Desquamative Inflammatory Vaginitis (DIV)
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Desquamative Inflammatory Vaginitis (DIV) is a rare form of vaginitis that causes inflammation, irritation, and increased vaginal discharge. Unlike other types of vaginitis, DIV is not caused by bacteria, fungi, or sexually transmitted infections (STIs). Treatment typically involves antibiotics and steroid medications. This article will guide you through the key aspects of DIV, including its symptoms, diagnosis, treatment, and prevention.
What is Desquamative Inflammatory Vaginitis (DIV)?
Who is at Risk of DIV?
Any person assigned female at birth can develop DIV, though it’s more commonly seen in women nearing menopause. White women are at a higher risk for developing this condition, especially those experiencing vaginal atrophy due to lower estrogen levels.
How Common is DIV?
DIV is relatively uncommon and is considered the least frequent form of vaginitis.
Is DIV Painful?
Yes, DIV can cause significant discomfort, including vaginal itching, irritation, and pain during sexual intercourse. Some women may also experience vulvar pain or irritation.
Symptoms and Causes
What Are the Symptoms of Desquamative Inflammatory Vaginitis?
Common symptoms of DIV include:
- Increased vaginal discharge, often yellowish-green.
- Vaginal and vulvar itching or burning (vulvodynia).
- Redness and irritation in the vaginal and vulvar areas.
- Pain during sexual intercourse (dyspareunia).
- Bleeding after sexual activity.
What Causes DIV?
The exact cause of DIV is not well understood. It is often linked to decreased estrogen levels, particularly during menopause or after the removal of the ovaries. Vaginal atrophy, or the thinning and drying of the vaginal tissue, is often seen in patients with DIV, suggesting a possible connection between the two conditions.
Diagnosis and Tests
How is Desquamative Inflammatory Vaginitis Diagnosed?
Diagnosing DIV often involves ruling out other conditions like bacterial vaginosis, yeast infections, or STIs. Your healthcare provider will likely perform a pelvic exam, during which they may observe:
- An excess of yellowish vaginal discharge.
- Red, inflamed vaginal tissue.
- Rash-like bumps inside the vagina.
A sample of the vaginal discharge will be examined under a microscope to rule out infections and confirm the presence of DIV. Since its symptoms are similar to other types of vaginitis, laboratory testing is crucial for accurate diagnosis.
Management and Treatment
How is Desquamative Inflammatory Vaginitis Treated?
Treatment for DIV generally involves the use of topical antibiotics or steroids, which are inserted into the vagina using an applicator. These medications help manage both bacterial presence and inflammation.
- Antibiotics: Target bacterial involvement.
- Steroids: Reduce inflammation and irritation.
Most patients experience relief within weeks of starting treatment. However, for some, the symptoms may return or persist. In such cases, ongoing treatment may be necessary. Wearing panty liners or pads can help manage the increased vaginal discharge.
Prevention
Can Desquamative Inflammatory Vaginitis Be Prevented?
Since DIV is often related to decreased estrogen levels, there are limited ways to prevent it. However, certain lifestyle changes can help minimize irritation:
- Avoid scented soaps and sprays around the vaginal area.
- Do not douche, as this can disrupt the natural balance of vaginal flora and lead to infections.
- Consult your healthcare provider for appropriate estrogen therapy if you are nearing menopause.
Outlook / Prognosis
What is the Outlook for Desquamative Inflammatory Vaginitis?
DIV can be a recurring condition for some people, while others may only experience it once. If you experience recurrent episodes of DIV, your healthcare provider may recommend long-term management strategies, including maintenance medications.
Living With
When Should I Contact a Healthcare Provider?
If you experience any of the following symptoms, you should contact your healthcare provider for an evaluation:
- Persistent or worsening vaginal discharge, especially if it’s yellow or green.
- Itching, pain, or irritation in the vaginal or vulvar areas.
- Pain during sexual intercourse or everyday activities.
- Unexplained pelvic pain.
- Vaginal bleeding outside of your normal menstrual cycle or after sex.
These symptoms could indicate DIV or another condition, such as a vaginal infection or STI.