Vaginal Intraepithelial Neoplasia

By | June 10, 2022

Vaginal intraepithelial neoplasia is tissue changes in the woman’s vagina. These dysplastic changes can sometimes lead to vaginal cancer.

What is vaginal intraepithelial neoplasia?

Dysplastic changes in the tissue on the mucous membrane of the female vagina (vagina) are referred to as vaginal intraepithelial neoplasia . Tissue changes also have the abbreviation VAIN. In some women, the changes trigger vaginal cancer.

Vaginal intraepithelial neoplasia is one of the neoplasms of atypical squamous epithelium that occurs in the mucous membrane of the vagina. There is no invasive growth. There are similarities to the intraepithelial neoplasms on the neck of the womb (cervix) and on the vulva. However, vaginal intraepithelial neoplasia is much less common. For histamine intolerance meaning, please visit

Only two to three out of a million women get it. In most cases, there is a vaginal intraepithelial neoplasia in the upper part of the vagina. In medicine, a distinction is made between three degrees of severity of vaginal intraepithelial neoplasia. They are labeled VAIN 1 to VAIN 3.

  • VAIN 1 is a mildly pronounced dysplasia. While the cells change atypically, the epithelial layering remains intact.
  • VAIN 2 is when the atypia are moderate. They occur in the middle and basal thirds of the epithelium.
  • If VAIN 3 is present, there are severe dysplasias that are noticeable throughout the epithelium. There is also an increased risk of vaginal intraepithelial neoplasia progressing to vaginal carcinoma.


The reasons for vaginal intraepithelial neoplasia have not yet been clarified. However, certain factors are known to have a favorable effect on the development of VAIN. These include other neoplasms that occur in the urogenital area, a weakening of the immune system, and infection with human papillomaviruses, which belong to the high-risk types 16 and 18.

Furthermore, recurring inflammation, a prolapsed uterus, genital warts or permanent pressure from vaginal pessaries are blamed as triggers for the neoplasia. This also applies to further development into a vaginal carcinoma.

Which form of vaginal intraepithelial neoplasia occurs depends on the age of the affected women. VAIN 1 usually appears between the ages of 40 and 50, while VAIN 3 occurs primarily in women around the age of 60. In around five percent of all patients, the neoplasia turns into vaginal cancer.

Symptoms, Ailments & Signs

Since the tissue changes in vaginal intraepithelial neoplasia are minor and there are no symptoms, the disease often goes unnoticed for a long time. On the other hand, if the neoplasia degenerates into a vaginal carcinoma, irregular bleeding and discharge can occur.

The bleeding often occurs after intercourse and is usually painless. The discharge is brownish-bloody and only occurs at an advanced stage. If the tumor spreads to neighboring tissue or organs, abdominal pain and organ disorders in the intestine or bladder are possible.

Diagnosis & course of disease

A vaginal intraepithelial neoplasia is usually detected during a gynecological check-up. The gynecologist checks the vagina and cervix using a colposcope. This is a type of microscope that is used specifically for gynecological examinations. The device is capable of taking pictures of the inner lining of the vagina.

A swab is also taken from the vagina. Atypical tissue can be identified within the smear using different staining methods. This includes the application of an iodine tincture, acetic acid, toluidine blue and a PAP stain. The course of a vaginal intraepithelial neoplasia is mostly positive if the tissue changes are removed in time. However, some women are at risk of vaginal cancer.


A vaginal intraepithelial neoplasia can eventually develop into a vaginal carcinoma. A degeneration of the tissue changes initially results in irregular bleeding and discharge. This is accompanied by physical discomfort that increases with the progression of the neoplasia and has a very negative effect on quality of life and well-being.

In later stages, the tumor can spread to adjacent tissue or organs and cause pain, organ disorders in the bladder and intestines, and vascular dysfunction. If left untreated, vaginal intraepithelial neoplasia can spread throughout the body and can even be fatal. The treatment also carries certain risks.

Freezing can cause frostbite and tissue necrosis. Radiation or chemotherapy can cause serious bone damage and other carcinomas. Such treatment also has an impact on the physical and psychological condition of the woman concerned.

Normal participation in everyday life is usually not possible with radiation or chemotherapeutic treatment, which can lead to depressive moods developing under certain circumstances. A surgical procedure can be associated with infections and injuries in the area of ​​the vagina. Partial removal of the vagina often leads to infertility.

When should you go to the doctor?

