Symptoms and main treatments for bacterial vaginosis

Last updated November 6, 2017 at 3:43 pm

Reading time: 6 min

The microflora that is located in the vagina is constantly changing and reflects the woman’s health status. Even in the absence of disease, there is a certain amount of pathogenic bacteria in the vagina. Typically, the vagina is protected by lactobacilli.

In addition to protection, they also normalize the acidity of the environment and form hydrogen peroxide, which, in turn, suppresses the proliferation of pathogenic microbes.

When the number of lactobacilli decreases, pathogenic microorganisms multiply unhindered; accordingly, vaginal dysbiosis begins and bacterial vaginosis develops in women.

What is bacterial vaginosis called?

What is bacterial vaginosis?

This condition is also called gardnellosis. The disease is infectious in nature, but is not an inflammatory process. Characterized by the replacement of normal microflora with pathogenic strains of anaerobic bacteria. Normal vaginal flora may be completely absent.

This disease is quite common; more than thirty percent of women consult a doctor with this disease. Moreover, there are scientific studies indicating that every woman suffers from this disease at least once in her life.

Despite the fact that manifestations of this disease are rare, patients experience the consequences quite often. They are mainly associated with pregnancy. An infected woman may have a miscarriage, premature birth at a later date, and postpartum problems with the vaginal mucosa.

Moreover, the infection can spread further and affect the pelvic organs.

Bacterial vaginosis is rarely the only problem a patient has; it is often accompanied by other diseases of the genitourinary system.

What causes the disease

The causes of bacterial vaginosis have not been fully identified. In order for the disease to develop, several factors must coincide. There are many factors that can influence the development of the disease.

Among the favorable factors are:

excessively frequent hygiene procedures;
frequent douching;
chronic STI;
change of sexual partner, presence of several partners at the same time;
wearing synthetic underwear;
use of antibiotics;
intestinal dysbiosis;
decreased immunity;
lack of fermented milk products in the diet.

Bacterial (microbial) vaginosis is caused by causes that disrupt the normal development of female microflora. The imbalance leads to a quantitative and qualitative change in glycogen in the secretions.

At the same time, female sex hormones continue to give a signal for further production of lactobacilli. As beneficial bacteria decrease, the number of harmful organisms also changes. They enter the active reproduction phase.

Ways of contracting the disease

Infection as such does not occur. Since bacterial (microbial) vaginosis is not an infection, it is therefore not transmitted from person to person. If this disease is detected in a woman, there is no need to treat her sexual partner. The bacteria does not come from outside. It is precisely those bacteria that were in the vagina in small quantities at rest that multiply.

You cannot become infected through contact. The disease is not transmitted when visiting a public toilet, swimming pool, or through bed linen. With bacterial vaginosis, active sex life is only a stimulating factor. Since in the absence of sexual intercourse, BV does not develop.

Internal consequences of infection

Normally, the vagina is acidic. It is supported by female hormones. In combination with lactic acid, a constant acidity value of pH 4-4.2 is maintained. This level helps the evolutionary function, since only a strong sperm can overcome it.

Such care reduces the likelihood of having weak and sick offspring.

Since there is no infection, but inflammation is present, the analysis does not show a high level of leukocytes, characteristic of the usual picture of the inflammatory process. Instead of leukocytes, the smear inoculates a large number of gardnerella.

A decrease in acidity leads to a violation of another protective function. The fact that the vagina is a hollow organ of the body makes it more susceptible to infection. Sexually transmitted infections are especially dangerous.

Even if the disease is completely eliminated, some of the pathogens can remain dormant in the vagina for a long time; when favorable conditions arise, they begin to actively multiply.

Symptoms of the disease

Most often it goes unnoticed. There may be no symptoms of bacterial vaginosis. However, there are common symptoms that are characteristic of bacterial vaginosis.

Sometimes the only obvious manifestation is the presence of an unpleasant odor from the vagina. It is somewhat reminiscent of the smell of fish. Along with the smell, women complain of strong vaginal discharge. They are especially intensified before menstruation and after sexual intercourse. Sometimes this discharge is accompanied by itching.

Patients try to eliminate discharge with the help of panty liners, but their use further aggravates the problem. In warmth, without access to oxygen, bacteria multiply much faster.

The consistency of the discharge may vary. There are both thick and liquid transparent discharges.

