Many women often complain to me: “Dr. Li, why does my vaginitis keep coming back over and over again? When I am on duty, I often encounter women who register for emergency treatment in the middle of the night for vaginitis attacks. As we all know, vaginitis is not a difficult disease, but due to the increase of leucorrhea (vaginal discharge), some of them are accompanied by odor, irritation around the vulva and anus, resulting in itching, frequent urination and painful urination, affecting life, study, work and conjugal life, but this pain can not be said to …… Li Haiyan, Department of Obstetrics and Gynecology, Wuxi Ninth People’s Hospital In fact, a woman will always have vaginitis in her lifetime, especially mycotic vaginitis, which occurs in at least 40%-50% of women, and individuals have recurrent episodes that develop into recurrent and persistent vaginitis. Why does this happen? It is due to the characteristics of the vagina itself. The normal vagina is inhabited by microorganisms that form a normal microbiota. The known ones are: aerobic bacteria, anaerobic bacteria, mycoplasma and pseudomycetes. Normally these little things do not cause discomfort in our body because the ecological balance of the vagina is maintained by Lactobacillus (gram-positive aerobic and partly anaerobic), estrogen and vaginal pH. Lactobacilli maintain the normal acidic environment of the vagina (PH <= 4.5) by producing hydrogen peroxide, which inhibits the growth of other little things; estrogen improves the vagina's own immune function and ability to defend against infection. If estrogen is lowered in the body (e.g. menopause) or if vaginal ph is raised (e.g. frequent intercourse, vaginal douching), inhibition of Lactobacillus growth (e.g. long-term antibiotics) can allow other conditionally pathogenic bacteria to grow and cause inflammation. < p=""> Knowing the characteristics of the vagina, we can know that the occurrence of most vaginitis is actually a sign: a reminder that we need to adjust our physical condition and lifestyle habits in the near future. A small problem reflects a big problem in life. The most common vaginitis are: trichomoniasis, vaginal pseudomycosis (commonly known as mycosis fungoides, often combined with vulvovaginitis), bacterial vaginosis, atrophic vaginitis (senile vaginitis), and vulvovaginitis in infants and children. In diagnosing vaginitis, you can find out which type of vaginitis is present by first checking the vaginal discharge (examination/culture) and then choosing the appropriate medication. Now we will tell you how to read the results of the leucorrhoea (vaginal discharge) test. For example, the presence of trichomonas (+) and mycobacteria (+) indicates the presence of vaginitis; the more epithelial cells are carriers of pathogenic bacteria, the more (+) indicates more vaginal flora; the concentration of hydrogen peroxide reflects the number of lactobacilli, (+) indicates disruption of the ecological balance in the vagina; the activity of leukocyte esterase reflects the presence of pathogenic bacteria in the vagina. （The higher the (+), the greater the inflammation of the vagina; sialoglucosidase activity indicates the invasion and reproduction of pathogenic bacteria in bacterial vaginosis, the higher the (+) the more vigorous; ß-glucuronidase activity indicates the invasion and reproduction of pathogenic bacteria in aerobic vaginitis, the higher the (+) the more vigorous; acetylaminoglucosidase activity: an indicator of pathogenic bacteria. The normal range of PH is 3.8-4.5 for mycosis vaginalis and 4.5 for trichomoniasis and 4.5 for mycosis, and 4.5 for bacterial vaginosis. When you see this, you may feel that you have a big headache: we are not medical students. We are not medical students, so you should tell us what special attention needs to be paid to the treatment of vaginitis. Here is the treatment for vaginitis (please follow the doctor’s orders for the specific medication). Trichomonas vaginalis is associated with trichomonas infection of the urethra, paraurethral glands, and vestibular glands, and treatment of this disease requires systemic medication and simultaneous treatment of sexual partners. Pseudomonas vulvae: local antifungal drugs are the mainstay, while oral drugs such as fluconazole can be used for unmarried people. Systemic medications are similar to local medications. Routine treatment of sexual partners is not necessary. Bacterial vaginosis can be treated with anti-anaerobic drugs such as metronidazole, tinidazole and clindamycin. Oral and topical medications are similar in effectiveness. Routine treatment of the sexual partner is not required. Atrophic vaginitis is mainly treated with estrogen supplementation to increase vaginal resistance (estriol ointment applied topically) + antibiotics to inhibit bacterial growth (norfloxacin suppositories, povidone-based suppositories, etc.). In infants and children with vulvovaginitis: the external application of estrogen ointment or antibiotic ointment can mostly loosen the adhesions of labia minora. So, how can we keep vaginitis from recurring? Here, Dr. Li repeatedly emphasized that although vaginitis is a local inflammation, it reflects the whole body. For example, in terms of sexual life, it is important to have hygiene between partners (for women, this hygiene does not mean repeated vaginal douching or washing of the vulva), to have regular sexual partners, to protect yourself and to moderate the number of sexual intercourse. For example, trichomoniasis and bacterial vaginosis can be transmitted through sexual intercourse. Change your sanitary napkins regularly during menstruation (no more than 2 hours), don’t wear tight pants or chemical fiber clothing all the time, don’t drink and smoke, don’t have a heavy taste (e.g. especially sweet food, spicy diet, etc.), all of these can change the ecological balance in the vagina, which can lead to vaginitis outbreaks when you are tired, have a cold or have a reduced resistance. Long-term use of birth control pills and antibiotics can also lead to vaginitis, as long as they are discontinued. This article is published with the authorization of Dr. Haiyan Li.