Bacterial vaginosis in women treatment. All about bacterial vaginosis and its treatment. Key causes of the development of the disease

An imbalance in the vaginal microflora can cause the development of bacterial vaginosis, an infectious disease that causes significant discomfort to women. We tell what kind of disease it is, how it manifests itself, and how doctors advise it to be treated.

WHAT IS BACTERIAL VAGINOSIS

Bacterial vaginosis(vaginal dysbacteriosis, gardnerellosis, nonspecific vaginitis) is the most common cause of vaginal infections in women of childbearing age. Despite the fact that the disease often develops after intercourse with a new partner, bacterial vaginosis is not.

“This is one of the types of bacterial vaginitis, when the balance between normal and conditionally pathogenic microflora is disturbed under the influence of a number of factors,” says obstetrician-gynecologist Elena Berezovskaya. - The occurrence of bacterial vaginosis depends on the woman's age, her sexual activity, hormonal balance, immunological status, hygiene of the genital organs, and the presence of skin diseases.

STIs, use of antibiotics, hormones, endocrine disorders, surgical termination of pregnancy, surgeries, penetrating diagnostic and therapeutic manipulations, intrauterine contraception, and even environmental problems can also lead to an imbalance in the vaginal flora. Under the influence of these factors, there is a sharp decrease in the number of lactobacilli, which, in turn, leads to a decrease in the content of lactic acid and a shift in pH to the alkaline side. This creates conditions for accelerated reproduction of opportunistic microflora and gardnerella.

Since it is gardnerella (Gardnerella vaginalis) that in most cases causes vaginal dysbacteriosis, many doctors call bacterial vaginosis gardnerellosis.

CAUSES OF BACTERIAL VAGINOSIS

Obstetrician-gynecologist Vyacheslav Ivannikov told us about the causes of bacterial vaginosis:

The microflora of the vagina is a mobile ecosystem. Normally, its basis is lactobacilli, which play a protective function. Lactobacilli convert glycogen into lactic acid, reducing the acidity of the vagina. In addition, lactobacilli form hydrogen peroxide.

Acidic and hydrogen peroxide inhibit the growth of opportunistic microbes (staphylococci, streptococci, E. coli, anaerobic bacteria, gardnerella, etc.), which are found in a small amount in the vagina in the vast majority of women. If the proportion of lactobacilli decreases, their place in the ecosystem is occupied by opportunistic microbes (primarily gardnerella).

Bacterial vaginosis can develop in any woman.

Thus, the cause of the disease is not just the presence of pathogens of bacterial vaginosis (almost every woman has them in a small amount), but a change in the ratio of the proportion of lactobacilli and opportunistic microbes that cause bacterial vaginosis. In bacterial vaginosis, the proportion of lactobacilli decreases, and the proportion of pathogens of bacterial vaginosis increases. That is why bacterial vaginosis is called vaginal dysbiosis.

Bacterial vaginosis can develop in any woman, although some factors disrupt the natural microflora and increase the risk of developing the disease:

• douching with water or medicinal solutions to cleanse the vagina;
• having a new sexual partner;
• having multiple sexual partners;
• use of scented soap;
• smoking;
• the use of intrauterine contraceptives (IUDs) made of plastic and copper;
• use of vaginal deodorants;
• washing underwear with some detergents.

You can NOT get bacterial vaginosis from swimming pools, toilets, bedding, or other items.

SYMPTOMS OF BACTERIAL VAGINOSIS

About 50% of women with bacterial vaginosis have no symptoms. What's more, sometimes bacterial vaginosis can come and go for no apparent reason. According to statistics, even if antibiotic treatment is effective in 90% of cases, 25% of women can develop bacterial vaginosis again within the next four weeks.

The main symptom of bacterial vaginosis is a vaginal discharge that is thin and watery, gray or white in color, odorless or with a strong fishy odor.

Burning during urination and can also indicate vaginal dysbacteriosis, but are much less common.

Usually, bacterial vaginosis is diagnosed during: the gynecologist, in addition to the patient's complaints, will pay attention to the presence of white or gray discharge and an unpleasant odor. If the patient is sexually active, there is a chance she may have an STI and the doctor may order some additional tests.

WHAT TO TREAT BACTERIAL VAGINOSIS

- The treatment of bacterial vaginosis is quite simple - it is the use of antimicrobials containing metronidazole, - says Elena Berezovskaya. – In some cases, treatment must be cyclic. After antimicrobial treatment, it is desirable to restore the normal microflora of the vagina with lactobacillus preparations. It is important to remember that the elimination or reduction of the influence of factors that provoke the growth of opportunistic flora is the key to successful treatment. Since vaginal dysbacteriosis is often associated with intestinal dysbacteriosis, correction of the bacterial flora of the intestine helps to reduce the number of relapses of the disease.

Treatment of male partners does not reduce the number of relapses of vaginal dysbiosis in women.

It is noteworthy that men generally do not require treatment for bacterial vaginosis: studies have shown that simultaneous treatment of partners does not reduce the number of relapses of vaginal dysbiosis in women. Treatment of bacterial vaginosis is especially important for, as the disease increases the risk of preterm birth. Women who have had a preterm or low birth weight baby should see a gynecologist even if they don't have any symptoms.

ANTIBIOTICS AND PROBIOTICS FOR THE TREATMENT OF BACTERIAL VAGINOSIS

Bacterial vaginosis can be treated with antibiotics. When used correctly, they give between 85% and 90% efficiency.

Metronidazole is the most common antibiotic for treating bacterial vaginosis.

He is appointed:

• in the form of tablets that are taken orally 2 times a day for 7 days. This is the preferred treatment if the woman is breastfeeding or expecting a baby;
• in the form of tablets that are taken orally once. Compared with a seven-day course of treatment, a single dose of metronidazole may lead to a recurrence of bacterial vaginosis;
• in the form of a vaginal gel, which is applied once a day for 5 days;
• in the form of probiotics with metronidazole.

In a Cochrane systematic review, researchers reported that probiotics, together with antibiotics, increase the effectiveness of treating vaginal dysbiosis. Important: metronidazole does not interact well with alcohol, therefore, while taking this antibacterial drug, you should not drink alcohol for at least 48 hours after the end of treatment.

Clindamycin is an antibiotic often used to treat bacterial vaginosis if metronidazole doesn't work or the disease has returned.

He is appointed:

• in the form of a vaginal cream, which is applied once a day for 7 days;
• in the form of a capsule, which is taken orally 2 times a day for 7 days.

This method is rarely used at present due to the risk of developing pseudomembranous colitis.
Important: when treated with clindamycin, some barrier methods of contraception become less effective (latex condoms, diaphragms), so women are advised to use additional contraceptives (polyurethane condoms).

Tinidazole- Another antibiotic that will help get rid of bacterial vaginosis if metronidazole was ineffective. It is taken orally 1 time. Do not drink alcohol while taking this medicine.

TREATMENT OF BACTERIAL VAGINOSIS WITH FOLK REMEDIES

On the Internet, you can find many tips for the alternative treatment of bacterial vaginosis. Most often, it is recommended to douche with infusions of chamomile, decoctions of oak bark, bird cherry, coltsfoot leaves and juniper fruits. There are also recipes for baths from herbal decoctions.

Self-treatment of bacterial vaginosis using unverified folk recipes is categorically not recommended: firstly, a woman can skip concomitant inflammation, in which heating is contraindicated, and secondly, scientists have proven that douching increases the risk by 2 times, can contribute to the development, candidiasis () and some genital infections.

