Gardnerella vaginalis: description of the pathogen and the diseases caused. Symptoms of gardnerellosis in women, the main drugs for treatment

Gardnerella or gardnerellosis is a female disease. The causative agent of the disease is considered to be the microorganism Gardnerella vaginalis. In fact, this is an imbalance of the microflora in the vagina. Bacterial vaginosis is also called gardnerellosis.

For a normal state in the vagina, the advantage of lactobacilli is characteristic. They help form lactic acid and hydrogen peroxide. This does not provide conditions for the reproduction of conditionally pathogenic microorganisms. The causative agent is opportunistic, which is always present in the vagina. Normally, there is not much of it, it is in a dormant state.

The causes of vaginal dysbacteriosis are:

douching;
some vaginal contraceptives;
change of sexual partner.

During the disease, another opportunistic microflora is activated - mycoplasma and anaerobic infection.

Regarding gardnerella, the doctor is treated as often as about thrush. According to the old qualification, this is an STI, but according to ICD 10, gardnerella does not belong to an STI. The most common lesions are the vagina, cervix and urethra.

The disease in women is characterized by the presence of scanty or copious discharge from the vagina and urethral canal. Uncomfortable sensations in the genitals, their itching and burning are characteristic. Coitus can be painful. A "fishy" odor is characteristic.

But sometimes the disease for certain women with good immunity proceeds unnoticed. They pose a risk of infecting their sex partners.

For men, damage to the urethra and the occurrence of sluggish urethritis are also possible. Perhaps the development of even chronic prostatitis or inflammation of the foreskin.

The bacterium was discovered and described in 1955. The name of one of the scientists who discovered the bacterium, G. Gardner, became the basis for the name of the pathogen.

The incubation period usually corresponds to a week - one and a half, sometimes up to five weeks.

The main cause of the disease is considered to be a decrease in the immune status of the body. It is necessary to treat, first of all, the pathology that contributed to this. You also need to adjust your lifestyle. Otherwise, gardnerella can be treated many times and a lasting positive effect cannot be obtained.

They are engaged in local treatment if bacterial vaginosis is not just dysbacteriosis, but there is inflammation in the affected organs. Correction of immunity is dangerous for pregnant women. The vagina is locally sanitized with drugs that are safe for the fetus. Such events are carried out in the second or third trimester of pregnancy.

The severity is divided into compensated, subcompensated and decompensated forms of the disease. Recurrences of the onset of symptoms of the disease are possible in the future if immunity deteriorates.

A man is more often only a carrier of gardnerella, but both a man and a woman need to be treated. But even if the couple is treated, the woman may relapse.

Treatment is aimed at the destruction of gardnerella vaginalis. Apply vaginal suppositories and tablets orally. Nutrition for gardnerellosis consists of dietary meat, sea fish and seafood, cottage cheese, dairy products, vegetables, cereals, fruits. Useful dishes from a double boiler, boiled and stewed. Frequent small meals are needed. Dishes from "heavy" meat are excluded. Fried, smoked, spicy and overly salty foods, and foods high in sugar are also excluded. The use of strong tea and coffee drinks is also limited. The use of alcoholic and sweet carbonated drinks is excluded.

Men are treated to improve their immune response and treat urethritis topically.

Treatment of gardnerella in women

Gardnerellosis in women has very poor symptoms. It is very similar in its manifestations to similar female diseases, for example, thrush.

The main signs are the presence of more often scanty, homogeneous, gray-white or yellowish discharge from the vagina with the smell of "rotten" fish. When inflammatory phenomena join, the discharge is accompanied by itching and burning in the vagina, soreness of the lower third of the abdomen and uncomfortable intercourse. The vagina and nearby organs are inflamed.

Gardnerella vaginalis itself does not cause much harm. But against its background, trichomonas, mycoplasmas, yeast-like fungi successfully develop, which can be very dangerous for the female body. So the sooner treatment is started, the better.

Gardnerella is not a dangerous sexually transmitted disease.

Very often, such bacterial vaginosis is promoted by:

a large number of sexual partners;
casual sex;
changes in the hormonal background;
douching with chlorhexidine and miramistin;
use of contraceptives with 9-nonoxynol:
chronic stress;
some antibacterial drugs.

Gardnerella needs to be treated comprehensively. Treatment consists of overcoming the imbalance of the microflora in the vagina and strengthening the immune defenses in the vagina. It is also necessary to increase the state of general immunity.

The therapy should be carried out in two stages.

During the first stage, the number of gardnerella in the vagina must be drastically reduced.

During the second - it is necessary to populate the vagina with lactobacilli. The effectiveness of the second stage is due to the quality of the first.

The first step is antibiotic therapy.

We'll talk more about drugs later.

If there are contraindications to the appointment of antibiotics (for example, the presence of pregnancy or breastfeeding, allergic reactions), then the drugs are used topically.

At the second stage, a more difficult task, you need to restore the normal microflora of the vagina. Repopulate the vagina with lactobacilli. Treatment should be not only local, but also general. Since, along with bacterial vaginosis, intestinal dysbacteriosis is also observed. The course of saturation of the body with lactobacilli lasts about one month. It is necessary to increase the overall immune status of the body. To do this, use vitamin complex preparations (such as Bomax, Vitrum, Alphabet) and preparations of natural immunomodulators (tincture of echinacea and magnolia vine).

Treatment should not take place against the background of an active sexual life, and if sex happens, then only protected. To evaluate the effectiveness of treatment, it is necessary to pass control tests.

If the gardnerella remains in the body, then the treatment is extended. If a woman who has one sexual partner falls ill again, then it is necessary to treat it from a preventive point of view. Because he is the cause of re-infection.

