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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Sexually transmitted disease that affect the vagina include:
- Herpes genitalis. The herpes simplex virus (HSV) can infect the vulva, vagina, and cervix, and this may result in small, painful, recurring blisters and ulcers. It is also common for there to be an absence of any noticeable symptoms.
- Gonorrhea
- Chlamydia
- Trichomoniasis
- Human papillomavirus (HPV), which may cause genital warts.
HIV/AIDS can be contracted through the vagina during vaginal intercourse, but it is not associated with any local vaginal or vulval disease.
Because of STIs, health authorities and other health outlets recommend safe sex practices when engaging in sexual activity.
Lichen sclerosus may have a genetic component. Higher rates of lichen sclerosus have been reported among twins and among family members.
Vaginitis an inflammation of the vagina, such as caused by infection, hormone disturbance and irritation/allergy.
Although it is not clear what causes LS, several theories have been postulated. Lichen Sclerosus is not contagious; it cannot be caught from another person.
Several risk factors have been proposed, including autoimmune diseases, infections and genetic predisposition. There is evidence that LS can be associated with thyroid disease.
Vaginal hypoplasia is estimated to occur in 1 in 4,000–5,000 live female births. It is often unnoticed until adolescence when pain and a lack of menstrual flow indicates the condition.
Fraser syndrome is a disorder that affects the development of the child prior to birth. Infants born with Fraser syndrome often have eyes that are malformed and completely covered by skin. Also the child is born with fingers and toes that are fused together along with abnormalities within the urine tract. As this disorder relates to vaginal atresia, infants born with Fraser syndrome are also born with malformations in their genitals.
While infections may occur without sex, a high frequency of intercourse increases the risk. Personal hygiene methods or tight-fitting clothing, such as tights and thong underwear, do not appear to increase the risk.
In pregnancy, higher levels of estrogen make a woman more likely to develop a yeast infection. During pregnancy, the "Candida" fungus is more common, and recurrent infection is also more likely. There is tentative evidence that treatment of asymptomatic candidal vulvovaginitis in pregnancy reduces the risk of preterm birth.
Cervical agenesis is estimated to occur in 1 in 80,000 females. It is often associated with deformity of the vagina; one study found that 48% of patients with cervical agenesis had a normal, functional vagina, while the rest of the cases were accompanied by vaginal hypoplasia.
Rokitansky-Mayer-Küster-Hauser syndrome is a disorder in females that causes the uterus and vagina to be absent or underdeveloped. Those born with this disorder are considered to be genetic female and have a 46XX chromosomes. Kidney anomalies often accompany this disorder as well. Also referred to as Müllerian agenesis, vaginal agenesis, or müllerian aplasia, this disorder affects 1 in every 4,000-5,000 females. A cloacal malformation often accompanies this disorder, which is the surgical treatment that incorporates several vaginal replacement techniques. This disorder is caused by an implication in the "WNT4" protein coding gene, which is found on the short arm (p) of chromosome 1. A genetic mutation occurs causing a substitution of leucine to proline residue at position 12 on the amino acid in the WNT4 protein. Essentially, this will cause a reduction in the intranuclear levels of β catenin. Additionally, the inhibition of steroidogenic enzymes such as 17α-hydroxylase and3β-hydroxysteriod dehydrogenase because of this mutation, which leads to an excess amount to androgen in the system. As "WNT4" gene is essential for developing a protein that is essential for female sex development, the Müllerian duct is either absent or deformed when this gene is not present. The development of the female reproductive system may be disrupted in the absence of the WNT4 protein's regulation. Abnormal androgen production is also induced, eventually leading to hyperandrogenism and Müllerian aplasia.
The following measures are advisable for keeping the vulva and vagina healthy:
- Avoiding washing with soap, since soap disturbs the natural pH balance of the vagina. Some pH-balanced soaps exist, but their effects remain unclear. Other measures are seldom necessary or advisable. Two notable examples: so-called "feminine hygiene sprays" are unnecessary, may be generally harmful, and have been known to cause severe allergic reactions. Vaginal douching is generally not necessary and has been implicated in helping to cause bacterial vaginosis (BV) and candidiasis ("yeast infections").
- After using the toilet, wipe from the front toward the back to avoid introducing bacteria from the anal area into the vulva. Use non-perfumed, undyed toilet paper.
- Drink plenty of water and urinate frequently and as soon as possible when you feel the need, to help flush bacteria out of the urinary tract and avoid urinary tract infections. For the same reason, try to urinate before and after sex.
- Change out of a wet swimsuit or other wet clothes as soon as possible.
- Avoid fragrances, colours, and "deodorants" in products that contact the vulva/vagina: sanitary napkins, tampons, and toilet paper. Some women who are sensitive to these substances should also avoid bubble baths and some fabric detergents and softeners.
