Flora change. Methods for restoring the vaginal microflora. Weakness and fatigue

The microflora of the vagina is the conditions intended for the favorable development of the functions of the female reproductive system. Normally, it maintains a constant balance with the environment, preventing the development of infectious processes and changes in the quantitative ratio of microorganisms in the vaginal environment.

Violation of the microflora of the vagina, or dysbiosis, has experienced a large part of the female population. Few of the women did not experience all of his "charms". Although most often the symptoms of this pathological condition are not very significant, nevertheless, in some cases, this violation can cause serious problems.

Causes that can disrupt the environment

There are many reasons that can lead the vagina to a state far from normal. It seems there is no effect that is not capable of harming the female body. The most common are the following:

Of course, not always these factors are able to make significant changes in the microflora, immune protection serves as a reliable barrier against the undesirable effects of microorganisms and contributes to its recovery in case of minor damage. However, the environment, unfavorable ecology and many other reasons, sooner or later, are still able to unbalance the microflora and cause the development of dysbacteriosis.

Symptoms of disturbed microflora in the vagina

Ideally, women have an ideal microflora in the vagina, consisting mainly of lactobacilli and 1/10 of bifidobacteria and key vaginal cells and a constant balance between the internal and external environment. This condition is controlled by the immune system, which suppresses every harmful environmental impact and creates favorable conditions for the vital activity of natural lactobacilli. But the efforts of immune defense are sometimes not enough, and in some situations, pathological microorganisms still enter the vagina and begin their activity in it.

When the microflora is disturbed, the balance of the number of natural inhabitants of the vaginal environment changes in the vaginal environment: lactobacilli and bifidobacteria and foreign microorganisms. They can be any pathogens of sexual infections, representatives of key cells or other bacteria. Each of them is capable of causing diseases of a different nature, which will also have to be disposed of using individual methods.

The situation is complicated by the fact that these bacteria, which caused the onset of dysbiosis, aggressively affect the walls of the vagina, thereby contributing to the occurrence of vaginal inflammation-vaginitis. Sooner or later this will happen, depends on the ability to counteract the protective forces of the vagina to the force of the onslaught of pathogenic microorganisms and bacteria. Most often, the initial period allows the immune system to safely hold such pressure for some time, preventing the development of the disease. However, in the absence of correct and timely therapeutic measures, protection, as a rule, does not last long.

The role of lactobacilli in the vaginal environment

For a long time, it was believed that the only beneficial bacteria that maintain a normal vaginal environment are lactobacilli. However, modern medicine has proven that up to 40% of healthy women contain a small number of these microorganisms. The new concept of an ecosystem is based on the inclusion of many nuances, including microorganisms of an opportunistic nature. About ten different lactobacilli and bacteria similar in value to lactobacilli can peacefully coexist in the body of women. Lactobacilli perform a stimulating role of the immune system and ensure the correct ratio of the bacterial norm of the vagina, preventing an excessive increase in the representatives of the pathogenic flora. As a rule, in every body of women there is one type of lactobacilli, and only 8% have several of their species.

Also, bifidobacteria perform an important function in the formation of immune defense; during the life of bifidobacteria, organic acids are formed that contribute to the restoration of a normal environment that does not allow the reproduction of pathogenic microflora.

Development of change

At the initial stage, the disturbances occurring in the microflora do not manifest themselves as any obvious symptoms. Vaginal discharge changes slightly, their number increases, they are accompanied by soreness and the appearance of an unpleasant odor. As dysbiosis develops, the discharge changes in color, they become more yellow. The rest of the unpleasant symptoms that are present during the development of dysbacteriosis are more related to the complications caused by it.

Violation of the microflora of the vagina in pregnant women

When pregnancy occurs, the main forces of the body are aimed at the development of the fetus, so this condition can cause an exacerbation of dysbacteriosis. The state of pregnancy can increase the amount of discharge, cause itching and burning, painful intercourse due to vaginal dryness, and much more. The reason for such violations in the ongoing hormonal changes in the body of a pregnant woman, which properly affects the immune defense and the microflora of the vagina.

The situation is complicated by the fact that during pregnancy it is impossible to carry out a full-fledged treatment, since any preparations for the immune correction of the vaginal environment cannot be used during pregnancy. Therefore, in order to alleviate the condition of a pregnant woman, only methods that eliminate the symptoms of complications are used as a treatment for her.

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Violation of the microflora of the vagina at least once in a lifetime worried any woman. Girls who have never had a sexual life also face this disease. The disease is asymptomatic, but can cause the most severe consequences, accompanied by an inflammatory process. Gynecologists call pathology dysbiosis or dysbacteriosis.

What is dysbiosis?

Dysbiosis is defined as a violation of the microflora of the vaginal environment. If it is not treated, the disease will progress, causing a number of the most negative consequences.

Violation of the microflora of the vagina at the first stage does not manifest itself. They change only to a slight extent. In a normal state, a woman does not have them, and if they do, then in small quantities. With a healthy microflora, there is no pain, pain, smell, burning sensation, dryness during intercourse and discomfort.

An unpleasant smell, an increase in the number indicate the presence of such a pathology as a violation of the microflora of the vagina. Why is this happening? This will be discussed further.

The normal microflora consists of 90% lactobacilli and 9% bifidobacteria. The remaining 1% falls on which rarely provoke any disease. A woman's body easily tolerates minor changes, especially with good immunity. With serious violations, where the number decreases, and the percentage of opportunistic microorganisms grows, the reproductive system may fail. As a result, such harmful bacteria as fungus, gardnerella, streptococcus, Proteus, E. coli, chlamydia, etc. multiply. Vaginal dysbacteriosis occurs and, as a result, an inflammatory process. The immune system continues to fight pathogenic bacteria, but in the absence of treatment, the protective functions of the body no longer give the desired effect.

The most common types of diseases include:

• bacterial vaginosis;
• candidiasis;
• thrush.

If dysbacteriosis occurs in a latent form, then severe symptoms are rarely observed. Without tests and examination by a doctor, it can be difficult to recognize a disease in this form. Therefore, women are advised to visit a gynecologist twice a year.

