Vulvitis is an inflammation of the external genitalia (vulva), which can be caused by infection, irritation or an allergic reaction. The vulva includes the labia minora and majora, the clitoris and the entrance to the vagina. Inflammation can be associated with various infectious agents (bacteria, fungi, viruses), as well as mechanical or chemical irritants (e.g. tight underwear, aggressive detergents or sanitary pads). Vulvitis is accompanied by symptoms such as itching, burning, redness and swelling of the genitals, as well as possible vaginal discharge. In some cases, the disease may be associated with other pathologies, such as vaginitis or dermatological diseases. It is important to diagnose and treat vulvitis in a timely manner to prevent complications and chronicity of the disease.
History of the disease and interesting historical facts
Vulvitis as a medical condition has been known since ancient times, but its causes and mechanisms were not fully understood until the advent of modern microbiological and dermatological diagnostic methods. For centuries, the disease was associated with poor hygiene, although some cultures and medical treatises observed a connection between inflammation of the genitals and infectious agents. With the development of gynecology in the 19th and 20th centuries, vulvitis began to be perceived as an independent disease, although often accompanying vaginal infections. In recent decades, much attention has been paid to vulvitis in children, since the disease can be associated with the peculiarities of the anatomy and physiology of the child's body, as well as with the influence of hygienic factors.
Epidemiology
Vulvitis is a fairly common disease, especially among women of childbearing age and children. According to epidemiological data, about 10-15% women experience symptoms of vulvitis during their lifetime. Among preschool and primary school-aged girls, vulvitis is diagnosed in 15-20% cases of visits to a pediatric gynecologist. In postmenopause, there is also an increase in the incidence of vulvitis due to changes in hormonal levels and a decrease in estrogen levels, which leads to atrophic changes in the mucous membrane of the vulva. Factors influencing the frequency of vulvitis include climatic conditions, hygiene habits, and the presence of chronic diseases.
Genetic predisposition to this disease
There is no direct genetic predisposition to the development of vulvitis, but studies show that women with hereditary dermatological diseases, such as atopic dermatitis or psoriasis, have a higher risk of developing vulvar inflammation. In addition, a predisposition to fungal infections may be associated with genetic factors, such as a hereditary tendency to candidiasis. It is also important to consider the role of the immune system: people with immunodeficiencies or genetic disorders of the immune response have a significantly higher risk of developing vulvitis.
Risk factors for the development of this disease
There are many risk factors that can contribute to the development of vulvitis:
— **Infectious agents**: bacteria (eg, *Staphylococcus aureus*, *Streptococcus*), fungi of the genus *Candida*, viruses (herpes virus, HPV).
— **Hygiene factors**: use of aggressive detergents, sanitary pads with fragrances, synthetic or tight underwear.
— **Hormonal changes**: decreased estrogen levels in postmenopause, menstrual cycle.
— **Allergic reactions**: to detergents, latex (in condoms), creams or lubricants.
— **Mechanical irritation**: tight or poor quality underwear, intense physical activity, use of sanitary tampons or pads.
— **Diseases**: diabetes, obesity, weakened immunity.
Diagnosis of this disease
Diagnosis of vulvitis involves analysis of clinical symptoms and laboratory tests. The main symptoms include:
— Itching, burning, pain in the vulva area.
— Redness and swelling of the external genitalia.
— Painful sensations when urinating or during sexual intercourse.
— Vaginal discharge (may be purulent, white or serous).
To clarify the diagnosis, the doctor conducts the following studies:
— Microscopic examination of smears to detect bacterial or fungal infections.
— Bacteriological culture to determine the pathogen.
— PCR diagnostics to detect viral infections such as herpes simplex virus or human papillomavirus (HPV).
— In some cases, a vulvar skin biopsy may be required to rule out cancer or autoimmune diseases.
Differential diagnosis is carried out with vaginitis, dermatitis, psoriasis and other diseases affecting the vulva area.
Treatment
Treatment of vulvitis depends on the cause of the inflammation and includes several areas:
— **Antibacterial therapy**: prescribed when a bacterial infection is detected. Broad-spectrum antibiotics or drugs aimed at a specific pathogen are used.
— **Antifungal medications**: used for fungal infections (*Candida albicans*). Usually used as topical creams or suppositories (e.g. clotrimazole).
— **Antiviral therapy**: For herpes infection, antiviral drugs such as acyclovir are prescribed.
— **Anti-inflammatory agents**: Topical corticosteroids may be used to reduce inflammation and itching.
— **Hygiene recommendations**: avoid factors that promote irritation (aggressive detergents, synthetic underwear), follow the rules of intimate hygiene.
— **Allergic reactions**: for allergic vulvitis, antihistamines are used and allergens are excluded.
List of medications used to treat this disease
— Antibiotics (azithromycin, amoxicillin, cephalosporins).
— Antifungal drugs (clotrimazole, miconazole).
— Antiviral drugs (acyclovir, valacyclovir).
— Corticosteroid ointments (hydrocortisone, prednisolone).
— Antihistamines (loratadine, cetirizine).
Disease monitoring
Monitoring of patients with vulvitis includes regular examinations to assess the effectiveness of treatment and exclude relapses. Patients are advised to follow all doctor's recommendations and avoid factors that cause irritation. The prognosis with timely and adequate treatment is favorable in most cases, but chronic or recurrent forms of the disease may require additional examination and adjustment of therapy. Possible complications include chronicity of the process, spread of infection to adjacent tissues and deterioration of quality of life.
Age-related features of the disease
Vulvitis can occur at any age, but different age groups have their own characteristics:
— **Children**: vulvitis in girls is often associated with poor hygiene, mechanical irritation or urinary tract infections.
— **Women of childbearing age**: the most common cause is infectious diseases, especially fungal diseases (candidiasis).
— **Postmenopausal women**: vulvitis is often associated with hormonal changes, atrophy of the vulvar mucosa due to estrogen deficiency, which requires additional hormonal therapy.
Questions and Answers
- What is vulvitis and what are its main symptoms? Vulvitis is an inflammation of the external genitalia, accompanied by itching, burning, swelling and redness.
- What are the causes of vulvitis? Vulvitis can be caused by infections (bacterial, fungal, viral), allergic reactions or mechanical irritation.
- How is vulvitis treated? Treatment includes antibacterial, antifungal or antiviral drugs, as well as the elimination of irritating factors.
- Can vulvitis
