Vaginitis is a general term for a variety of inflammatory diseases of the vaginal mucosa caused by different etiologies. In a normal physiological state, the histological and biochemical characteristics of the vagina are sufficient to defend it from external microorganisms. If this is disrupted, pathogenic bacteria can take advantage of the opportunity to enter the vagina and cause inflammation through various factors. Non-specific vaginitis: there is a sensation of falling and burning in the vulva and vagina, a large amount of vaginal epithelium is shed, the vaginal mucosa is congested, and tenderness is obvious. In severe cases, there is general weakness, abdominal discomfort, leucorrhea in large amount, purulent or plasmacy, leucorrhea outflow irritates the urethra, and frequent and painful urination may occur. ②Mycotic vaginitis: It is also called vaginal Candida infection. The prominent symptoms are increased leucorrhea and strange itching of vulva and vagina. In severe cases, it is uncomfortable and painful to sit and lie down, and there may be frequent urination, painful urination and painful intercourse. The leucorrhea is white and thick like bean residue, the vaginal membrane is highly edematous, there are white flakes of film adhering, easy to peel off, under which is the base of erosion of damaged mucosa or the formation of shallow ulcers, in severe cases may leave petechiae is the typical symptom of the disease; another group of patients have a large amount of watery or purulent leucorrhea without white flakes, the vaginal mucosa is moderately red, edematous, no serious itching and burning sensation, only a feeling of vulvar dampness. The incidence of mycosis vaginalis is second only to trichomoniasis and is mainly caused by Candida albicans infection. It is generally believed that Candida albicans is mainly caused by anal transmission and is not related to tinea capitis. Of course, mycotic vaginitis can also be transmitted through sexual intercourse. According to statistics, about 10% of non-pregnant women and 30% of pregnant women have this fungus in their vagina with no obvious symptoms. Candida can be present in the oral cavity, intestinal tract and vaginal mucosa without causing symptoms, and the Candida in these three areas can be transmitted to each other. When the local conditions are suitable or when the hygiene habits are not good, and when antibiotics are used for a long time, it is easy to cause a change in the pH of the vagina, which allows Candida to multiply and cause infection. Patients with mycosis vaginalis mainly have itching and burning pain in the vulva, which is unbearable and painful in severe cases; some patients also have symptoms of urinary tract irritation and painful intercourse; the leucorrhea increases in the acute stage and is white and thick like beans. The above situation should be found in time to seek medical attention, after examination and laboratory tests are easy to diagnose. Treatment must be carried out in strict accordance with medical advice. Trichomonas vaginitis: the leucorrhea is increased and yellowish white, occasionally yellowish green pus, often with foam, fishy odor, mixed with blood when the lesion is serious; followed by lumbago, frequent urination, painful urination, vulvar itching and vague pain in the lower abdomen. The vaginal mucosa is red and swollen, with scattered bleeding spots or strawberry-like protrusions, occasionally causing painful intercourse. When the infection is severe, the discharge may turn into purulent and smelly, with occasional symptoms of spotting and bleeding. There is a burning sensation of vaginal cramps, abdominal discomfort, frequent and painful urination. The vaginal mucosa is red, mildly edematous, and painful to palpation, with scattered punctate or patchy bleeding spots of varying sizes, sometimes accompanied by superficial ulcers. Diagnosis: ① Non-specific vaginitis is detected by taking a smear of the secretion and microscopy with Gram stain, which reveals common pathogens without the presence of mycobacteria or trichomonas. ② Mycosis fungoides is taken as a smear and stained with Gram stain. Microscopically, clusters of Gram-positive intensely stained ovoid cells can be found, or pseudomycorrhizal filaments can be seen connected with emergent cells in a chain or branched form. The most reliable method is to perform a culture test for mycobacteria. ③ Trichomonas vaginalis is detected by taking the discharge and mixing it with a small amount of warm saline that has been dripped on a glass slide and microscopically examined. Active Trichomonas vaginalis can be seen. If trichomonas cannot be detected in special cases, culture test can be used instead and the results are highly accurate. ④ The discharge examination of senile vaginitis should be distinguished