Causes of violation of the microflora of the vagina

There are many factors that influence the appearance of dysbiosis:

• Single and constant hypothermia, which reduces immunity and contributes to the development of dysbacteriosis.
• Change in hormonal background. Unsystematic sex life, menopause, pregnancy, childbirth, abortion, menstrual irregularities, etc.
• Change of climatic zones.
• stressful situations.
• Chaotic sex life. Frequent change of sexual partners. Ignoring methods of contraception.
• Inflammatory and pelvic.
• Infections acquired after sexual intercourse.
• Prolonged antibiotic treatment.
• Intestinal diseases.
• Incorrect insertion and use of menstrual tampons.

All these and other reasons cause a violation of the microflora of the vagina.

Symptoms of the disease

They will help in time to recognize the violation of the microflora of the vagina, the symptoms of the disease. Although in many cases, especially at the initial stage of the disease, they are simply absent. If the bacteriosis began to progress, there may be:

• highlighting white and yellow;
• bad smell;
• discomfort in the genital area;
• dryness during sex;
• burning, itching and pain in the genital area.

These are the main signs of a violation of the microflora of the vagina. If dysbiosis is not treated, endometritis, inflammation of the appendages, cervix, or vaginal walls may occur. If the infectious process has affected the genitourinary organs and the urethra, then, as a rule, cystitis or urethritis develops.

Violation of the microflora of the vagina during pregnancy and after childbirth

Pregnancy, hormonal changes can provoke an acute stage of vaginal dysbiosis. During the period of bearing a child, the symptoms of the disease worsen. There is an abundance of discharge, an unpleasant odor, itching and burning in the genital area, and pain during sex.

Many drugs are contraindicated for women during pregnancy, so it is not possible to conduct a full-fledged treatment here. All actions are directed only to the temporary elimination of symptoms, and the necessary treatment with antibiotics is carried out after delivery.

There may be a violation of the microflora. How to treat the patient in this situation? This question is decided only by the doctor. Often, young mothers are diagnosed with thrush, which is caused by a yeast-like disease. This process is influenced by hormonal changes in the body, as well as a number of medications that the woman giving birth was forced to take.

In this case, therapy is carried out with antifungal agents in combination with probiotics, which have a positive effect on the vaginal microflora and prevent the secondary appearance of the disease.

Vaginal dysbacteriosis and sexual partner

Often, the imbalance of the microflora of the vagina does not affect the sexual life of a woman and does not cause any special problems for the sexual partner. An exception is the advanced stage of dysbiosis. In this case, a man may develop signs of balanoposthitis or nonspecific urethritis, and then only if the stronger sex has a predisposition to the disease.

As a rule, diseases of the sexual partner do not affect the woman's vaginal environment, of course, we are not talking about sexually transmitted diseases.

Treatment of vaginal dysbiosis is carried out only in women, without involving a partner, unless the pathology is caused by a sexual infection.

If STDs occur, they are accompanied by severe dysbacteriosis. Cause imbalance in the vaginal environment. They provoke the appearance of an inflammatory process and disrupt the microflora of the vagina. However, there are no situations where the causative agent is only a sexually transmitted infection. Always the disease is accompanied by negative changes in this should be taken into account in the fight against the disease. Here, taking antibiotics alone is unlikely to help, since it will not restore the normal level of microflora.

The course of treatment should always end with probiotics that restore the vaginal environment. Serious problems caused by chlamydia and Trichomonas are solved by antibiotic therapy, after which the restoration of microflora is necessary. These courses should be separated and run one after the other.

In situations where the disease has a mild form, it is necessary to carry out urogenital diagnostics. And you can restore the necessary background simultaneously with the elimination of sexual infection.

Dysbacteriosis in girls

Violation of the microflora of the vagina occurs even in girls who have never had sexual intercourse. A variety of factors come into play here. This is hormonal changes in the body during puberty, and features of the structure of the hymen, and non-compliance with the rules of hygiene (including improper washing of the genitals), and taking antibiotics and other drugs. The reasons in this case are similar to the factors contributing to the development of dysbacteriosis in women who have an active sex life. But there are also nuances.

Unlike women, girls rarely experience heavy discharge, since the hymen does not allow them to leave the vagina in full. A certain part of them accumulates in the small pelvis, which causes an inflammatory process. Also, at the beginning of the development of sexual life in girls, a lot of bacteria enters the urethra from the vagina, which can cause “honeymoon cystitis”.

Therapy of dysbacteriosis in virgins is quite complicated, since the hymen does not allow for a thorough treatment of the vagina. In some cases, even hymenectomy is indicated, in which there is a violation of the hymen.

Development of dysbiosis and the intestinal environment

Often, some diseases of the stomach and intestines lead to a violation of the microflora both in the intestinal walls and in the vagina.

The rectum is in close contact with the vaginal cavity, as a result, bacteria freely pass through the walls of the organs. When intestinal dysbacteriosis develops and progresses, the bacteria (E. coli, enterococci, etc.) that cause this disease easily penetrate the walls of the vagina, where they also disturb the background. What to do in such a situation? Of course, contact a specialist, in no case resorting to "amateur" and the help of folk remedies.

Treatment of a violation of the microflora of the vagina in this case is a complex process, since the likelihood of a new infection is quite high. Here, simultaneous therapy of both the vagina and the intestines should be carried out. This is the most severe form of dysbiosis.

Diagnosis of dysbacteriosis

In order for the treatment to give a result, it is necessary to correctly diagnose the disease. First of all, a gynecological examination of the patient is performed. Then tests are ordered. As a rule, this is:

• PCR diagnostics, which allows you to verify the absence or presence of genital infections;
• a smear on the flora, indicating the state of the vaginal microflora;
• sowing vaginal discharge;
• the sensitivity of the patient to antibiotics is determined.

The obtained data of laboratory studies allow us to establish the cause of the disease and the degree of its complexity.

Treatment of dysbiosis

Therapeutic measures to restore the vaginal microflora are divided into several stages:

• Destruction of pathogenic bacteria that caused this disease.
• Restoration of the vaginal microflora.
• Immunity boost.

If dysbacteriosis has arisen due to genital infections, then the causative agent of the disease is first eliminated by prescribing a course of antibiotics. If the violation of the microflora of the vagina is caused by another reason, then antibiotics may not be used. And if such therapy is prescribed, then for a period of no more than five days.