Sexually mature girls and women should visit a gynecologist at regular intervals. Participation in the preventive medical check-ups offered is generally advisable. Abnormalities or changes in the internal sex organs can be noticed and a treatment plan can be drawn up. If special features or disturbances of the menstrual period occur, there is a need for action. Sudden bleeding that is not related to menstruation often indicates existing disorders or diseases.

If the bleeding occurs repeatedly, a doctor should be consulted. Abdominal pain, restrictions on the usual range of motion or a general feeling of being unwell should be examined and clarified. Abnormal sexual intercourse, libido disorders or an unusual discharge from the vagina are signs of a disease. If the symptoms persist or increase in intensity, you should see a doctor.

Since, in the worst case, a tumor can form without diagnosis or treatment, a doctor should be consulted at an early stage if the first abnormalities or changes in the state of health occur. If there are any peculiarities when going to the toilet, irregularities in the area of ​​the intestines or the bladder and a feeling of illness occurs, the cause needs to be clarified. Various medical tests must be performed to diagnose the health irregularities.

Treatment & Therapy

Therapy of vaginal intraepithelial neoplasia also depends on the particular stage. In the case of VAIN 1 and VAIN 2, one observation is initially sufficient. In addition, the use of topical 5-fluorocil and removal with a carbon dioxide laser are possible. However, these methods have the disadvantage that they do not allow histological work-up.

If the condition of VAIN 1 or VAIN 2 worsens, the patient is given drugs with immunomodulating or cytostatic agents. Icing ( cryotherapy ) can also be carried out. However, the safest procedure is the partial removal of the vagina. If the lesions are left untreated, there is a high risk that further degeneration will take place. However, spontaneous normalization is also possible.

If VAIN 3 is already present, it is a real cancer, but it is still limited. In such cases, a complete operation as well as radiation must be performed. Chemotherapy can also be useful. The first-line treatment is radiation, which is given either before or after surgery.

However, an operation only takes place if the vaginal tumor is still small enough. Depending on the extent and stage of the tumor, it is cut out of the mucous membrane of the vagina. It may also be necessary to remove parts of the vagina and the uterus.


In order to prevent vaginal intraepithelial neoplasia and thus also vaginal cancer, it is recommended to have an early detection examination by a gynecologist once a year. Bleeding that occurs outside of the menstrual cycle should be taken seriously. This is especially true for bleeding after intercourse.


After the successful treatment of a vaginal intraepithelial neoplasia, intensive follow-up treatment should always take place in order to be able to identify and treat complications that may result from the disease and the treatment in good time. The follow-up treatment depends on the type of severity of the vaginal intraepithelial neoplasia.

In general, regular gynecological follow-up examinations, which also include colonoscopies of the vagina, should always follow the treatment of vaginal intraepithelial neoplasia. In this way, it can be recognized in good time whether there are new tissue changes in the vaginal mucosa. If this is the case, a new treatment must take place.

If parts of the vagina have been removed, this can also represent a psychological burden for the affected patient, which can result in mental illnesses, especially if this has resulted in sexual restrictions or permanent infertility. In such a case, in addition to the gynecological treatment of infertility and sexual restrictions, psychotherapy must also be carried out.

In addition to psychiatric drug therapy, this should also include deep psychological therapeutic support. Behavioral therapy can also help to cope with the limitations that result from the disease. If the partner in love is also affected by the illness, they should be included in all therapeutic follow-up treatments and, if necessary, also receive psychotherapy.

You can do that yourself

Vaginal intraepithelial neoplasia usually does not cause any symptoms that affect the daily life of the affected women. However, in order to prevent the tissue changes from forming a vaginal carcinoma, it is advisable to take some precautionary measures.

Affected women should pay close attention to external changes in the vagina area. Regular gynecological examinations must be carried out after consultation with the doctor treating you. This is particularly necessary if pain and bleeding occur outside of the menstrual period. In these cases, the patients should also refrain from sexual intercourse for some time. In general, the use of condoms is advisable for vaginal intraepithelial neoplasia. Affected women should boost their immune systemsthrough a healthy lifestyle to prevent the development of cancer. Unhealthy habits such as smoking or excessive alcohol consumption should therefore be stopped. Obesity should be reduced if necessary.

In severe cases, vaginal intraepithelial neoplasia is treated surgically by partially removing the vagina. This can be a great burden for the affected woman as well as her partner. Patients can get help in self-help groups. In some cases, it is also advisable to consult a couples therapist or a pastor.

Vaginal Intraepithelial Neoplasia