What is Vaginal intra-epithelial neoplasia (VAIN)?
VAIN is not the same as VIN which occurs in the vuvlar (the external gentials). Like HPV it often has no symptoms and disappears without treatment.
VAIN causes changes to cells within the vagina and if these become more severe, there is a chance that cancer might develop so it's considered a pre-cancerous condition.
VAIN is now fairly commonly diagnosed. It can affect women of any age, but is more common in women over 50. Occasionally, women may have abnormal changes that affect other areas in addition to the vagina, such as the cervix, vulva, and anus.
The grades of VAIN describe how deeply the abnormal cells are embedded in the surface layer of the vagina:
- VAIN 1 (low-grade VAIN) - one-third of the thickness of the surface layer of the vagina is affected.
- VAIN 2 (high-grade VAIN) - two-thirds of the thickness of the surface layer of the vagina is affected.
- VAIN 3 (high-grade VAIN) - the full thickness of the surface layer of the vagina is affected. VAIN 3 is also known as carcinoma in situ but is not cancer of the vagina.
With all three grades of VAIN, only a small area of the vagina may be affected by abnormal changes, or there may be several areas of the vagina affected by a mixture of grades of VAIN.
Symptoms of VAIN
VAIN causes no outward symptoms.
Causes of VAIN
It is not yet understood what causes VAIN, but infection in the skin of the vagina, caused by certain types of human papilloma virus (HPV) may be a factor.
VAIN is more common in women who've had a hysterectomy following a cervical cancer diagnosis or severe pre-cancerourous changes (CIN).
Having said that HPV sufferers will not always devlop VAIN and it's unlikely to be the sole cause. A depressed immune system is also likely to increase the chance of developing VIN.
Women who have had previous pre‑cancerous or cancerous conditions in the vagina or cervix, or who have been treated with radiotherapy for conditions of the cervix, womb and pelvic area may have a slightly increased risk of developing VAIN.
Treatment for VAIN
Usually only VAIN 2 and 3 require treatment and this can include local ablation (the removal or destruction of affected cells using Loop diathermy or LEEP or Carbon dioxide (CO2) laser treatment), surgery, radiotherapy, chemotherapy cream.
Some of these treatments make impact on your sex life afterwards with vaginal sensation altered or impaired, however your clitoris will be unaffected. Specialist gynaecology nurses can help you understand your options should you experience this.