- Use a menstrual cup instead of sanitary pads or tampons. Menstrual cups are a new form of menstrual product that has recently been rapidly gaining in popularity as a greener, more cost-effective and healthier alternative to tampons and sanitary pads.
- Avoid wearing leather trousers, tight jeans, panties made of nylon or other synthetic fabrics, or pantyhose without an all-cotton crotch (not cotton covered by nylon - cut out the nylon panel if necessary).
- Anything which has been in contact with the anal area (see anal sex) should be thoroughly washed with soap and water or a disinfectant before coming in contact with the vulva or vagina.
- Use condoms during heterosexual intercourse, practise safer sex, know your sex partners, ask sex partners to practise basic hygiene of their genitals. Use artificial lubrication during the intercourse if the amount naturally produced is not enough.
- Be careful with objects inserted inside the vagina. Improper insertion of objects into any body opening can cause damage: infection, cutting, piercing, trauma, blood loss, etc.
- Avoid letting any contaminants inside the vagina, including dirt but especially sand.
- See your gynecologist regularly.
- Be careful while removing hair in this area.
Women who are unable to walk are more likely to have infections. The problem can be prevented according to above-mentioned and following measures:
- Wash crotch and rectal areas (with a soap-substitute if desired) and large amount of warm running water, every morning and evening. The disabled person can sit on a shower chair with an open seat or on a toilet. Use a shower head or water container to wash more directly.
- Use towel to dry.
- DO NOT use talcum/body powder, if desired use corn starch powder (corn-flour) on the skin of the genital area to absorb perspiration.
- Avoid sitting on plastic or synthetic materials for extended lengths of time.
- Wear loose underpants and change if soilage or wetness occurs.
Vaginal hypoplasia is the underdevelopment or incomplete development of the vagina. It is a birth defect or congenital abnormality of the female genitourinary system.
A wide variety of possible causes and treatments for vulvodynia are currently being explored. Moreover, there are probably several causes of vulvodynia, and some may be individual to the patient.
Possible causes include Sjogren's syndrome, the symptoms of which include chronic vaginal dryness. Others include genetic predisposition to inflammation, allergy or other sensitivity (for example: oxalates in the urine), an autoimmune disorder similar to lupus erythematosus or to eczema or to lichen sclerosus, infection (e.g., yeast infections, bacterial vaginosis, HPV, HSV), injury, and neuropathy—including an increased number of nerve endings in the vaginal area. Some cases seem to be negative outcomes of genital surgery, such as a Labioplasty. Initiation of hormonal contraceptives that contain low- dose estrogen before the age of 16 could predispose women to vulvar vestibulitis syndrome. A significantly lower pain threshold, especially in the posterior vestibulum, has also been associated with the use of hormonal contraceptives in women without vulvar vestibulitis syndrome. Pelvic floor dysfunction may be the underlying cause of some women's pain.
Hormonal vaginitis includes atrophic vaginitis usually found in postmenopausal or postpartum women. Sometimes it can occur in young girls before puberty. In these situations the estrogen support of the vagina is poor.
Vaginitis is the disruption of the healthy vaginal microbiota. The vaginal microbiota consists of those organisms which generally do not cause symptoms, infections, and results in good pregnancy outcomes, and is dominated mainly by Lactobacillus species. The disruption of the normal microbiota can cause a vaginal yeast infection. Vaginal yeast infection can affect women of all ages and is very common. The yeast "Candida albicans" is the most common cause of vaginitis. Specific forms of vaginal inflammation include the following types:
Infectious vaginitis accounts for 90% of all cases in reproductive age women:
- Candidiasis: vaginitis caused by proliferation of "Candida albicans", "Candida tropicalis", "Candida krusei"
- Bacterial vaginosis: vaginitis caused by increased growth of "Gardnerella" (a bacterium).
- Aerobic vaginitis
Other less common infections are caused by gonorrhea, chlamydia, "Mycoplasma", herpes, "Campylobacter", improper hygiene, and some parasites, notably "Trichomonas vaginalis". Women who have diabetes develop infectious vaginitis more often than women who do not.
Vaginal infections often have multiple causes (varies between countries between 20 and 40% of vaginal infections), which present challenging cases for treatment. Indeed, when only one cause is treated, the other pathogens can become resistant to treatment and induce relapses and recurrences. Therefore, the key factor is to get a precise diagnosis and treat with broad spectrum anti-infective agents (often also inducing adverse effects).
Further, either a change in pH balance or introduction of foreign bacteria in the vagina can lead to infectious vaginitis. Physical factors that have been claimed to contribute to the development of infections include the following: constantly wet vulva due to tight clothing, chemicals coming in contact with the vagina via scented tampons, antibiotics, birth control pills, or a diet favoring refined sugar and yeast.