Improper treatment of vaginal dysbacteriosis can lead to dangerous consequences. If you want to cure bacterial vaginosis without antibiotics, be sure to consult a gynecologist.

Improper treatment of vaginal dysbacteriosis can lead to dangerous consequences:

• make a woman more susceptible to HIV infection, chlamydia, gonorrhea and HPV;
• increase the risk of developing certain complications of pregnancy: premature birth, miscarriage, chorioamnionitis and postpartum endometritis, pelvic inflammatory disease and upper genital tract infections.

Source Zvezda is a social and political newspaper of the Khvalynsk region. Khvalynsk: https://hvzvezda.ru/zdorove/kak-lechit-bakterialnyi-vaginoz.html

Bacterial vaginosis (or gardnerellosis) is a common disease of women, and women of young, reproductive age. The disease develops against the background of an imbalance of bacteria in the vagina.

The vagina of a healthy woman is a balanced environment where more than 1000 types of microorganisms coexist, each of which has its own role; they form a normal vaginal microflora. A special role in it is played by lactobacilli, or lactobacilli (Lactobacillus spp.), As well as bifidobacteria and propionic acid bacteria.

Lactobacilli (they are normal - almost 90%) - lactic acid bacteria, perform a primary task - produce hydrogen peroxide, creating an acidic environment in the vagina (pH 3.8 - 4.5). It is this environment that restrains and balances the aggressive activity of other (anaerobic) representatives living in the vagina.

The “trigger” of bacterial vaginosis is always a decrease in the number of beneficial lactobacilli in the vaginal environment (or their disappearance altogether), which reduces the concentration of lactic acid in the vagina. Conditionally pathogenic (not dangerous under normal conditions) anaerobic microorganisms are activated, primarily gardnerella (Gardnerella vaginalis), which occupy the vacated niche. Their number increases by 5-6 times. Gardnerella colonize the vagina in the form of colonies, and the volatile compounds they form - amines - have a characteristic smell (rotten fish).

Symptoms of bacterial vaginosis in women

Bacterial vaginosis has 2 variants of the course: with characteristic symptoms of the disease and without symptoms. Women pay attention to abundant, sometimes foaming, vaginal discharge, reminiscent of the smell of rotten fish. The smell can intensify before and after menstruation, during intercourse.

During the course of the disease, the viscosity and color of the discharge may change. So, at the beginning of garnerellosis, the symptoms are reduced to the appearance of leucorrhoea of ​​a liquid-mucous consistency, with a protracted course they become thick and viscous. The color of the discharge may become yellowish-green. As a rule, the process is delayed for 2-3 years.

Often the only sign of gardnerellosis in women is the appearance of gray-whitish discharge (whites) from the genital tract. Pays attention to the smell of whites, similar to the smell of rotten fish. But quite often, bacterial vaginosis does not manifest itself at all. Approximately 45% of cases of bacterial vaginosis in women are asymptomatic, and this complicates the process of diagnosis.

Other symptoms can be added to the discharge: pain and discomfort in the genital area that occurs during intercourse - dyspareunia, itching and burning in the vulva.

With these symptoms, bacterial vaginosis is easy to suspect. However, approximately half of the patients are asymptomatic with positive laboratory findings for bacterial vaginosis and no clinical symptoms. In this case, the idea of ​​a possible bacterial vaginosis is suggested by frequent and severe inflammatory diseases and regularly occurring relapses after the treatment.

Why are the symptoms of gardnerellosis in men often erased?

The "strong half" receives the bacterium Gardnerella vaginalis, the causative agent of gardnerellosis, from an infected woman during intercourse. But, unlike a woman, gardnerellosis in a man is more often observed in a carrier format. This is explained by the features of the urogenital tract, in the lower sections of which gardnerella gets and where it lingers. During this period, without knowing it (since there are no symptoms), a man is dangerous for his partners, because he infects them through sexual contact.

If, against the background of Gardnerella vaginalis, inflammation develops in the genitourinary system of a man, the symptoms become brighter: urethritis (painful urination, pain and burning in the urethra), and then inflammation of the glans penis (swelling, pain, discharge with an unpleasant odor). Symptoms of gardnerellosis in a man in the form of non-specific inflammation help the doctor quickly diagnose and prescribe treatment.

- an infectious non-inflammatory lesion of the vagina, in which the normal flora is replaced by polymicrobial associations of conditionally pathogenic bacteria. Bacterial vaginosis occurs against the background of immune disorders, inflammatory diseases of the reproductive system, menstrual disorders, prolonged use of the intrauterine device, unsystematic use of antibiotics and hormonal drugs. Accompanied by profuse discharge with an unpleasant odor. Sometimes it is asymptomatic. The diagnosis is established on the basis of complaints, anamnesis and data from special tests. Treatment is local and general pharmacotherapy.

General information

Bacterial vaginosis is a non-inflammatory infectious process in which the normal lactoflora of the vagina is replaced by associations of anaerobes. It is a widespread pathology, diagnosed in 21-33% of patients who visit gynecologists. May be latent or with overt clinical symptoms. With the improvement of the general condition of the body, the symptoms of bacterial vaginosis disappear or smooth out, when exposed to various endogenous and exogenous factors, they reappear, which causes a long relapsing course of the disease. Pathology does not apply to sexually transmitted diseases. Due to hormonal changes, it often occurs during gestation and menopause. Treatment of bacterial vaginosis is carried out by specialists in the field of gynecology.

Causes of bacterial vaginosis

Normally, more than 95% of the vaginal microflora in women of childbearing age are aerobic and anaerobic lactobacilli. The remaining 5% includes more than 40 species of various microorganisms. The ratio of anaerobes and aerobes in a healthy vaginal microflora is 10:1. Lactobacilli are the basis of the natural barrier between the external environment and the uterine cavity. Due to the formation of acids and the release of hydrogen peroxide, they create an acidic environment that prevents the reproduction of pathogenic and conditionally pathogenic microbes.

Under adverse conditions arising under the influence of one or more endogenous and exogenous factors, the quantitative and qualitative composition of the microflora changes. The number of lactobacilli decreases, other microorganisms begin to actively multiply, primarily obligate anaerobes. The total number of bacteria increases. Bacterial vaginosis develops. A distinctive feature of this pathology is the absence of a specific pathogen. The cause of the infectious process is not one type of microorganisms, but polymicrobial associations.

Bacterial vaginosis can occur with immune disorders as a result of a general weakening of the body, acute and chronic infectious diseases. Another factor contributing to the development of bacterial vaginosis are changes in the hormonal background when the phase of the menstrual cycle changes, amenorrhea, oligomenorrhea, single-phase cycles, during gestation, in adolescence and menopause. Of great importance is the use of hormonal agents (corticosteroids, oral contraceptives), antibacterial, antiviral and antifungal drugs.

The likelihood of bacterial vaginosis increases with non-compliance with hygiene rules, frequent douching, increased radiation exposure (radiation therapy, exposure during professional contact with radioactive substances), malformations of the reproductive system, conditions after surgical interventions, polyps and cysts of the vagina, the use of an intrauterine device, diaphragms, tampons and spermicides. Risk factors for developing bacterial vaginosis also include post-abortion and childbirth conditions, atrophic changes in the vaginal mucosa, and intestinal dysbacteriosis.

