Menopausal colpitis

Menopause is a difficult and inevitable period in the life of every woman. Changes in hormonal levels affect almost all organs and systems, and immune defense weakens. The likelihood of the occurrence and development of inflammatory processes associated with climacteric age-related transformations increases in a woman's body.

Colpitis (vaginitis) is an inflammatory disease associated with a violation of the vaginal microflora, caused by thinning of the multilayered epithelium under the influence of a decrease in estrogen hormones. Colpitis during menopause is called atrophic, senile or senile. After 6-8 years of the climacteric period, every second patient suffers from colpitis. Over the next 10 years, the chances of this disease increasing and amount to 70-80% among the female population in the menopausal period.

Senile colpitis is characterized by inflammatory reactions in the vaginal mucosa (tunica mucosa) and has a pronounced symptom complex caused by the introduction and development of secondary pathogenic flora. Vaginal discharge becomes more abundant, sometimes with ichor (due to thinning and increased vulnerability of the vaginal mucosa), with a strong foul odor, painful unpleasant sensations occur during intimate intercourse, as well as burning and itching. The urge to urinate becomes more frequent. A microscopic analysis and cytological examination of the discharge from the genitourinary organ confirm a change in the vaginal flora, the addition of secondary microflora and the presence of changes in the acidity of the vaginal environment. In very rare cases, senile colpitis is asymptomatic.

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Epidemiology

The reason that provokes the appearance and progression of senile colpitis is that the walls of the vagina are formed by multilayered flat non-keratinizing epithelium and with a decrease in the amount of estrogens in the bloodstream, thinning of the epithelial layer may occur, leading to a decrease in cells producing glycogen, which is a source of nutrition for lactobacilli.

The main metabolite of lactobacilli is lactic acid, which maintains a certain internal acidity of the vaginal environment. A decrease in the polysaccharide glycogen provokes a decrease or almost complete extinction of lactobacilli strains. As a result, the acidity of the vagina decreases, and favorable conditions arise for the attachment and development of pathogenic microbes, causing a local inflammatory reaction in the mucous membrane.

Pathogenic and opportunistic flora provoke the development of bacterial colpitis (viruses, certain types of bacteria and mycotic cultures).

Pathogens - E. coli, streptococci, gardnerella, give impetus to the appearance of atypical senile colpitis with mixed infection. The complexity of diagnosing atypical colpitis lies in differentiating the type and kind of pathogen.

Among mycotic microorganisms, in most cases, colpitis during menopause is caused by fungi of the Candida family, which provoke the development of candidomycosis (thrush).

Viruses cause colpitis with accompanying symptoms and characteristic changes by which the type of pathogen is determined. For example, gonorrhea, ureaplasmosis, trichomoniasis, mycoplasmosis, chlamydia. Most often in this situation, the pathogens of colpitis are trichomonads and cytomegalovirus.

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Causes menopausal colpitis

Factors that precede and create favorable conditions for the development of senile colpitis are: natural menopause, ovarian ablation, partial or complete hysterectomy (surgical excision of the uterus).

The main reason for the appearance of colpitis during menopause is the appearance of estrogen deficiency, which is accompanied by a decrease in the growth of vaginal epithelium, a decrease in the secretory function of the vaginal glands, a decrease in the thickness of the mucous membrane, its dryness and fairly strong damage.

Changes in vaginal microflora occur due to a significant decrease in glycogen, leading to a decrease in the number of lactobacilli and a change in pH, which promotes the growth of opportunistic microorganisms and the invasion of external bacterial flora. Provoking factors that contribute to the addition of a secondary infection are sexual intercourse, failure to observe hygiene rules or home gynecological procedures (douching). In the presence of weakened immunity and extragenital diseases that have a chronic course, senile colpitis during menopause becomes recurrent and persistent.

Patients who have experienced early menopause, have a history of endocrinological diseases (diabetes mellitus, thyroid disease) or have undergone ovariectomy are most prone to developing senile colpitis.

