Desquamative Inflammatory Vaginitis
DIV is known as a kind of vaginitis (an inflammation of the vagina) because of the highly inflammatory way your vaginal skin reacts to the type of discharge produced by desquamative inflammatory vaginitis. However, desquamative inflammatory vaginitis is not truly an infection because it is not brought about by a specific organism invading your vagina, the way yeast infiltrates your vagina during a yeast infection. DIV is a form of vaginitis resembling atrophic vaginitis (an inflammation of the vagina due to the thinning and shrinking of the tissues and decreased lubrication caused by a lack of estrogen), except it can also affect women with normal estrogen levels.
DIV is uncommon; it is a very rare but debilitating condition.
Symptoms of Desquamative Inflammatory Vaginitis
If you have DIV, you will experience symptoms of an excessive discharge coming out of your vagina. This vaginal discharge has no smell. It is usually yellow but can also be gray or green. It is very sticky and dries on your vulva like glue. In the spots where this discharge dries, the skin becomes red, inflamed, and itchy. Other symptoms of desquamative inflammatory vaginitis include:
- Dyspareunia: difficult or painful sexual intercourse. Most women with DIV report feeling a scratchy, raw sensation during sex.
- Introital Pain: Pain that is affecting the introitus, or opening, of your vagina.
- Purulent Vaginal Discharge: Pus discharge is leaking out of your vagina.
- Vaginal Inflammation: Infection and inflammation that impacts your vagina.
- Vaginal Pain: Pain affecting the vagina
Risks with Desquamative Inflammatory Vaginitis
Both premenopausal and postmenopausal women can be diagnosed with desquamative inflammatory vaginitis.
The patients that are most affected by DIV are perimenopausal women. Perimenopause is the time in your life where the physiological changes that begin your transition to menopause start occurring.
Causes of Desquamative Inflammatory Vaginitis
There is no medical consensus about what the cause of DIV is. There are three current theories about the cause of desquamative inflammatory vaginitis:
- Erosive Lichen Planus: A debilitating, painful condition caused by an over-active immune system that affects your mouth, esophagus, and genital region. Some vulvar specialists think that DIV is an early form of this disease.
- Estrogen Deficiency: leads to menopause.
- Infection: Some vaginal infectious disease experts think that DIV may be caused by an infection of an unknown organism.
Diagnosing Desquamative Inflammatory Vaginitis
Your doctor will diagnose you with DIV after he or she has examined a sample of your vaginal discharge under a microscope. If DIV is indeed what you have, your physician will see a huge amount of white blood cells and parabasal cells (immature cells of the vagina). This discharge, when tested for bacteria and pH level, shows a pH of about 5.5 or more. The bacteria levels show an increase in Staph or Strep and an absence of good lactobacilli.
Treatment for DIV consists of antibiotic or corticosteroid therapy. The most common antibiotics and medications used along with them are:
- Cleocin (clindamycin): An antibiotic used to treat serious infections caused by bacteria
- Estrogen Cream: A preparation of estrogen in cream form, used for topical application to your vaginal area. Estrogen cream treats certain menopausal symptoms such as the urgent need to urinate and dryness, burning, and itching in the vaginal area.
- Hydrocortisone (intravaginal): Your adrenal cortex usually produces this steroid hormone. It will be used medicinally and intravaginally to treat the inflammation resulting from desquamative inflammatory vaginitis.
- Metrogel (metronidazole): A bacteria-fighting substance used to treat an infection. Commonly used to treat bacterial vaginosis.
The antibiotic you will take will either be a suppository that is directly inserted into your vagina, or a cream that you rub onto the outside of your vagina for about two weeks. There is a chance that you will be prescribed with both
Although being diagnosed with desquamative inflammatory vaginitis may be very daunting, it is important to stay positive, especially if you are going through the hormonal and physical changes associated with menopause. Things like:
- Frequent Need to Urinate
- Hot Flashes
- Increased Anxiety
- Increased Irritability
- Night Sweats
- Pain During Intercourse
The combination of these symptoms can make you feel a sense of depression, especially if desquamative inflammatory vaginitis is plaguing you at the same time. It is important to seek mental help from a counselor, therapist, or even a psychiatrist as well as help from your physician.
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