In terms of female physiology, the vagina is part of the channel between the outside world and the pelvic and abdominal cavity, it is attached to the cervix and opens at the lower end to the vulva. In a normal healthy woman, the vagina itself is self-cleaning and has a natural defense function. Under normal physiological conditions, the anterior and posterior walls of the vagina are close together. The vaginal epithelium is compound squamous epithelium and contains varying degrees of glycogen, which is converted to lactic acid by Bacillus vaginalis, making the vagina acidic and preventing the growth and reproduction of disease-causing bacteria, thus preventing disease. If the above prevention mechanism is damaged, germs can take advantage of the opportunity to cause various gynecological inflammatory diseases. Normally, about half of the women have a variety of bacteria and mycobacteria living in the vagina, but they do not cause diseases because of the balance of the vaginal environment and its self-cleaning function, and because these microorganisms live in symbiosis, restrain each other and live in harmony, like a small society in good order. Estrogen, Lactobacillus and vaginal pH play an important role in maintaining the ecological balance of the vagina. In spring and summer, especially during the rainy season, the weather is hot and humid; in summer, the heat makes the body less resistant, especially in women’s vagina due to sexual intercourse, swimming and vaginal douching activities, which can easily damage the vaginal disease prevention mechanism and lead to vulvar and vaginal inflammation. From a clinical point of view, the common inflammatory diseases of the vulva and vagina include non-specific vulvovaginitis, trichomoniasis, mycotic vaginitis, bacterial vaginosis and senile vaginitis. Non-specific vulvovaginitis: The vulva is close to the urethra and anus and is often stimulated by menstrual blood, vaginal secretions and urine, which can cause vulvovaginitis if the skin is not cleaned. Non-specific vulvovaginitis. Patients with vulvar skin and mucous membrane have obvious itching, pain or burning sensation, which is aggravated during activity, sexual intercourse and urination. Treatment should be to keep the area clean and dry, apply local antibiotics, and actively search for the cause for targeted treatment. Trichomonas vaginalis: caused by Trichomonas vaginalis. Trichomonas is suitable for living in a warm, humid environment with a pH close to neutral. After menstruation, when the pH of the vagina is close to neutral, Trichomonas can multiply in the glands and folds of the vagina and cause inflammatory episodes. Trichomonas not only lives in the vagina, but also invades the urethra and the male partner’s foreskin folds, urethra or prostate. Trichomonas vaginalis is associated with vulvar itching and increased discharge, which is typically thin, purulent, yellow-green, foamy and smelly. Trichomonas can engulf sperm, interfere with sperm survival in the vagina, and cause infertility. Treatment of trichomoniasis requires systemic medication, the main treatment being metronidazole. Since it is mainly transmitted by sexual intercourse, sexual partners should be treated at the same time and sexual intercourse should be avoided during treatment. Mycotic vaginitis: It is very common, with about 75% of women having had at least one episode of mycotic vaginitis in their lifetime. 45% of women have had two or more episodes. Many normal people have this organism in their vagina, mouth or intestines, but it does not cause discomfort and symptoms appear when the systemic and local vaginal immunity decreases and the mycobacteria proliferate. It often occurs in the following situations: when broad-spectrum antibiotics are applied, pregnancy, diabetes, and heavy application of immunosuppressive drugs. The disease is mainly endogenous in transmission. The disease is associated with vulvar itching, burning pain and sexual colic; vaginal discharge is characterized by a white thick tofu-like consistency. Treatment should eliminate the above causes, local or systemic application of antifungal drugs; diligent change of underwear, used underwear, basin and towels should be scalded with boiling water. A few details to keep you away from mycosis vaginalis: n Cut your nails and bathe regularly n Wash your hands before going to the toilet n Wash your underwear separately n Dress appropriately n Use appropriate hygiene products n Do not over-hygienic n Do not abuse antibiotics n Pay attention to hygiene in public places n Do not eat foods with high sugar content Bacterial vaginosis: It is a mixed infection caused by dysbiosis of the normal vaginal flora. The normal vaginal flora is dominated by Lactobacillus, and a decrease in Lactobacillus can lead to a proliferation of other bacteria, which may be related to frequent sexual intercourse, multiple partners, or vaginal irrigation. Bacterial vaginosis is characterized by increased vaginal discharge, which is off-white and thin, with a fishy odor, especially after sexual intercourse. If the disease is not treated early, it can lead to other adverse outcomes, such as amnionitis, premature rupture of membranes and preterm birth during pregnancy, and endometritis and pelvic inflammatory disease during non-pregnancy. The main treatment drugs are metronidazole and clindamycin, which need to be used continuously for 1 week. Sexual partners do not need routine treatment. Aging vaginitis: It is common in postmenopausal women. Due to the decrease in estrogen level, the vaginal wall atrophy, epithelial thinning, local resistance decreases and other pathogenic bacteria overgrow or easily invade causing inflammation. It may be accompanied by sexual colic and recurrent urinary tract infections. The onset of the disease is characterized by discomfort, itching and increased vaginal discharge; the discharge is thin and pale yellow. Antibiotics such as metronidazole can be used to inhibit bacterial growth and the main treatment is estrogen supplementation to strengthen vaginal resistance. As mentioned above, different types of vaginitis have different pathogenesis and treatment methods, and sometimes there may be a mixture of two or more types of vaginal infections, so if medication is used indiscriminately, the treatment is not targeted and may delay treatment, aggravate the disease or even spread to more serious gynecological inflammation, which will have a greater impact on women’s health. Therefore, it is important for women to go to the right medical institution for treatment of vaginitis once it occurs, rather than avoiding treatment or using medication blindly.