Even if he has no symptoms, he is a carrier.

During the first trimester of pregnancy, vaginal suppositories are used. They are safe for the developing fetus.

If necessary, apply general treatment in the second trimester.

The third trimester is characterized by the use of drugs with clindamycin. The most important thing during pregnancy is not to kill the pathogen, but to reduce its number and remove inflammation of the vagina.

Untreated gardnerellosis can cause diseases of the reproductive system and MPS of the female body.

Medicines for treatment

At the first stage of treatment, antibacterial drugs are used to combat gardnerella vaginalis.

First, be sure to conduct a test for the sensitivity of the pathogen to various drugs. It is also necessary to treat the sexual partner if PCR showed the presence of a pathogen in him. Treated with tetracyclines, lincosamides and fluoroquinolones.

metronidazole (Trichopolum);
tinidazole;
doxycycline;
clindamycin (dalacin);
levofloxacin.

Metronidazole is treated with oral tablets and vaginal tablets.

Treatment takes about ten days.

The antibacterial and antiprotozoal agent tinidazole is treated according to the course of treatment individually prescribed by the attending physician. Doxycycline (tetracycline group of antibiotics) and levofloxacin (fluoroquinolone) often treat manifestations of bacterial vaginosis in men.

Tablets for internal use - clindamycin (an antibiotic of the lincosamide group) are very good at suppressing gardnerella vaginalis. But the appointment of drugs is made only by the attending physician.

Self-medication is unacceptable.

Topically apply Miramistin solution, Metronidazole gel or Betadine vaginal suppositories.

For the prevention of gardnerella, douching should not be carried away.

Give preference to loose underwear made of good natural fiber, strictly observe intimate hygiene, and strengthen immunity. And be sure to get treated and consult a doctor. Only the doctor decides whether to continue treatment or not.

Traditional medicine against gardnerella

The first stage - treatment with antibacterial drugs prescribed by a doctor, must be completed.

At the second stage, the effect of traditional medicine preparations is good for restoring the microflora of the vagina. By regular prophylaxis, we achieve the constancy of the microflora of the vagina. But pregnant women must consult a doctor before treatment.

The first means to strengthen the immune system, at the cellular level.

On the leaves of birch, geranium, mint, celandine, thyme, flowers of pharmacy chamomile and meadowsweet, the first infusion is prepared.

The same parts of these medicines are taken. This raw material is poured with boiling water, and infused for about 6 hours. Take before meals 0.5 cup three times a day. Store refrigerated at a temperature of 4 C. Treatment takes a period of about a month. 4 times a year.

The second remedy, also to strengthen immunity at the cellular level.

Another infusion is also prepared on the grass of sweet clover, nettle, cudweed, lavender, marshmallow root and leuzea. And they also take the same portions. Infusions should be taken alternately, first in the course of the first, then the second.

Third remedy.

A walnut is used, or rather an infusion of its leaves to stabilize the amount of gardnerella vaginalis. 5 crushed raw leaves in a glass of boiling water. Or dried leaves - 1 tablespoon per 200 ml of boiling water. This infusion should be drunk little by little throughout the day. And so, about two weeks.

Fourth remedy.

Infusion of sage leaves to restore the health of the vaginal mucosa. Take this infusion between meals. 200 ml morning and evening. One tablespoon of sage is poured with two hundred milliliters of boiling water for half an hour.

If you alternately drink these infusions for a whole year, then both the vagina and the adjacent organs will be in order. These infusions are excellent prophylactic agents, and not just therapeutic ones.

In our body there is a huge number of not only harmful, but also beneficial bacteria. They live everywhere: on the surface of the skin, in the intestines, on the mucous membranes and in the vagina. Thus, almost every organ has its own individual microflora, which ensures its normal functioning. The beneficial bacteria that live in the vagina allow it to fight various infections. But quite often, the delicate balance of microflora is disturbed, resulting in more harmful microbes, the most common of which are gardnerella. This leads to the development of a disease of the same name that harms the body and requires treatment.

Definition of gardnerellosis in women

Gardnerellosis, or bacterial vaginosis, is a pathological condition in which the gardnerella microorganism predominates in the vagina. It is the smallest bacterium that, under normal conditions, also lives in the human body along with many others. It is believed that in a healthy woman, acidifying lactobacilli predominate in the vagina, which create an optimal environment. If this ratio is violated, gardnerellosis occurs with all the accompanying symptoms.

The predominance of gardnerella in the microflora of the vagina is called bacterial vaginosis.

The disease occurs both in women of all ages, and in men. Representatives of the stronger sex suffer from the disease much less frequently, since they have a smaller volume of the mucous membrane compared to girls.

How many microorganisms in a smear is considered the norm

If the number of gardnerella exceeds the allowable values, the patient begins to form the main symptoms of the disease. Under normal conditions, this bacterium can also be detected in analyzes. The following indicators are important for diagnosis:

10 5 -10 6 microorganisms in a smear of a healthy woman is considered the norm;
10 7 -10 9 - indicates a stable infection;
10 4 microorganisms in a pregnancy smear is a cause for concern.

Can gardnerella be in the mouth

If the disease exists in the body for a long enough time (six months or more), the bacteria gradually spread through the bloodstream and migrate into the oral cavity. And also infection can occur during oral sex without protection. Gardnerella settle on the oral mucosa and begin to actively grow and multiply, accumulating in the tonsils and pharynx. Often this ends with the development of inflammatory processes (stomatitis, pharyngitis, laryngitis).

