Infecções vaginais (mulheres, meninas) – causas, sintomas, tratamento

Infecções vaginais podem ser causadas por bactérias, fungos e outros microorganismos. As infecções vaginais mais comuns que são vistas incluem vaginose bacteriana, infecção fúngica vaginal e tricomoníase.

O corrimento vaginal excessivo e / ou anormal é o sintoma típico de uma infecção vaginal, embora nem todas as corridas vaginais sejam causadas por infecção. Pode haver uma mudança no odor ou na cor da descarga, que provavelmente é acompanhada de coceira, vermelhidão e inchaço da vagina. Leia mais em coceira na vagina e vulva inchada .

Certas condições podem aumentar o risco de uma infecção vaginal e exacerbar uma infecção existente. Isso inclui :

• Má higiene pessoal.
• Vestindo roupas íntimas apertadas e não absorventes.
• Causas de diminuição da acidez vaginal, como corrimento menstrual, ejaculação no homem e muco cervical infectado.
• Ducha freqüente.
• Diabetes mellitus (diabetes de açúcar).
• Falta de estrogênio endógeno – antes da puberdade e após a menopausa.
• Corpos estranhos na vagina, como um tampão esquecido ou preservativo retido.

Vaginose bacteriana

Causas

A vaginose bacteriana é uma infecção bacteriana da vagina causada pela Gardnerella vaginalis . Existem muitos tipos de bactérias presentes numa vagina normal e saudável, das quais os lactobacilos são importantes para ajudar a manter o ambiente ácido normal da vagina, desencorajando assim o crescimento de bactérias nocivas.

Sob certas circunstâncias, há uma diminuição no número de lactobacilos, resultando em um supercrescimento de outros tipos de bactérias normalmente presentes na vagina, como a Gardnerella vaginalis .

Sintomas

A vaginose bacteriana é o tipo mais comum de infecção vaginal e, embora algumas mulheres possam ser assintomáticas, os sintomas típicos associados a esse tipo de infecção incluem:

• Excessive vaginal discharge, which is usually thin, white or grey in color.
• Typical fishy odor of the discharge, stronger after sexual intercourse and during periods.
• Vaginal itching in some women.

Risk Factors

Bacterial vaginosis is not usually sexually transmitted but it is seen to be more common in women suffering from a sexually transmitted disease (STD). Additional risk factors for developing this type of infection may be :

• Multiple sex partners.
• Use of intrauterine device (IUD).
• Pregnancy.
• Frequent douching.

Complications

Bacterial vaginosis may lead to complications such as :

• Pelvic inflammatory disease (PID).
• Infection of the membranes around the fetus (chorioamnionitis). Read more on infected placenta.
• Premature rupture of membranes.
• Preterm labor and delivery.
• Infection of the uterus after childbirth or miscarriage.

Treatment

Bacterial vaginosis usually resolves in a few days with the appropriate treatment. This includes metronidazole or clindamycin vaginal gel or cream, or metronidazole or tinidazole orally. Recurrence is common, however, and may need long-term treatment.

Vaginal Fungal or Yeast Infection (Candidiasis)

Causes

Vaginal yeast infection or candidiasis is caused by the fungus Candida albicans which is normally found on the skin or in the intestine, from where it can spread to the vagina. It is most common in women of childbearing age and is relatively less common after menopause, except in those women who are on hormone replacement therapy.
Candidiasis is not transmitted sexually.

Symptoms

• Thick white discharge.
• Odorless discharge in most cases.
• Intense itching of the vulva and vagina, especially during intercourse.
• Swelling and redness of the vagina.

Risk Factors

• Pregnancy.
• Diabetes.
• Obesity.
• Oral contraceptives.
• Weakened immune system – may be caused by HIV/AIDS, corticosteroids, or chemotherapy.
• Antibiotic use.
• Wearing tight, non-absorbent undergarments.

Treatment

Antifungal drugs may be used in the form of creams, vaginal suppositories, or oral tablets. This includes clotrimazole, fluconazole, miconazole, tioconazole, butoconazole, nystatin, and itraconazole. Recurrence is common and may need repeated treatment.

Trichomonas Vaginitis

Causes

Trichomonas vaginitis or trichomoniasis is a vaginal infection caused by the protozoa Trichomonas vaginalis, which is usually sexually transmitted. Other STDs may also be present. Trichomoniasis, when seen in children, may point to sexual abuse.

Symptoms

Symptoms may occur immediately after infection or the protozoa can remain in the vagina or cervix for a long time (several weeks or months) without leading to any symptoms. This makes it difficult to determine when the infection was acquired and from whom.

The symptoms may include :

• Excessive vaginal discharge.
• The discharge may be frothy, with a greenish or yellowish color.
• Unpleasant or fishy odor.
• Vaginal itching.
• Vagina may be red and painful to touch.
• Pain during sexual intercourse and/or pain or burning sensation while passing urine.

Complications

• PID.
• Preterm labor and delivery.

Treatment

Use of condoms during sexual intercourse can prevent transmission of infection.

Condoms should be used during treatment till the infection resolves completely. A single dose of metronidazole or tinidazole taken orally is effective in most cases. Simultaneous treatment of partners is advocated so as to prevent re-infection.