阴道炎（Vaginitis），不用谈之色变

阴道炎是一种常见的妇科疾病，请不用谈之色变。本文介绍了不同类型阴道炎的诱因、症状、治疗方法，以及应该怎样“预防”。关爱女性健康，从更懂自己的身体开始。

一. 什么是阴道炎？

阴道炎也称为外阴阴道炎，是阴道的炎症或感染。它也可以影响外阴会阴(女性生殖器的外部部分)。阴道炎可引起瘙痒，疼痛，漏液和(特殊)气味。

阴道炎是常见的，特别是在育龄妇女中。它通常发生在阴道内通常携带的细菌或真菌的平衡发生变化时。阴道炎有不同类型，对应不同的诱因，症状和治疗。

二. 阴道炎的分类

1. 细菌性阴道炎 是15-44岁女性最常见的阴道感染。当在女性阴道中通常携带的“有益”和“有害”细菌之间存在不平衡时，就会发生这种情况。可能的原因有： > 服用抗生素 > 阴道灌洗 > 避孕环（宫内节育器，IUD） > 与新的伴侣进行无保护的性行为 > 有多个性伴侣 2. 霉菌（念珠菌）感染 发生在阴道内太多念珠菌生长时(念珠菌是这种霉菌的科学名称)。这是一种无处不在的真菌，包括在你身体的其他地方。你的阴道生长有过多的念珠菌可能是因为： > 使用抗生素 > 怀孕 > 糖尿病，特别是不能很好地控制的糖尿病 > 皮质类固醇药物 3. 滴虫病 也可引起阴道炎。滴虫病是一种常见的性传播疾病。它是由寄生虫引起的。 4. 过敏 如果您对某些您使用的产品过敏或敏感，也可能患有阴道炎。过敏原包括阴道喷雾剂，冲剂，杀精剂，肥皂，洗涤剂或织物柔软剂。它们会引起灼热，瘙痒和漏液。 5. 激素变化 也可引起阴道刺激。例如，怀孕或哺乳期，或是更年期。 以上致病原因有可能同时发生。

三. 阴道炎的症状

阴道炎的症状取决于对应的类型。

1. 细菌性阴道炎 你可能没有症状，也可能有稀薄的白色或灰色的阴道分泌物。分泌物可能会有强烈鱼腥味的气味，特别是性行为之后。

2. 真菌感染阴道炎 阴道会排泄看起来像干酪（如下图）的白色分泌物。分泌物可以是水状，通常没有气味。霉菌感染通常会导致阴道和外阴变得瘙痒和发红。

3. 滴虫病 可能没有症状。如果有症状，包括阴道和外阴瘙痒，灼热和酸痛，排尿期间有灼热感，灰绿色的恶臭漏液。

如何鉴定你患有哪种类型的阴道炎？

要了解症状原因，医护人员可能会

> 询问你的健康史

> 做盆腔检查

> 观察阴道分泌物的颜色、质地和气味

> 用显微镜观测你的阴道液体标本

在某些情况下，你可能需要更多的测试。

四. 阴道炎的治疗

细菌性阴道炎可用抗生素治疗。患者可能需要口服抗生素，或使用外用放在阴道的乳状或凝胶状药品。在治疗过程中，性行为应当使用避孕套，或是避免性行为。

霉菌感染阴道炎通常使用涂在外阴道的乳状膏药。患者可以自行购买霉菌感染的非处方药，但需要确认患的确实是霉菌感染阴道炎，而不是其他类型。不论是首次还是再次感染霉菌性阴道炎，用药前咨询医护人员更妥善。

滴虫病的治疗通常是单剂量抗生素。患者和患者的性伴侣（们）都应接受治疗，以防止传播给他人，或是二次感染。

如果是过敏性阴道炎，需要确定是哪个产品导致了问题。它可能是您最近开始使用的产品。一旦弄清楚，需要停止使用该产品。

如果是激素变化产生的阴道炎，医护人员可能会提供雌激素乳霜来改善症状。

阴道炎会引起其他健康问题吗？

治疗细菌性阴道炎和滴虫病很重要，因为它们中的任何一种可以增加感染艾滋病或另外一种性传播疾病的风险。如果患者怀孕，这两种阴道炎也会增加早产的风险。

五. 阴道炎的预防

> 经常感染真菌性阴道炎的妇女要尽量避免穿着闷热或是潮湿的衣服，例如没有棉衬里的连裤袜，尼龙内裤或紧身牛仔裤。 > 不要灌洗内阴或使用阴道喷雾，因为它们可以杀死“好”的细菌或引起刺激。 > 安全性行为可以帮助防止通过性行为传播的阴道炎，如限制性伴侣的数量和使用安全套。