Gardnerellosis of the oral cavity is accompanied by the formation of plaque on the mucous membrane

Table: difference between gardnerellosis and thrush

comparative sign	Gardnerellosis	Thrush
A type of microorganism that causes a disease	Bacterium
What do selections look like?	Greenish brown, cloudy	White, yellowish
There is a specific smell	Spoiled fish or rotten meat, sharp	Sour, curdled, barely perceptible
Number of selections	Up to 250 milliliters per day	50–200 milliliters
Increased symptoms after sexual contact	Expressed	Virtually absent
Damage to other organs and systems	Occurs extremely rarely	Oral cavity, gastrointestinal tract

Existing varieties of the disease

Classification of the disease according to the course of the pathological process:

acute (occurs when a large dose of the pathogen enters the body during sexual contact, symptoms increase in 2-3 days);
subacute (formed in one and a half to two weeks);
chronic (exists for six months);
recurrent (exacerbation phases are replaced by remission).

Varieties of the disease according to the nature of the discharge:

serous form - a yellow tint of discharge predominates;
purulent - mostly green color of the secret;
fibrinous - there are bloody streaks in the discharge.

Classification of the disease by the presence of a secondary infection:

isolated gardnerellosis;
combination with:
- chlamydia;
- syphilis;
- trichomoniasis;
- gonorrhea;
- candidiasis.

Why does gardnerellosis occur?

In order for such a disease to develop, not only the presence of a bacterium is necessary, but also some acting factors. Most often they include:

frequent change of sexual partners;
uncontrolled intake of antibacterial drugs;
daily douching;
the use of ordinary soap as a means for intimate hygiene;
visits to public places such as baths, saunas, swimming pools, gyms;
neuro-emotional shocks;
wearing tight underwear made of synthetic fabrics;
work in conditions of high temperature and humidity;
infectious diseases;
pathologies of the immune system (HIV, primary damage to the bone marrow).

Ways of transmission of the disease

The disease can occur in a perfectly healthy woman if the normal microflora of the vagina is disturbed, even if she did not have unprotected sexual intercourse. However, the leading route of infection is still sexual (oral, anal and vaginal penetration have the same risk of infection). Gardnerellosis can also be transmitted by wearing shared underwear, using under-treated sex toys.

The duration of the incubation period

On average, clinical symptoms of the disease begin to appear 2-14 days after infection. Their intensity depends on the age of the patient, her state of health and the presence of other sexually transmitted diseases.

In the elderly, in 80% of cases, the disease is almost asymptomatic, which is associated with slower metabolic processes.

Video: the doctor talks about the features of the onset of the disease

The main symptomatic signs of pathology

Bacterial vaginosis is characterized by the predominance of local manifestations over the general ones. The disease progresses extremely slowly, and an increase in symptoms is observed after a viral infection (ARVI, colds), stress, physical activity or sexual activity.

The main symptoms of the disease:

Pain in the pelvic area. It has a weak aching character, the intensity increases with urination. During the period of menstruation, unpleasant sensations intensify several times, become compressive and cramping.
Pathological secretions. They have an unpleasant odor that can be felt from several meters away, as well as a yellow, brown or green color. The secretions are quite difficult to wash off from clothes and can overwhelm a panty liner.
Swelling of soft tissues. The labia minora and clitoris swell, become extremely sensitive and sharply painful. After some time, in the absence of wiping and the use of absorbent wipes, a dark coating appears on them, which is easily peeled off.
Itching and burning during urination indicate the penetration of bacteria into the urethra and bladder. This symptom occurs in the later stages of the development of the disease.

Gardnerellosis and childbearing

With a long-term disease, the likelihood of becoming pregnant decreases every year. If conception did occur, the expectant mother faces a huge risk of infection for the baby: bacteria enter the fetus through the child's place. There is a high chance of infection during childbirth.

Symptoms of the disease during pregnancy intensify: a woman experiences unbearable itching and burning, and the amount of discharge increases to 300–350 milliliters per day. Often, during a night's sleep, the victim injures the mucous membrane of the external genital organs with her nails, which ends with the addition of a secondary infection.

I happened to participate in the delivery of a woman who had suffered from gardnerellosis for a long time. She was unable to cure the disease before pregnancy, as a result of which the baby was also confirmed to have this infection. The child was born much prematurely, as a result of which he could not breathe on his own. Doctors decided to nurse the baby in intensive care. A few months later, he began to recover, but in the future, such an infection causes a serious lag in physical and neuropsychic development from peers.

How is the disease diagnosed?

External manifestations of gardnerellosis have similar signs with many other pathologies that are sexually transmitted. This greatly complicates the diagnosis. Bacterial vaginosis has to be differentiated from:

trichomoniasis;
candidiasis;
chlamydia;
ureaplasmosis;
mycoplasmosis;
gonorrhea.

Remember that before visiting the gynecologist and taking a smear, you should not douche the vagina with antiseptic solutions. During my work in a medical laboratory, I often had to deal with the fact that women independently washed off all the pathogenic microflora, as a result, the study had to be redone again. If you want to get a reliable result, it is recommended to postpone the hygiene measures for a while. This is the only way to identify the disease at an early stage.

Ways to confirm the diagnosis:

Leading methods of treatment of gardnerellosis in women

Treatment of bacterial vaginosis is based on the normalization of the vaginal microflora. For this, doctors use not only pharmaceuticals, but also a special diet. And also in the recovery period, it is permissible to use various physiological procedures that help strengthen immunity. In most cases, the disease treatment is mandatory. Extremely rare episodes of self-elimination of the disease without medical intervention (mainly in young patients).

The sexual partner of a woman needs therapy only if he also has an increased level of gardnerella. For this, a man needs to pass special tests from a urologist (smear from the urethra).

