonads are not found in special cases, culture testing can be used instead, which has a high accuracy rate.
④ For atrophic vaginitis, secretion examination should be distinguished from trichomonal and candidal vaginitis. Pay attention to the size and morphology of the cervix and uterus, the source of bleeding, and vaginal cytology results. If necessary, perform cervical or endometrial biopsy to rule out the possibility of uterine cancer.
Treatment:
Dietary therapy and drug therapy can be used. In drug therapy:
① For non-specific vaginitis: The principle of treatment is to correct vaginal pH and locally apply antibiotics.
② For candidal vaginitis: Related triggers such as diabetes should be treated, and broad-spectrum antibiotics or hormones should be discontinued promptly.
③ For trichomonal vaginitis: There are two methods—systemic medication and local medication.
④ For atrophic vaginitis: The principle of treatment is to supplement a small amount of estrogen to enhance vaginal resistance and inhibit bacterial growth.