The only way to notice a problem in time is to carefully monitor your health. If the changes are periodic, then you need to consult a doctor. The attending physician will not always notice the problem during a visual examination.

The vaginal mucosa does not look inflamed. For asymptomatic BV, a laboratory test using the Nugent system is prescribed. It is this analysis that can confirm the diagnosis.

With a long course of the disease without treatment, the discharge thickens and is noticeable on the walls. If the signs of bacterial vaginosis recur periodically for three months, then we can talk about a relapsing course of the disease. Unfortunately, this disease has a high risk of relapse.

Half of the patients experience a re-exacerbation of the condition within a year after treatment.

If the infection has spread very strongly, patients complain of cramps and pain, especially after sexual intercourse. In the presence of inflammation of the pelvic organs, aching pain in the lower abdomen appears, fever, general deterioration of the condition, and weakness are possible.

Not everyone has this disease. Men cannot become infected and are not carriers.

Treatment methods for vaginosis

Bacterial (microbial) vaginosis, the symptoms of which are very vague, must be treated. Otherwise, it leads to complications and irreversible consequences.

The course of treatment can be divided into two stages. At the first stage, the main task is to destroy pathogens that have begun to multiply excessively. For this, a course of exposure to vaginal suppositories and gels that contain an antibiotic is prescribed. Treatment with antibiotics should only be carried out under the supervision of the attending physician.

Different bacteria can be killed with different drugs. Therefore, before starting the use of antibiotics, an analysis should be carried out to determine the sensitivity to antibiotics of precisely those microorganisms that populate the vagina.

In addition, there are also personal characteristics of the body. Some patients experience allergic reactions to medications. Before starting the course, you must do an allergy test.

For bacterial vaginosis, an additional oral antibiotic may also be prescribed. This method is used only in severe cases.

The next stage of treatment is the restoration of normal vaginal microflora. Using special vaginal suppositories, lactobacilli are introduced into the vaginal cavity.

It is quite difficult to achieve complete restoration of the flora. Bacterial suppositories are not completely absorbed. Therefore, in addition to suppositories, lactobacilli are often prescribed additionally orally.

In addition to restorative treatment, drugs that restore immunity may be prescribed. Despite the fact that this method has not proven its effectiveness, it is often prescribed by gynecologists.

Treatment during pregnancy

During pregnancy, there are restrictions on many medications. This is the reason for difficult and long-term treatment of many diseases, including BV. The use of antibiotics is contraindicated for pregnant women, so they have to undergo treatment for a very long time.

In parallel with treatment, it is necessary to diagnose intestinal dysbiosis and, if possible, eliminate all factors that provoke the disease.

Along with medications, a woman should eat more fermented milk products.

Possible complications of the disease

Vaginosis is very dangerous for a woman’s health. It causes severe complications if left untreated. This is not only a cosmetic inconvenience, but also a serious sign of health problems.

As soon as pathogenic microflora begins to multiply uncontrollably, bacteria become provocateurs of serious diseases. For example, a sexually transmitted infection that was successfully treated may return.

Inflammation of the pelvic organs

As a result of the low acidity of the vaginal environment, microorganisms gain access to the genital organs of the small pelvis. Very quickly, the infection can reach the cervix, uterine body and rise to the ovaries.

Inflammation of the ovaries and fallopian tubes is a very serious disease that requires long-term and complex treatment. Sometimes the disease even affects the bladder.

Complications during pregnancy

If a complication develops during pregnancy, then doctors are very limited in their methods of intervention.

Bacterial vaginosis can cause miscarriage in the early stages and premature birth later in pregnancy. Even while you are expecting a baby, you need to take measures to eliminate the infection and restore healthy vaginal flora.

Probability of getting an STD

Since the protective mechanisms of the vagina are greatly reduced, a woman can easily become infected with any sexually transmitted infection. In addition, the patient often suffers from concomitant candidiasis.

conclusions

Despite the fact that BV cannot be called an infectious disease, it is a serious problem for the female body. If treatment is not timely, a large number of complications may develop.

To prevent the disease, you need to follow the rules of hygiene, closely monitor your health, beware of stress and be careful about your choice of sexual partners. Men do not suffer from this disease, but vaginal dysbiosis is often a reaction to a change in partner.