Symptoms of bacterial vaginosis

The most characteristic and often the only symptom of bacterial vaginosis is discharge from the genital tract, often with an unpleasant odor similar to the smell of stale fish. Usually leucorrhea is liquid, white or slightly grayish. They can be abundant, constant, lasting for several years, or sparse, short-lived, appearing from time to time. The average amount of leucorrhea in bacterial vaginosis is about 20 ml per day, which is 10 times the volume of normal secretions. With a long course of the disease (for several years), the color and consistency of the discharge often change. Leucorrhea becomes thicker, frothy, sticky, yellowish or greenish.

The nature and amount of whites with bacterial vaginosis vary depending on age, general health, mental and emotional state of the woman (mental trauma and intense stress), sexual activity, phase of the menstrual cycle, endocrine disorders, diseases of the reproductive system and somatic diseases. In some cases, patients with bacterial vaginosis complain of burning, itching, urination disorders, pain or discomfort during intimacy.

Perhaps acute or torpid, asymptomatic, monosymptomatic (only with secretions) or polysymptomatic course of the disease. In some patients, the manifestations of bacterial vaginosis persist for a long time, in others they periodically occur under the influence of adverse factors. When collecting an anamnesis, it turns out that more than 90% of patients with suspected bacterial vaginosis have previously consulted a gynecologist and other specialists with complaints of discharge and other symptoms. Three-quarters of patients have been repeatedly treated for non-specific vaginitis using antibacterial suppositories and various oral antibacterial agents.

Diagnosis of bacterial vaginosis

The diagnosis of "bacterial vaginosis" is established on the basis of complaints, anamnesis, gynecological examination data and the results of special tests. During the survey, the doctor clarifies whether the woman suffers from diseases of the reproductive system, endocrine and somatic diseases, whether she takes hormonal drugs and antibacterial agents, whether she uses contraceptives, whether there were childbirth, abortions and surgical interventions on the genitals in the anamnesis, what is the intensity of sexual life etc.

The main laboratory study in bacterial vaginosis is the microscopy of smears taken from the posterior fornix and stained by Gram. During microscopy, the number of leukocytes is estimated, the forms and types of microorganisms that make up the vaginal microflora are studied. The presence of a large number of anaerobes with a decrease in the number of lactobacilli indicates the presence of bacterial vaginosis. A characteristic sign of the disease are key cells - mature epithelial cells, on the membrane of which various microorganisms (gardnerella, cocci, mobiluncus) are detected. Normally, such cells, as a rule, are not detected. In some cases, a false diagnosis of bacterial vaginosis is possible, due to the presence of epithelial cells with adherent lactobacilli in the smear.

Some studies of bacterial vaginosis mention serological, enzyme-linked immunosorbent and culture methods for diagnosing this pathology, however, such methods are still of purely scientific interest and are not used in wide clinical practice. Diagnostic criteria for bacterial vaginosis are the presence of specific leucorrhoea, identification of key cells by smear microscopy, a pH greater than 4.5, and the appearance of a stale fish odor when the leucorrhea reacts with potassium hydroxide. The diagnosis of bacterial vaginosis requires the presence of at least three of the four criteria.

If comorbidities are identified, additional examinations and consultations of various specialists may be required. Patients with bacterial vaginosis may be referred for a consultation with a general practitioner, endocrinologist, urologist, venereologist, mycologist, or gastroenterologist. If necessary, ultrasound of the pelvic organs, general blood and urine tests, a biochemical blood test, a stool test for dysbacteriosis, a blood test for hormones and other studies are prescribed.

Bacterial vaginosis is differentiated from gonorrhea, trichomoniasis, vaginal candidiasis, and nonspecific vaginitis. The hallmarks of gonorrhea are a liquid discharge with a yellowish or greenish tinge, combined with painful urination. The presence of trichomoniasis is evidenced by abundant sticky or frothy gray-yellow-green discharge, possibly with a stale odor. Sometimes whites are combined with itching and pain when urinating. Candidiasis can be suspected when flaky, cheesy white discharge appears, combined with burning and itching of the vagina. To exclude these diseases, special laboratory tests are required.

Treatment and prevention of bacterial vaginosis

The treatment regimen is determined individually, taking into account the severity of symptoms, the duration and form of bacterial vaginosis, the presence of concomitant inflammatory processes, changes in the reproductive system, somatic and endocrine diseases. Treatment includes two stages: taking antibacterial agents and restoring normal microflora. For the entire period of therapy, a patient with bacterial vaginosis is recommended to exclude alcoholic beverages, limit the intake of spicy and spicy foods.

At the first stage, metronidazole or clindamycin is prescribed orally or intravaginally, in the form of vaginal tablets, suppositories or creams. The duration of taking these drugs for bacterial vaginosis is 7-10 days. If necessary, immunocorrectors and antihistamines are used simultaneously. For the prevention of candidiasis (especially important - in the presence of a history of fungal infection), antifungal drugs are used. To correct the pH, topical agents with a high content of lactic acid are administered.

1-2 weeks after the completion of the first stage of treatment, a re-examination and laboratory tests are carried out to evaluate the effectiveness of bacterial vaginosis therapy. After another 2-3 days, the second stage begins, the main task of which is to restore normal lactoflora. Probiotics and eubiotics are used. In 90% of cases, the result of treatment is the normalization of the vaginal microflora. The tests are repeated after 10 days and 1-1.5 months. after completion of the second stage of therapy. With a persistent course of bacterial vaginosis, additional examinations are prescribed to identify pathogenic factors that contribute to the development of relapses of the disease.

Among the measures for the prevention and timely detection of bacterial vaginosis include compliance with the rules of intimate hygiene, the thoughtful use of hygiene products, the exclusion of frequent douching and the rational selection of methods of protection, taking into account the intensity of sexual activity, the state of health and the hormonal background of the patient. Uncontrolled intake of antibacterial and antifungal drugs should be avoided, consult a doctor in a timely manner if symptoms of inflammatory diseases appear, regularly visit a gynecologist for preventive examinations, and treat intestinal dysbacteriosis.

Bacterial vaginosis is a condition in which there is a violation of the quantitative and qualitative composition of the microflora of the vagina. According to various data, about 20 percent of women of reproductive age suffer from this disease. This disease may not manifest itself for a long time. In some cases, external manifestations in the form of secretions from the genital tract with a pungent odor can be so pronounced that it makes a woman seek help from a gynecologist at the very debut of the disease. Unfortunately, timely seeking medical help is not always the key to successful treatment. The reason for the failure in the treatment of this disease is the many factors that can cause vaginosis.

What is the normal microflora of the vagina?

Normally, the vast majority of vaginal bacteria are lactobacilli, which are also called Doderlein sticks. These bacteria are represented by 4 species: Lactobacillus acidofilus, Lactobacillus Casei, Lactobacillus Fermentum, Lactobacillus cellobiosus. These bacteria have a number of properties inherent only to them: they produce peroxides that form an acidic environment in the vagina (normal pH is 3.8-4.4) and prevent the reproduction of other types of microorganisms in the vaginal lumen.

How does the body control the microflora of the vagina?

The immune system
It controls the microflora due to the secretion of IgA antibodies. On the surface of the cells of the vaginal mucosa, this immunoglobulin prevents bacteria from attaching to epithelial cells, which prevents the penetration of bacteria into the cell or into the layers of the mucous epithelium. With infectious inflammation, the army of leukocytes immediately moves into the lumen of the vagina to destroy the pathogenic or conditionally pathogenic microflora that caused the inflammation.

