1. Vulvo-Vaginitis
Dr.Jyoti Agarwal
Dr. Sharda Jain
Director of Lifecare Centre
Lifecare IVF

2. Vulvo vaginitis
• It is one of the most
common reasons for a
women to seek
Gynecological care.
• If left untreated, can
lead to more serious
conditions such as PID,
endometritis, post
surgical complications
and spread of AIDS

3. Normal Vaginal Discharge
A normal vaginal discharge consists
of about a teaspoon (4 ml.) a day
that is white or transparent , thick to
thin and odorless. It is sufficient to
lubricate the vagina and labia
minora without staining or
moistening the underclothes

4. The Vaginal Ecosystem
Estrogen
Glycogen
Promotes
growth of
lactobacilli;
inhibits growth
of pathogenic
organisms
Lactobacilli
Lactic acid
pH 3.8 – 4.2

5. Natural conditions altering
the Vaginal Ecosystem

6. Conditions that may alter
the vaginal acidity:
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Menstruation
• Sexual activity
• Antibiotic therapy
• Click to edit Master text styles
• Vaginal infections
– Second level
• Obstetrical and
• Third level
gynecological procedures
– Fourth level
» Fifth level• Postpartum
6

7. Altered vaginal ecosystem may
lead to vulvo vaginitis
&

8. Treatment
• Medical treatment
• Concurrent supportive therapy –
Perineal Hygiene

9. A Vicious Circle with poor perineal hygiene
Infections /
Recurrent
Infections
Antibiotics
(Systemic /
Topical)
Poor
Perineal
Hygiene
Flora & pH
Disturbance

10. Role of Perineal Hygiene
Vicinity of Potentially Infected Organs
• Urethra
• Anal Canal.
Proper Perineal Hygiene plays a definite
preventive role!
ACOG 2004.

11. Perineal Hygiene
Cleaning Habits

12. Patient Education & Counselling
• The perineal area of the woman is extremely
delicate & susceptible to infections.
• Because of the close proximity of the vagina
to the rectum the Golden rule in cleaning the
perineal area is “Front to Back”.

13. For good Perineal Hygiene
antiseptic liquids
excessive soap
tissue paper
anti-perspirants
deodorants
talcum powder
tight nylon undergarments
Special attention in monsoon season

14. Managing pubic hair hygiene
* Trimming
This is the ideal method. Take care not to cut too close to the skin.
* Shaving
Must make sure that you use a disposable blade.
Could create cuts & abrasions which serve as an entry point for
bacteria
* Hair removal creams
Creams contain chemicals and can cause itching & irritation.
* Waxing
One must be very careful to wash away all wax residues as it may
lead to itching/rashes.

15. Perineal Hygiene During Menstruation
• Sanitary napkins should ideally be made of cotton
lining.
• Avoid the nylon-lined ones or those that are heavily
deodorized.
• Douches & Tampons should be discouraged
– Alters pH, suppress endogenous bacteria, and
introduces microbes
• Change of napkins frequently
• Keep the vulval area clean & dry.

16. Best Vulval Wash
• Water
• Keep the area dry

17. Summary
• There exists a dynamic vaginal ecosystem
which maintains perineal health aided by
natural defense mechanisms
• Perineal hygiene plays a very important and
definitive role in maintaining and restoring
good perineal health

18. Care of the body
• Beautiful outside
• Beautiful inside

19. Take Home Messages
‘ for good genital health’
1. Perineal Care
2. Perineal Care
3.Good Perineal Care

20. &
ADDRESS
35 , Defence Enclave, Opp. Preet Vihar
Petrol Pump, Metro pillar no. 88, Vikas
Marg , Delhi – 110092
CONTACT US
011-22414049, 42401339
WEBSITE :
www.lifecarecentre.in
www.drshardajain.com
www.lifecareivf.com
E-MAIL ID
Sharda.lifecare@gmail.com
Lifecarecentre21@gmail.com
info@lifecareivf.com