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Non-infectious desquamative inflammatory vaginitis
Last reviewed: 07.07.2025
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Non-infectious desquamative inflammatory vaginitis is an inflammation of the vagina in the absence of the usual infectious causes of the disease. The disease may be autoimmune in nature. Streptococci are adsorbed on the cells of the superficial layer of the vaginal epithelium. The main risk factors are a decrease in estrogen levels, which occurs during menopause, or a decrease in ovarian function (for example, due to removal of the ovaries, irradiation of the pelvic organs, or chemotherapy). Atrophy of the genitals predisposes to inflammatory vaginitis and increases the risk of relapse.
[ Symptoms of Vaginitis
Common symptoms of the disease include purulent vaginal discharge, dyspareunia, dysuria, and irritation of the vaginal mucosa. There is also vaginal itching, hyperemia, sometimes burning, pain, or moderate bloody discharge. Dryness in the vagina and depletion of the mucous membrane are noted. Vaginitis may recur.
Since the symptoms of vaginitis may be common with other forms of vaginitis, differential diagnostics (determination of vaginal secretion pH, microscopic examination, amine test) are necessary. The diagnosis is made if the vaginal secretion pH is more than 6, the amine test is negative, and leukocytes and parabasal cells are detected during smear microscopy.
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Treatment of vaginitis
Vaginal clindamycin cream is prescribed at 5 g every evening for 1 week. After treatment with clindamycin, women should be examined for atrophy, since it increases the risk of recurrence. If atrophy is present, topical estrogens should be prescribed (eg, 0.01% estradiol vaginal cream 24 g once a day for 1-2 weeks, then 1-2 g once a day for 1-2 weeks, then 1 g 1-3 times a week; estradiol hemihydrate vaginal tablets 25 mcg twice a week; estradiol rings every 3 months). Preference is given to treatment with topical preparations, which are safer than oral hormone therapy (hormone replacement therapy).
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