Properties of lactobacilli
Naturally, most of the bacteria colonizing the vaginal mucosa tend to create an environment that would be most favorable for their own development and unsuitable for the reproduction and development of competitors. Due to the ability of lactobacilli to secrete hydrogen peroxide, a rather acidic environment is created, which is unsuitable for life for many pathogenic bacteria.

What is vaginosis?
Vaginosis is a violation of the composition of the microflora of the vaginal mucosa that does not cause an inflammatory reaction. The clinical symptoms of such a disorder can be different - from the complete absence of symptoms, to pronounced discharge with an unpleasant odor, with a feeling of itching and discomfort.

Causes of bacterial vaginosis

• Violation of the hormonal background. A number of gynecological and endocrinological diseases are accompanied by a violation of the cyclical change in the concentrations of female sex hormones in the blood. Violation of the hormonal background leads to changes in the renewal of the vaginal epithelium, the properties of the cells of the vaginal epithelium.
• Decreased immunity. Violation of the activity of the immune system leads to a decrease in the ability of the immune system to influence the composition of the microflora, the activity of the synthesis of secretory antibodies, the activity of immune cells decreases.
• Violation of the intestinal microflora. A change in the bacterial composition of the intestine leads to a change in the composition of the microflora of the vagina. Therefore, intestinal dysbacteriosis can serve as the main cause of vaginosis.
• Use of antibiotics- in some cases, it can lead to a change in the qualitative and quantitative composition of the vaginal mucus. The thing is that antibiotics do not have a selective effect on certain types of bacteria. For example, in the treatment of bronchitis, along with the destruction of the bacteria of the bronchial tree, the antibacterial drug also destroys the beneficial microflora of the intestines and genital tract.

Symptoms of bacterial vaginosis

• Abundant or scanty discharge from the genital tract. More often, the discharge is purulent, white in color, with an unpleasant pungent odor, the discharge is more active after sexual contact or during menstruation.
• Itching is constant, may intensify during menstruation.
• Pain during genital intercourse. This symptom can be caused by a change in the mucous epithelium of the vagina and the aggressive properties of the vaginal microflora.
• Adhesion of the labia minora - associated with the active release of pus.
• Burning sensation during urination - this symptom rarely occurs and may be associated with irritation of the mucous membrane of the external urethra.

Diagnosis of bacterial vaginosis

The symptoms of bacterial vaginosis are listed in the previous chapter of the article.

Gynecological examination
On examination, the gynecologist reveals abundant purulent discharge of their genital tract, in some cases the labia are glued together with drying pus. When viewed in the mirrors, pus can be detected on the surface of the mucosa.

Laboratory research

Microscopic examination of a smear from the vaginal mucosa- is the main method in the diagnosis of vaginosis. A smear is taken from the posterior surface of the vaginal part of the cervix during a gynecological examination in the mirrors. After staining with special reagents, the smear is examined under a microscope. Most of the known bacteria that actively colonize the uterine mucosa in vaginosis can be identified as a result of this examination. The sensitivity of this method reaches 100%.

Bacteriological research not as effective in diagnosing the cause of vaginosis. However, this method in some cases is indispensable for diagnosing concomitant infectious lesions.

Amino test effective for express diagnosis of vaginosis caused by anaerobic bacteria. As a result of the vital activity of these bacteria, organic substances such as putrescine, cadaverine, trimethylamine are released into the external environment. These substances create the smell of "spoiled fish".

DefinitionspH vaginal secretion. Revealing a pH over 4.5 is one of the signs of vaginosis. As we said above, low pH values ​​​​in an acidic environment provide beneficial bacteria (Doderlein sticks). A decrease in acidity indicates that their number is reduced.

Treatment of bacterial vaginosis

The second and third stages are standard for all types of vaginosis:

Use of antibiotics

Restoration of the numerical and qualitative composition of the normal microflora of the vagina

It is important to note that the use of local forms of eubiotics (in the form of vaginal suppositories) does not always bring the expected result. Therefore, the recommendations are reduced to an integrated approach - the intake of eubiotic preparations orally and the local use of drugs in this group.

The duration of treatment is determined by the attending gynecologist individually, depending on the results of the intermediate diagnosis and the dynamics of the process.

The effectiveness of the treatment can be assessed only 4-6 weeks after the end of the course of treatment. The main criterion for the normalization of microflora is a quantitative and qualitative bacteriological examination of a smear from the vaginal mucosa.

Prevention of bacterial vaginosis

• Rational use of antibiotics.
• Maintaining the intestinal microflora at a normal level (prevention of intestinal dysbacteriosis).
• Normalization of the hormonal background (treatment of hormonal gynecological diseases).
• Maintaining the protective properties of the body (immunity) at a high level
• In some cases, the use of vaginal hygiene products and contraceptives should be excluded.

How to treat vaginosis during pregnancy?

For the treatment of vaginosis during pregnancy, drugs containing metronidazole. In this case, vaginal remedies are preferable to tablets that must be taken orally. It is especially convenient to use the gel with metronidazole (it is inserted into the vagina with a special syringe). The drug is used once a day at bedtime for 7 days.

Equally effective and convenient is metronidazole in the form of vaginal pills ( Klion-D) to be inserted deep into the vagina at bedtime for 10 days.

For the treatment of vaginosis in pregnant women, drugs such as Trichopolum, Metrogil, Tiberal, Ornitazol produced in various forms.

All of these drugs are used only after 20-22 weeks of pregnancy, when they cannot harm the developing fetus.

In the earlier stages of pregnancy, treatment of vaginosis with antimicrobial drugs is prescribed only in case of a real threat to the health of the mother and fetus.

In addition to specific drugs, in the treatment of vaginosis, pregnant women must be prescribed drugs containing lactobacilli. They are used both inside and in the form of douching. They are useful not only for restoring the microflora of the vagina, but also for the female body as a whole.

Treatment of vaginosis in a pregnant woman can only be carried out as directed and under the supervision of a gynecologist.

What suppositories are effective in the treatment of vaginosis?

How to treat vaginosis at home?

• In the initial stages, douching can be dispensed with. For this, a 2-3% solution of lactic or boric acid is suitable. For the procedure, it is enough to take a large syringe. The solution should be warm, but not hot. Procedures can be carried out 1-2 times a day. Efficacy depends on how early treatment is started. If the symptoms of vaginosis are not particularly pronounced, then douching will be enough, but in any case, tests should be taken after treatment.

• Medicines can be injected into the vagina using tampons. To do this, a cotton swab is moistened with the selected agent (it can be a solution of ascorbic or lactic acid; ointment with metronidazole or tinidazole; lactobacterin) and inserted deep into the vagina. The duration of the procedure is 15-20 minutes. After that, remove the swab and do not wash. The effect appears after 3-4 procedures. To achieve the desired result, you need to do 10 procedures.

• It is especially convenient to use vaginal tablets or suppositories. It can be Klion-D, Metronidazole, Vaginorm, Ecofemin, Klevazol, etc. A tablet or suppository should be inserted deep into the vagina. The duration of treatment depends on the type of drug and is indicated in the instructions. Signs that the remedy really helps will appear in a couple of days. As a rule, the itching decreases, and the discharge disappears. But do not give up treatment; you need to complete a full course of 7-10 days.

What are the traditional methods of treating vaginosis?

