Vaginitis
Vaginitis is an inflammation of the vagina that may result in symptoms of itching, burning, and abnormal discharge. The most common cause of vaginitis is infection. The infection could be bacterial vaginosis, yeast infection or trichomoniasis. Other causes of vaginitis include estrogen deficiency (atrophic vaginitis), and irritation or allergy. In some cases, a cause cannot be identified. Risk factors for vaginitis include diabetes, immune deficiency, and use of antibiotics. Conventional treatment varies according to the cause, and may include antibiotics, antifungal agents, boric acid vaginal suppositories, estrogen (oral, transdermal or intravaginal), or vulvovaginal (skin around the vagina) application of glucocorticoids.
Diet: In women with recurrent Candida vaginitis, excessive intake of sugar will trigger the infection. In a study of 46 women with recurrent Candida vulvovaginitis, 40% were found to be consuming excessive amounts of sucrose. Excessive consumption of sugar may suppress immune function and potentially increase a woman’s susceptibility to other vaginal infections as well.
Allergy: In a case report, food allergy was implicated as the cause of persistent vaginal soreness. The vaginal tissue appears to be a target for allergic reactions in susceptible women. Allergy to foods, inhalants, or chemicals can cause an inflammatory response that can lead to itching, irritation, and decreased resistance against infections. In addition, hypersensitivity to pollen or Candida albicans has been reported to contribute to the development of chronic vaginitis. In patients who have this sensitivity, desensitization with pollen extract or Candida albicans extract was an important component to their treatment.
Yeast, Mold, And Carbohydrates: Some patients with recurrent vaginal candidiasis are sensitive to yeast or mold containing foods, and some patients do better on a low-carbohydrate diet.
Friendly Bacteria: Lactobacilli and other probiotic bacteria are normal inhabitants of the vagina. These friendly bacteria may help prevent vaginitis by competitively excluding pathogens (bad bacteria) and by producing compounds like hydrogen peroxide (H2O2) that inhibits the growth of pathogens. Certain strains of lactobacillus have been shown in some studies to prevent recurrences of Candida vaginitis and bacterial vaginosis. The probiotic was administered intravaginally or given orally. Two particular strains of lactobacillus have been reported to be useful for preventing genitourinary infections in women, better than other strains.
Zinc: Zinc plays a role in immune function so low levels of zinc could render women more susceptible to various infections especially vaginitis. Some studies, but not all, have shown that plasma zinc levels were significantly lower in women with recurrent vaginal candidiasis. In one study of 279 pregnant women evaluated at the time of delivery, the prevalence of vaginitis was significantly higher in the women with low plasma zinc levels.
Vitamin E: Vitamin E has been reported to be beneficial in the treatment of atrophic vaginitis (thinning vaginal walls due to estrogen deficiency). It has also been of benefit to women with vaginitis associated with diabetes and impaired carbohydrate metabolism.
Vitamin C: In a double blind trial with 100 women with bacterial vaginosis, intravaginal tablets daily at bedtime for 16 days produced significant improvement, however, 2 weeks after the treatment was over, the benefits waned. This treatment might be considered in patients who do not improve with other treatments.
At my clinic:
The woman with vaginitis first needs a vaginal culture collected by me and processed by an exceptional functional medicine lab. The results indicate the exact organism we are dealing with. In addition, I also check for food and inhalant allergies to rule out hypersensitivity to pollen or candida or mold. A zinc level is also obtained. An empiric trial with specific probiotics for the vagina and a low sugar or low carbohydrate diet is also recommended. Vaginal estrogen (bioidentical and compounded) can be effective for postmenopausal women with atrophic vaginitis, urinary tract infections. Oral antifungal medicine like nystatin along with intravaginal antifungal agents enhances the treatment for vaginal candidiasis or yeast infections. Oral nystatin works by eliminating the intestinal reservoir of candida. Homeopathy may also be of benefit in some patients.