Brief overview
- Symptoms: Discharge, sometimes with an unpleasant fishy odor, pain, burning, itching, frequent urination
- Treatment: Depending on the cause, usually antibiotics or other medication in the form of ointments, suppositories or tablets
- Causes and risk factors: Infection, usually caused by bacteria, fungi, viruses or protozoa, sometimes by chemicals or foreign bodies; menopause
- Diagnosis: Consultation and physical examination by a gynecologist, smears and microscopic examination
- Course of the disease and prognosis: Good chances of recovery without complications if treated early, risk of ascending infection with possible infertility without treatment
- Prevention: Ensure healthy vaginal flora
What is colpitis?
Normally, pathogens do not survive in the vagina because the environment there is too acidic for them. The healthy vaginal flora, which mainly consists of lactic acid bacteria (lactobacilli), is responsible for the acidity level. By breaking down sugar from the vaginal cells into lactic acid, they ensure a low pH value in the vagina – as protection against infections such as colpitis.
The female sex hormone oestrogen has a decisive influence on the mucous membrane and the acidic environment of the vagina. It supports the growth and regular renewal of the vaginal mucosa. In addition, oestrogen increases the sugar content in the vagina, allowing the healthy lactic acid bacteria to multiply.
Two forms of colpitis
Doctors distinguish between two forms of colpitis:
- Primary colpitis: A large number of pathogens enter the vagina and disrupt the natural vaginal flora to such an extent that inflammation occurs.
- Secondary colpitis: The vaginal environment is disturbed to such an extent that isolated pathogenic bacteria multiply and trigger inflammation.
What are the symptoms of colpitis?
- Bacteria: A colorless to gray, thin discharge indicates bacterial vaginosis, a common form of bacterial colpitis caused by anaerobic bacteria such as Gardnerella. An unpleasant, fishy odor is typical here. There are also other bacterial triggers such as Chlamydia trachomatis, aerobic bacteria or mycoplasma.
- Fungi: Infections with Candida fungi cause a white-yellowish, creamy to crumbly, odorless discharge and severe itching.
- Unicellular organisms (protozoa): If trichomonads (unicellular parasites) cause colpitis (trichomonas colpitis), the discharge is yellow-green, frothy, foul-smelling and accompanied by itching.
Other common symptoms of colpitis are pain and burning in the vaginal area. The pain occurs during sexual intercourse (dyspareunia) or independently of mechanical irritation. Vaginitis also sometimes causes pain when urinating.
Depending on the cause, various mucosal changes such as patchy or diffuse redness, papules or flat and slightly bleeding ulcers may also appear in the vagina.
In some cases, however, colpitis remains asymptomatic, i.e. without symptoms.
How is colpitis treated?
The treatment of infection-related colpitis depends on the pathogen or pathogens. For example, doctors use antibiotics (such as metronidazole) against bacteria and antifungals (such as clotrimazole) against fungi. Sometimes they also prescribe antiseptic agents (Betaisodona). They are effective against bacteria, fungi, viruses and protozoa.
Depending on the dosage form, the active ingredients act locally (for example in the form of suppositories or creams) or systemically, i.e. via absorption into the bloodstream (usually as tablets). In the case of sexually transmitted vaginitis pathogens, such as chlamydia or trichomonads, it is also necessary to treat the partner.
If no pathogens can be found as the cause of colpitis, but there is an incorrect colonization of the vagina (dysbiosis), medication is used (for example with probiotics) to restore the balance of the vaginal flora.
What home remedies can be used for treatment?
Some women use various natural products to treat the symptoms of vaginitis. However, special care should be taken when using tampons soaked in natural yoghurt or milk and inserted into the vagina, as well as when using sitz baths with apple cider vinegar, for example. There is a risk of introducing more germs into the vagina in this way, as well as disturbing the vaginal environment with harsh substances such as vinegar and further irritating the mucous membranes.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not improve or even get worse, you should always consult a doctor.
What causes colpitis?
Apart from bacteria, other pathogens such as fungi (Candida fungi), viruses (such as HPV viruses or herpes viruses) or unicellular parasites (such as trichomonads) cause colpitis.
In addition to this infection-related vaginitis, there are also forms of vaginitis caused by chemicals or other irritants. The cause of traumatic colpitis is usually a foreign body in the vagina, such as a forgotten tampon or a pessary.
Atrophic colpitis, sometimes referred to as colpitis senilis, is another type of non-infectious vaginitis. It occurs in women during or after the menopause because the vaginal mucous membrane no longer builds up completely due to the increasing lack of oestrogen. This reduces the local defense against pathogens. As the initially non-infectious vaginal inflammation progresses, germs such as bacteria or fungi settle and multiply easily.
Risk factors for colpitis
- Diabetes mellitus
- Obesity (obesity)
- Cushing’s syndrome
Iron deficiency, tumors, operations and a genetic predisposition also contribute to the development of colpitis. The same applies to certain medications such as antibiotics, corticosteroids (“cortisone”) and cancer drugs.
All of these factors have a negative impact on the vaginal flora and thus pave the way for vaginitis. In principle, however, it is also possible to develop colpitis with healthy vaginal flora.
How is colpitis diagnosed?
If colpitis is suspected, the gynecologist is the right person to contact. During an initial consultation, they will take your medical history (anamnesis). You will have the opportunity to describe your symptoms and complaints in detail. The doctor will ask you specific questions, for example whether you have had such symptoms in the past or whether you are taking any medication.
In order to identify any colpitis pathogens, the doctor takes swabs from the vaginal mucosa. Under the microscope, the smears can show whether fungi, bacteria or worms, for example, have spread in the vagina. For more precise detection, doctors sometimes have a culture of the pathogen prepared in the laboratory.
Older women often have atrophic colpitis. In most cases, no pathogens can be detected.
If colpitis is suspected, it is important to rule out other causes for the symptoms. For example, in older women with colpitis, a possible cancerous tumor should always be diagnosed.
The doctor will also identify possible risk factors for colpitis, such as certain metabolic diseases or incorrect hygiene techniques. It is advisable to eliminate or at least reduce such factors as far as possible in order to reduce the risk of recurrent vaginitis.
How does colpitis progress?
In order to reduce the risk of re-inflammation after colpitis has healed, it is advisable to eliminate or reduce existing risk factors. Excessive intimate hygiene, for example, should be avoided as it disturbs the vaginal flora. It is therefore advisable to avoid vaginal douches and intimate cosmetics (such as intimate deodorants) that are not adapted to the acidic vaginal environment.
However, a lack of intimate hygiene also favors colpitis.
Colpitis during pregnancy
It is possible that vaginal inflammation during pregnancy can cause premature labor or premature rupture of the membranes and thus a miscarriage. It is therefore essential that pregnant women treat colpitis.
Because there is a possibility that the pathogens causing vaginitis (such as herpes viruses, gonococci or chlamydia) may infect the newborn during natural birth, doctors usually perform a caesarean section on pregnant women with acute colpitis.
Can colpitis be prevented?
There are several aspects that support healthy vaginal flora and thus reduce the risk of colpitis. These include the following:
- Do not use vaginal douches or intimate deodorants, as these usually destroy the healthy vaginal flora.
- Wear underwear made of materials that are permeable to air, such as cotton, and that can be washed at 60 degrees.
- Avoid panty liners with plastic film, as this restricts air circulation.
- Support your immune system and thus a healthy vaginal flora through regular exercise and relaxation as well as a healthy and balanced diet with little sugar.
