One of the most common complaints among women is vulvar and vaginal inflammation, which often leads to self-medication. If not treated properly, it tends to recur and become more complicated.
Sometimes, a pathogen is the main factor responsible for these inflammations, while in frequent cases, no germ is identified and the condition is referred to as non-infectious vulvovaginitis. There are many causes that can lead to the latter type of inflammation, which are often little known and almost never diagnosed.
The main risk factors for developing non-infectious vulvovaginitis are:
- Hygienic habits: intimate cleansers, especially if rich in deodorants, perfumes and additives, and vaginal douches, if used in excess, expose the skin and mucous membrane of the genitals to the irritating action of chemicals that cause damage either by allergy or by direct effect.
- Sexual intercourse: if adequate lubrication is not present during sexual activity, as is the case with women who suffer from recurrent vulvovaginal inflammation, microscopic abrasions may be created that allow external agents to penetrate the body. This could be a possible source of sensitisation.
- Clothing: wearing very tight clothing, especially if it is made of synthetic materials such as nylon or Lycra, can alter the vaginal ecosystem, making it more sensitive to foreign substances.
- Psychological factors: sometimes, women suffering from recurrent non-infectious vulvovaginitis lead an unsatisfactory sexual life or experience various psychological symptoms related to self-esteem and relationship harmony, ranging from mild anxiety to depression.
Regarding infectious vulvovaginitis:
In some cases, such as trichomoniasis, chlamydia and herpes, these are true sexually transmitted infections. In other cases, such as candidiasis and sometimes vaginosis, the cause of the inflammation is not so much aggression by an external germ, but rather alteration of the natural defence barriers.
The vagina is an environment in communication with the outside world that is normally populated by germs (such as fungi, viruses and bacteria). However, there are defence mechanisms against infection.
These include the presence of immune system cells and the acidic nature of the vaginal environment (pH <4.5), which is achieved through the production of lactic acid by lactobacilli (Döderlein’s bacillus).
The presence of lactobacilli is influenced by oestrogen levels, which is why there is an increased risk of vaginal infections during menopause.
Do you always need to swab for inflammation?
It is not always necessary to swab the vagina because the diagnosis is often clinical. The gynaecologist can institute empirical therapy by observing the type of vaginal secretion with the speculum or by performing the vaginal pH test. However, in cases of recurrent and relapsing infections, a vaginal swab may be useful in identifying the causative agent.
Come evitare infezioni vaginali ricorrenti?
It is important to strengthen your defences and maintain the balance of your vagina. Here’s how:
- Avoid excessive genital cleansing with disinfectant or aggressive products, especially those containing perfumes or additives.
- Avoid or minimise the use of vaginal douches and use those with a physiological pH instead.
- Observe safe sexual behaviour and always use condoms, especially if you have multiple partners.
- Perform proper post-coital hygiene and remember that urinating after intercourse reduces the risk of infections and cystitis.
- Perform proper perineal hygiene in the direction of the vulva to the rectum.
- Avoid wearing synthetic underwear, coloured briefs, panty liners and tight-fitting clothes, especially if they are made of nylon or Lycra. Synthetic materials do not allow proper tissue oxygenation and can cause stagnation of secretions and over-infection, as well as sensitisation to contact factors.
- Prefer pure cotton underwear that is not coloured.
- At the seaside or in the swimming pool, do not stay in a wet swimming costume for long periods, as the hot, humid environment encourages the growth of candida.
- Follow a balanced diet.
If your doctor deems it necessary, you may wish to take milk enzymes or organic food supplements to reduce the risk of recurring infections.
If you’d like to book a gynaecological consultation—online or in person—you can contact me here or book directly online.
I see patients weekly in my clinics in Milan and Florence and am always available to support you in choosing the best path for your health and comfort.