Dysbacteriosis of the vagina (bacterial vaginosis), symptoms and treatment

Dysbacteriosis of the vagina is expressed in violation of normal vaginal flora. This disease occurs in most of the fair sex. In most cases, this disease manifests itself in an insignificant degree, but it can cause the development of a number of serious inflammatory diseases of the female genital area of ​​an infectious nature.



It should be noted immediately that several terms can be used to refer to the vaginal dysbacteriosis. Vaginal dysbacteriosis or dysbacteriosis of the vagina is considered the most accurate of the existing terms, as verbatim in translation means a violation of the microflora of the vagina. But with all this used this term is extremely rare. As a rule, this disease is called bacterial vaginosis, which also means a violation of the vaginal microflora. Meanwhile, bacterial vaginosis, many doctors identify gardnerellez, which is a particular case of vaginal dysbiosis. As a result, when using this term, it is not always possible to be sure that vaginal dysbacteriosis is meant.

In addition, often all sorts of manifestations of the violation of the vaginal microflora are considered "candidiasis" ( milkmaids ), which is completely unjustified. Candidiasis or thrush is a manifestation of one type of microflora disturbance, expressed in an increase in the number of Candida fungi, which happens extremely rarely. As a rule, women and many doppler doctors call any vaginal discharge, often not understanding the nature of their occurrence.

The causes of the violation of the vaginal microflora.
Various factors can provoke the development of vaginal dysbiosis. Let's name the most widespread of them:

• Prevalence in the vagina of fungi of the genus Candida, with dysbiosis will be called thrush.
• It can be both a single strong and frequent overcooling of the female body, which reduces the general and local immunity, which, naturally, can not but affect the vaginal microflora.
• Any hormonal changes or failures in the body, in particular: puberty, irregular sex life, pregnancy and childbirth, menstrual disorders, abortions, premenopausal period, menopause, etc.
• Change of climatic zone.
• Constant stress.
• Unintelligible sexual relations with different partners, neglect of contraceptives.
• Any disease of the pelvic organs is infectious-inflammatory.
• Sexual infections (ureaplasmosis, trichomoniasis, chlamydia).
• Prolonged or frequent treatment with antibiotics.
• Intestinal diseases, persistent problems with stool, intestinal dysbiosis.
• Incorrect use of tampons with monthly. Not everyone knows that during menstrual bleeding when using tampons, they should be changed every two hours, even at night. This is not only uncomfortable, but it contributes to the development of excellent conditions in the vagina for the growth of various infections. Use of sanitary napkins will relieve this problem.
• It can be gardnerelles. In this case, the disease will be called gardnerellez (bacterial vaginosis). This type of disease is most often asymptomatic. Only occasionally it can show itself with itching and abundant vaginal discharge with an unpleasant fishy smell.
• Any microorganisms with pathogenic activity.

Of course, not always these factors can immediately cause bacterial vaginal vaginosis, because the immune system is responsible for maintaining the microflora in its normal state, helping it to recover in case of minor disturbance. But since the factors provoking the emergence of bacterial vaginosis are very many and they occur often enough, and the immune system can not always cope with its task, the development of the disease in women still occurs.

The mechanism of disease development.
Violation of the vaginal microflora is due to an imbalance of bacteria that live in the vagina. Normally, about 90% of useful lactobacilli (the so-called Dederlein sticks) are in the woman's vagina, about 10% are bifidobacteria, and less than 1% are the "key cells of the vagina" (leptotriks, gardnerella, fungi of the genus Candida, mobiluncus and some other representatives). It is one of the representatives of key cells that can become a causative agent of dysbacteriosis. In addition, they may be one of the sexual infections or any saprophytic pathogen (streptococci, Escherichia coli, Proteus, Staphylococcus, etc.). When there is a violation of the vaginal microflora, a significant reduction in the number of beneficial bacteria and a predominance of pathogenic microflora occur.

Microorganisms-the inhabitants of the vagina never behave in a hostile manner to the walls of the vagina, they do not allow a negative change in the ratio of beneficial organisms and pathogens. At the same time, the immune system provides active support. It is the immune system that helps restore normal microflora in non-essential disorders. But this does not always happen, unfortunately.

Any pathogen that leads to a dysbacteriosis can provoke a serious complication in the form of vaginitis or colpitis (inflammation of the vagina). The emergence of this complication occurs depending on the amount and pathogenicity of the pathogen, as well as on how strong the immunity of the walls of the vagina. Initially, the defense copes with its task and prevents the progression of the disease and its complications. However, if you do not take timely and competent treatment, then inflammation in this situation is simply inevitable.