It is very important for dysbiosis to carry out external procedures. These are various baths and tampons. Such activities inhibit the development of pathogenic microorganisms and restore immunity. Treatment of violations of the microflora of the vagina with antiseptics - in this case they are used topically - is much more effective than antibiotics, and their area of ​​​​effect is much wider. Almost all bacteria are susceptible to their influence. Antiseptics also help develop the immunity of the walls of the vagina and normalize its microflora. They inhibit the growth of pathogenic bacteria.

The neglected form of dysbacteriosis is difficult to cure only with immunomodulatory therapy; here, in addition, antibiotics are almost always prescribed.

Drugs for the treatment of dysbiosis

Violation of the microflora of the vagina (drugs are usually prescribed in the form of ointments, suppositories, vaginal tablets and creams) is a rather complex disease, which often requires an integrated approach.

Often, Dalacin cream, which is an antibiotic with a wide spectrum of action, is used to treat dysbacteriosis. The active ingredient is clindamycin phosphate 2%. It intensively affects the vaginal microflora. Also effectively restore the background with such a pathology as a violation of the microflora of the vagina, suppositories "Dalacin". They contain up to 100 mg of antibiotic.

A good result in vaginal dysbiosis is given by Flagil candles. The drug is used once a day, at night. Also, for the treatment of the disease, doctors recommend using "Hexicon" - these are suppositories with chlorhexidine. They are inserted into the vaginal cavity once a day. The course is 10 days.

For the treatment of vaginal dysbiosis, many today choose Betadine and Terzhinan suppositories. Metronidazole gel also gives a good effect.

If the disease is advanced, and only topical preparations cannot be dispensed with, then tablets are prescribed for oral administration. It:

• "Ornidazole".
• "Naxojin".
• Meratin.
• "Tiberal".
• "Tinidazole".
• "Trichopol" or "Metronidazole".
• "Clindamycin".

Medicines are taken throughout the week. It should be remembered that when using oral medications, alcohol is prohibited. This is especially true for Trichopolum.

In combination with other drugs for the normalization of microflora, it is prescribed: "Linex", "Probifor", "Bifidumbacterin", "Bifiform", "Bifidin" or "Bifiliz". To increase the number of lactobacilli in the vaginal environment, "Acilact", "Lactobacterin", "Acepol", etc. are prescribed. It is recommended to drink the medicine in a course, starting from the second day of taking antibacterial agents. They also prescribe means to maintain immunity - "Immunal", "Cycloferon", etc.

If the cause of the violation of the microflora was sexual intercourse, then the sexual partner should also be examined and treated.

About preventive measures

Treatment for dysbiosis can take up to four weeks. In some cases, it is difficult to prevent this disease, since it is difficult to establish the real cause that caused the disease. The only thing a woman can do is to strengthen the immune system and follow the necessary rules of hygiene.

After the restoration of the microflora of the vagina, you should visit the gynecologist every three months for a year. This is necessary in order to detect a relapse in time and take appropriate measures. In the future, under normal circumstances, you can see a doctor once a year.

Oddly enough, but most girls and women remember the microflora of the vagina only when it begins to be disturbed. Leading experts rightly believe that maintaining the normal microflora of the vagina creates serious barriers to the occurrence of various infectious and inflammatory processes in the internal genital organs. As recent statistics show, from 20 to 30% of women of reproductive age have a violation of the vaginal microflora.

Normal biocenosis of the vagina

Thanks to clinical studies, scientists have found that the natural microflora of the vagina is a combination of beneficial and opportunistic microorganisms. Normally, beneficial bacteria significantly outnumber opportunistic species in quantity. It is reliably known that approximately 95–97% of the vaginal biocenosis is made up of lactobacilli, which, by producing lactic acid, provide an acidic environment in the vagina and protect it from infection. Conditionally pathogenic microorganisms (3–5%) are represented by the following species:

• Gram-positive rods.
• Gram-positive and Gram-negative cocci.
• Anaerobic sticks.
• Enterobacteria.

The symbiotic relationship of beneficial and opportunistic microorganisms not only does not cause any harm, but even protects the internal genital organs from infection. Most infectious agents, penetrating into the vagina, are neutralized in an acidic environment. However, it is worth noting that changes in the microflora can occur during the menstrual cycle. For example, at the beginning of the cycle, there is some deviation in the pH of the vagina towards the alkaline side. It will be characterized by a decrease in the number of lactobacilli, which is accompanied by an increase in opportunistic pathogens. But immediately after menstruation, there is a rapid restoration of balance.

Noticing any unnatural discharge from the genitals, do not postpone a visit to the doctor.

Violation of the biocenosis of the vagina

Not so long ago, a violation of the microflora of the vagina was considered a clinical syndrome. Nevertheless, now it has been attributed to a separate nosological unit, which was given the name bacterial vaginosis. In this pathological condition, there is a sharp decrease or absence of lactobacilli and an increase in the number of opportunistic microorganisms, in particular gardnerella and gram-negative anaerobic bacteria. It should be noted that neither bacterial sexually transmitted infections nor fungi or pathogenic protozoa are the cause of bacterial vaginosis.

As a result of the development of vaginal dysbiosis, the pH of the medium in the vagina shifts to the alkaline side and becomes more than 4.5. Such changes are associated with the presence of a large number of anaerobic bacteria that produce volatile amines that have an extremely unpleasant odor reminiscent of rotten fish. Changing the biocenosis and pH of the environment deprives the vagina of a biological protective barrier, creating all the conditions for the occurrence of infectious and inflammatory diseases of the female reproductive system.

What causes dysbiosis?

Bacterial vaginosis does not appear out of nowhere. The role of a provoking factor leading to a violation of the microflora of the vagina can be:

• Hormonal imbalance. It is often observed during pregnancy and breastfeeding, during abortions, menopause, irregular sexual life, etc.
• Taking antibacterial agents. If you use antibiotics, they destroy not only dangerous, but also beneficial bacteria and other microorganisms. Uncontrolled long-term use of antibacterial drugs brings particular harm to health.
• Constant hypothermia, physical fatigue, unbalanced psycho-emotional stress, leading to a decrease in immunity.
• Failure of the menstrual function of the ovaries of a different nature.
• Transferred infectious and inflammatory diseases of the reproductive system.
• Too active sex life (several sexual partners or their frequent change).
• Both insufficient and too thorough hygiene of the intimate area.
• The use of hormonal oral contraception and / or the use of intrauterine contraceptives.