Source: https://GemoParazit.ru/bakterii/simptomy-bakterialnogo-vaginoza

Bacterial vaginosis: symptoms, diagnosis and treatment

The content of the article:

The diagnosis of bacterial vaginosis refers to a change in the normal flora of the vagina. Doctors also call this disease vaginal dysbiosis.

What is bacterial vaginosis

Under normal conditions, the female organ contains a lot of fermented milk bacteria (Lactobacillus acidophilus, or rods and Lactobacillus Doderlein). Thanks to such microorganisms, an acidic environment is formed.

As a rule, during a sexually transmitted disease, the number of lactic acid microorganisms decreases, and then they are replaced by pathogenic, or rather opportunistic, bacteria. Such microorganisms provoke the development of the disease with a weakened immune system. This phenomenon causes a drop in the acidity level in the vagina.

Previously, it was believed that bacterial vaginosis occurs due to the penetration of any one type of microorganism. Consequently, a second name for bacterial vaginosis arose - gardnerella or hemophilic vaginitis. Today it has been determined that bacterial vaginosis does not occur due to one microbe, but due to an imbalance of different types of bacteria.

As a result, bacterial vaginosis is not an infectious disease and is not sexually transmitted. Unlike vaginitis, bacterial vaginosis does not provoke inflammatory processes in the vagina.

Can you get bacterial vaginosis through sexual contact?

It is immediately worth noting that this sexual disease does not apply to sexually transmitted diseases.

Provocateurs of bacterial vaginosis (primarily gardnerella) can be transmitted through sexual contact.

However, their transmission from one carrier to another does not yet cause the disease, since these microorganisms are present in small quantities in the normal vaginal flora of many women.

However, sexual intercourse without the use of contraceptives affects the appearance of bacterial vaginosis. This does not concern the infection itself, but the fact that when a partner changes, the vaginal flora changes.

Risk factors for developing bacterial vaginosis

It is possible to assume that bacterial vaginosis is present in the following cases: - Your sexual partner has recently changed; — Antibiotics were taken not long ago; — For several weeks there was a frequent change of sexual partners; — There is an intrauterine device; - Used contraceptive creams and suppositories containing 9-nonoxynol (for example, Nonoxynol, Patentex Oval); - Douching was recently performed; — Lack of personal hygiene. The above factors are not the main root cause of the pathological process, however, they negatively affect the vaginal environment and provoke the appearance of bacterial vaginosis.

Symptoms of bacterial vaginosis

The main symptom of bacterial vaginosis is profuse grayish vaginal discharge. There can be up to 30 ml per day.

The discharge has a fairly liquid consistency and has a characteristic fishy odor, which becomes more intense after sexual intercourse without a contraceptive, because the alkaline pH of semen increases the production of volatile amines.

Sometimes during sexual intercourse you may notice a burning sensation or discomfort, as well as irritation of the vulva. In some cases, bacterial vaginosis occurs without discomfort.

Bacterial vaginosis: photo

Diagnosis of bacterial vaginosis

In order to identify the disease, the following diagnostic methods are used:

— Analysis of a smear under a microscope; — Culture of the vaginal microflora, quantitative and qualitative research to determine the degree of dysbacteriosis; — Determination of the type of all pathogens, including Gardnerella, using modern API systems; — Establishing the sensitivity of isolated pathogens to antibiotics and bacteriophages, which makes it possible to select medications for treatment; — Determination of the genetic material of Gardnerella in the polymerase chain reaction, the most sensitive test, but not specific for Gardnerella.

To make an accurate diagnosis, diseases such as ureaplasmosis in women, vaginal candidiasis, trichomoniasis in women and other sexually transmitted diseases should be excluded.

When does a smear indicate bacterial vaginosis?

Diagnosis of bacterial vaginosis is carried out based on characteristic vaginal discharge, changes in the vaginal smear, and decreased acidity. Many patients learn about the diagnosis by the result of a smear on Wednesday.

If the patient has bacterial vaginosis, then the following changes are present in the smear: - Many key cells (cells of the vaginal epithelium, which are covered by a large number of coccobacilli); — A large number of cocco-bacillary forms (bacteria in the form of cocci and rods); — Lactic acid bacteria are practically absent; — Leukocytes are at normal levels or slightly elevated; - Presence of Mobiluncus; — The pH level of the discharge exceeds 4.5.