The causes that provoke senile colpitis are the following:

• Weakening of the immune system, as a result of which the body becomes more vulnerable and does not provide adequate resistance to the invasion of pathogenic bacteria from outside;
• Long-term use of synthetic underwear, leading to the emergence of a greenhouse effect and the rapid proliferation of pathogenic microorganisms that cause inflammatory processes;
• Radiation therapy, which causes almost complete suppression of the immune system;
• A decrease or cessation of ovarian hormone production that occurs in association with perimenopause, menopause, postmenopause, or after oophorectomy.

Patients at risk of developing atrophic colpitis during menopause include those who are overweight, have diabetes, HIV, and have a promiscuous sex life.

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Risk factors

The formation and progression of colpitis during menopause can be provoked and facilitated by:

• poor and insufficient hygiene of the genitals,
• using an antibacterial soap solution or gel with a strong smell,
• wearing underwear made of synthetic fabrics.

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Symptoms menopausal colpitis

In many cases, patients do not complain about the occurrence and progression of atrophic colpitis. It can have a sluggish course and have virtually no pronounced symptoms until a certain period. Symptom complexes of senile colpitis are classified as subjective and those identified by a gynecologist during examination of the patient.

Subjective factors include:

Scanty, periodically occurring, leucorrhoea, itching and burning sensations when urinating or using soap for hygienic purposes, vaginal dryness, painful sexual intercourse and the appearance of bloody discharge after it. The presence of blood in vaginal discharge is associated with microtraumas that occur during intimacy. A minor violation of the integrity of the mucous membrane of the vagina and vulva is dangerous due to the imposition of a secondary infection and the occurrence of a pronounced inflammatory process.

During a gynecological examination, the doctor may find:

• Pronounced age-related changes in the vulva, vagina and its mucous membrane. The mucous membrane is pale with focal or total hyperemia and bleeding areas. Areas without epithelial tissue and loose adhesions may be visualized.
• The vagina becomes narrow with indistinct vaults. Its walls are thin and smooth without folds.
• The cervix is atrophic, the size of the uterus is reduced, and age-related changes in the vulva are present.
• When a gynecologist takes a smear, a bleeding area may appear on the thinned and easily damaged vaginal mucosa.
• The diagnosis is made based on data from a gynecological examination and bacteriological analysis of vaginal discharge.

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First signs

Atrophic colpitis during menopause develops in the 5th-6th year after the natural cessation of the menstrual cycle. At first, the pathology does not have clearly expressed symptoms and can proceed almost asymptomatically. Patients note periodic vaginal discharge, burning, pain, irritation in the genital area, which intensify during hygiene procedures using soap. Unpleasant sensations can become more intense after emptying the bladder. Weakened muscle tone of Kegel and the bladder (vesica urinaria) are the cause of frequent urge to urinate. Vaginal dryness leads to damage to the mucous membrane during sexual intercourse. Small bloody discharge appears. Microtraumas serve as "entry gates" for various types of infections that cause persistent inflammatory processes. Vaginal discharge with bloody inclusions is one of the initial manifestations of the disease. When the first signs or alarming symptoms of colpitis during menopause are detected, a specialist consultation is necessary. You should not postpone a visit to the doctor for a long time due to the risk of developing a secondary infection, which will require long-term and complex treatment.

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Complications and consequences

Failure to seek medical help in a timely manner and to prescribe adequate drug therapy for atrophic colpitis can lead to quite serious consequences for the female body and the development of aggressive infectious processes.

The following conditions are particularly dangerous and require long-term therapy:

• The transition from the acute stage of the disease to a chronic one, which is difficult to treat, reduces the woman’s quality of life and periodically recurs.
• The ability of a pathogenic culture that has caused an inflammatory process to spread to parts of the urinary system and provoke the emergence of ascending infectious processes (urethritis and cystitis).
• Risk of endometritis (inflammation of the uterine mucosa), parametritis (inflammation of the parauterine tissue), perisalpingitis (local inflammation of the peritoneum covering the fallopian tube), pyovarium (inflammation of the ovary), general peritonitis.