Violation of the microflora of the vagina is a disease that must be purposefully treated.

Manifestation of dysbiosis

In the vast majority of cases, bacterial vaginosis is manifested by local symptoms. In some patients, subjective sensations may be absent. A typical clinical picture in vaginal dysbiosis:

• Abundant discharge from the internal genital organs (whitish-gray hue, sharp unpleasant odor) is noted. Quite often observed after intimacy or during menstruation.
• If the violation of the microflora of the vagina is chronic, then the discharge becomes yellowish-green, more saturated and thick, looks like a curd mass.
• The volume of secretions can vary from insignificant to very abundant.
• Women rarely complain of itching sensation and problems with urination. If they are present, they usually appear periodically.
• A characteristic symptom of bacterial vaginosis is the absence of inflammation of the vagina.
• Sometimes there is heavy menstrual bleeding and a feeling of soreness in the lower abdomen.

A woman who has a violation of the microflora of the vagina can contribute to the development of inflammation of the head and foreskin in her sexual partner.

How to define dysbiosis?

The main clinical and laboratory criteria indicating bacterial vaginosis:

• Abundant cheesy discharge with a whitish-gray tint and a very unpleasant odor, evenly covering the walls of the vagina.
• The pH of the vaginal environment is more than 4.5.
• Positive amine test. By mixing samples of vaginal discharge with a solution of potassium hydroxide in equal proportions, a characteristic fishy odor appears.
• Microscopic examination reveals "key cells". These are desquamated epithelial cells to which various opportunistic microorganisms are attached. Normally, key cells are not detected.

If at least three of the above criteria are found, then we can safely talk about a violation of the vaginal microflora, characteristic of bacterial vaginosis. If necessary, the diagnosis is supplemented with a bacteriological research method, which allows you to determine the qualitative and quantitative composition of the vaginal biocenosis.

If the microflora of the vagina has been disturbed for a long time, then this may affect the reproductive function of a woman.

Restoration of the biocenosis of the vagina

To successfully eliminate bacterial vaginosis, two main tasks must be completed:

• Suppress the excessive growth and reproduction of opportunistic bacteria (especially anaerobes) through the use of antibacterial drugs.
• Restore normal vaginal biocenosis with the help of eubiotics, which will help increase the proportion of beneficial microorganisms.

Currently, antibacterial therapy for the suppression of opportunistic flora includes the appointment of the following drugs:

• Clindamycin.
• Metronidazole.
• Tinidazole.
• Ornidazole.

The therapeutic course can last for 5-7 days. If a woman is pregnant and suffers from bacterial vaginosis, then Clindamycin cream is usually used. After completion of antibacterial treatment, measures are taken to restore normal vaginal biocenosis. There are no special restrictions in terms of sexual activity during therapy. To raise immunity, it is recommended to take vitamin-mineral complexes and biogenic stimulants (Actovegin, aloe extract, etc.).

With proper observance of the regimen and the fulfillment of all the instructions of the attending physician, the normal microflora of the vagina is restored within a few weeks.

Preparations for the normalization of biocenosis

How to improve the microflora of the vagina? Having effectively coped with opportunistic bacteria, they switch to taking eubiotics that help restore vaginal biocenosis. This group of drugs includes:

• Lactobacterin.
• Lactonorm.
• Bifidumbacterin.
• Acylact.
• Ecofemin.
• Gynoflor.

Lactobacterin

One of the most popular eubiotics used to correct vaginal biocenosis is Lactobacterin. The live bacteria contained in the preparation ensure the normalization of the microflora, maintaining the pH of the vaginal environment at a level of no more than 4.5. In the acidic environment created by lactobacilli, many pathogenic and opportunistic microorganisms cannot grow and multiply. Allergy to the components of the drug, vulvovaginal candidiasis and childhood are considered contraindications for use.

Side effects in the form of allergic reactions are very rare. Due to a decrease in the therapeutic effect, the simultaneous use of Lactobacterin and antibacterial drugs is not recommended. Restorative therapy using intravaginal suppositories can last 10-14 days. If necessary, repeat courses of treatment can be prescribed after 2-3 weeks. The cost of the drug Lactobacterin ranges from 130-150 rubles.

Gynoflor

Gynoflor is widely used to normalize the vaginal microflora. Unlike the previous drug, this medicine contains not only acidophilic lactobacilli, but also a small amount of estrogen (estriol). Lactobacilli successfully cope with pathogenic and conditionally pathogenic flora. Estriol provides restoration of the vaginal epithelium, maintenance of the biocenosis and pH of the environment, without having a systemic effect on the female body. In a healthy epithelium, glycogen accumulates, which is necessary for the normal functioning of lactobacilli. Among the contraindications are the following conditions and diseases:

• Allergy to the main and auxiliary components of Gynoflor.
• Neoplasms sensitive to estrogen (tumors of the breast, reproductive system, etc.).
• Any form of endometriosis.
• Bloody discharge from the genitals of unknown origin.
• Young age.

I would like to note that Gynoflor does not change the level of natural hormones in the blood. In the early stages of pregnancy (1st trimester), it is not recommended to prescribe the drug. At the same time, in the later stages, its use is allowed if there are appropriate indications and there are no contraindications. However, there are no reliable data on the effect of Gynoflor on pregnancy and fetal development, since long-term clinical studies have not been conducted.

Side effects are recorded quite rarely. Some women have experienced local adverse reactions such as redness and burning sensation in the genital area. In addition, simultaneous use with antibiotics can lead to a decrease in the effectiveness of the drug. Spermicidal agents are also not recommended to be combined with Gynoflor. The course of treatment is determined exclusively by the attending physician, but on average it can last 1-2 weeks. During therapy, it is better for girls and women to use hygienic tampons.

In most pharmacies, the price of a domestically produced Gynoflor drug does not exceed 950 rubles per package (6 vaginal tablets). On sale there are also packages of 12 tablets worth about 1300 rubles.

