Patient's question:
I have always had gynecological inflammation, which isn't very severe, just mild. However, it hasn't been completely eradicated, and it hasn't affected my normal life, so I stopped taking medication and didn't pay further attention. I don't know what precautions are needed for gynecological inflammation in daily life?Doctor's answer:
Dietary considerations should focus on avoiding spicy, cold, and irritating foods. Engage in moderate exercise to boost immunity and maintain good hygiene of the vulva. Vaginitis! Vaginitis is a common yet often unspoken discomfort for many women. Throughout their lives, women may encounter vaginitis attacks at different stages or due to various factors or causes. The best solution, of course, is for gynecological experts to prescribe appropriate medications and provide timely treatment.1. Trichomoniasis Vaginitis – Caused by the pathogen Trichomonas vaginalis, it is transmitted through sexual contact or indirect transmission (e.g., hot tubs, swimming pools, clothing, bedding, or contaminated instruments). Symptoms primarily include vulvar itching, increased vaginal discharge, and frothy yellow discharge. In severe cases, the discharge may contain blood. Additional symptoms include a burning sensation, pain during intercourse, and, if the urethra is also infected, frequent urination, painful urination, or even hematuria.
Treatment Approach: Oral metronidazole and intravaginal tinidazole suppositories are commonly used, with a course of 7–10 days repeated for 3 months. A 1% lactic acid solution can also be used to rinse the vulva. The partner should also be treated, and sexual activity should be avoided during treatment. Additionally, patients should maintain good hygiene, avoid unsafe sex, and prevent cross-infection.
2. Candida Vaginitis – Caused by Candida albicans, it is more common in women who use hormones or antibiotics long-term, have diabetes, or are pregnant. Transmission occurs mainly through sexual contact, hot tubs, towels, etc. Symptoms include cottage cheese-like discharge and vulvar itching.
Treatment Approach: Oral fluconazole (150mg) or intravaginal kefotin can be used. Nystatin suppositories may also be inserted into the vagina. Avoid sexual activity during treatment, change underwear frequently, and sterilize washing utensils with boiling water.
3. Gardnerella Vaginitis – Caused by Gardnerella vaginalis, it is transmitted through sexual contact and has a high prevalence in sexually active individuals. The infection is more common in women with frequent sexual activity. In acute cases, symptoms include increased discharge with a fishy or ammonia-like odor, damp and uncomfortable vulva, vaginal burning, pain during intercourse, and vulvar itching.
Treatment Approach: Tetracycline and sulfamethoxazole can be combined into suppositories for deep vaginal insertion, used once nightly for 10 days. Oral metronidazole or amoxicillin can also be prescribed. For systemic infections, amoxicillin or chloramphenicol may be administered intravenously.
4. Neisseria Vaginitis – Caused by Neisseria gonorrhoeae, it is transmitted through unsafe or promiscuous sexual contact. It can also be spread indirectly through contaminated swimsuits or hot tubs, bathtubs, or sitz baths. Symptoms include lower abdominal pain, increased vaginal discharge, purulent discharge, and swollen, painful vaginal lips. Untreated, it can become chronic and lead to infertility or ectopic pregnancy in 10–20% of women.
Treatment Approach: Ceftriaxone and spectinomycin injections for 10 consecutive days. Alternatively, decoct 100g of Salix matsudana leaves, 15g of Atractylodes macrocephala, 15g of Coptis chinensis, 15g of Phellodendron amurense, 20g of Pogostemon cablin, 15g of Cnidium monnieri, 30g of Pulsatilla chinensis, 30g of Sophora flavescens, and 15g of Triadica sebifera. Use the warm decoction to rinse the vulva 1–2 times daily for 7 days (one course), typically resolving within 1–2 courses.
5. Childhood Vaginitis – Common in young girls who wear open-bottom pants. Causes include sitting or crawling on the ground during play, inserting fingers directly into the vagina, or placing foreign objects, leading to vulvar and vaginal contamination. Symptoms include swollen and red vulva, watery vaginal discharge, burning or severe pain.
Treatment Approach: Rinse the vagina and vulva with Zanthoxylum water or Liuyi Powder (containing talc and licorice) for effective results. To prevent recurrence, avoid open-bottom pants and switch to loose, easy-to-remove closed-bottom pants. Educate girls on hygiene, discouraging touching the vagina with hands or foreign objects, and cleaning the vulva nightly.
6. Pubertal Vaginitis – Occurs when a girl first menstruates. Due to shyness and limited understanding of menstruation, they may neglect hygiene, use unclean sanitary pads, leading to vulvar contamination and bacterial growth. Symptoms include a sensation of heaviness or burning in the perineum, increased vaginal discharge, or purulent discharge. Leaking discharge may irritate the urethral opening, causing frequent urination and painful urination.
Treatment Approach: Clean the vaginal opening and vulva before bed, dry, and gently insert Jie Er Yin suppositories for excellent anti-inflammatory effects without damaging the hymen.
7. Tight-Pants Vaginitis – As the name suggests, this type of vaginitis is caused by wearing tight, hip-hugging triangular underwear and high-elasticity leggings. Some girls who value appearance may prefer tight clothing that accentuates curves. These pants are tight and hip-covering, made of non-breathable synthetic fabric, trapping vaginal discharge and sweat, creating a breeding ground for bacteria. Symptoms include excessive discharge, vulvar and labial itching, and urinary frequency, urgency, or urethral irritation.
Treatment Approach: Avoid synthetic fabric tight pants and switch to cotton underwear and loose pants. Clean the vulva nightly and take ciprofloxacin, vitamin C, or traditional Chinese medicine like Fu Yan Bao.
8. Senile Vaginitis – A common condition in postmenopausal women, primarily due to estrogen deficiency, reducing local resistance and allowing bacterial growth. Symptoms include vulvar itching or burning, severe cases with urinary frequency or pain, increased yellowish discharge, and bloody purulent discharge with an odor. Further examination is recommended to rule out tumors.
Treatment Approach: Early treatment is essential, as delayed treatment may lead to vaginal adhesions. Local use of a 1:5000 potassium permanganate solution for rinsing, or insertion of estrogen tablets or suppositories into the vagina, may be prescribed. Systemic estrogen use is also an option but must be done under medical guidance.