It is possible for a woman with atrophic colpitis during menopause to become infected as a result of an incorrect invasive gynecological examination or minor surgical intervention with access through the vagina.

The sooner the problem is diagnosed and adequate treatment is prescribed, the lower the chance of developing life-threatening complications.

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Diagnostics menopausal colpitis

Methods that help diagnose colpitis during menopause include:

• Gynecological examination using speculums;
• Colposcopic method;
• Measurement of acid-base balance;
• Pap test and smear microscopy;
• Ultrasound diagnostics of the pelvic organs for the diagnosis of concomitant pathologies.

A doctor, conducting a visual examination using a special instrument (a gynecological speculum), can state: thinning, superficial smoothness and pallor of the vaginal mucosa, the presence of small eroded inflamed areas without epithelial cover, which begin to bleed upon contact, the presence of plaque (serous or serous-purulent), the presence of foci with clearly expressed inflammatory processes and swelling. If colpitis during menopause is chronic, recurrent or neglected, then the visual symptom complex of defects of the vaginal mucosa may not be clearly expressed, and the discharge is scanty and insignificant.

Colposcopy allows for a more detailed examination of the affected areas of the vaginal mucosa, to detect a shift in pH levels and, using the Schiller test, to identify unevenly or weakly colored areas of the mucosa without the presence of glycogen.

During microscopic analysis of a smear, senile colpitis can be suspected if there is an increase in the level of leukocytes, a significant increase in epithelial cells, a sharp decrease in the content of vaginal lactobacilli and the possible presence of various opportunistic microorganisms.

Additionally, material is collected for cytological examination, a biopsy of questionable areas of the vaginal mucosa may be prescribed to exclude the development of malignant neoplasms, PCR and analysis of secretions to identify STIs and specific factors of colpitis manifestation.

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Tests

To clarify and confirm diagnostic details, the following must be prescribed:

• Hormonal background studies.
• Smears for microscopy and cytology.
• PCR (polymerase chain reaction) for detection of pathogens of STDs (chlamydia, ureaplasma, gardnerella, trichomonas, herpes and papilloma viruses).
• Bacteriological examination of vaginal microflora.
• Bacteriological analysis of vaginal flora to determine the type of pathogen present and its sensitivity to antibiotics.
• Cytological examination of a cervical smear.
• Bacteriological examination of urine.
• ELISA blood test (chlamydia, mycoplasma, herpes, cytomegalovirus, hepatitis, etc.).
• General blood and urine analysis.
• Blood test for HIV and Wasserman reaction.

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Instrumental diagnostics

To confirm the diagnosis of colpitis during menopause, in addition to laboratory microscopic studies, various types of instrumental diagnostic procedures are widely used:

Ultrasound diagnostics of the pelvic organs (used to identify possible concomitant pathologies);

Colposcopy is an examination of the vulva, vaginal walls and cervix under significant magnification using an optical device called a colposcope. It is performed to detect mucosal defects and determine their nature.

Schiller test is a method of colposcopic testing with chromodiagnostics. The areas of the vagina, with senile colpitis, with reduced glycogen production will be weakly and unevenly colored.

Vaginal acidity analysis using test strips. If there is a disease, the index will fluctuate between 5.5 - 7 conventional units.

Cytological analysis of the smear. Colpitis during menopause is characterized by a significant increase in the number of cells in the prebasal and basal layers.

Microscopic and bacteriological examination of a vaginal smear. The titer of vaginal bacilli in the preparation drops sharply, an increased number of leukocytes is observed, and the addition of opportunistic flora is possible.

Cystoscopy is a therapeutic and diagnostic procedure on the bladder, performed using a cystoscope. It is recommended for diagnosing colpitis with an accompanying secondary infection and is used to determine the possible consequences of the pathogen entering the bladder by an ascending type of spread;

Vaginal scraping and diagnostics using PCR.

