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Vaginitis: A Problem Almost Every Woman Faces in Her Life

Vaginitis is inflammation of the vagina that may result from an infection, change in the vaginal flora or bacterial concentrations, or lower estrogen levels. It is a common condition and tends to affect most women more than once in their lifetime. This condition is classified into four major types.

Types of Vaginitis

• Bacterial vaginosis caused by an abnormal increase in the number of bacteria normally found in the vagina.
• Trichomoniasis, an infection of the vagina caused by the parasites trichomonads generally acquired through sexual intercourse.
• Vaginal yeast, vaginal candidiasis or fungal infections that are caused by an overgrowth of the candida albicans fungi found in the vagina.
• Atrophic vaginitis, caused by lower estrogen levels especially after menopause.

Risk Factors of Vaginitis

The incidence of vaginitis is often higher due to the following factors:

• Hormonal imbalances from pregnancy, menopause, and birth control pills
• Sexually transmitted infections
• Multiple sex partners
• Antibiotic or steroid therapy
• Douching and the use of vaginal sprays or deodorants
• Bubble baths and moist or tight fitting underwear
• Diabetes, especially uncontrolled

Symptoms of Vaginitis

Vaginitis results in inflammatory changes around the vagina, and most symptoms are related to these changes. Here’s a list of the different symptoms that you may experience if you have this condition.

• Changes in the color, quantity, and odor of vaginal discharge. The kind of vaginal discharge often helps diagnose the type of vaginitis too. While bacterial vaginitis produces a grey or white discharge with a foul of fishy odor, vaginal yeast infections produce thick cheesy white discharge with lots of itching. Similarly, trichomoniasis causes yellowish green discharge.
• Itching around the genitals, especially in the vagina
• Pain during sex
• Pain when passing urine
• Rarely, slight vaginal bleeding

Treatment of Vaginitis

The treatment of vaginitis depends on its type. Bacterial vaginitis is treated successfully with antibiotics, mainly metronidazole and clindamycin creams for 5-7 days. On the other hand, vaginal yeast infections require antifungal therapy that includes miconazole, clotrinazole, or tiocanazole creams and suppositories. Trichomoniasis is treated with metronidozole or tinidazole oral tablets. In case of post-menopausal or low estrogen related vaginitis, the insertion of estrogen containing vaginal rings, tablets, or creams is often successful in halting atrophic vaginitis.

Endometrial Hyperplasia: Get the Facts on Symptoms and Prognosis

Endometrial hyperplasia involves an increase in the proliferation of the inner lining of the uterus. This lining is known as the endometrium and it generally increases in thickness throughout a woman’s menstrual cycle to prepare the uterus for a possible pregnancy. However, when the woman fails to conceive around her ovulation, her uterus begins to shed the endometrium resulting in the menstrual period. This happens every month in women in their reproductive age. However, some women develop an abnormally thick endometrium due to excessive growth during the proliferation phase of the menstrual cycle. This is known as endometrial hyperplasia. Although, most endometrial hyperplasias are noncancerous, this disease requires careful follow-ups and monitoring as it is one of the risk factors of endometrial cancer.

Causes of Endometrial Hyperplasia

Endometrial hyperplasia is believed to result from increased levels of the hormone estrogen. This hormone is also responsible for helping the endometrium grow during a normal menstrual cycle in preparation for pregnancy. As a woman begins to approach menopause, her estrogen levels tend to increase. Hence, this condition has an increased incidence in women nearing their menopausal years. Additionally, obesity, polycystic ovarian syndrome, and diabetes mellitus are likely to increase one’s risk of developing this condition, as they tend to result in higher estrogen levels.

Symptoms of Endometrial Hyperplasia

Abnormalities in the menstrual bleeding are common symptoms of endometrial hyperplasia, particularly since this condition involves the endometrium. Increased vaginal bleeding, spotting in between periods, prolonged bleeding, sudden changes in menstrual bleeding, or vaginal bleeding after menopause are some of the symptoms that women with this disorder may experience. Another, symptom of endometrial hyperplasia could be anemia or low hemoglobin levels. Although, anemia isn’t a direct result of endometrial hyperplasia, it may arise from increased or prolonged blood loss due to a thicker endometrium.