Video: doctor's opinion on the need for therapy

Treatment of the disease with the help of pharmaceuticals

Drug therapy for gardnerellosis includes the use of both local and general drugs. The former can be used in the form of suppositories and solutions for douching, as well as in the form of ointments and gels. The latter are represented by tablets, capsules and injections for intramuscular or intravenous administration. The duration of therapy and the choice of drugs is determined by the gynecologist. Self-treatment can lead to aggravation of already existing problems in the body.

Gardnerella is sensitive to antimicrobial agents. That is why they are the first group of drugs that help to cope with the disease.

Local preparations used to combat the disease:

Candles with an antibiotic can prevent the growth of gardnerella and its further development in the body. The most commonly used drugs are:
- Metronidazole;
- Clindamycin;
- Acylact;
- Iodoxide;
- Hexicon.
Antifungal ointments and suppositories prevent the development of fungal microflora and prevent thrush from forming. For this purpose, use:
- Nystatin;
- Pimafucin;
- Levorin;
- Fluconazole;
- Flucostat.
Candles containing a large number of lactobacilli help to normalize the internal environment of the vagina. The most famous drugs:
- Lactobacterin;
- Vaginorm-S;
- Vagilak;
- Lactoginal.
Antiseptic washing agents help to remove harmful microflora. For this purpose, diluted solutions of Miramistin, Chlorhexidine, Furacilin are used.

Photo gallery: preparations for local therapy for gardnerellosis

Polygynax - suppositories with an antibiotic that affects gardnerella Clotrimazole helps prevent thrush Lactonorm promotes the growth of lactobacilli Miramistin creates conditions for the death of harmful bacteria

Systemic drugs

Medications for systemic treatment of the disease:

Antibiotics in tablets and capsules are used when local therapy has not brought the expected effect. The most common drugs:
- Azithromycin;
- Ornidazole;
- Dalacin;
- Unidox Solutab.
Non-steroidal anti-inflammatory drugs help to get rid of itching and burning, and also reduce the severity of discomfort in the pelvic area. For this purpose, use:
- Diclofenac-Sodium;
- Indomethacin;
- ibuprofen;
- Pyroxifer;
- Ortofen;
- Rodanol;
- Celecoxib;
- Rofecoxib;
- Viox;
- Celebrex;
Immunostimulants improve the recovery processes in the body, promoting the formation of new cells. The most famous medicines of this group:
- Viferon;
- Wobenzym;
- Amiksin;
- Polyoxidonium;
- Tsitovir.

Photo gallery: drugs for systemic therapy of gardnerellosis

Doxycycline is an antibiotic that kills gardnerella Meloxicam relieves inflammation Immunal helps to strengthen the immune system

Traditional medicine as an aid

Quite often, patients do not have the opportunity to immediately consult a doctor (business trip, vacation), or a doctor's appointment is scheduled after a few days, and discomfort continues to overcome. In these cases, the use of traditional medicine is acceptable. Various douches and tampons will help get rid of the main manifestations of the disease and make it easier to wait. Remember that such treatment will not completely solve the problem, since pharmaceutical preparations are necessary to restore normal microflora.

I happened to encounter a patient who completely abandoned traditional therapy, preferring to use herbs and plants in order to eliminate bacterial vaginosis. Regular douching with high-dose solutions led to the fact that the patient not only did not cure gardnerella, but also acquired a serious chemical burn of the vaginal mucosa. The victim was taken by ambulance to the gynecology department, where she underwent reconstructive plastic surgery. Unfortunately, as a result of this procedure, the woman has lost her sensitivity and is experiencing problems with her sexual life.

The most popular folk recipes:

Table: physiotherapy in the treatment of the disease

Method name	How is the procedure carried out	Main Effects
Radon baths	Immersion of the patient waist-deep in water enriched with this chemical element	Causes the death of most pathogenic microorganisms, while not damaging the normal microflora
	Point impact of the smallest impulses on certain parts of the body	Helps accelerate the recovery and regeneration processes in the human body
Medicinal electrophoresis with anti-inflammatory drugs	The introduction of drugs into the body with the help of current	Faster and more efficient administration of the substance and its distribution in soft tissues
inductothermy	Application of magnetic fields of different intensity	Reducing discomfort, preventing the formation of adhesions

Photo gallery: physiotherapy in gynecology

Radon baths cause the death of pathogenic microbes Electrical stimulation accelerates the formation of new cells Medicinal electrophoresis is used to administer anti-inflammatory and antibacterial agents.

Changes in diet and lifestyle in gardnerellosis

To restore the normal microflora of the vagina, doctors recommend that women follow a certain diet. To do this, you must adhere to the following rules:

use only fresh and natural products without chemical additives (you can buy on the market or from private sellers);
Be sure to have breakfast, lunch and dinner. There should also be two snacks so that the breaks between meals do not last longer than three hours;
drink up to one and a half liters of pure water daily;
stop drinking alcohol;
bake, stew or boil food so that vitamins are preserved in it;
do not eat sweets, as they contain a lot of fast carbohydrates and sugars, which create an optimal environment for the reproduction of bacteria;
reduce the amount of salt to 5 grams per day.

What foods must be included in the diet:

Rules for women for the period of treatment

During the treatment of gardnerellosis, you will have to slightly change your usual lifestyle and give up some habits until you fully recover. Do not forget that following these rules will help you achieve positive results in just a few weeks. What is not recommended for bacterial vaginosis:

epilate bikini and perineum - these procedures are stressful for the body;
visit baths, saunas, lie in a hot tub or jacuzzi for a long time;
have sex - there is a risk of infecting a partner;
drink antibiotics on your own;
wear tight underwear;
swim in open water and pools.