Differential diagnosis of bacterial vaginal vaginosis with trichomoniasis, candidiasis and ureaplasmosis

Signs	Vaginal candidiasis or thrush	Trichomoniasis	Bacterial vaginosis	Ureaplasmosis
The smell of discharge	Sourish-sweet smell	Strong foul odor of fish	Unpleasant fishy smell	May have a natural or ammonia odor
Nature of the discharge	Abundant, thick, homogeneous, milky, cheesy consistency	Abundant, foamy, purulent, yellow-green in color	Abundant, liquid, gray-white, may be foamy	Abundant, cloudy, sometimes whitish in color; between cycles there may be brown spotting
Feel	Burning and itching in the vagina, discomfort and pain during urination and during sexual intercourse, the burning intensifies when a woman sits cross-legged	Severe external and internal itching in the vagina and external genitalia, hyperemia of the vaginal mucosa, disturbances in the urination process	Vaginal itching, discomfort during intercourse	Pain in the lower abdomen, discomfort during intercourse, itching and burning in the genital area

Treatment of bacterial vaginosis

The first reason to start treatment is regular vaginal discharge. In addition, this phenomenon after some time develops into an inflammatory-infectious process. During treatment, it is necessary, first of all, to restore the correct balance of vaginal microorganisms, and not just to eliminate pathogenic microbes.

Long-term dysbiosis, which is present in bacterial vaginosis, can have a bad effect on the immune system, allowing it to weaken, which in turn can lead to other diseases or cause exacerbation of chronic ones.

Let's look at how bacterial vaginosis is treated, if it appears for the first time, keep in mind that if the disease recurs, then the treatment is increased or switched to other drugs.

Please note the following: the following medications are selected individually and only by a doctor.

Before starting treatment, it is important to visit and consult with your treating gynecologist, and you should also undergo tests.

Specific treatment for bacterial vaginosis

Specific treatment is aimed at destroying the microorganisms that cause the disease.

Treatment regimen for bacterial vaginosis

Orally

■ Metronidazole (Trichopol) 2 g. inside once.

■ Metronidazole (Trichopolum) 250 mg, take one tablet twice a day (morning and evening) during or after meals. The course is 10 days.

When taking Metronidazole, urine may turn red-brown in color due to the presence of a water-soluble pigment formed as a result of the metabolism of metronidazole.

■ Tinidazole 2 g per day, these are 4 tablets of 500 mg (therapy lasts 2 days) or 1 g per day - 2 tablets (treatment lasts 5 days).

■ Clindamycin 150 mg. You need to take 1 tablet 4 times a day. The duration of treatment is 7-10 days.

■ Ornidazole (Tiberal) 500 mg. 1 tablet or capsule 2 times a day. The course of treatment is usually 5 days.

Vaginally

■ Clindamycin (Dalacin) 2% 100 mg (vaginal cream). One applicator (5 g of cream) should be administered at night. Duration of treatment – 1 week.

■ Metronidazole (Flagyl, Metrogyl) 500 mg (vaginal suppositories). At night you need to administer one suppository. The course of treatment is 10 days.

■ Neo-penotran forte is a combination drug that consists of metronidazole and

miconazole. Has antimicrobial and antifungal effects. 1 suppository is inserted deep into the vagina at night for 7-14 days.

■ Fluomizin , one vaginal suppository before bedtime for 6 days.

■ Betadine (povidone-iodine) 200 mg. one candle per week.

■ Chlorhexedine diglucanate (Hexicon) 1 suppository 2 times a day for 1 week.

Immunocorrective therapy for bacterial vaginosis

Viferon 1 rectal suppository 2 times a day every 12 hours every day for 5-10 days.

Lactobacillus acidophilus in bacterial vaginosis

Acylact is inserted 1 suppository 2 times a day for 5-10 days. Acylact in suppositories is contraindicated for candidiasis, since a rapid shift in pH to the acidic side promotes fungal growth.

Restoration of intestinal microflora

When taking antibiotics, the following drugs are prescribed together: Linex or Bifiform.

Normalization of pH levels

Biofam is a means for restoring the intimate microflora of the intimate area by creating the most favorable conditions due to the content of lactic acid, which maintains a pH of 3.8-4.5.

Vaginal products that contain strains of lactobacilli are designed to replace the dead native microflora, but it is difficult to predict the survival rate of foreign microflora.

Biofam not only creates a favorable environment for the growth and reproduction of its own microflora, but also, due to glycogen - a nutrient substrate - supports their vital activity, and thyme oil reduces the likelihood of an increase in pathogenic strains and relapse.

