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Vaginal Infections

Information for the patientVaginal Infections

A vaginal infection is a name that is commonly used for external and internal infections of genitals.

Infections can be caused by various types of microorganisms, i.e. bacteria, fungi, protozoa and viruses. The infection of vagina and vulva are usually caused by species of skin and mucous membrane saprophytes, and the infection occurs as a result of disorder of appropriate microflora or reduced body resistance.

One of the infection symptoms is inflammation of the affected area which is characterized by redness, pain and skin and mucous membrane swelling1.

The female vaginal inflammation constitutes the most often infection, specifically with women of childbearing potential2.

The following are the most common types of vagina and vulva infections which constitute ¾ of the above specified infections:

  1. bacterial vaginosis (which constitutes 22-50% of the cases3). This type of vaginal infections (otherwise: vaginosis) is divided into:
  • infections caused by bacteria which require oxygen for their growth (aerobic vaginosis -AV), most commonly caused by streptococcuses,
  • infections caused by bacteria which develop without oxygen (bacteria vaginosis - BV), most commonly caused by Gardnerella vaginalis
  1. mycoses (which constitute 17-39% of the cases4). Candida albicans are reported with 90-95% of vagina and vulva mycoses5.

Vulvovaginal candidiasis (VVC) is, following bacterial  vaginosis, the second in terms of occurrence inaccuracy related to vagina biocoenose. The symptoms of mycosis include6:

  • strong itching of intimate parts
  • characteristic white, lumpy, sometimes  filled with water odourless discharge  
  • pain during sexual intercourse (dyspareunia)
  • burning when passing urine (dysuria)
  • redness of external genital organs
  • vaginal pH value is within the limits reported with a healthy woman (pH 3,5- 4,5)

It is often reported that mycosis and bacterial infections exist at the same time, this is the so-called mixed infection.

The frequency of occurrence of mixed vaginal infections is determined at 33-50% of all the cases of vaginal infections7.

In Poland, the most common combination of pathogens isolated with the cases of mixed vaginal infections is co-existence of aerobic bacteria from the group of streptococcuses (AV) and candida.

Most common symptoms of the mixed vaginal infection include atypical and non-usual symptoms of candida, bacteria vaginosis or aerobic vaginosis. A clinical image of the mixed vaginosis usually constitutes a resultant of symptoms characteristic to infections with specific pathogens reported with the patient2.

The following are most commonly reported symptoms:

  • strong vaginal discharge of different colour,
  • unpleasant odour,
  • swelling,
  • itching,
  • increase of a pH value in vagina (over 4,5).

One of the most effective and shortest topical therapies of mycoses (vaginal and vulva candida) and mixed vaginal infections (specifically caused by fungi and bacteria) involves the application of fenticonazole nitrogen in 200 mg soft vaginal capsules for 3 days, i.e. Gynoxin® OPTIMA or in a dose of 600 mg to be administered once - Gynoxin® UNO.  Another medicinal product Gynoxin® in the form of vaginal cream is also available; treatment with the use of the cream takes 3 days when administered twice a day or for 6 days when administered once a day. The drug is characterised by a wide scope of anti-fungal and anti-bacterial effect, and its application causes a quick reduction of infection clinical symptoms. Gynoxin® is an OTC drug.

 

Literature:

  1. Anderson MR. (2004). Evaluation of vaginal complaints. JAMA, 291:1368–79..
  2. Sobel J. Vaginitis. N Engl J Med, 1997, 337, 1896–1903.
  3. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. A J Obstet Gynecol, 2013; 209: 505–523.
  4. Sobel J., Faro S., Force R. i wsp. Vulvovaginal candidiasis: epidemiologic, diagnostics, and therapeutic considerations. Am J Obstet Gynecol, 1998, 178, 203–211.
  5. Achkar JM, Fries BC. Candida infections of the genitourinanry tract. Clin. Microbiol Rev, 2010, 23:253–73.
  6. Sobel JD. (2007). Vulvovaginal candidosis. Lancet, 369:1961–71.
  7. Donders G, Vereecken A, Bosmans E [et al.] Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG, 2002, 109, 34–43.