Treatment prognosis and possible adverse effects

Therapy of gardnerellosis is an extremely complex and lengthy process. Often, it takes a very long time to restore normal microflora, and some women quit treatment before even reaching half. Remember that rehabilitation after such a disease is much slower with the following ailments:

diabetes;
hypertension;
phlebeurysm.

In adolescent girls and young people, gardnerellosis disappears with practically no visible consequences if therapy is started in a timely manner. In older women and the elderly population, due to slow metabolic processes, rehabilitation lasts up to several years.

The disease is prone to recurrence. A cure does not guarantee that in a couple of months or years you will not have gardnerellosis again.

Compliance with the rules of personal hygiene plays a special role in restoring the normal microflora of the vagina. During the treatment period, it is extremely important that you have the opportunity to clean the perineum every few hours and change the pads. I happened to participate in the treatment of a patient who spent twelve hours at work in a hot shop. She practically did not have the opportunity to wash herself, and in the hot season, even despite the ventilation, the temperature in the room was high, as a result of which the woman was constantly sweating. Excessive formation of sebum contributed to the appearance of itching and burning, and all ongoing therapy for gardnerellosis was useless. Only after the patient managed to take a vacation for two months and go to a sanatorium, the treatment became effective. Sea water and warm air, combined with pharmaceuticals and good hygiene, helped the woman forget about her illness.

What complications and negative consequences occur in patients with gardnerellosis:

problems with conception - an altered microflora causes the death of spermatozoa when they do not have time to reach the egg;
the formation of adhesions - growths of connective tissue in the pelvic cavity, which disrupt the normal attachment of the embryo in the uterus;
long-term infertility of a different nature;
inflammatory diseases of the pelvic organs: uterus, tubes, ovaries, bladder and urethra;
decreased immunity;
intrauterine infection of the fetus;
the penetration of bacteria into the body of the child during childbirth.

Photo gallery: complications of the disease

Long-term jaundice indicates infection of the newborn Inflammation of the ovaries occurs when the microflora penetrates from the vagina The adhesive process is characterized by the growth of connective tissue and disrupts the processes of conception and fetal development.

How to protect yourself from developing the disease

Treatment of gardnerellosis requires a large amount of effort and money. That is why it is much easier to protect your body from the development of such a disease than to undergo a course of therapy. To this end, doctors have developed rules for individual prevention of the disease.

During my fourth year at the Medical University, I had the opportunity to do an internship at the Department of Gynecology in Serbia for several months. At this time, doctors were just conducting a study on the prevention of bacterial vaginosis by taking lactobacilli and dairy products. For the study, a group of patients was selected who throughout their lives in the winter season faced with garnerellosis and its unpleasant consequences. More than half of them had problems with immunity (often got sick, caught a cold). Throughout the autumn, doctors recommended that they take certain tablets with a high content of Latobacteria, and the women added dairy products (cheeses, sour cream, sourdough) to their diet, which they consumed several times every day. With the approach of cold weather, the doctors took the necessary tests from the patients - swabs from the vagina. In 95% of the studied patients, practically no gardnerella was observed in the material. Another 5% admitted that they did not always strictly follow the recommendations of doctors and consumed alcoholic beverages. Thanks to this technique, most of all the victims were able to forget about their disease forever.

Rules for individual prevention of gardnerellosis in women:

Bacterial vaginosis is a disease that often occurs in sexually active women. In the vast majority of cases, pathology appears under the influence of bacteria Gardnerella vaginalis (Gardnerella vaginalis). Strictly speaking, gardnerellosis is not classified as a sexually transmitted infection, however, sexually transmitted diseases provoke the development and aggravate the course of bacterial vaginosis of a similar etiology.

Gardnerella is a conditionally pathogenic microorganism, that is, it is present in small quantities on the mucous epithelium of the vagina. Taxonomically, these pathogens are classified as facultative anaerobic flora. In other words, their life cycle proceeds without access to oxygen, however, unlike other anaerobes, gardnerella can also tolerate aerobic conditions.

Outwardly, gardnerella are similar to small sticks with oval ends, their size rarely exceeds 1.5 microns. Previously, pathogenic microorganisms Gardnerella were considered representatives of the genus Haemophilus (they were called Haemophilus vaginalis).

However, in the mid-1980s, they were proven to belong to the Bifidobacteriaceae family. The vast majority of cases of Gardnerella are Gram-negative, although a Gram-positive stain is occasionally possible.

"Inhabiting" the mucous epithelium of the vagina, lactobacilli, as a result of the destruction of glycogen, produce lactic acid. It determines the pH value in the range of 3.8 - 4.5, which prevents the reproduction of various microorganisms. In addition, lactobacilli have an enzymatic effect, so their level serves as a kind of indicator of the state of the female genital organs. Bacvaginosis develops against the background of the replacement of microorganisms of the genus Lactobacillus by an association of pathogenic or conditionally pathogenic bacteria.

Gardnerella vaginalis produces specific catabolites that inhibit the functional activity of local immunity and leukocytes. As a result, bacteria penetrate deep into the vaginal mucosa, affect the overlying sections of the genital tract, and spread to the urinary tract. In addition, the development of gardnerella contributes to the reproduction of other flora (staphylococci, streptococci, klebsiella, E. coli, klebsiella, etc.).

Bacterial vaginosis provoked by gardnerella is the most common infectious disease among sexually active women aged 18-45 years. According to different authors, the incidence of such an infection ranges from 30 to 80% in the structure of inflammatory diseases of the genital organs in the fairer sex. Such inaccuracy in the numbers is due to the fact that in a third of women gardnerellosis is asymptomatic.

