Definition
Kolpitis senilis is an acute inflammation of the vaginal mucosa and occurs mainly in women after menopause (menopause). On average, every woman suffers from vaginal inflammation at least once in her life. The frequency of the inflammation increases with age due to the decreasing estrogen level. The vaginal mucosa is made up of multi-layered squamous epithelium and is colonized by various lactic acid bacteria that build up an acidic environment and form a natural defense barrier.
What are the causes?
Function and regeneration of the vaginal mucosa is dependent on the female sex hormone estrogen. A drop in the estrogen level during menopause causes the vaginal mucosa to recede – it atrophies. The squamous epithelium of the mucosa becomes permeable to fluid and dries out.
Due to the lack of barrier of the mucosa, the tissue becomes susceptible to infections. Bacteria and fungi can easily penetrate the skin layers. The inflammation is usually caused by several pathogens, but the most common are the bacterium Gardnerella vaginalis and various fungi.
Associated symptoms
At the beginning of colitis patients report persistent local itching. The defective skin causes pain during urination and sexual intercourse. The most important sign of an infection, however, is discharge from the vagina (fluorine vaginalis).
Depending on the bacterial flora, a distinction is made between yellowish-greenish (mixed infection) or whitish (fungus/Candida albicans) discharge. In addition, bleeding may occur on contact. If there is an infection with genital herpes, blisters may also become visible. If the vaginal mucus continues to dry out, small bleedings may occur during manipulation, e.g. when inserting a tampon or during sexual intercourse. The resulting wounds serve as a breeding ground for bacteria and fungi.
How does the therapy work?
In order to prevent inflammation and further progression of atrophy (regression) of the mucosa, ointments and creams containing estrogen can be introduced into the vagina. In order to restore the natural vaginal environment, lactic acid bacteria (lactobacteria) should also be introduced into the vagina. Various products such as Vagiflor® are available for this purpose.
As household remedy yogurt can be introduced with the help of a tampon. In addition, excessive washing with soaps should be reduced and sexual intercourse should be avoided during therapy. If an infection has already occurred, antimycotic (against fungi) or antibacterial (against bacteria) ointments or suppositories are used.
Depending on the bacterial colonization, the antibiotic metronidazole or clindamycin are available. Additionally, hydrocortisone or antiseptics can be used locally. Depending on the infection, partner treatment may be necessary, otherwise there is a ping-pong effect. In the case of very persistent courses, the drugs may have to be taken orally (as tablets).