Pap Smear and  Endometrial Biopsy

Endometrial hyperplasia is diagnosed with an endometrial biopsy. A pap smear may sometimes show atypical glandular cells that would suggest the possibility of endometrial hyperplasia. However, the pap smear is not diagnostic and only an endometrial biopsy can provide an accurate diagnosis.

Treatment of Endometrial Hyperplasia and Endometrial Cancer

The treatment of endometrial hyperplasia may vary according to the age of the woman and the severity of the symptoms. Most women are better with cyclical or progesterone only contraceptive pills. The former tend to reduce the estrogen levels in the blood stream, whereas the later tend to relive endometrial hyperplasia by stopping the menses completely. However, severe symptoms or a possibility of endometrial cancer may require hysterectomy.

What Is Premature Menopause and How to Cope with It?

Menopause is considered as premature when menstruations end before the age of 40. Normally, average women reach their menopause after the age of 51. Various diseases and their treatment as well as genetics may lead to premature menopause.

What Causes a Premature Menopause?

Genetics plays a great role in premature menopause. Women who have had someone in the family with premature menopause, especially if their mothers have had premature menopause, are at a greater risk of being diagnosed with premature menopause.

Chromosomal disorders like Turner’s Syndrome, Lupus and Grave’s Disease may lead to premature menopause.

Autoimmune disorders also lead to premature menopause by attacking the ovaries and interrupting their normal functionality.

Chemotherapy or pelvic radiation therapy for cancer treatment also may lead to premature menopause.

Surgical Procedures That May Lead to Premature Menopause

Hysterectomy alone or accompanied with oophorectomy can also lead to premature menopause. Hysterectomy is the removal of the uterus due to various diseases like uterine cancer, endometriosis, uterine prolapse, pelvic inflammatory disease, complications after childbirth, etc.

Oophorectomy is the surgical removal of one or both ovaries. Oophorectomy is necessary in cases with ovarian cancer, benign tumors of the ovaries, ovarian cysts, twisted ovary, endometriosis, etc. The removal of one ovary usually does not lead to premature menopause. However, the removal of both ovaries leads to premature menopause and cessation of the reproductive activity.

Signs and Symptoms of Premature Menopause

A sudden change of the menstrual flow does not have to mean that menopause is coming. There are many other causes that can change the quantity and duration of the menstrual flow. Once the period is missed, the first thing that comes in everyone’s mind is pregnancy.

Menopause is considered when women have not had menstrual periods for at least 12 months and which first proceeded by a transitional period, known as the perimenopause.

Perimenopause is characterized by:

• Hot flashes — a hot sensation that flashes across upper body
• Irregular periods or less frequent menstruation
• Emotional symptoms – depression, irritability, and sleeplessness
• Lighter or heavier menstrual periods than before
• Vaginal dryness
• Decreased libido
• Dry skin, etc.

The perimenopause signs and symptoms vary in women. For some, this period is very challenging, while for others it is unnoticed.

Proper Diagnostics Helps Define Premature Menopause

Women who are facing with the signs and symptoms of early menopause should consult their doctor immediately in order to determine if premature menopause is the real cause, or something else is causing them.

The diagnostic process includes a complete physical examination, blood tests and measurement of the levels of the hormones estradiol and follicle-stimulating hormone (FSH). First, pregnancy and thyroid diseases have to be ruled out.

Today many medications are available in order to help women manage the perimenopause signs and symptoms. This includes herbal treatments, but also hormone replacement therapy.

Diagnosed with Premature Menopause – Now What?

The first thing that concerns every women diagnosed with premature menopause is the inability of having children in the future. The procedure of freezing the eggs and surrogacy offer for many women the hope of having biological children in the future, even after they have entered menopause.

Women who have been diagnosed with premature menopause should also be aware of other negative health influences like osteoporosis, cancer, periodontal disease, etc.