Gardnerella vaginalis: transmission routes, factors provoking the development of pathology

Some doctors are inclined to believe that gardnerellosis is sexually transmitted. However, in this case, the question of the presence of these bacteria in a small amount in the vagina of girls and virgin girls remains open. Therefore, experts believe that this disease can be safely attributed to polyetiological.

The following factors contribute to the appearance of pathological concentrations of gardnerella vaginalis:

promiscuity, especially without the use of proper protective measures (condoms);
concomitant sexually transmitted diseases (trichomoniasis, chlamydia, gonorrhea, etc.);
a variety of therapeutic and diagnostic intravaginal manipulations (douching, especially if it is therapeutically unreasonable, colposcopy, etc.);
abortions;
taking drugs that impair the functioning of local immunity (corticosteroids, antibiotics and fungicides, including local action in the form of ointments and suppositories, cytostatics, chemotherapy);
extragenital diseases that negatively affect the state of the immune system;
improper diet with a predominance of too sweet foods and a deficiency of sour-milk products;
use of topical spermicides;
the use for hygiene purposes of pads, tampons, intimate products with too high a content of synthetic perfumes and allergens;
wearing tight underwear with a synthetic gusset;
hormonal disorders caused by both natural causes (pregnancy, childbirth, breastfeeding period), diseases or taking appropriate medications;
chronic fatigue, emotional overstrain and exhaustion;
diseases and conditions accompanied by a violation of the microflora of the digestive and genitourinary tract;
malformations and anatomical features of the structure of the vagina;
insufficient personal hygiene;
foreign bodies in the vagina and uterus (spirals, caps, etc.).

Infection with gardnerella vaginalis does not occur through sexual contact. However, the development of this disease is closely related to the characteristics of sexual relationships. The risk of bacterial vaginosis increases with an early onset of sexual activity, the presence of a large number of sexual partners, a high frequency of urogenital, rectogenital sexual contacts, etc.

Gardnerella infection: symptoms in women, diagnostic methods, possible complications

Symptoms of bacterial vaginosis provoked by Gardnerella are nonspecific. Many sexually transmitted diseases (for example, chlamydia, trichomoniasis) can occur under the guise of gardnerellosis. The incubation period of infection is from 3 to 10 days, but on average - a week.

Symptoms characteristic of the pathology are:

quite abundant, sometimes foamy discharge from the vagina, at the initial stages of the disease they are homogeneous, gray-white in color, but later acquire a thicker consistency and a yellowish tint;

the characteristic unpleasant smell of stale fish, it intensifies after sex, during menstruation, after washing with soap, such a sign is due to the breakdown of amino acids produced by anaerobic gardnerella;
itching and burning, but only a third of women with bacterial vaginosis complain of these symptoms.

The occurrence of an unpleasant "fishy" odor from the vagina, combined with abundant discharge, is the reason for contacting a gynecologist.

Diagnostic criteria for gardnerellosis are:

plaque, evenly covering the mucous membrane of the vagina and external genital organs, while pathophysiological signs of the inflammatory process occur extremely rarely;
pH values above 4.5 after carrying out pH-metry separated by the vaginal epithelium;
a positive amino test result, this is one of the express diagnostic methods, which is carried out by mixing a vaginal smear with a 10% potassium hydroxide solution on a glass slide, in the presence of gardnerella, a strong smell of rotten fish appears;
detection of cells characteristic of bacterial vaginosis after microscopy of a Gram-stained smear from the vagina.

Instrumental methods for detecting the disease supplement the data of the anamnesis and complaints of the patient. Gardnerella infection requires differential diagnosis with other urogenital pathologies caused by gonococcus, trichomonas, chlamydia, opportunistic microorganisms. For this, PCR tests are prescribed to detect the DNA of bacteria.

Without appropriate treatment (and sometimes against the background of drug therapy), gardnerellosis is prone to a chronic relapsing course. So, six months after the first episode, the symptoms of bacterial vaginosis reappear in a third of patients, and within a year - in 50 - 70% of women. Such violations of the composition of the physiological microflora of the vagina often leads to persistent recurrent candidiasis and other lesions of the urogenital tract. Sometimes gardnerella is also found in the bladder in the process of identifying the causes of cystitis.

In recent years, information has appeared that anaerobic pathogens of bacterial vaginosis secrete nitrosamines. They serve as coenzymes of carcinogenesis and can cause dysplastic and dystrophic processes in the cervix. They, in turn, can cause a variety of pathologies, including malignant cell transformations.

Gardnerellosis in women: features of the course and therapy during pregnancy, manifestations of the disease in men

Often, bacterial vaginosis, provoked by bacteria of the genus Gardnerella, occurs during pregnancy. As a rule, this is due to concomitant changes in hormonal balance. For early detection of pathology, regular gynecological examination is mandatory, especially in women at risk (with previous or concomitant sexually transmitted infections, chronic inflammatory lesions of the genitourinary system, etc.)

But to date, a clear connection has been established between the development of such a disease and infertility, an unfavorable outcome of pregnancy, the threat of miscarriage, and premature birth. In addition, in the absence of therapy, gardnerellosis is dangerous for early rupture of amniotic fluid, intrauterine infection of the fetus, and various inflammatory lesions of the uterus in the postpartum period.

Therefore, with the appearance of secretions of a characteristic consistency and with a specific odor, it is necessary to urgently begin therapy. Most medications for bacterial vaginosis are contraindicated in the first trimester. Therefore, at this stage, even doctors recommend using folk remedies.