Infusions of medicinal plants for oral use:

• Mix equal amounts of leuzea and marshmallow roots, as well as pine buds, sweet clover grass, wormwood, cudweed, lavender. Two tablespoons of the mixture is poured with a liter of boiling water. After 6 hours, you can take the infusion inside half a glass before meals three times a day. The treatment lasts three months.
• Also inside you can use an infusion from the following mixture: elecampane roots, birch leaves, mint, chamomile, licorice, thyme, geranium and meadowsweet in equal amounts. The method of preparation and dosage are similar to those described above.
• You can try the following mixture: lingonberry leaves, knotweed, elecampane, viburnum, lavender, plantain, tansy, leuzea and mistletoe, taken in equal parts. The solution is prepared in the same way as in the previous recipes.
• Another option is to mix equal amounts of dry herbs of bergenia, knotweed, calendula, angelica, nettle, toadflax, coltsfoot; chicory and dandelion roots. Apply as in previous recipes.

• Mix dry crushed blueberry, cuff, birch, tansy and Greek leaves taken in equal amounts. Two tablespoons of the mixture is brewed with one liter of boiling water and infused for 6-8 hours. After this, the infusion must be filtered and used for douching or vaginal tampons, wetting the tampon with infusion and inserting it deep into the vagina. The procedure is carried out daily up to 2-3 times a day. One procedure will require a glass of infusion.

• Mix in equal proportions oak bark, geranium herbs, wormwood, chamomile and violets. The infusion is prepared in the same way as in the previous recipe. It is used in the form of douching or tampons.
• A mixture of the roots of mountaineer serpentine, Veronica grass, plantain, yarrow, thyme, calendula flowers and bird cherry leaves. The components are mixed in equal amounts. The infusion is prepared in the manner described above. Used for douching.
• Marshmallow roots, St. John's wort, marigold flowers, meadowsweet grass, dandelion leaves and blueberries are mixed in equal amounts. The infusion is prepared by the method described above. It is used in the form of douching or tampons.

Many of the fair sex at least once in their lives faced with such a problem as bacterial vaginosis (or bacterial vaginosis). This is an unpleasant disease that threatens not only with its clinical manifestations, but also with possible complications. What is this disease, what leads to its appearance, how does it manifest itself and is it possible to fight it?

The development of gardnerellosis affects women of reproductive age. Therefore, the cause of the development of the disease is often associated with sexual transmission. The physiological environment of the vagina is acidic. It is with such a microflora that pathogenic pathogens, having penetrated the genital canals, cannot have a negative impact on health.

The natural environment of the vagina is represented by lactobacilli - short thick rods that dissolve glycogen. Cells are not visible visually - their number can only be determined using a microscope. To maintain a stable pH level, the concentration of lactobacilli must be at least 98%. Bacterial vaginosis is one of the polymicrobial diseases.

The spontaneous reduction in vaginal acidity and lactobacilli is not caused by a single pathogen, but by a combination of them. The definition of "bacterial vaginosis" is explained by the peculiarities of the development of the disease. The pathogenic process proceeds with the participation of a large number of aerobic and anaerobic microflora. A feature of the pathology is the absence of leukocytes (cells that are elevated only during inflammation).

How does it develop

The replacement of the physiological environment of the vagina with pathogenic microorganisms occurs under the influence of a wide range of adverse factors. They are associated with previous interventions on the organs of the reproductive system, lifestyle, and nutritional habits.

From the moment the microflora of the vagina changes (after gardnerella gets into it) and until the first signs appear, it can take from several days to 2-3 months and even six months. In extremely rare cases, the incubation period took more than 1 year. In this matter, the determining factor is the state of the woman's immunity. The weaker the protective properties of the body, the more pronounced the symptoms of the pathology and the earlier it manifests itself.

Risk factors

With a high degree of probability, bacterial vaginosis develops in women for whom the following are relevant:

1. Frequent stress, psycho-emotional state problems
2. Recent surgical interventions or instrumental diagnostic procedures on the organs of the urogenital tract
3. Cystic neoplasms in the organs of the genitourinary system (regardless of the number, size, location, cause of development)
4. The use of drugs containing nonoxynol-9 (for example, Patentex oval, Nonoxynol)
5. Condition after recent childbirth (especially burdened)
6. Wearing underwear made from synthetic fabrics
7. The formation of the menstrual cycle (the period of hormonal changes negatively affects the condition of the vaginal mucosa, making it vulnerable)
8. Uncontrolled or unreasonably long-term use of hormonal, anti-inflammatory, antifungal drugs. This is especially true for the use of antibiotics.
9. Transferred radiation or chemotherapy (for tumor diseases)
10. Poor nutrition, obsessive diets
11. Using low quality detergents

The risk group for the development of gardnerellosis includes women who douche excessively often, do not perform hygiene procedures, and supercool. Latex intolerance, hypersensitivity to lubricants, spermicidal creams adversely affect the condition of the vaginal mucosa.

Symptoms

The main signs of the development of bacterial vaginosis:

1. Vaginal discharge. They are characterized by a sharp fishy smell, green-yellow hue, abundance (their number is 20 times higher than the norm). The consistency is thick, sticky, foamy. Secretion increases after intercourse, douching, menstruation.
2. Severe pain during intercourse, which prompts to stop it. Discomfort has an acute, burning character, persists for a certain time after intimacy.
3. Unpleasant sensations during urination (stinging, irritation inside the urethra).
4. Insomnia, discomfort in the lower abdomen during menstruation, not related to the cycle.
5. A sharp, putrid-fishy smell from urine, a change in its shade.

During the examination, the color of the mucous membranes of the vagina characteristic signs of the inflammatory process (edema, redness) is not observed. The body temperature remains within the normal range, and there are no complaints about the typical signs of intoxication (chills, weakness). Therefore, not suspecting the presence of the disease, the woman does not go to the doctor or does it late.

The reasons

Experts identify the following causes of bacterial vaginosis:

• Change in hormonal background. It is observed during puberty, pregnancy, menopause, after an abortion.
• Intestinal dysbacteriosis (violation of its natural microflora). It develops as a result of inflammation of the large or small intestine, intoxication. Violation of the microflora contributes to the observance of an exhausting diet, starvation.
• Atrophic changes in the mucous membrane of the vagina (occur mainly during menopause).
• Constant use during menstruation only tampons. They contribute to intravaginal stagnation of blood, create a favorable condition for inflammation.
• The presence of diabetes mellitus decompensated form. Pathology contributes to regular irritation of the vaginal mucosa.

The risk of developing gardnerellosis increases if a woman is sexually promiscuous, uses an intrauterine device for an excessively long time. The source of inflammation present in the body increases the likelihood of an infectious pathology.

Degrees

In gynecology, a certain classification of bacterial vaginosis is used. According to this, according to the severity of symptomatic manifestations, the disease is divided into compensated, subcompensated and clinically pronounced type.

Compensated

It is characterized by the absence of lactobacilli in the vagina, which creates the risk of replacing the natural microflora with pathogens. Such indicators do not apply to a pathological condition. Often they are associated with overly thorough hygienic treatment of the genital tract before a visit to the gynecologist. In particular, if a woman used antiseptic preparations or highly concentrated detergents to cleanse the intimate area. Also, bacterial vaginosis of this type occurs with oncological neoplasms - due to radiation and chemotherapy.