Differential diagnosis

It is necessary to differentiate atrophic colpitis from a large group of infections and candidiasis, which are sexually transmitted.

The volume and nature of vaginal discharge can be used to presumably diagnose the causative agent of the inflammatory process. The doctor makes a final verdict after receiving the results of a microscopic examination of a smear or bacterial culture.

With a trichomonas infection, vaginal discharge is very abundant, foamy, thick, yellow or gray in color, and has a strong unpleasant odor.

The invasion of the gonococcal pathogen leads to the formation of excess discharge with a purulent component.

Infection with streptococcal or staphylococcal cultures contributes to the appearance of yellowish-cloudy, white, gray, with the presence of a fishy odor discharge from the vagina.

The addition of yeast-like fungi of the genus Candida to the inflammatory process provokes cheesy, thick discharge, accompanied by itching.

Diagnosed gonorrhea, syphilis, genital herpes infection is an indication for a consultation with a venereologist.

Treatment menopausal colpitis

Therapeutic measures for senile colpitis begin with an accurate diagnosis and a comprehensive treatment plan. It consists of hormone replacement therapy (HRT), local or general effects on the inflammation site.

Therapeutic measures include the appointment of:

• HRT and antibacterial drug regimens;
• vaginal and vulvar sanitation;
• therapy of concomitant diseases;
• temporary abstinence from sexual intercourse;
• examination and, if necessary, treatment of the partner;
• compliance with hygiene rules.

Vaginal inflammations are eliminated by instillation, using anti-inflammatory drugs, antibacterial drugs or herbal infusions. Vaginal lavage can be done at home with strict adherence to the rules of asepsis and antisepsis.

When diagnosing senile colpitis, the doctor will definitely recommend hormonal drugs. The woman is prescribed an individual treatment regimen, which includes the use of tablets or injections, vaginal suppositories or tampons, vaginal douching with an anti-inflammatory component. Hormonal drugs correct the ratio of hormones and help reduce the manifestations of the inflammatory process. Tampons with various medicinal ointments, which are prescribed by the doctor individually and act locally on the resulting source of infection.

Colpitis responds to treatment if the diagnosis is made accurately and in a timely manner. Therefore, at the first signs of the disease, it is necessary not to delay visiting a gynecologist. It is important to complete the treatment regimen prescribed by the doctor in full, and not to stop when the unpleasant symptoms disappear. Untreated colpitis is complicated by a chronic recurrent course and the growth of specific pathogenic flora resistant to anti-inflammatory drugs that were used and led to positive dynamics. Microorganisms that caused inflammation may not respond to repeated use of drugs and the course of the disease will worsen.

When atrophic colpitis is detected during menopause, taking into account the type of pathogen causing the inflammatory process, it is necessary to carry out etiotropic (aimed at eliminating the cause) therapy.

In case of frequent urination, the occurrence of cystitis with ascending infection, and urinary incontinence, uroseptic drugs are indicated.

Medicines - hormone replacement therapy

For HRT, drugs containing estrogens and gestagens are prescribed. Their type and dosage depend on the woman's age and the state of the body's hormonal balance.

The medicines Femoston or Femoston conti contain estradiol (first digit) and dydrogesterone (second digit), are produced in tablet form of three types with dosage designation 1/5, 1/10 or 2/10. There are many analogues of the drug Femoston with identical hormone content: Klimaksan, Aktivel, Divitren, Pauzogest, Revmelid, etc.

In the treatment of colpitis during menopause, the combined hormonal drug Klimanorm is used, containing estradiol or estradiol with gestagen. The release form is two types of dragees: dragees containing estradiol and dragees with estradiol and levonorgestrel. Using Klimanorm with estradiol, the deficiency of the hormone in the woman's body is replenished. Using the drug with a combination of estradiol and gestagen, a double effect is achieved: the balance of estrogens in the body is restored and endometrial hyperplasia is prevented. Prevention of hyperplastic conditions of the endometrium occurs under the action of levonorgestrel.