Symptoms of the development of the disease and its main complications.
As already noted, at first the disease occurs almost asymptomatically. The changes concern the nature of vaginal discharge, but, as a rule, women do not pay much attention to this. Normally, a woman can have a slight transparent discharge without an unpleasant odor, there should be no other kind of secretions, as there should be no unpleasant sensations of dryness in the vagina during intimate intimacy, rez, itching and burning in the vagina . As a rule, with vaginal dysbacteriosis, the amount of discharge sharply increases, while they may have a whitish or yellowish hue with an unpleasant odor reminiscent of foul fish. There are no other symptoms in this disease. Itching and burning, dryness of the vagina testify to the duration of the disease and the absence of treatment, as a result of which complications developed.

In general, this disease is chronic, accompanied by periods of exacerbations and remissions. In the absence of adequate therapy, the constant infection of the uterus with bacteria from the vagina can lead to the development of inflammation of the mucous membrane of the uterus (endometritis) and its appendages (adnexitis). In addition, prolonged non-treatment can promote the development of vaginitis or colpitis, in which the discharge becomes purulent, pain and sensation in the genitals occur, and not infrequently, and a rise in body temperature. Another complication of dysbiosis can become cervicitis - inflammation of the cervix, at which pains in the lower abdomen are observed, and intimate affinity becomes very painful. In addition, with this disease, there is a constant infection of the urethra, which ultimately leads to the development of cystitis, the main symptoms of which are burning and burning with urination.

Bacterial vaginosis of the vagina during pregnancy.
Quite often pregnancy becomes the cause of exacerbation of bacterial vaginosis. Since during this period the female body undergoes huge hormonal changes, immunity decreases, nutrition and lifestyle change, then discharges, itching or burning in the sexual organs, pain during sexual intercourse, etc. may appear or increase on this background.

Since during pregnancy, in general, any drug therapy is contra-indicated, it is not possible to obtain full-value treatment. Any treatment of this disease, even if without the use of antibiotics, is always accompanied by immunocorrection, which during pregnancy is unacceptable. This is why local therapy is prescribed to eliminate the symptoms of this disease.

Reception of antibiotics after childbirth can provoke a dysbacteriosis, which is also manifested in increased secretion, dryness, itching and burning, and rubbing. Treatment of this disease in women during breast-feeding is undesirable, therefore, local therapy is prescribed, which reduces to symptomatic treatment or, in other words, elimination of manifestations of the disease. It includes sanation of the vagina and antibacterial candles. Then, at the end of breastfeeding, if necessary, the treatment is repeated using other drugs.

Bacterial vaginosis and sexual infections.
Sexual infections in any case are associated with a violation of the microflora of the vagina. The appearance of sexual infection in the vagina shifts the pH, contributing to the onset of an inflammatory reaction and even greater progression of the disease.

Sexual infection is always associated with a conditionally pathogenic microflora, so it must be taken into account in the treatment of STDs, since there may be a situation where antibiotic treatment completely kills the causative agent of STDs, while the amount of opportunistic infection only increases.

The final stage in the treatment of STDs in women should be the restoration of the microflora of the vagina. In case of serious infections or the presence of several STDs, antibiotic therapy should be performed and only then the vaginal microflora should be restored. In simple cases, it is possible to carry out a complex diagnosis of the entire urogenital microflora, after which it is possible to restore it with simultaneous elimination of sexual infection.

Bacterial vaginosis and intestinal diseases.
In the presence of severe intestinal dysbacteriosis, bacterial vaginosis should also be expected. This is due to the fact that the wall of the rectum is in close contact with the wall of the vagina, as a result of which bacteria easily pass through it. As a rule, one of the intestinal infections is sown from the vagina - E. coli, enterococci, etc.

In this case, the treatment is complex, since there is a high probability of relapse. In this case, the restoration of normal vaginal microflora is carried out with simultaneous treatment of bowel diseases.

Bacterial vaginal vagina in girls.
This disease in girls who do not yet have an active sex life, is very common, which is due to many factors: this is the instability of the hormonal background, the formation of the menstrual cycle, the anatomical features of the structure of the hymen.

Bacterial vaginosis in girls only rarely occurs with abundant secretions, since a small hole in the hymen prevents them from emerging from the vagina completely. Because of this, there is a stagnation of vaginal discharge, which sharply increases the risk of inflammatory diseases. Meanwhile, at the first intimate proximity, a large number of bacteria are thrown from the vagina into the bladder, which can provoke the so-called "cystitis of the honeymoon".

