vaginitis

Etiology. Inflammation of the vaginal mucosa is invariably related to a disturbance in normal vaginal physiology. A healthy vagina depends on (1) normal estrogen secretion to maintain a thick squamous epithelium containing glycogen and (2) chemical reactions beginning with the glycogen thus available. The glycogen stimulates the growth of lactobacilli, which are beneficial normal vaginal flora that metabolize glycogen to form lactic acid. The lactic acid maintains vaginal acidity at a pH of 4.0 to 4.5.



Tampons, condoms, neglected diaphragms, and irritating douches or deodorant sprays can upset the vagina's environmental balance and produce abnormal vaginal discharge. Hyperglycemia and antibiotics can also disturb this balance. However, infectious agents are the most common cause of vaginitis; these include Trichomonas and Candida. (See also bacterial vaginosis.) Characteristics of these types of vaginitis and medical treatment and nursing intervention are summarized in the accompanying table.

Patient Education. Patients with infectious vaginitis need to know the purpose and importance of diagnostic testing and examination to verify a diagnosis, the specific type of infection or infections thus identified, and changes that may need to be made in their sexual activity to avoid reinfection. Sexual intercourse is avoided while active symptoms are present. Concurrent treatment of the partner is often necessary to avoid cyclic reinfection of one another. Condoms are encouraged because they can provide both the man and woman with some protection against sexually transmitted diseases.



In regard to prescribed treatment, the patient should be instructed to take all of the medication exactly as prescribed; a follow-up examination and testing may be necessary. If the woman has a cervical Pap smear done while she has vaginitis, there may be an abnormal test result.