from trichomoniasis and mycotic vaginitis. Pay attention to the cervix, uterine body size and its morphology, source of bleeding and vaginal cytology results, and if necessary, make a biopsy of the cervix or endometrium to exclude the possibility of uterine cancer. Treatment: Dietary therapy and pharmacological therapy can be used. Among the pharmacological therapies: ① Non-specific vaginitis: the principle of treatment lies in correcting vaginal pH and local application of antibiotics. (ii) Mycotic vaginitis: the relevant causative factors should be treated, such as diabetes mellitus, and timely discontinuation of broad-spectrum antibiotics or hormones. ③Trichomonas vaginitis: divided into two methods: systemic and local medication. ④Geriatric vaginitis: treatment principle is to supplement small amount of estrogen, increase vaginal resistance and inhibit bacterial growth. Prevention: ① Non-specific vaginitis: strengthen exercise and physical fitness. Actively treat the causes of the disease, such as vaginal injury, pelvic inflammatory disease and uterine bleeding, to reduce the growth and reproduction of pathogenic bacteria. ②Mycotic vaginitis: Pay attention to the reasonable application of broad-spectrum antibiotics and hormones. Diabetic patients should pay special attention to skin and vulva cleanliness. Vaginal mycobacteria often coexist or cross-infection with other parts of the mycobacterial pathogens, such as itching skin and scratching with the hands will make the nails with mycobacteria; patients with itching around the anus may have intestinal infection mycobacteria. The disease can also be infected through sexual life, so during treatment should avoid sexual life, if necessary, couples at the same time for diagnosis and treatment. Trichomonas vaginalis: Trichomonas can maintain a certain level of viability during freezing and drying, and also has a rather tenacious resistance in different concentrations of soap and water, which can be easily transmitted. Firstly, the source of infection must be eliminated. Regular screening and treatment, the trichomonas patient’s lover should also be treated. Secondly, eliminate the means of infection. We advocate showering, changing the sitting toilet to squatting, and not renting swimming clothes and towels. ④Age-related vaginitis: Enhance the defensive function of the vagina and use acid or acid-producing drugs. Bacterial vaginitis Bacterial vaginitis is also known as nonspecific vaginitis, Haemophilus vaginitis, Corynebacterium vaginitis, Pressure-oxygen vaginitis, Gatnerella vaginitis, etc.; bacterial vaginosis was named at an international conference in 1984; the disease is caused by a mixed infection of Gatnerella vaginalis and some pressure-oxygen bacteria, which can be transmitted through sexual contact and has a higher incidence in people with chaotic sexual relationships. The prominent clinical manifestation is increased vaginal discharge with a fishy odor. This is due to the peculiar odor emitted by the secretions. Whenever sexual intercourse or activity promotes into the release of the odor, the odor is particularly pronounced due to the large amount of amines in the vagina and the ph of the vaginal secretions is also increased; bolus examination with a speculum reveals increased vaginal secretions that are off-white and very sticky, but inflammation of the vaginal wall is not evident. There are four diagnostic criteria for this disease: a. Vaginal discharge is grayish-white, very viscous, even pasty, uniform, but not purulent, and the amount is variable. The amine content in the discharge is particularly high, so it smells fishy. The smell is often aggravated by the promotion of amine release during sexual intercourse or after activities. The ph value of vaginal secretions is increased, ranging from 5.0 to 5.5, compared to 4.5 to 4.7 in normal people. 4. Translucent cells can be detected in the wet smear of vaginal secretions. The diagnosis can be confirmed by having three or more of the above four criteria, with emphasis on the fourth one as the required diagnostic criterion. The disease must be differentiated from other causes of vaginitis: i. Trichomonas vaginalis: There is also an increase in vaginal discharge and a peculiar odor. However, the diagnosis can be confirmed by taking a microscope of the discharge, which shows an increase in the number of leukocytes and no clue cells, and by finding active trichomonads. Fungal vaginitis: Vaginitis caused by fungi is mostly caused by Candida albicans. The clinical manifestations are sometimes difficult to distinguish from bacterial vaginosis, but the discharge of fungal vaginitis has no amine odor, ph value is greater than 4. 5 wireless cells, direct microscopy can detect yeast-like spores and pseudomycetes than, culture can detect Candida albicans.