Solkotrichofak

With prolonged and recurrent forms of bacterial vaginosis, the immunostimulating vaccine Solkotrichofak is used to normalize the vaginal microflora. The use of this specific drug not only contributes to the stabilization of vaginal biocinosis, but also prevents the likelihood of relapses and mixed infections in about 80% of women. Solkotrichofak is actively used as a therapeutic and prophylactic agent for bacterial vaginosis.

Vaccination with this drug should only be carried out by a doctor. The course includes 3 intramuscular injections. The interval between each introduction is 14 days. The exact time of vaccination is calculated in advance so that the injections do not coincide with the monthly ones. Revaccination is carried out after 12 months. The main contraindications to the use of Solkotrichofak are:

• Allergy to vaccine components.
• Various infections in the acute stage.
• Tuberculous lesions of organs.
• Diseases of the blood system.
• Severe cardiovascular pathology.
• Serious disorders of the kidneys.
• immunodeficiency states.

During pregnancy, to vaccinate with Solkotrichofak or not is decided by the doctor, taking into account the benefits for the woman and the possible risk for the child. Adverse reactions are practically absent. In rare cases, headaches, chills, fever, general weakness, etc. have been observed. The drug is also effective in recurrent trichomoniasis. You can buy the Solkotrichofak vaccine at pharmacies with a prescription.

Vaginal dysbiosis is a violation of its normal microflora. The manifestations of this condition are usually minor, so a woman often postpones a visit to the doctor. However, in some cases, vaginal dysbiosis leads to very serious problems.

First, a few words about the different terms that are used to refer to the same disease.

Vaginal dysbiosis, or dysbiosis (dysbacteriosis) of the vagina, is the most accurate term, it just translates as "violation of the microflora of the vagina." However, it is used relatively rarely. More often, to define the disease, they resort to the name "bacterial vaginosis", this term means the same. However, the term "bacterial vaginosis" is used by many doctors to refer to gardnerellosis (a disease in which gardnerella bacteria appear in large numbers) - a special case of vaginal dysbiosis.

Therefore, when using this term, it is not always possible to be sure what exactly is meant. Often, any manifestation of a violation of the microflora of the vagina is called "candidiasis", or "thrush". This is not entirely justified. Candidiasis, or thrush, is the name of only one type of violation of the microflora of the vagina - the predominance of fungi of the genus Candida. However, traditionally women call any vaginal discharge "thrush" without really understanding their nature.

What happens in the body?

So, what is the essence of the disease? Normally, the so-called normal microflora lives in the vagina of a woman. It consists of approximately 90% lactobacilli (the so-called Dederlein sticks), a little less than 10% bifidobacteria. and less than 1% are other microorganisms. These include gardnerella, mobilunkus, fungi of the genus Candida, leptothrix and some others. The normal microflora does not allow the appearance of any other infection or changes in the ratio of pathogens living in the vagina normally.

All this picture is actively supported by the immune system. The immune system has no effect on the natural inhabitants of the vagina, but behaves aggressively against any other infection. It is the immune system that contributes to the restoration of the normal microflora of the vagina with its minor violations. But she does not always cope with this task. If the microflora is disturbed, the balance between bacteria, the normal inhabitants of the vagina, changes. At the same time, the number of lacto- and bifidobacteria decreases and the amount of some other pathogen increases. This pathogen sooner or later causes inflammation in the vagina. Depending on the microflora that forms in the vagina during dysbiosis, the condition may not manifest itself in any particular way. As a rule, the nature of vaginal discharge changes slightly, but rarely does anyone pay attention to it.

Normally, a woman should either not have any vaginal discharge, or it may be a small amount of clear discharge without an unpleasant odor.

With the development of vaginal dysbiosis, the amount of discharge usually increases, they become whitish-yellowish in color, and an unpleasant odor appears. No more symptoms of vaginal dysbacteriosis appear - all other symptoms are already associated with its complications.

Causes of violation of microflora

There are many reasons for vaginal dysbiosis. Almost any effect on a woman's body can lead to a violation of the microflora. Let's just list some of the factors.

• Hormonal changes and disorders. These include irregular sex life, pregnancy, childbirth, abortion, any kind of cycle disorders, puberty, pre-menopause and menopause, etc.
• Change of climate zone. It is not uncommon to hear about exacerbations of vaginal dysbiosis while traveling to warm countries.
• Stress (both a single severe stress and a chronic stressful situation).
• Promiscuous sex life, a large number of sexual partners.
• Any infectious and inflammatory diseases of the pelvic organs.
• Sexually transmitted infections.
• Treatment with antibiotics, especially prolonged or repeated.
• Intestinal diseases, chronic stool problems, intestinal dysbacteriosis.
• Incorrect use of tampons during menstruation. Tampons should be changed exactly every 2 hours. This is quite inconvenient, but otherwise good conditions are created in the vagina for the growth and reproduction of pathogenic microbes. Pads can be changed after 3-4 hours.
• Hypothermia of the body (both a single severe hypothermia and constant freezing). All this leads to a decrease in general and local immunity, which also affects the vaginal microflora.

Of course, all these factors do not always lead to a violation of the vaginal microflora. The immune system maintains normal microflora and helps it to recover in the event of a minor disturbance. However, there are so many of these factors and they occur so often that in most cases, vaginal dysbacteriosis in a woman still develops.

Possible Complications

So, there is a situation in which there is a large number of pathogenic bacteria in the vagina. Sooner or later, these bacteria will cause inflammation of the vaginal wall and cervix - those organs with which they are in constant contact. This is manifested by a sharp increase in the amount of vaginal discharge, the appearance of unpleasant sensations in the genitals (itching, pain, burning, pain) and pain during intercourse. One of the first symptoms of inflammation is often the lack of sufficient lubrication during intercourse. In addition, bacteria from the vagina can enter the uterus, which will lead to the development of endometritis (inflammation of the endometrium - the inner wall of the uterus) and uterine appendages, with the prospect of developing adnexitis - inflammation of the ovaries and fallopian tubes.

Also, vaginal dysbiosis can lead to infection of the urethra and bladder, which can cause symptoms of their inflammation.

It is not uncommon to hear about exacerbations of vaginal dysbiosis while traveling to warm countries.