For complex therapy of colpitis during menopause, the drug Ovestin can be used, the active ingredient of which is estriol. The drug is available in different pharmaceutical forms: tablets, vaginal suppositories and cream. It is prescribed by a doctor for the corresponding symptoms of colpitis.

To stabilize the hormonal background of the female body and eliminate the discomfort of senile colpitis, there are many combined drugs with a combination of estrogens and gestagens, the deficiency of which is observed during menopause. These are drugs such as Tibolone, Ladybon, Liviol.

In the treatment of atrophic colpitis, drugs are widely used that include phytohormones and plant extracts that alleviate climacteric symptoms - these are Klimadinon, Klimakt-heel and Klimaktoplan.

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Antibiotic therapy

Antibacterial drugs are prescribed to a patient with atrophic colpitis in accordance with the results of bacterioscopy of a vaginal smear and bacteriological culture of discharge.

The cultural method (bacterial culture) is the most accurate in identifying the pathogen that caused inflammation in the vagina. During the period of growth of colonies of microorganisms, an analysis of their sensitivity to antibacterial drugs is necessary. Such a study allows for the effective elimination of pathogens that caused the inflammatory process. The use of broad-spectrum antibiotics is usually recommended.

If the inflammatory process is caused by yeast-like fungi, antimycotic (antifungal) agents are used: Pimafucin, Mikozoral, Irunin, Fucis, Diflazon, etc. In the fight against candidal colpitis (vaginal thrush), medications can be prescribed for internal use (tablet forms of the drug) or locally (ointments, vaginal suppositories, creams).

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Local treatment

In local treatment, it is recommended to use anti-inflammatory emulsions, ointments, creams, vaginal suppositories, baths, and vaginal douching. A positive aspect of local use of drugs is the effect of the active substance of the drug on the pathogen directly at the site of inflammation, bypassing the gastrointestinal tract and the barrier function of the liver. Local use of drugs gives a good result if it is combined with drug therapy that eliminates the cause of atrophic changes in the vaginal walls.

In case of senile vaginitis, the vagina is irrigated with lactic acid, and then tampons with syntomycin emulsion or with oil solutions of estrogens (the drug Sinestrol) are inserted.

To improve the trophism of the vaginal mucosa, suppositories or cream containing estriol and ovestin are recommended. At the beginning of treatment, suppositories with antiseptics are used, such as iodoxide, betadine, hexicon or terzhinan. Such local therapy lasts for 7-10 days. All procedures are preferably performed at night.

Acilact suppositories help restore healthy vaginal microflora (1 suppository is inserted at night for 10 days).

Warm sitz baths and douching with herbs that have an antiphlogistic effect (sage, calendula, elecampane) bring good results if a secondary infection has not joined the inflammation process of the atrophied vaginal walls and the visit to the gynecologist was timely.

Physiotherapy

Physiotherapeutic methods are used to treat colpitis during menopause and its complications. The doctor may prescribe UHF therapy or UV irradiation, laser beam, magnetic therapy, mud sitz baths. The effect of physiotherapeutic procedures on the body promotes the activation of the healing of the vaginal mucosa.

General tonics.

To stabilize the body's defenses, various vitamins, vitamin-mineral complexes and drugs that stimulate the immune system (for example, Aflubin) are used.

Diet

During treatment, the diet should be enriched with plant foods and fermented milk products. Salty, fatty, spicy, smoked delicacies are completely excluded.

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Folk remedies

Traditional healers offer a large number of remedies and methods for treating colpitis. But these methods should only be an addition to the main drug therapy. The doctor may recommend the use of herbs if the disease is at an early stage and is not complicated by a secondary infection. Traditional remedies are good for preventing inflammatory processes in the recurrent course of colpitis. When drawing up a treatment plan, specialists most often recommend using a decoction of one plant or a collection of herbs. Herbal decoctions are used for douching, irrigation, instillations. It is possible to insert tampons soaked in herbal decoction into the vagina for the purpose of disinfection and relief of the inflammatory process. Herbal decoctions and infusions are perfect for the treatment of colpitis of various etiologies, relieving inflammation, irritation and having an antibacterial effect on the affected areas of the mucous membrane.

