Cyclic vulvovaginitis

What is cyclic vulvovaginitis?

Cyclic vulvovaginitis refers to recurrent burning and itching sensation that occurs at the same stage of each menstrual cycle. The pain specifically worsens just before or during menstrual bleeding, or may subside during bleeding.

Cyclic vulvovaginitis occurs in women of all ages who are still menstruating.

What are the symptoms of cyclic vulvovaginitis?

• Between cyclical outbreaks, the patient may have no symptoms.
• Severe burning, irritation, itching and stinging just before or during menstrual bleeding.
• The pain can be aggravated by sexual activity and is usually worse the day after sexual intercourse.

Cyclic vulvovaginitis can lead to located or generalized vulvodynia

What causes cyclic vulvovaginitis?

Cyclic vulvovaginitis is due to recurrent thrush (candida infection) Vaginal smears and cultures should be performed to confirm this. If a culture taken during a symptomatic phase returns negative, a swab and scrape during the asymptomatic phase must be taken and cultivated.

The laboratory must report the specific strain of candida and its drug sensitivities so that the most appropriate treatment can be selected.

When candida is not cultured, symptoms may be due to dermatitis associate with estrogen hypersensitivity, which is believed to be due to the higher levels of circulating estrogens present premenstrually. It is treated by progesterone.

Management of cyclic vulvovaginitis.

The main goal of treatment is to eliminate the cause.

When candida is responsible, current and oral antifungal agents are used to treat outbreaks. The oral agent fluconazole may also be prescribed to prevent further candida infection, taken intermittently (there are several regimens). Intravaginal boric acid capsules or pessaries may also be prescribed.

If candida is not cultured, all antifungal agents should be discontinued. To reduce contact with irritants, it may be helpful to use pads instead of tampons during menstruation and take baking soda baths. Soap-free cleaner should be used for washing.

Irritation from dermatitis can be resolved with hydrocortisone. cream; It is not usually helpful or desirable to use more potent topical steroids.