Starting from the second trimester, gardnerellosis in women is treated with:

Clindamycin (Dalacin, Clindamycin) in the form of a cream or suppositories of 5 g or one piece, respectively, at night for 3 to 5 days;
Metronidazole (Metrogil, Metrovagin, Trichopolum, Trihosept, Flagyl) cream (0.75%), suppositories - 2 times a day intravaginally or tablets of 0.5 g twice a day, the course of therapy is 5 - 7 days.

In men, gardnerellosis is usually asymptomatic. As a rule, representatives of the stronger sex are carriers of the infection. However, if immunity is weakened as a result of any diseases or medications, there is a risk of developing bacterial urethritis (inflammation of the urinary canal) or balanoposthitis (damage to the head of the penis, foreskin).

Similar pathologies are manifested in the form of burning during urination, discharge with an unpleasant odor from the urethra. Often note the appearance of a grayish-white sticky coating on the glans penis, redness and slight swelling of the skin in the area of the foreskin.

How to treat gardnerella: drug and alternative therapy, restoration of local immunity, methods of prevention

Anaerobic pathogens of bacterial vaginosis are highly sensitive to various antibacterial drugs from the group of fluoroquinolones, penicillins (but only in combination with clavulanic acid), macrolides. Tetracycline antibiotics (for example, Minocycline) are less active against Gardnerella. However, most experts believe that the use of potent antimicrobial agents for the treatment of uncomplicated vaginosis is unjustified.

Therefore, first-line drugs are:

Nitroimidazoles(Metronidazole, Ornidazole, Tinidazole). They are used orally, intravaginally in women and topically in men. Dosage and duration of treatment is determined individually. As a rule, take Metronidazole (or its analogues under other trade names) 2.0 g once or 0.5 g twice a day for a week. Ornidazole drink 0.5 g twice a day for 5 days, Tinidazole - 2.0 g once. Preparations of this group in the form of suppositories or ointments are used twice a day for 5 days.
Lincosamides. Of the drugs in this class, clindamycin is the most effective. It is applied topically (applied to the glans penis or inserted into the vagina) once a day at night for 6 days. Oral administration of 0.3 g twice a day for a week is possible.

Additionally, doctors emphasize that metronidazole is absolutely incompatible with alcohol. Therefore, it is necessary to refrain from taking alcoholic beverages for the entire duration of treatment and for 24 hours after its completion. Clindamycin creams and suppositories can damage the latex used in condoms and vaginal diaphragms. Therefore, during therapy with this drug, it is better to give up sexual life (sexual contacts with gardnerellosis without a condom can aggravate the course of the disease).

Some patients prefer to treat bacterial vaginosis and urethritis with alternative medicine methods.

Pour 3 tbsp. dry herb celandine with a liter of boiling water, squeeze a few cloves of garlic, insist for 3-4 hours, strain and use for douching.
Pass pine and juniper needles through a meat grinder (take in a ratio of 1: 1), squeeze out the juice from the resulting slurry, moisten a regular swab in it and insert it into the vagina overnight. To increase the effectiveness of treatment, alternate with gauze or cotton swabs soaked in a mixture of onion and horseradish juice. The course of therapy lasts 12 days.
Mix 10 g of lavender herb, bird cherry flowers and Chernobyl, 20 g of calendula herb, sage and cudweed, oak bark, birch leaves, 30 g of chamomile flowers. Pour two tablespoons of the mixture with a liter of hot water, wrap the dishes with a towel, leave for 2-3 hours, strain and douche at night for 2 weeks.
Buy yarrow and eucalyptus tinctures at the pharmacy, mix and drink 25 drops in 50 ml of water three times a day on an empty stomach.
Mix equal proportions of mistletoe and yarrow herb. Brew a couple of spoons with half a liter of boiling water, insist overnight and strain. Can be used for douching or taken orally 1 tbsp. three times a day.
Grind a tablet of Trichopolum into powder, add a teaspoon of honey and the same amount of onion gruel. Apply the resulting mass to a swab and insert into the vagina at night. Alternate with tampons with calendula ointment (available at the pharmacy).
A tablespoon of tansy baskets is poured with a glass of boiling water, simmer in a water bath for 15 minutes, cool to room temperature and strain. The solution is used for douching.
Mix in equal proportions black poplar buds, calendula and chamomile flowers, eucalyptus and bird cherry leaves. Take 2 - 3 tablespoons, pour a liter of boiling water, insist overnight and strain. First, douche with this solution, then insert a swab with lanolin-based propolis ointment into the vagina (if it is not in the pharmacy, you need to mix 10 g of crushed propolis and melted lanolin). The duration of treatment is 2 weeks. In parallel, you can drink a decoction of wormwood.
Pour a tablespoon of bird cherry fruits with 300 ml of boiling water, boil over low heat for 20 minutes, cool and strain. Drink 1/3 three times a day half an hour before meals. Also, this solution can be used for douching.
For men, for the hygiene of the penis, the following composition is recommended: half a liter of chamomile decoction, 1 tbsp. soda, 5 drops of potassium permanganate and 2 drops of iodine.

However, treatment does not guarantee re-infection. Its likelihood increases if provoking risk factors are not excluded. You can increase the activity of local immunity with the help of drugs designed to restore the normal composition of the vaginal microflora. They are used both in the form of suppositories and in the form of tablets.

In order not to face the problem of how to treat gardnerella, it is better to engage in the prevention of infection in a timely manner. It is necessary to minimize the wearing of tight synthetic underwear and clothing, especially in the hot season. Panty liners and sanitary pads should be changed at least every three hours. Too frequent and unnecessary douching should also be avoided. In addition, you must adhere to the rules of safe sex and use condoms.