For senile colpitis - make a herbal mixture of oregano, quercus bark, and dried mallow root. Take these components in equal proportions. Pour 1 liter of clean boiling water over the mixture and let it brew for 2-3 minutes, then strain through gauze or a sieve. Use warm for gynecological douching twice a day.

A decoction of the leaves of "Kashlegon" (coltsfoot). Take 50 g of crushed dry plant, pour 1 liter of boiling water, leave for an hour and strain. The finished infusion is recommended to be used twice a day.

For douching, anti-inflammatory tampons, it is possible to prepare a decoction from a herbal collection. Mix in a separate container 25 g of stripped chamomile flowers, 10 g of dried forest mallow flowers, 10 g of dried oak bark, 15 g of dried sage leaves. Pour 2 tbsp. of the mixture into 1 liter of boiling water, let it brew and cool slightly. Then the decoction must be filtered and it is ready for use.

For pain associated with colpitis, it is recommended to take equal proportions of chamomile flowers and plantain leaves. Pour 1 tbsp of the mixture into ½ l of boiling water, leave for 1 hour, strain. Use during douching for the treatment of atrophic colpitis twice a day.

Chamomile infusion. For 2 tbsp. of plant flowers use 1 liter of clean water. Boil for a quarter of an hour. Leave to cool, strain (it is best to use several layers of gauze) and use as a solution for douching, which is carried out twice a day, do not skip procedures. Duration of treatment is 14 days.

Instead of chamomile, you can use calendula flowers. The preparation of the infusion and the scheme of use are identical to those described above.

Another method recommended by traditional medicine doctors to relieve the pain symptoms of senile colpitis: make a mixture of the flowers of the stripped chamomile (Matricaria chamomilla) and the wild mallow (Malva sylvestris), as well as the leaves of the medicinal sage (Salvia officinalis), the leaves of the walnut (uglans regia), the dried bark of the common oak (Quercus) in equal proportions. Pour 2 tbsp. of the well-stirred mixture into 1 liter of boiling water, cool and strain. Use both for douching and for soaking vaginal tampons to treat colpitis during menopause.

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Homeopathy

Homeopathic doctors offer their own methods of treating colpitis during menopause. The following medications are most often prescribed for this purpose.

Echinacea compositum S. The homeopathic remedy stimulates the immune system, has an indirect antiviral and antimicrobial effect, has a detoxifying (removes toxins) and antiphlogistic effect on the body. Single dose - 1 ampoule. The drug can be administered from 1 to 3 times a week by various injection methods: intramuscularly, subcutaneously, intramuscularly, and intravenously if necessary. In acute cases and in severe cases of the disease, the drug is used daily. One of the options for using the drug is oral administration (in the form of "drinking ampoules").

Gynacoheel. It is prescribed for various inflammatory diseases of the external and internal female genital organs: adnexitis, parametritis, myometritis, endometritis, colpitis, vulvitis, cervicitis. The presence of thyroid pathologies is not a contraindication to the use of the drug, but a consultation with an endocrinologist is necessary. The homeopathic remedy is contraindicated in case of hypersensitivity to the venom of honey bees, wasps, hornets and bumblebees. The maximum single dose is no more than 10 drops. The drug is taken sublingually (under the tongue) or orally with 1 teaspoon or tablespoon of clean water, three times a day 15-20 minutes before meals or 1 hour after meals. In acute cases, a single dose should be taken every quarter of an hour, not exceeding a two-hour time interval. The treatment regimen and dosage of the drug are recommended by a homeopath.