Treatment of this disease in virgin girls is hampered by the structure of the hymen, which prevents the vagina from treating the drug as much as necessary. Therefore, sometimes doctors are forced to resort to artificial violation of the integrity of the hymen (hymenectomy) to conduct optimal treatment.

Bacterial vaginosis and sexual partner.
The broken microflora of a woman when intimacy with a man does not affect his health, even without using contraceptives. Very rarely in cases of pronounced dysbacteriosis of the vagina, a man may have balanoposthitis and nonspecific urethritis. However, this happens, if a man had a clear predisposition to these diseases. Absolutely healthy male body, these inflammatory diseases are not terrible. In a completely healthy body they will not develop.

It should be noted that no partner diseases affect the vaginal microflora of a woman, except venereal diseases. Treatment of impaired microflora in a woman does not require compulsory treatment of a sexual partner, unless he has a sexual infection. Therefore, it is necessary to pass the examination to the sexual partner.

Diagnosis of the disease.
For an experienced specialist, the diagnosis of bacterial vaginosis will not be difficult. In addition to visual inspection, the diagnosis of this disease includes taking a general mask for flora, PCR diagnosis of sexual infections and sowing of vaginal discharge or special study of vaginal microflora. The smear shows the state of the microflora of the vagina and the vaginal wall, the degree of their violation and the severity of the inflammatory process, and the diagnosis of sexual infections and sowing make it possible to identify pathogens due to which a microflora disorder has occurred and to reveal the sensitivity of bacteria to antibiotics. The correct course of treatment can not be made only by one stroke.

Treatment of bacterial vaginosis should be comprehensive and include three areas:

Suppression of bacteria.
If the violation of microflora is associated with the presence of sexual infection, then the treatment should first be directed at the complete elimination of the causative agent of the infection. In this case, the treatment is to take antibiotics with simultaneous carrying out other activities. If there are no sexual infections, then antibiotic therapy is not necessary. In this situation, either a short course of antibiotic therapy is used, about three to five days, or the local use of antibiotics and antiseptics is used. Their action simultaneously performs all treatment tasks (suppression of pathogenic flora, the population of normal vaginal dwellers and local immunocorrection). And the use of antiseptics generally excludes the probability of bacteria being immune to them. Antibiotics are most often used to suppress pathogens (Amoxiclav, Sumamed, Doxacyclin, Trichopolum, etc.), local antiseptics (Miramistin, Chlorhexidine), antibacterial suppositories (Terzhinan, Ginopevaril etc.).

The population of the normal microflora of the vagina.
This item is the main one in the treatment of dysbiosis. The remaining measures are aimed at creating conditions for engraftment and growth of normal flora. However, in practice, most doctors neglect this stage of treatment. For the population of the normal microflora of the vagina, massive doses of eubiotics (preparations with live bacteria) of general and local action are used. But the use of only eubiotics to restore microflora without suppressing pathogens is simply useless.

Restoration of the immune system of the vaginal walls.
Local immunocorrection should also be one of the stages of treatment of dysbiosis, otherwise other measures taken will not have the expected effect. In simple situations for immunocorrection, as a rule, they are limited to the use of local immunomodulators (Polyoxidonium, Cycloferon, Genferon, Immunal), as well as the intake of any probiotics with lactobacilli (Lactobacterin, Linex, Narine, Normoflorin, etc. It is also recommended to include in their diet as much as possible sour-milk products.In cases with neglect of the disease, restoration of the vaginal wall immunity will require the implementation of more complex measures.

Treatment of this disease usually takes about three weeks. At the end of the course of medical therapy, a control examination is carried out, and control tests are submitted. As soon as the population of normal microorganisms recovers, some time is prescribed the use of special candles with lactic acid bacteria or substances that will maintain their balance. This is especially important for women during pregnancy, as well as for those who only plan it, since dysbiosis can provoke the birth of a premature baby and the development of infections after birth, and also create a threat of miscarriage .

According to traditional medicine, for dysbacteriosis, douches with lemon juice, diluted water, lactic acid, and tampons soaked in kefir are effective. All this contributes to the creation of an acidic environment in the vagina, without which there can be no growth and life activity of good bacteria lactobacilli.

Prevention of vaginal flora microflora.
Those who have been treated for this disease should be inspected every three months throughout the year. At the reception the patient talks about her condition, is examined and if necessary, tests are taken. If there is a tendency to disruption of microflora, then a small preventive course of treatment is prescribed. Restoration of microflora at the initial stage of its disturbance is very easy.

If within a year there are no serious problems, then you can go to the doctor once every six months. This allows us to assess and identify the presence of a tendency to relapse and to prevent developmental diseases again.