Vaginal dysbiosis and genital infections. Sexual infections (chlamydia, mycoplasmas, herpes virus, gonococci, etc.) are always associated with a violation of the vaginal microflora. On the one hand, the normal microflora will not allow the development of a sexual infection in a woman, and if a sexual infection is detected, the microflora cannot but be disturbed. On the other hand, the appearance of the causative agent of any sexually transmitted disease (STD) in the vagina shifts the pH, causes an inflammatory reaction, and further contributes to the progression of microflora disorders.

Vaginal dysbiosis and bowel disease. Many diseases of the gastrointestinal tract (gastritis, colitis, peptic ulcer, etc.) lead to disruption of the normal intestinal microflora and the development of dysbacteriosis. With intestinal dysbacteriosis, approximately the same thing happens as with vaginal dysbacteriosis - a large number of some "bad" bacteria live in the intestine.

Constipation also provokes vaginal dysbiosis. The wall of the rectum is in close contact with the wall of the vagina, with constipation, stagnation occurs in the vessels of the small pelvis, which negatively affects the strength of local immunity and in the vagina.

With severe intestinal dysbacteriosis, as a rule, one of the intestinal infections is sown from the vagina - E. coli, enterococci, etc. Restoring the normal microflora of the vagina in such a situation is possible only with the simultaneous treatment of intestinal diseases.

Diagnosis of vaginal dysbacteriosis

A woman goes to the doctor when symptoms of the disease appear; it is mainly either discharge, or various kinds of discomfort in the genital area. And, of course, it is necessary to undergo an examination by a gynecologist about once every six months or a year, even if nothing bothers you.

Diagnosis of violations of the microflora of the vagina is not particularly difficult. A complete diagnosis of vaginal dysbiosis, in addition to the usual examination, includes the following tests: a general smear for flora, PCR (polymerase chain reaction - a method for detecting STD pathogens by detecting their DNA in the test material) and sowing vaginal discharge (or a special study of the vaginal microflora) . A smear gives a general idea of ​​the state of the microflora of the vagina and the vaginal wall. Diagnosis of genital infections and sowing allow us to find out due to which pathogens the microflora was disturbed, as well as to determine the sensitivity of bacteria to antibiotics. Antibacterial therapy should never be started without these tests. Smears and PCR are done from several hours to several days, crops - from a week to 2 weeks. Diagnosis of vaginal dysbiosis can never be carried out by one common smear per flora, which is always taken during examination by a gynecologist.

Treatment of vaginal dysbiosis

Treatment of dysbiosis (dysbacteriosis) of the vagina should include the following tasks:

• elimination or suppression of pathogenic bacteria in the vagina;
• population of the normal microflora of the vagina;
• restoring the immunity of the vaginal wall so that it again takes control of the vaginal microflora.

Let's talk about each of these tasks in more detail.

To suppress pathogenic bacteria, either antibiotics are used (amoxiclav, sumamed, doxacicline, trichopol, etc.), or local antiseptics (miramistin, chlorhexidine), antibacterial suppositories (terzhinan, gynopevaril, etc.).

Any probiotics containing lactobacilli, from lactobacterin to linex, narine, normoflorin-L, etc., contribute to the restoration of the normal microflora of the vagina, plus the daily use of fermented milk bioproducts.

To restore the immunity of the vaginal wall, general and local immunomodulators are prescribed: polyoxidonium, cycloferon, geneferon, immunal, etc.

If sexually transmitted infections are suspected or present, the sexual partner is also examined.

Suppression of disturbed microflora. If vaginal dysbiosis is associated with a sexual infection, then the goal of treatment is to completely eliminate the causative agent of the sexually transmitted disease from the woman's body. In this case, treatment necessarily includes a course of antibiotic therapy, at the same time or after which all other measures are taken. If we are not talking about genital infections, then, as a rule, in this case either a very short course of antibiotic therapy (3-5 days) is used, or treatment with systemic antibiotics is not carried out at all - they are limited to local use of antibiotics, antiseptics.

The use of local procedures is much more effective. They allow you to simultaneously combine all the tasks of treatment - and the suppression of pathogenic flora, and the population of normal inhabitants of the vagina, and local immunocorrection. The use of antiseptics in local procedures is much more effective than the use of antibiotics. The spectrum of action of antiseptics is wider, and bacteria almost never become resistant to them.

The population of the normal microflora of the vagina. This is the most important part of the treatment. All other activities are carried out only in order to create conditions for the engraftment and growth of normal flora. The population of the normal microflora of the vagina is carried out mostly in the second stage of the course, when the pathogen that lived in the vagina is maximally suppressed. For this, massive doses of eubiotics (preparations containing live bacteria) of both general and local action are used. The use of eubiotics alone to restore the vaginal microflora is not justified and, as a rule, is useless. While a woman's vagina lives in large quantities, say, E. coli, a woman can eat a kilogram of lactobacilli, but none of them will take root in the vagina. Be sure to first suppress the bacterium (or bacteria) that caused the disease, and only then populate the normal microflora of the vagina.

Restoring the immunity of the vaginal wall. The immune system of the vaginal wall controls the microflora of the vagina, preventing the growth of other bacteria. Violation of the microflora of the vagina is always associated with a decrease in the immunity of its wall. Therefore, local immunocorrection must necessarily be part of the treatment, otherwise all other measures will be ineffective. In simple cases, immunocorrection can be limited to the use of local immunomodulators. In cases with a sharply reduced general immunity of the body, restoration of immunity requires more serious measures, and sometimes, in very difficult situations, a course of immunomodulatory therapy should be carried out before all other treatment. As a rule, the treatment of vaginal dysbiosis takes 3 weeks. Before this, the patient is carefully examined, if necessary (if there is a suspicion or presence of sexually transmitted infections), her sexual partner is also examined. Treatment of vaginal dysbiosis in women does not imply mandatory treatment of the sexual partner, unless at least one of them has a sexual infection. After treatment, a follow-up examination is carried out, control tests are done. If no symptoms of the disease are detected, then the treatment can be considered completed.

Dysbacteriosis in a nursing mother

During pregnancy, a woman's body undergoes a significant change in hormonal levels and a decrease in the body's immunity. This is necessary for bearing a fetus, but it has a significant impact on almost all organs and systems of the mother's body. In addition, as a rule, diet and lifestyle changes. All these reasons may well provoke a pronounced violation of the microflora of the vagina.