In pathological processes of inflammatory nature of non-specific etiology (adnexitis, oopharitis, salpingitis, colpitis, parametritis, endometritis, myometritis), which do not require more radical methods of treatment, positive dynamics are provided by monotherapy with the homeopathic drug Gynekoheel. Its use should be combined with physiotherapeutic procedures. Given the neglect of the inflammatory disease, the course of therapy can last from 3 weeks to 1 month, in rare exceptions up to 2-3 months. The treatment time is reduced if bicomponent therapy is used according to the standard scheme:

1. Gynekoheel (10 drops twice a day, course of treatment up to 1.5 months) together with Traumeel S (1 tablet 2-3 times a day, standard course - 3 weeks or 1 ampoule twice a week intramuscularly or subcutaneously).
2. In case of recurrent senile colpitis with a significant volume of leucorrhoea and the absence of a pathogenic inflammatory agent, therapy with Agnus Cosmoplex C in combination with Gynecoheel (10 drops 2-3 times a day) is advisable. These homeopathic preparations enhance each other's anti-inflammatory properties.

Revitax vaginal suppositories. This is a preparation that combines natural ingredients with healing, antiseptic, antiphlogistic and immunoactivating effects. They are used in gynecological practice to regenerate the damaged vaginal mucosa. The active ingredient of vaginal suppositories is a natural polysaccharide - non-sulfated glycosaminoglycan (hyaluronic acid). As the suppository dissolves, hyaluronic acid is evenly distributed over the surface of the vaginal mucosa and creates additional protection for the epithelial layer, stimulating the healing of tissue defects. Vaginal suppositories significantly reduce the inflammatory reaction of the vaginal walls (hyperemia, itching, irritation).

The drug can be used to prevent vaginitis after long-term therapy with corticosteroids or antibiotics. Suppositories are used to prevent infections when visiting swimming pools, saunas, baths or swimming in open stagnant water bodies. It is recommended to use Revitax in case of physiological predisposition to inflammatory reactions due to microtrauma of the vaginal mucosa after sexual intercourse. The use of suppositories is necessary during a long absence of the opportunity to perform hygienic manipulations (business trips, travel, travel, hiking).

For therapeutic purposes, Revitax vaginal suppositories are prescribed for the regeneration of damaged areas of the vaginal mucosa due to inflammatory conditions in atrophic colpitis and the presence of cervical erosions.

Suppositories are used once a day (preferably before bedtime). The suppository must be inserted into the vagina as deeply as possible. If the suppository consistency is too soft for insertion, it must be cooled for several minutes without removing it from the blister.

The duration of use is individual and determined by the indications. The drug is usually prescribed for at least 5 days.

Surgical treatment

Surgical treatment is required for a number of diseases that may have developed and progressed as a result of advanced colpitis. These include: pelvic peritonitis (not amenable to therapy within 4-6 hours), pyosalpinx, pyovar, tubo-ovarian saccular formation with the risk of perforation, perforation with the development of pelvio- and peritonitis, peritonitis. The emergence of gynecological diseases that are treated surgically is caused by untimely referral to a specialist and neglect of the situation. The decision on surgical intervention regarding the acute gynecological pathology that has arisen is made by a doctor.

Prevention

The main goal of preventive measures is regular observation by a gynecologist and timely detection of pathological processes. If necessary, a specialist will prescribe HRT after the onset of menopause. Hormonal drugs have a direct effect on the epithelial layer of the vagina, endometrium, help prevent the development of osteoporosis and cardiovascular lesions.

Preventive measures for atrophic colpitis include preventing early menopause, giving up bad habits (smoking, drinking alcohol), regular exercise, proper balanced nutrition, and avoiding stressful situations. Activating immune responses, carefully performing hygienic procedures for the intimate area, and wearing cotton underwear will significantly reduce the risk of senile colpitis.

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Forecast

Colpitis during menopause has a favorable prognosis for life, although it reduces its quality and tends to recur.

Carrying out preventive measures, regular visits to the gynecologist, timely detection of pathological deviations, compliance with hygiene rules minimize the risk of atrophic colpitis during menopause. It is necessary to start worrying about hormonal changes and their consequences after 35-40 years. If you determine and start HRT in time, then the unpleasant sensations associated with the occurrence of senile colpitis can be avoided.

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