Exact cause of Fox-Fordyce is currently unknown. Studies have not been able to confirm if apocrine gland duct obstruction is required for development. It is speculated that gland duct rupture causes inflammation. Inflammatory response includes white blood cells.
In 2016, interferon gamma/CXCL10 axis was hypothesized to be a target for treatments that reverse inflammation. Apremilast is undergoing investigation as a potential treatment .
Most commonly affects women aged 13–35 years, approximately puberty through their prime. Some reports show affected women to men at 9:1. Rare cases have been shown to affect post-menopausal women, children, and men. Incident report is currently unknown. Although rare, men and children have been shown to be affected. Heat, humidity, stress, and exercise have been shown to worsen symptoms. Rate of incidence is currently unknown. Fox-Fordyce has also been shown to be severe during menstruation and spontaneously disappear during pregnancy
The overall prevalence of lichen planus in the general population is about 0.1–4.0%. It generally occurs more commonly in females, in a ratio of 3:2, and most cases are diagnosed between the ages of 30 and 60, but it can occur at any age.
Oral lichen planus is relatively common, It is one of the most common mucosal diseases. The prevalence in the general population is about 1.27–2.0%, and it occurs more commonly in middle aged people. OLP in children is rare. About 50% of females with oral lichen planus were reported to have undiagnosed vulvar lichen planus.
Vulvovaginal health is the health and sanitation of the human vulva and vagina.
Problems affecting this area include vulva diseases, vaginal diseases and urinary tract infections.
Little is known about the cause of vestibulodynia. A number of causes may be involved, including sub-clinical human papillomavirus infection, chronic recurrent candidiasis, or chronic recurrent bacterial vaginosis. Muscular causes have been implicated as well, since chronic vulvar pain may be the result of chronic hypertonic perivaginal muscles, leading to vaginal tightening and subsequent pain. Some investigators have postulated the existence of neurological causes, such as vestibular neural hyperplasia. Finally, psychological factors may contribute to or exacerbate the problem, since the anticipation of pain often results in a conditioned spasmodic reflex along with sexual desire and arousal problems.
The percentage of women affected is not entirely clear, but estimates range as high as 16%. Many other conditions that are not truly vulvodynia (diagnosis is made by ruling out other causes of vulvar pain) could be confused with it. Vulvar pain is a quite frequent complaint in women's health clinics. Vulvodynia is a new term in the medical literature.
The first line of therapy after diagnosis typically involves the administration of the combined oral contraceptive pill, medroxyprogesterone acetate or a gonadotropin-releasing hormone agonist to suppress menstruation and thereby relieve pain. Surgically, cervical agenesis has historically been treated through hysterectomy (removal of the uterus) to relieve symptoms caused by hematocolpos (the accumulation of menstrual fluid in the vagina). Other surgical methods of management involve the creation of an anastomotic connection between the uterus and vagina by neovaginoplasty or recanalization of the cervix. Outcomes in these cases are generally poor, since the natural functions of the cervix—such as mucus production and providing a barrier against ascending infection—cannot be replicated. Furthermore, the success rate of uterovaginal anastomosis is less than 50% and most patients require multiple surgeries while many develop cervical stenotis. Despite this, several pregnancies have been reported in women with cervical agenesis who underwent surgical treatment.
Many postmenopausal women (who are not using topical estrogen) have at least some degree of vaginal atrophy; however, many women do not actively ask that medical attention be paid to this, possibly because it is naturally caused, or because of the taboo that still exists surrounding aging and sexuality.
The cause of vaginal atrophy is usually the normal decrease in estrogen as a result of menopause. Other causes of decreased estrogen levels are decreased ovarian functioning due to radiation therapy or chemotherapy, immune disorder, removal of the ovaries, entering the post-partum period, and lactation. Various medications can also cause or contribute to vaginal atrophy, including tamoxifen (Nolvadex), danazol (Danocrine), medroxyprogesterone acetate (Depo-Provera), leuprolide (Lupron), and nafarelin acetate (Synarel). Vaginal atrophy can also be idiopathic.
Atrophic vaginitis (also known as vaginal atrophy, vulvovaginal atrophy, or urogenital atrophy) is an inflammation of the vagina (and the outer urinary tract) due to the thinning and shrinking of the tissues, as well as decreased lubrication. These symptoms are due to a lack of the reproductive hormone estrogen.
The most common cause of vaginal atrophy is the decrease in estrogen which happens naturally during perimenopause, and increasingly so in post-menopause. However this condition can occur in other circumstances that result in decreased estrogen such as breastfeeding and the use of medications intended to decrease estrogen too, for example, treat endometriosis.
The symptoms can include vaginal soreness and itching, as well as painful intercourse, and bleeding after sexual intercourse. The shrinkage of the tissues and loss of flexibility can be extreme enough to make intercourse impossible.