The use of antibiotics for one reason or another after childbirth is also a risk factor for the development of dysbiosis.

The manifestations of vaginal dysbacteriosis in a young mother are no different. In the same way, discharge may appear or intensify, and various kinds of discomfort arise - itching, pain, burning, dryness, etc.

Treatment of vaginal dysbacteriosis in women during breastfeeding has a number of features. Since during this period of time the use of most drugs that are used to treat the disease is strictly prohibited or undesirable, the help is reduced to symptomatic treatment, that is, the elimination of the manifestations of the disease. As a rule, local procedures (sanation of the vagina, antibacterial suppositories) are prescribed in the amount necessary to minimize the symptoms of dysbiosis. In the future, such treatment is repeated, if necessary, with the use of other drugs at the end of breastfeeding.

Mikhail Sovetov, urologist-andrologist

The gynecologist also prescribed epigen for me, after I went on vacation in the summer. When I arrived back, I found that the symptoms were somehow suspicious, and most importantly, out of the blue. turned out to be dysbiosis. Two weeks later I was like a cucumber, now I always take a bottle with me

Dysbacteriosis is a terrible thing! I had it before my honeymoon... it was a nightmare! I flew to the hospital at a run, and there my doctor told me that you have Vaginosis, baby, and that’s it. Basically, I figured it out myself. He prescribed Epigen spray for me and after a couple of days everything almost returned to its place, thank God. Now I use it from time to time as a preventive measure, I don’t want to get into such a situation a second time.

Yes, dysbiosis is terrible. Was on vacation. And got a bad cold. And discomfort in the vagina and pain during urination began. Strongly frightened. I went to the doctors and began to treat with antibiotics, but that did not help much. Then I got an appointment with a gynecologist and said that the microflora of the vagina was disturbed. And antibiotics only make it worse. He advised me to spray epigen. The discomfort has passed. Well, I think the microflora has recovered. Since everything is fine.

It is strange that in general many good remedies were not mentioned: \ The same Epigem-intim, it not only restores the flora, but also increases the immunity in the vagina, and this is very important, since strengthening the immune system is an integral part of the treatment of dysbiosis!

Vagilak is also good at the stage of flora restoration, it is strange that it was not mentioned among others. In my opinion, it is much better than those listed, I drank it in a course, I know. By the way, you can drink it only for the flora, do not take something extra for the intestines. The lactic bacteria in this probiotic are, of course, specific to the vaginal flora, but the intestinal flora is also very positively affected. Again, confirmed by personal experience;)

What is a violation of the microflora of the vagina? Violation of the microflora of the vagina (vaginal dysbactriasis, vaginal dysbiosis) is a phenomenon associated with the functioning of the female reproductive system. Violation of the microflora of the vagina: symptoms, treatment depend on many factors. These factors include the general condition of the patient, the course of concomitant diseases, diet, quality of sexual life, etc. Violation of the vaginal microflora is manifested by whitish discharge from the vagina. Such secretions can have a different consistency, smell and abundance. Such discharge may be a normal part of the process of cleansing the vagina of a healthy woman. But also vaginal discharge may indicate a pathological process, including vaginal dysbacteriosis.

According to statistics, a violation of the microflora of the vagina occurs in every second woman. Such a violation can occur in mature women after the onset of menopause, in middle-aged women with an established sexual life, in girls before the onset of sexual activity, in girls before the onset of the menstrual cycle. Often, vaginal dysbacteriosis goes unnoticed. A woman may not suspect a violation of the vaginal microflora for a long time. Asymptomatic course is dangerous for its complications. It is the complications in the asymptomatic course that make the patient go to a specialized clinic.

Normally, a normal, non-pathogenic microflora lives in the woman's vagina. This microflora ensures the functioning of the genital organs. The microflora of the vagina consists of approximately 90% lactobacilli, 9% bifidobacteria and less than 1% other opportunistic pathogens. Conditionally pathogenic microorganisms normally do not provoke the development of the disease, but under the influence of predisposing factors can cause the disease. Opportunistic pathogens cover the walls of the vagina. These include fungi of the genus Candida, gardnerella and some other microorganisms. The body of a healthy woman controls the ratio of microorganisms in the vagina and prevents the appearance of uncharacteristic microflora. At the same time, immunity does not react in any way to representatives of the characteristic microflora of the vagina. If there have been minor changes in the microflora of the vagina, then the microflora will renew itself. Such a process is not reflected in any way on the health of a woman. The impact of predisposing factors and violation of the vaginal microflora reduces the number of lactobacilli and bifidobacteria. At the same time, an increase in the number of conditionally pathogenic microflora is observed, and pathogenic microorganisms also appear. Such a microorganism can be gardnerella, a fungus of the genus Candida, a sexual infection (trichomoniasis, chlamydia, gonorrhea, etc.), as well as another pathogen from the environment (staphylococcus aureus, streptococcus, proteus, E. coli, etc.). Such microorganisms during reproduction and vital activity are the cause of inflammation of the vagina. Inflammation depends on the level of immunity of a woman, the general condition of her body, on the number of pathogenic microorganisms, etc. In the absence of treatment for inflammation and in the absence of therapy against pathogenic microorganisms, the disease will progress.

Symptoms of a violation of the microflora of the vagina

Violation of the microflora of the vagina, as mentioned above, will often be asymptomatic. A woman for a long time may not even suspect a violation of the microflora of the vagina. But still, a violation of the microflora of the vagina provokes a number of symptoms. So, vaginal discharge of various types can be observed. Often women ignore this symptom, or do not notice it at all. Allocations are not accompanied by dryness of the vagina and external tissues of the genital organs, discomfort during intercourse. Over time, the amount of secretions increases and such secretions acquire a characteristic odor. If other symptoms are observed, they are related to symptoms of concomitant diseases. After all, dysbacteriosis is often the cause and predisposing factor for the development of sexually transmitted diseases, erosion processes, inflammatory processes, tumor growth, etc.

