Anatomy and physiology of Vagina to prevent infection

In adult female ,vagina is lined by stratified squamous epithelium.In newborn female,it is lined by transitional epithelium.squamous epithelium is resistant to gonococcal infection.Thus , gonococal vaginitis cannot occur in adult female.

Vagina has local inhabitant bacteria called Doderlein's bacillus Which breaks down the glycogen present in vaginal epithelium into lactic acid resulting in acidic pH(4-5.5, average 4.5) of vagina.The acidic pH of vagina acts as a barrier for external organism and protect from infection.

Physiological vaginal discharge.....

Clear, white and flocculent odourless discharge.

Smear contains epithelial cells, lactobacillus

pH ranges from 3.8 to 4.2

pH increase with increased oestrogen States:in pregnancy,OCP,mid-cycle,PCOS or premenarchal

If pH increase in primenopausal woman, investigation for other effects of excess oestrogen.

This area is subject to both primary and secondary infection.Ascending infection can occur from the vagina and cervix to the uterine cavity and to the fallopian tubes through direct spread or via the lymphatic leading to severe pelivc inflammation disease and pelvic peritonitis.

Infection can be broadly divided into lower and upper genital tract depending on the site and affection of the infective organism.

Vulvovaginitis is among the most common of all infection.the three most prevalent primary viral infection of the vulva are herpes genitals,candyloma acuminatum,and molluscum congtagiosum.