Content:

Gardnerella (bacterial vaginosis) is a very common infection these days. According to statistics, more than 20% of sexually active women suffer from this disease.

The thing is that gardnerella is always present in the microflora of the female genital organ.

But with a sharp increase in the number of these bacteria, the vaginal microflora is disturbed, which leads to the development of infection.

The question of whether this type of vaginosis is precisely the disease that, like many, is sexually transmitted, still does not have a clear answer from physicians. However, bacterial vaginosis requires immediate treatment, and this is not even discussed.

Gardnerella itself is not pathogenic, but it leads to the emergence of other pathogens that are more dangerous to women's health. Gardnerella performs the function of preparing the soil for harmful microorganisms. When these microorganisms begin to multiply at an accelerated pace, the products of their metabolism adversely affect not only the vagina, but also penetrate the urethra.

The disturbed microflora for gardnerella is the cause of occurrence No. 1. Bacteria that have grown in such a “favorable” environment cause inflammation.

Is bacterial vaginosis contagious?

Of course. It is patients who are very actively sexually active who most often encounter this disease. You can avoid the transmission of vaginosis by using contraceptives, especially if you are starting a relationship with a new partner. This statement does not mean at all that a man is “contagious”. It is possible that the microflora of a man will be alien to your body. This will lead to dysbacteriosis, and then to gardnerellosis.

Treatment of this disease is no different from other sexually transmitted infections. Regardless of the confirmation of the disease, both partners must undergo a full course of treatment with the drugs prescribed by the doctor, one of them.

It is possible to get sick with gardnerellosis, even if there was no fact of infection as such. The disease can develop due to the use of antibiotics or topical contraceptives. Many cases of gardnerella development have been recorded after taking the following drugs: Terzhinan, Betadin, Polygynax.

It is possible to disrupt the microflora of the vagina with prolonged stress, diets, and intense physical and emotional stress.

Symptoms of gardnerellosis

Every woman should know the first signs of the onset of the disease, because it is necessary to start treatment and take special drugs as early as possible.

Symptoms of gardnerellosis in women are much more noticeable than in the representatives of the stronger sex. Vaginal discharge may be yellow, green, white, clear, or white-gray. They have a uniform consistency, creamy or watery, often foamy.

The labia swell, redden, itching and burning appear during urination or during sexual intercourse. The main symptom of the disease is the smell of spoiled fish.

In addition to secretions, gardnerella in women cause an internal inflammatory process, which also entails itching, pain and burning in the vagina.

In men (in 90%), gardnerella does not cause any discomfort. In rare cases, the presence of the disease can be judged by painful urination. Even less often there are abundant discharge from the penis, burning and itching.

If any minor symptoms of gardnerellosis appear in women, it is recommended to immediately consult a doctor. Experts say that it is possible to cure the disease the first time only at an early stage of development.

Complications and consequences of the disease are varied.

Urethritis, prostatitis, infertility threatens men. And women often develop inflammatory diseases of the pelvic organs. The vulva, the vagina, the cervix - everything is at risk. The result is endometritis and adnexitis, which will bother you all your life.

If we talk about the consequences that appear immediately, then this is a sharp decrease in immunity and a high risk of diseases of the genitourinary system.

Gardnerellosis is often found in pregnant women. Often a woman becomes infected even before the conception of a child, and during pregnancy, pathogenic microbes exacerbate. The reasons are as follows: during pregnancy, the immune defense of the body drops sharply and hormonal changes occur. These factors affect the microflora of the female vagina, and if a girl has a minimal risk of getting gardnerellosis, the body does not act to the benefit of the hostess.

Diagnosis of the disease

Nowadays, gardnerella in women can be detected at the initial stages, fortunately, this is possible for every specialist. Women at the first suspicion should immediately contact a gynecologist, and men - a venereologist or urologist.

First, the patient is examined, the symptoms are evaluated. The most common complaint is discharge with a strong unpleasant odor. If the symptoms of gardnerella are not so well expressed, then a laboratory analysis is carried out, which allows you to identify the pathogen.

The analysis is a general smear with microscopy. Examining the cells of a sick person under a microscope, you can see a thick layer of microbes, which indicates the fact of the disease. Another analysis to confirm the disease is the measurement of the pH of the vaginal environment. You can finally make a diagnosis after a reaction to isontril (exactly the substance that emits a terribly unpleasant odor).

If the diagnosis is confirmed, ask the doctor to conduct an examination for the presence of inflammatory processes in the vagina (sowing of vaginal discharge, analysis for dysbiosis, PCR).

Gardnerellosis in women during pregnancy is the most common disease, but do not despair, the main thing is to cope with the disease in a timely manner. Drugs for treatment must be prescribed by a doctor, since many drugs are prohibited, including antibiotics.

Usually, doctors prescribe the following drugs for treatment: Metronidazole, Clindamycin. Both one and the other drug is available both in the form of a gel for external use, and in the form of tablets. Treatment and dosage of the drug is prescribed by the attending physician. It should be remembered that these drugs are incompatible with alcohol. After completing the course of treatment, take the tests again, and then monitor your health and prevent relapses.

Prevention of the disease is quite simple:

Take good care of your health.
Strengthen your immune system.
Lead a healthy lifestyle (do not overwork, eat right).
Avoid casual sex.
Use condoms.
Within 2 hours after the "suspicious" sexual intercourse, use antiseptics.
Avoid douching and drugs containing 9-nonoxynol (contraceptives).

Constantly monitor your genitals, keep them perfectly clean. At the first appearance of any symptoms, consult a doctor, do not self-medicate!