Burning in vagina
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Burning in Vagina: Causes, Symptoms, and Treatments
Common Causes of Vaginal Burning
Vaginitis: Vaginitis is a broad term for inflammation or infection of the vagina, often presenting with symptoms such as burning, itching, irritation, and abnormal discharge. The most common causes include bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis . Noninfectious causes like atrophic, irritant, allergic, and inflammatory vaginitis are less common but can also lead to burning sensations.
Cytolytic Vaginosis: This condition is often misdiagnosed and can cause cyclic vaginal itching and burning, particularly before menstruation. It is characterized by an overgrowth of lactobacilli, leading to a low vaginal pH and symptoms that mimic other types of vaginitis.
Candida Vaginitis: Caused by the fungus Candida albicans, this type of vaginitis is marked by itching, burning, pain, and redness of the vulva and vaginal mucosa. It is a common condition, affecting up to 75% of women at least once in their lifetime.
Symptoms and Diagnosis
Symptoms: Common symptoms of conditions causing vaginal burning include redness, swelling, pain, and sometimes blistering and erosion of the perivaginal tissue. These symptoms can be exacerbated by sexual intercourse and may be accompanied by abnormal discharge and a foul odor .
Diagnosis: Diagnosis typically involves a combination of symptom assessment, physical examination, and laboratory tests. For instance, bacterial vaginosis is diagnosed using Amsel criteria or Gram stain, while vulvovaginal candidiasis is confirmed through potassium hydroxide microscopy or DNA probe testing. Cytolytic vaginosis is identified by a low vaginal pH and the presence of numerous lactobacilli on microscopic examination.
Treatment Options
Bacterial Vaginosis: Treatment usually involves antibiotics such as oral or intravaginal metronidazole or clindamycin.
Vulvovaginal Candidiasis: This condition is treated with antifungal medications, including oral fluconazole or topical azoles. Recurrent cases may require maintenance therapy.
Cytolytic Vaginosis: Treatment focuses on reducing the overgrowth of lactobacilli, often through the use of sodium bicarbonate douches to increase vaginal pH.
Atrophic Vaginitis: Common in postmenopausal women, this condition is treated with low-dose estrogen therapy, which helps restore the vaginal microbiota and alleviate symptoms .
Special Considerations
Sexual Activity: Vaginal burning can be triggered or worsened by sexual intercourse, as seen in cases where symptoms appear several hours post-coitus and resolve spontaneously over a few days.
Communication and Emotional Impact: Vaginal discomfort can significantly impact sexual relationships and self-esteem. Open communication between partners and healthcare providers is crucial for effective management and treatment.
Conclusion
Vaginal burning is a symptom with multiple potential causes, ranging from infections like bacterial vaginosis and Candida vaginitis to noninfectious conditions such as cytolytic and atrophic vaginitis. Accurate diagnosis and appropriate treatment are essential for relief and prevention of recurrence. Open communication and timely medical consultation can significantly improve outcomes and quality of life for affected individuals.
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