Subcompensated

It is characterized by a decrease in the number of lactobacilli, which indicates a violation of the natural microflora of the vagina. Edema and redness of the mucous membrane of the genital tract is not observed. Therefore, changes can only be detected in the laboratory. Leukocytes - 15-20 in the field of view, which refers to a moderate degree. There is an increase in other microbial flora.

Against the background of leukocytosis, the so-called "key" cells appear. Their number is up to 5 in the field of view. The main symptoms of this degree of vaginal candidiasis are itching, soreness during intimacy. Additionally, there is an increase in vaginal discharge, the appearance of an unpleasant odor from them.

clinically pronounced

It is characterized by the complete absence of lactobacilli and the presence of anaerobes. When examining a smear under a microscope, "key" cells occupy the entire field of view of the laboratory assistant. The main manifestations of the condition are a large amount of vaginal discharge, itching inside the genital tract. Pathogenic secretion, the volume of which increases after intercourse, glues the walls of the vagina.

Features in pregnant women

Bacterial vaginosis is one of the diseases, given the danger to the fetus, gynecologists recommend undergoing a detailed preliminary study. The main consequences of the disease for the child and the expectant mother:

1. Intrauterine fetal injury. The consequences of exposure to pathogenic flora on a child are anomalies in his development. There is an incorrect laying of organs - in particular, the heart, neural tube, musculoskeletal system, skull bones.
2. Miscarriage. The infectious process stimulates uterine spasms, which contributes to the rejection of the fetal egg. The first signs of the condition are pain in the lower abdomen, the appearance of bloody discharge from the genital tract.
3. Freezing fetus. Bacterial vaginosis is a pathological process that has an extremely negative effect on the developing fetus. The infection contributes to disruption of the blood supply to the child, causes its intoxication, which leads to intrauterine death. The first signs of the condition are dark spotting from the genital tract, an increase in body temperature to high numbers. During a gynecological examination, a discrepancy between the size of the uterus and the gestational age is established.

Often, bacterial vaginosis can cause polyhydramnios or oligohydramnios, isthmic-cervical insufficiency, placental insufficiency. Also, complications of gardnerellosis are premature onset of labor or infection of the child during its passage through the birth canal. In 2% of cases, the presence of bacterial vaginosis is associated with the development of preeclampsia during pregnancy and premature rupture of the membranes.

If the pathology occurs during pregnancy, the condition becomes more complicated due to problems with the selection of treatment. The difficulty lies in the fact that antibiotics and other anti-inflammatory drugs are contraindicated during gestation.

Possible Complications

Bacterial vaginosis can cause urethritis, cystitis, colpitis, cervicitis, and in the most severe cases, endometritis. Listed inflammation of the bladder, urethra, vagina, cervical canal, the inner layer of the uterus. Due to chronic and often latent inflammation of these organs, infertility develops, but the risk of ectopic pregnancy is also high. Violation of the vaginal environment that occurs during gestation increases the risk of serious complications.

Which doctor to contact

Bacterial vaginosis is treated by a gynecologist. But the determining factor is the root cause of the pathology. If the disease is caused by diabetes mellitus, an additional appeal to the endocrinologist will be required. With the relationship of bacterial vaginosis with genital infections, it is necessary to contact a venereologist. If gardnerellosis is a consequence of intestinal dysbacteriosis, you need to consult a gastroenterologist.

Diagnostics

Initially, the doctor conducts a survey and examination of the patient. From the anamnesis, she learns about the presence of problems with digestion, the change of sexual partner, the use of new intimate products. An obstetric history is also of no small importance - you need to inform the doctor if complications occurred during pregnancy or labor. During the examination on the gynecological chair, no signs of inflammation are detected.

The purpose of the examination is to exclude the presence of diseases with similar symptoms, and then to determine the degree of organ damage and the presence of complications. Similar signs in the course of ureaplasmosis, thrush (vaginal candidiasis), trichomoniasis. Examination of the patient makes it easy to differentiate infectious pathology. Standard set of diagnostic procedures:

1. Microscopic examination of a smear from the vagina. The most revealing type of examination. Detects all changes in the vaginal microflora.
2. Blood test for glucose, general clinical and biochemical parameters.
3. Urinalysis is general (a large number of leukocytes are detected in the sample).
4. Bacteriological examination of urine (sowing).
5. PCR diagnostics (detection of the causative agent of pathology - gardnerella).

Already on the basis of the results of the smear, it becomes clear that the microflora of the vagina is disturbed. It is established that lactic acid bacteria are almost absent, the level of leukocytes corresponds to the norm or slightly exceeds it, the pH of the secretions is more than 4.5. In 95% of cases, the listed types of examination are enough to clarify the clinical picture.

Additional types of diagnostics depend on the characteristics of the underlying cause of bacterial vaginosis. It is possible that an ultrasound of the abdominal cavity and small pelvis will be required. Diagnosis is carried out on the eve of treatment, 2 weeks after its start, and 1 month after its completion.

Treatment

Gardnerellosis is not treated in an operative way - a fairly comprehensive, but conservative approach. In addition to eliminating the infectious agent, you need to restore the pH of the vagina. In the long term recovery is of no small importance strengthening the body's immune abilities.

To stop bacterial vaginosis, the patient is prescribed:

1. Use of an anti-inflammatory drug (of the options listed below, 1 or 2 is prescribed). Metronidazole (Trichopol) 1 tab. 2 p. per day, the duration of the therapeutic course is 10 days. Clindamycin (150 mg) - 1 tab. 4 p. per day. The duration of treatment is 1-1.5 weeks. Tiberal (500 mg) - 1 tab. twice a day, up to 5 days in a row.
2. The use of vaginal suppositories with anti-inflammatory, antifungal, antibacterial action. These include Vagisept, Terzhinan, Vagiferon. Assign the introduction of 1 candle 1 p. per day, after careful intimate hygiene. The therapeutic course is 10 days.
3. Restoration of intestinal microflora. Assign Linex (2 capsules 3 rubles a day, 3 weeks in a row) or Hilak Forte (1 teaspoon per 100 ml of water 3 rubles a day, 3 weeks).
4. Vitamin therapy. Group B drugs are administered individually or in the form of complexes (these include Neurobex, Neurorubin). The therapeutic course, subject to intramuscular administration of drugs, is 10 days.
5. Diet food. Refusal to eat sweets, sour, spicy, salty, smoked foods, dishes. Alcohol and caffeine are prohibited. If bacterial vaginosis is caused by intestinal dysbacteriosis, undesirable foods include fried and fatty foods, legumes.

After stopping pathogenic microorganisms, the normalization of the vaginal microflora is shown through the use of drugs such as Laktonorm, Bifidumbacterin, Acilact. Vaginally administered Vaginorm, Laktogel or their analogues.

At the time of treatment, it is necessary to observe sexual rest. It is equally important to carry out hygiene measures in full (especially after going to the toilet and during menstruation). It should be remembered that bacterial vaginitis can infect a man during intimacy, cause complications for the sexual health of a partner. Therefore, he needs to simultaneously undergo treatment by contacting a urologist.

Forecast

If you eliminate not only gardnerellosis, but also the cause of its development, the prospect of restoring health is favorable. When the pathology takes a protracted course, the reproductive function of a woman is threatened. In general, the disease lends itself well to elimination, but on condition that the treatment is made by a doctor, and the patient follows all his recommendations.

