From the Research
There is currently no established direct link between Desquamative Inflammatory Vaginitis (DIV) and a history of anorexia. The condition of DIV is characterized by vaginal inflammation, discharge, and discomfort, typically caused by an imbalance in vaginal flora rather than infection 1. While anorexia can cause hormonal disruptions that affect vaginal health, including decreased estrogen levels that may lead to vaginal atrophy and dryness, this differs from the specific inflammatory process seen in DIV. Some key points to consider in the management and understanding of DIV include:
- DIV is generally treated with clindamycin cream (2%) applied intravaginally once daily for 1-2 weeks, or with 10% hydrocortisone vaginal suppositories 2.
- Patients with anorexia may experience various gynecological issues due to hypothalamic dysfunction and resulting hypoestrogenism, but DIV specifically has not been directly linked to eating disorders in medical literature 3.
- If a patient has both conditions, each would typically be treated separately - addressing the eating disorder through appropriate medical and psychological interventions while managing DIV with the standard antimicrobial or anti-inflammatory treatments. It's also worth noting that the etiology and pathogenesis of DIV remain unknown, but the favorable response to anti-inflammatory agents suggests that the etiology is immune mediated 1. In terms of prognosis and treatment, a study found that treatment with topical 2% clindamycin or 10% hydrocortisone dramatically relieved symptoms within 3 weeks in 86% of patients, although relapse occurred in 32% of patients who discontinued treatment 2. Overall, the management of DIV should focus on alleviating symptoms and preventing relapse, while also addressing any underlying conditions such as anorexia nervosa through separate and appropriate interventions.