防治阴道炎需要注意的事

当患有阴道炎时，请保持生殖器部位的清洁和干燥： > 清洗外阴、会阴、PP时避免使用肥皂，用清水冲洗干净。 > 泡澡使用温水而不是热水。 > 洗后彻底干燥。 > 避免冲洗内阴道，这可能会使阴道炎症状恶化，因为它会去除阴道内的“好”细菌，这些细菌有助于防止感染。 > 避免在生殖器区域使用保健喷雾剂、香水或粉末。 > 感染时使用卫生巾，而不是卫生棉条。 > 如果有糖尿病，请控制血糖水平。

允许更多的空气到达生殖器区域： > 穿宽松的衣服，而不是紧身连裤袜。 > 穿棉质内裤（而不是合成纤维的），或内裤裆部有棉衬里。棉质材料通风性好，可以避免水分积累。 > 夜晚睡觉时裸睡。

各年龄段的妇女都应该： > 知道如何在坐浴或淋浴时适当地清洁他们的生殖器区域。 > 大号后正确擦拭，方向从前往后。 > 上厕所前后洗手。

安全性行为并使用避孕套避免感染或传播各种传染性致病细菌、真菌、病毒、滴虫等等。

自治真菌感染阴道炎

（这是针对美国的医疗体系，医疗服务可能会很慢很贵。鉴于国内医疗服务并不是那么贵，有病还是赶紧就医，避免莆田系之类的败类。）

外用乳霜或栓剂用于治疗阴道中的念珠菌感染，不需处方可在药店，一些杂货店等购得。

如果自行治疗霉菌感染阴道炎，请注意满足以下条件：

> 以前曾经感染过霉菌阴道炎，知道症状，而且阴道炎并不频发。

> 症状很温和，没有盆腔疼痛或发烧。

> 没有怀孕。

> 不可能在最近的性行为中产生另一种感染。

自行用药请参考药物的使用说明。 > 使用药物3至7天，具体取决于使用什么样的药物。 > 即使症状消失，也不要比说明提早停止使用药物。

一些治疗霉菌感染阴道炎的药物只需使用一天。如果您不是经常感染，可以选用这种只用一天的药物。

医护人员还可能开一种称为氟康唑的药物，是一种只需口服一次的药物。

对于更严重的症状，可能需要使用药物长达14天。如果经常感染霉菌性阴道炎，医护人员可能会建议你每周使用药物以预防感染。

如果正在服用抗生素以抵抗另一种感染，食用有活性菌的酸奶或服用嗜酸乳杆菌补充剂可能有助于防治真菌感染阴道炎。

如果你的症状没有改善，或是出现盆骨痛、发烧的症状，请赶紧就医。

正文部分完

因为我不是医学从业者，所以我并不能自己写出原创的权威的相关科普文。以上内容翻译自MedlinePlus，源链接： https://medlineplus.gov/vaginitis.html https://www.nichd.nih.gov/health/topics/vaginitis/conditioninfo/Pages/prevention.aspx https://medlineplus.gov/ency/patientinstructions/000566.htm

MedlinePlus与MedlinePlus医学百科（MedlinePlus Medical Encyclopedia）是一个存放有关健康与医疗讯息的网站，内容来自属于美国国家卫生研究院的美国国家医学图书馆（United States National Library of Medicine）。除此之外，也提供了线上医学辞典，以及药物索引、医学新闻报导等服务。

该网站地址内容与一众其他后缀为.org的科研机构对Vaginitis的介绍高度重合，具有很高的可信度，感兴趣的同志可以自行查阅相关内容。

英语只过了四六级，尽量翻译，如有不严谨或是无伤大雅的错漏，请海涵。

更多内容请参照： https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024522/ https://www.nichd.nih.gov/health/topics/vaginitis/Pages/default.aspx https://en.wikipedia.org/wiki/Vaginitis http://www.medicinenet.com/vaginitis_overview/article.htm https://www.medicalnewstoday.com/articles/175101.php

英语原文

Vaginitis, also called vulvovaginitis, is an inflammation or infection of the vagina. It can also affect the vulva, which is the external part of a woman's genitals. Vaginitis can cause itching, pain, discharge, and odor.

Vaginitis is common, especially in women in their reproductive years. It usually happens when there is a change in the balance of bacteria or yeast that are normally found in your vagina. There are different types of vaginitis, and they have different causes, symptoms, and treatments.

Bacterial vaginosis (BV) is the most common vaginal infection in women ages 15-44. It happens when there is an imbalance between the "good" and "harmful" bacteria that are normally found in a woman's vagina. Many things can change the balance of bacteria, including: > Taking antibiotics > Douching > Using an intrauterine device (IUD) > Having unprotected sex with a new partner > Having many sexual partners

Yeast infections (candidiasis) happen when too much candida grows in the vagina. Candida is the scientific name for yeast. It is a fungus that lives almost everywhere, including in your body. You may have too much growing in the vagina because of > Antibiotics > Pregnancy > Diabetes, especially if it is not well-controlled > Corticosteroid medicines

Trichomoniasis can also cause vaginitis. Trichomoniasis is a common sexually transmitted disease. It is caused by a parasite.