Prevention

To avoid the development of bacterial vaginosis, the following recommendations will help:

• The use of vitamins (especially during the off-season)
• Cold protection
• Maintaining a decent sex life
• Restriction from stress
• Exclusion of the use of abortion as the optimal method of birth control
• Prevention of constipation - refusal to eat dry food, fractional nutrition
• Selection of an alternative method of contraception (for latex intolerance)
• Timely correction of the state of intestinal microflora
• Full implementation of hygiene measures
• Normalization of blood glucose levels, regular visits to the endocrinologist (with a hereditary predisposition to diabetes)
• A healthy approach to the use of intimate products
• Refusal of the experimental attitude to the selection of hygiene products

Excessive use of tampons during menstruation causes irritation of the vaginal mucosa. Therefore, it is recommended to periodically apply gaskets. It is equally important to timely eliminate diseases of the organs of the urogenital tract, preventing the transition of pathologies into a chronic form. You should also adequately approach the issue of douching, taking medications.

Bacterial vaginosis is a gynecological pathology of polymorphic origin, which is eliminated without surgery. Even with a conservative approach, treatment should be comprehensive - in addition to medication, include diet, hygiene, and sexual rest. Pathology causes complications only in case of prolonged neglect of one's health. In particular, when a woman does not visit a gynecologist for a long time and does not know about the presence of the disease. If the pathology is caused by endocrine or gastrointestinal disorders, you will need to visit doctors of these profiles.

Video: How to cure bacterial vaginosis

Almost ninety percent of the microflora are lactobacillus bacilli, which prevent the colonization of pathogenic microorganisms and monitor the amount of opportunistic microflora. In addition, bacilli produce the production of substances with antibacterial activity.

If the acidity of the vaginal environment changes towards alkalization, favorable conditions are created for the active reproduction of conditionally pathogenic microorganisms. In general, our body strictly controls the microflora of the vagina and does this using the following mechanisms:

• hormonal system. If the hormonal background changes, then the number of receptors that are on the surface of the cells changes accordingly, and it is to these receptors that harmful bacteria attach. Also, it is the hormonal system that controls the process of updating the vaginal mucosa;
• immunity. This protective system controls the number of opportunistic microflora, and immunoglobulins prevent harmful bacteria from attaching to cells and penetrating deeper;
• lactobacilli. These beneficial microorganisms create an acidic environment in which pathogenic bacteria simply cannot actively multiply.

What is bacterial vaginosis

This is a disease of the female genital organs with specific vaginal discharge that has an unpleasant odor. In simple terms, this is vaginal dysbacteriosis. Unlike vaginitis, there are no inflammatory signs in bacterial vaginosis.

Although the disease itself is not a sexually transmitted infection, early sexual activity, promiscuity and unprotected sex can significantly contribute to the occurrence of bacterial vaginosis.

The basis of this disease is a change in the quantitative composition of the microflora of the vagina. The number of beneficial bacteria decreases, while the conditionally pathogenic microflora begins to multiply actively.

In each case, the clinical picture of the disease may differ, ranging from an asymptomatic course to a pronounced clinical picture with severe discomfort, itching and discharge.

Causes of vaginosis

As for the specific pathogen, it simply does not exist. Entire polymicrobial complexes lead to the appearance of the disease, among which mycoplasmas and gardnerella can be noted.

The causes of vaginal dysbacteriosis can be very many. Consider the most important provoking factors:

• hormonal changes, for example, after an abortion, during menopause or pregnancy;
• weakening of general or local immunity;
• endocrine disruption;
• poor observance of the rules of intimate hygiene;
• deformation of the vagina or cervix;
• frequent use of soap when washing and the abuse of douching;
• the presence of foreign bodies in the vagina;
• the use of hormonal agents, as well as immunosuppressants;
• use of oral contraceptives or long-term use of intrauterine contraceptives;
• severe stressful situations;
• inflammatory processes of the urinary and reproductive systems;
• intestinal dysbacteriosis;
• prolonged or uncontrolled use of antibiotics.

Immediately it should be noted that the disease has no characteristic signs. Often, its only symptom is profuse vaginal discharge with an unpleasant fishy odor.

At the very beginning of the development of the pathological process, the discharge has a white or grayish color. With a long course of that ailment, they can acquire a thick consistency with a yellow-green tint. In their appearance, they resemble cottage cheese, foam, become sticky and viscous.

There are no such signs of the inflammatory process as edema and hyperemia with vaginosis, this is a hallmark of vaginitis. Often the disease is accompanied by such pathological processes: cervicitis, erosion, scarring. Approximately in fifty percent of cases, patients experience the addition of vaginitis.

The most common signs of the disease are the following symptoms:

• abundant grayish-white discharge of a homogeneous creamy consistency, which is evenly distributed along the walls of the vagina;
• discomfort with intimacy;
• pain in the perineum;
• urination disorders.

If the disease lasts more than two years, the following symptoms are characteristic:

• discharges change their color and consistency, resembling a curdled mass;
• whites become dark green;
• pathogenic flora joins the infectious process, which leads to inflammation of the vagina, manifested as swelling and redness;
• whites are easily removed from the walls of the vagina with a cotton swab;
• frequent and painful urination;
• itching around the vulva.

Types of bacterial vaginosis

There are several classifications of bacterial vaginosis. Depending on the clinical manifestations, the disease is divided into the following groups:

• asymptomatic;
• monosymptomatic;
• polysymptomatic.

By the nature of the pathological process, the disease is:

• sharp;
• chronic;
• recurrent.

Depending on the severity, bacterial vaginosis occurs in the following forms, namely:

• compensation stage. The compensated type manifests itself in the form of a slight decrease in the number of lactobacilli. At this stage, the colonization of microorganisms that have entered the body from the outside takes place;
• subcompensated stage. The reduction of lactobacilli occurs in a significant form and the activation of conditionally pathogenic microorganisms occurs;
• stage of decompensation. Lactobacilli are completely absent. There is a pronounced clinical symptomatology and such a pathological process requires long-term therapeutic therapy.

Bacterial vaginosis during pregnancy

Often the disease is diagnosed during pregnancy. According to statistics, the disease occurs in every fifth woman.

In pregnant women, the hormonal background changes, the immune system weakens, thus creating favorable conditions for the development of the disease. In its manifestations during pregnancy, the disease is no different, and a woman is also worried about thick foamy discharge with an unpleasant smell of stale fish.

Bacterial vaginosis poses a risk to both the mother and the developing fetus:

• in the early stages, spontaneous abortion may occur;
• a disease that develops in the second or third trimester threatens to infect the fetus, which can lead to premature outflow of water;
• premature birth;
• complications during labor;
• purulent-septic complications in the postpartum period.

For the treatment of pregnant women, it is preferable to use local rather than systemic drugs. Means that include metronidazole are usually prescribed. Such drugs are used in the form of vaginal pills or gels. Doctors also prescribe to pregnant women such remedies: Trichopolum, Metrogil, Tiberal.

The above funds are prescribed from the second trimester of pregnancy, so in the first there is a laying of vital organs and systems. If there is a real threat to the mother or child, then the doctor may decide to prescribe antimicrobial agents at an earlier date.

Women are also prescribed drugs containing lactobacilli to restore microflora. They can be used both inside and in the form of douching. Treatment is carried out under the strict supervision of a doctor.

Forecast

Despite treatment, in some cases, relapses may occur at any stage after the end of therapy. This is most likely due to the fact that antibiotics that affect pathogenic microflora interfere with the rapid creation of favorable conditions for the active reproduction of beneficial bacteria.

