Before discussing vulvitis, it is worth briefly recalling what the vulva actually is. Many patients do not clearly distinguish between the vulva and the vagina. However, these are not the same thing.
So, what is the vulva? It is the external area surrounding the vaginal opening and corresponds to the external female genital organs. More specifically, the vulva includes the following structures: the mons pubis; the labia majora and labia minora; the vaginal vestibule; and the clitoris. The vulvar complex also includes the Bartholin glands, the hymen, and the external opening of the urethra.
Vulvitis is an inflammation of the vulva. Given its anatomy, the vulva may become involved in inflammatory processes affecting the genital organs, urinary tract, and skin.
What causes vulvitis? Vulvitis may be caused by fungi (Candida albicans), bacteria (streptococci, staphylococci, and enterococci), protozoa (Trichomonas vaginalis), and viruses (herpes simplex virus). Parasitic infections, including scabies and pubic lice, as well as sexually transmitted diseases, should also be considered among the causes.
Other factors that may contribute to vulvar inflammation include injuries sustained during sexual intercourse; irritation caused by urine or feces in patients with incontinence or those who are bedridden; and poor intimate hygiene. The use of harsh cleansing products, scented toilet paper, poorly breathable sanitary pads, and synthetic underwear also plays a significant role.
Vulvitis may also be associated with psychosomatic disorders, an unbalanced diet, immunosuppression, and systemic diseases such as diabetes and uremia.
Who is at risk? Specialists at the “Bogolyuby” Medical Center would like to draw your attention to the fact that vulvitis can affect women of any age, although prepubertal girls and older women may be more predisposed to developing this condition. In particular, after menopause, a significant decline in estrogen levels leads to progressive thinning of the vulvar and vaginal mucosa. This phenomenon increases susceptibility to inflammatory processes.
How does vulvitis manifest itself? The symptoms of vulvitis mainly include redness, itching, swelling, burning, and tenderness. Vulvar irritation may worsen during sexual intercourse and with excessive intimate hygiene. In addition, vulvitis often coexists with various types of vaginitis. In such cases, the condition is referred to as vulvovaginitis.
What are the complications?
In patients with urinary incontinence or those who are bedridden, poor hygiene may lead to chronic vulvitis due to prolonged contact with urine or feces. Without proper treatment, vulvitis may be complicated by infections that can progress to vaginitis, urethritis, and cystitis. In rare cases, chronic inflammation may cause adhesions of the labia.
How can it be treated?
In cases of bacterial infection, treatment includes the use of antibiotics. In cases of fungal infection, antifungal medications are indicated. If allergic reactions occur, the sensitizing agent should be avoided.
For moderate or severe symptoms, a physician may prescribe medical treatment based on antiseptic and anti-inflammatory agents. Topical corticosteroids may be recommended to relieve itching.
In addition to strictly following the treatment prescribed by a gynecologist, the management of vulvitis should include the correction of hygiene habits. Keep the vulva clean and dry, change underwear frequently, and maintain daily personal hygiene. After each bowel movement, carefully dry the skin and mucous membranes from front to back and always wash your hands. Until complete recovery, it is recommended to abstain from sexual intercourse or use a condom. Cotton underwear is preferable.
If chronic vulvitis does not respond to treatment, the attending physician may order a biopsy to rule out lichen sclerosus, squamous cell hyperplasia, or vulvar cancer.
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