You can also have vaginitis if you are allergic or sensitive to certain products that you use. Examples include vaginal sprays, douches, spermicides, soaps, detergents, or fabric softeners. They can cause burning, itching, and discharge.

Hormonal changes can also cause vaginal irritation. Examples are when you are pregnant or breastfeeding, or when you have gone through menopause.

Sometimes you can have more than one cause of vaginitis at the same time.

The symptoms of vaginitis depend on which type you have.

With BV, you may not have symptoms. You could have a thin white or gray vaginal discharge. There may be an odor, such as a strong fish-like odor, especially after sex.

Yeast infections produce a thick, white discharge from the vagina that can look like cottage cheese. The discharge can be watery and often has no smell. Yeast infections usually cause the vagina and vulva to become itchy and red.

You may not have symptoms when you have trichomoniasis. If you do have them, they include itching, burning, and soreness of the vagina and vulva. You may have burning during urination. You could also have gray-green discharge, which may smell bad.

To find out the cause of your symptoms, your health care provider may > Ask you about your health history > Do a pelvic exam > Look for vaginal discharge, noting its color, qualities, and any odor > Study a sample of your vaginal fluid under a microscope

In some cases, you may need more tests.

Creams or suppositories are used to treat yeast infections in the vagina. You can buy most of them without a prescription at drug stores, some grocery stores, and other stores.

Treating yourself at home is probably safe if: > You have had a yeast infection before and know the symptoms, but you have not had a lot of yeast infections in the past. > Your symptoms are mild and you DO NOT have pelvic pain or a fever. > You are not pregnant. > It is not possible that you have another kind of infection from recent sexual contact.

Follow the directions that came with the medicine you are using. > Use the medicine for 3 to 7 days, depending on what kind of medicine you are using. > DO NOT stop using the medicine early if your symptoms go away before you have used it all.

Some medicine to treat yeast infections is used for only 1 day. If you DO NOT get yeast infections often, a 1-day medicine might work for you.

Your health care provider can also prescribe a medicine called fluconazole. This medicine is a pill that you take once by mouth.

For more severe symptoms, you may need to use the yeast medicine for up to 14 days. If you have yeast infections often, your provider may suggest using medicine for yeast infections every week to prevent infections.

If you are taking antibiotics for another infection, eating yogurt with live cultures or taking Lactobacillus acidophilus supplements may help prevent a yeast infection.

Call your provider if: > Your symptoms are not improving > You have pelvic pain or a fever

It is important to treat BV and trichomoniasis, because having either of them can increase your risk for getting HIV or another sexually transmitted disease. If you are pregnant, BV or trichomoniasis can increase your risk for preterm labor and preterm birth.

> Women who often get yeast infections may want to avoid clothes that hold in heat and moisture, such as pantyhose without a cotton lining, nylon panties, or tight jeans. > Do not douche or use vaginal sprays because they can kill "good" bacteria or cause irritation. > Practicing safe sex can help protect against sexually transmitted forms of vaginitis. Limiting the number of sex partners and using condoms are examples of safe sex.

Keep your genital area clean and dry when you have vaginitis. > Avoid soap and just rinse with water to clean yourself. > Soak in a warm bath -- not a hot one. > Dry thoroughly afterward.

Avoid douching. Douching may worsen vaginitis symptoms because it removes healthy bacteria that line the vagina. These bacteria help protect against infection. > Avoid using hygiene sprays, fragrances, or powders in the genital area. > Use pads and not tampons while you have an infection. > If you have diabetes, keep your blood sugar levels under control.

Allow more air to reach your genital area. > Wear loose-fitting clothes and not panty hose. > Wear cotton underwear (rather than synthetic), or underwear that has a cotton lining in the crotch. Cotton increases air flow and decreases moisture buildup. > DO NOT wear underwear at night when you sleep.

Girls and women should also: > Know how to properly clean their genital area while bathing or showering > Wipe properly after using the toilet -- always from front to back > Wash thoroughly before and after using the bathroom

Always practice safe sex. And use condoms to avoid catching or spreading infections.

The treatment depends on which type of vaginitis you have.

BV is treatable with antibiotics. You may get pills to swallow, or cream or gel that you put in your vagina. During treatment, you should use a condom during sex or not have sex at all.

Yeast infections are usually treated with a cream or with medicine that you put inside your vagina. You can buy over-the-counter treatments for yeast infections, but you need to be sure that you do have a yeast infection and not another type of vaginitis. See your health care provider if this is the first time you have had symptoms. Even if you have had yeast infections before, it is a good idea to call your health care provider before using an over-the-counter treatment.

The treatment for trichomoniasis is usually a single-dose antibiotic. Both you and your partner(s) should be treated, to prevent spreading the infection to others and to keep from getting it again.

If your vaginitis is due to an allergy or sensitivity to a product, you need to figure out which product is causing the problem. It could be a product that you started using recently. Once you figure it out, you should stop using the product.

If the cause of your vaginitis is a hormonal change, your health care provider may give you estrogen cream to help with your symptoms.