Complications of microflora disorders include: inflammation of the walls of the vagina (vaginitis), inflammation of the cervix (cervicitis). These complications are the most common. The symptoms of inflammation include an increase in vaginal discharge, the appearance of discomfort during urination, the appearance of discomfort in the perineum (itching, burning, pain, pain, etc.), pain during intercourse or after intercourse, and other symptoms. Pain during intercourse occurs due to vaginal dryness and insufficient secretion. Long-term infection can spread to all internal genital organs. So inflammation of the uterus (endometriosis), inflammation of the uterine appendages (adnexitis) can occur. Infection and pathogenic bacteria can enter the urethra. The penetration of pathogenic bacteria into the urethra provokes the development of cystitis and urethritis.

There are many reasons for the development of a violation of the microflora of the vagina. Violation of the microflora of the vagina: symptoms, causes, treatment - every woman needs to avoid predisposing factors. It is better to prevent the development of the disease than to treat its consequences.

Violation of the microflora of the vagina - causes:

Local or general hypothermia. Hypothermia is the cause of a decrease in immunity and is displayed on the ratio of microorganisms in the vagina.

Hormonal disorders. Hormonal disorders occur with irregular sexual activity, menstrual irregularities, puberty, pregnancy, after childbirth, abortion, menopause, etc. A sharp change in hormonal levels is reflected in the state of the genital organs.

Change of climate zone. A change in the climatic zone or a sharp change in climate provokes an exacerbation of dysbacteriosis.

Sexual infections. Sexual infections can be both a cause and a consequence of a violation of the microflora of the vagina.

Inflammatory process of the pelvic organs. The inflammatory process of the pelvic organs provokes the occurrence of specific symptoms, and the cause of inflammation can be an imbalance of microorganisms in the vagina.

Taking antibiotics. Long-term use of antibiotics disrupts the microflora of the vagina and destroys not only harmful microorganisms, but also beneficial microorganisms. Therefore, with prolonged use of antibiotics, it is necessary to colonize beneficial microorganisms in the vagina (which an experienced gynecologist should do).

Failure to comply with the rules of personal hygiene or hygiene of sexual life. Improper hygiene can cause pathogenic microflora to enter the vagina.

Intestinal disease (intestinal dysbiosis). The intestinal microflora is associated with the microflora of the vagina. Therefore, the presence of one of them causes a violation of the other.

Poor hygiene during menstruation. Poor menstrual hygiene involves the improper use of tampons and pads during menstruation. It is recommended to replace hygiene products during menstruation every two hours. If you ignore the recommendations, then favorable conditions are created for the reproduction of opportunistic microflora of the vagina, as well as for the development of inflammation.

The above factors do not always lead to a violation of the microflora of the vagina. After all, the woman's immune system is able to control and regulate the microflora of the vagina in case of its change. But still, it is better to avoid predisposing factors.

Violation of the microflora of the vagina - treatment

Treatment of violations of the microflora of the vagina is based on the results of the preliminary diagnosis. For the purpose of diagnosis, the following tests are carried out: a smear for the flora, a PCR test, crops of vaginal discharge with the determination of sensitivity to antibiotics. A smear on the flora allows you to determine the state of the microflora of the vagina and identify inflammation. The PCR test allows you to determine the type of microorganism that caused the violation of the microflora. Culture of bacteria also allows you to calculate the pathogen and determine its sensitivity to antibiotics. In parallel with laboratory tests, an ultrasound examination of the small pelvis and calposcopy are performed. Ultrasound examination of the small pelvis allows you to assess the condition of the genital organs, their shape, the presence of tumors, etc. Cytoscopy allows you to assess the condition of the walls of the vagina and identify uncharacteristic changes in the epithelial cover of the vagina. Quality diagnostics is essential. After all, 90% of the treatment depends on the results of the diagnosis.

Treatment of violations of the microflora of the vagina includes:

Suppression of pathogenic and conditionally pathogenic microorganisms. If a violation of the microflora of the vagina is associated with a sexual infection, then the treatment is aimed at the complete destruction of such an infection. In this case, treatment includes a course of antibiotics. But if genital infections are not caused by a violation of the vaginal microflora, antibiotics are not prescribed. Sometimes a short course of antibiotics is prescribed. Local procedures are considered very effective in the treatment of violations of the microflora of the vagina. This is how special tampons, candles, creams, ointments, special baths, etc. are prescribed. Such drugs combine all the tasks of treatment: suppression of pathogenic microflora, restoration of normal vaginal microflora, correction of immunity. It should be noted that in the treatment of vaginal microflora, the use of antiseptics is much more effective than the use of antibiotics. The effectiveness of antiseptics is explained by the broad action, the resistance of bacteria to antiseptics.

Restoration of normal microflora. In order to restore the microflora of the vagina, special vaginal preparations are used. Such drugs allow you to populate the vagina with useful and necessary microorganisms, as well as restore the walls of the vagina.

Restoring the immune system looms the vagina. Restoring the immunity of the vaginal wall will help maintain the normal composition of the vaginal microflora. For this, various systemic and local preparations are used. It is not recommended to engage in the restoration of immunity on your own. Immunity-correcting drugs have contraindications for use and specifics of use. Advanced forms of the disease require a serious approach to treatment. Often, immunostimulants are combined with antibiotics. This treatment takes on average several weeks (2-4 weeks). It is worth noting that in the treatment of violations of the microflora of the vagina, it is recommended to conduct a study of the state of health and the sexual partner of a sick woman. After the end of treatment, control studies are carried out. Control studies allow confirming the quality of treatment and confirming the elimination of predisposing factors for the recurrence of vaginal dysbacteriosis.

You can prevent the violation of the microflora of the vagina by adhering to the rules of prevention. For the purpose of prevention, all women are recommended to visit the office of a gynecologist-endocrinologist at least 1-2 times a year. So, when visiting a specialist, you should report changes in the body, past diseases, bad habits, etc. This information allows you to timely assess changes in the state of the vaginal microflora. If the gynecologist detects the influence of predisposing factors, then he prescribes a number of necessary studies. Also, measures to prevent violations of the vaginal microflora include: timely treatment of genital infections; timely treatment of acute diseases; proper nutrition; rejection of bad habits; use of mechanical contraceptives; having one sexual partner, etc.

Experienced doctors, including a gynecologist-endocrinologist, conduct their practice at the Hippocrates clinic. With us you can undergo the necessary examinations, as well as undergo the treatment of gynecological diseases with modern methods. Our specialists accept by appointment. Appointments can be made at any time by phone. Take care of your health.