For this reason, probiotic preparations should be included in the complex therapy. Their action is aimed at restoring the natural balance of microflora, which will serve as a good prevention of relapse.

Diagnostics

The most informative diagnostic method is a microscopic examination of a gynecological smear. Under a microscope, a specialist detects key cells - a clear sign of gardnerellosis. A bacteriological study is also carried out, which will help identify the pathogen.

Already on the basis of clinical symptoms alone, a specialist may suspect the presence of vaginosis, but an accurate diagnosis is made on the basis of laboratory data. The gynecologist conducts an examination, during which he detects a discharge characteristic of the disease.

Bacterial vaginosis in men

Many experts consider it incorrect to use the very expression "bacterial vaginosis" in relation to men, because this is vaginal dysbacteriosis. Nevertheless, the causative agents of this disorder - gardnerella - can provoke the development of the pathological process in the male body.

The causative agents of gardnerellosis can penetrate through sexual contact. Unlike the female body, gardnerella are not natural inhabitants of the male body. It is for this reason that the disease in men is treated as a sexual infection.

In most cases, the causative agent of the disease easily penetrates the male body and is just as quickly excreted after two or three days. Sometimes there may be a chronic carriage, in which there are no clinical manifestations. The danger lies only in the fact that a man may not know about the carriage, but at the same time pass gardnerella to his partner.

Sometimes these microorganisms during sexual intercourse can penetrate the urethra and cause a sluggish current inflammatory process. In this situation, green discharge appears from the penis. Which practically do not disturb the man. And sometimes this can lead to the development of urethritis with the appearance of pain and burning during urination, this of course requires medical therapy.

How is bacterial vaginosis transmitted?

Bacterial vaginosis is not a sexually transmitted disease!

In general, pathogens, in particular, gardnerella, can be sexually transmitted, but this will not cause the development of dysbacteriosis, because these microorganisms are part of the natural microflora in small quantities. If immunity is normal, then the body's defense mechanisms simply will not allow the opportunistic pathogen to attach to the surface of the cell, and even more so to penetrate deeper.

Then what role do unprotected sex play in the onset of the disease? Here the point is not at all in infection, but in the fact that the frequent change of sexual partner violates the natural balance of microflora.

When should you see a doctor?

Consider the reasons that may serve as a reason for contacting a specialist:

• infectious process arose for the first time. The doctor will help identify the etiological factor and talk about the characteristic symptoms, as well as tell you how to deal with them;
• the disease did not occur for the first time, but the symptoms this time are different;
• you have a new sexual partner. Signs of sexually transmitted diseases are similar in their manifestations to bacterial vaginosis;
• fever and unpleasant odor from the vagina;
• despite self-treatment, recovery never came.

What is the treatment for bacterial vaginosis?

Bacterial vaginosis in women is treated in two main steps:

1. Restoration of the physiological properties of the vagina, strengthening the body's defenses, normalization of hormonal levels and the fight against pathogens.
2. Restoration of the natural balance of the microflora of the vagina.

In addition to the main treatment, the patient is prescribed immunocorrective and desensitizing agents. It is not advisable to treat a sexual partner.

Medicines for bacterial vaginosis

Medicines are used after medical prescription. Self-medication is unacceptable.

Eubiotics

Consider a treatment regimen with effective eubiotics:

• Baktisubtil. One capsule is drunk one hour before meals three to four times a day;
• Khilak forte. Fifty drops three times a day;
• Linex. It is taken two tablets three times a day.

Candles from bacterial vaginosis

Vaginal suppositories act directly in the focus of the pathological process. The active substance is practically not absorbed into the blood, which means it causes a minimum of side effects.

• Ecofemin. The composition of the drug includes live lactobacilli. Suppositories are administered for ten days two to three times a day;
• Bifidumbacterin. Contains bifidobacteria. It is enough to introduce one candle at bedtime for ten days;
• Hexicon. Contains chlorhexidine. A feature of Hexicon is that it has a detrimental effect on pathogenic microorganisms, while not affecting lactic acid bacteria. One or two suppositories are introduced for 10 days.

Treatment regimen for bacterial vaginosis

To begin with, consider the standard treatment regimen with systemic drugs:

• Ornidazole. A single dosage is 500 mg. The remedy should be taken twice a day for one week;
• Metronidazole. The usage pattern is exactly the same;
• Clindamycin. Single dosage - 300 mg. Take the tablets twice a day for seven days.

Now let's talk about the scheme of using local drugs:

• Neo-penotran. For seven days, a suppository is injected intravaginally twice a day;
• Terzhinan. One suppository is inserted deep into the vagina twice a day for five days;
• Clindamycin cream. The full applicator is administered at bedtime for seven days.

How to treat vaginosis at home

Consider several ways to treat the disease at home:

• if the disease has just begun to develop, douching can be of good help. Lactic or boric acid is suitable as a solution. The liquid for the procedure should be warm, but in no case hot. One or two douches per day are enough;
• You can use tampons intravaginally. They are wetted in ascorbic or lactic acid. Tampons are also lubricated with metronidazole ointments. The tampon is left in the vagina for twenty minutes, after which it should not be washed away. It is necessary to do ten such procedures, but the effect is already visible after the third application.

Folk remedies for bacterial vaginosis

Treatment with the help of non-traditional methods is longer, but the safest. But this is provided that they are correctly used. Folk remedies are not an alternative to medical treatment, but only auxiliary help. You can use them with the permission of the doctor.

Consider the most effective recipes:

• sitz baths. The duration of this procedure is fifteen minutes. They quickly remove the itch. For their implementation, you will need two glasses of herbal infusion, which are mixed with ten liters of warm water. Infusions can be prepared from the following medicinal plants: oak bark, chamomile, wormwood, St. John's wort, calendula, dandelion, etc.;
• infusions for oral administration. Take the following ingredients in equal proportions: elecampane root, birch leaves, mint, chamomile, licorice, thyme. One tablespoon of crushed raw materials is poured with half a liter of boiling water. The remedy must be infused for six hours. After it has been filtered, the infusion is ready for use. Treatment lasts for three months. Half a glass is drunk half an hour before a meal;
• cotton swabs are soaked in the infusion and inserted into the vagina. To prepare the medicine you will need: marshmallow root, St. John's wort, meadowsweet, dandelion leaves, blueberries and calendula. The components are taken in equal proportions, poured with boiling water and the remedy should be infused for several hours.

Prevention

It is important for every woman, especially those who have already been treated for gardnerellosis, to follow simple but effective preventive measures:

• proper observance of the rules of intimate and sexual hygiene;
• in case of casual sexual intercourse, the use of barrier methods of contraception;
• timely treatment of inflammatory processes of the genitourinary system;
• full sleep and the fight against stressful situations;
• balanced diet;
• rational use of antibiotics;
• normalization of hormonal levels;
• prevention of the development of intestinal dysbacteriosis;
• regular visits to the gynecologist.

So, bacterial vaginosis is a disease in which there is a violation in the natural balance of the microflora of the vaginal mucosa. A number of reasons can lead to its appearance, among which we can distinguish a change in the hormonal background and weakening of the immune system. One of the main signs of the disease is copious discharge from the vagina of a white-gray color with a fishy smell.

Bacterial vaginosis should be treated by a doctor. It all starts with a diagnostic examination and an accurate diagnosis. Accurate adherence to the treatment regimen, preventive measures, as well as the elimination of provoking factors will help get rid of the disease once and for all!