Probiotics for bacterial vaginosis

Probiotics are drugs that include beneficial microorganisms that are important for the vaginal microflora and that help protect it from infections. These include:

■ Vagilak (tablets for internal use).

■ Gynoflor (vaginal tablets).

The regimen for taking probiotics is as follows:

— A week of admission without breaks.
- A week of rest.
— Week of secondary reception. This drug regimen makes it possible to avoid re-infection after a certain period of time after the end of antibacterial therapy. Taking probiotics is not allowed during pregnancy and lactation.

Treatment of bacterial vaginosis during pregnancy

It happens that bacterial vaginosis causes early labor, so it is important to treat the disease immediately. Medicines prescribed to pregnant patients must be taken with the onset of the 2nd trimester of pregnancy, that is, no earlier than the 13th week.

During pregnancy, ornidazole is allowed, 1 tablet 2 times a day for 5 days, or metronidazole 250 mg, which should be taken 1 tablet 2 times a day. Duration of treatment – 10 days. Clindamycin is contraindicated during pregnancy.

Local treatment with metronidazole or Neo-Penotran forte may also be prescribed. Using vaginal cream or ointment alone does not eliminate the risk of complications from bacterial vaginosis during pregnancy.

Acylact in suppositories can be used in any semester of pregnancy (1st, 2nd and 3rd), in the absence of thrush.

Bacterial vaginosis treatment table

Does my husband (sexual partner) need treatment?

According to statistics, in the majority of the male population whose sexual partners were exposed to the disease, the main provocateurs of bacterial vaginosis (Gardnerella and other bacilli) were found in the urethra. This may indicate that the bacteria can move from the vagina to the man's urethra during unprotected sex.

However, men may not receive treatment. Many studies have demonstrated that therapy with sexual partners does not improve the woman’s condition and the likelihood of a secondary disease does not decrease.

A man may need treatment when bacterial vaginosis is not the first time a woman has developed it, or when sexually transmitted diseases have been diagnosed.

Why is bacterial vaginosis dangerous?

The bacteria that provoke the pathological process of bacterial vaginosis are very susceptible to simple medication treatment, and the disease can be easily cured.

However, if the disease is ignored, the following complications may develop: - Inflammation of the uterine appendages, ovaries and fallopian tubes (adnexitis); — Inflammation of the uterus (chronic endometritis); — Inflammation of the fallopian tubes (salpingitis); - Infertility; — Premature birth (during pregnancy);

- Ectopic pregnancy.

Kraurosis of the vulva

Kraurosis of the vulva is a benign pathology, which, due to the risk of malignancy (20-50%), is classified as a precancerous condition. Characterized by tissue changes with the development of atrophy and sclerosis

Anomalies in the structure of the female reproductive tract

The external and internal genital organs, their formation, growth and development are regulated by the endocrine glands. Any structural changes can impair gonadal function. Reproductive defects

In detail Pelvic organ prolapse in women

Pelvic organ prolapse in women is a condition in which one or more anatomical structures in the pelvic area are displaced from their normal position and bulge into the vagina

Dyspareunia in women in detail

Dyspareunia is a general concept of pain during sexual intercourse. The causes of this sexual dysfunction are varied; pain during sex can be of psychogenic or organic origin. According to

Details

Bacterial vaginosis: causes of the disease, effect on pregnancy, treatment

Bacterial vaginosis is a non-inflammatory disease of the vagina associated with changes in its microflora. This condition is extremely widespread among women of fertile age (20-45 years), its occurrence in this group reaches 80%. That is, out of ten women, 8 experience bacterial vaginosis at least once in their lives.

The disease does not pose a danger to the patient herself, but can negatively affect her reproductive function. Bakvaginosis often causes miscarriages, intrauterine infection of the fetus, complications after childbirth, abortions and invasive interventions on the genitals. How the disease is transmitted and how to get rid of it, read on.

How does bacterial vaginosis develop?

Human existence is inseparable from the activities of various microorganisms. Those of them that, in the process of evolution, have adapted to productive cooperation with people are called normal microflora/biocenosis. Its composition is constant: some microorganisms are found only on the skin, others in the mouth and intestines. In their habitat, they perform essential functions: they protect the host’s body from pathogenic bacteria, produce vitamins, and stimulate the immune response.

Normally, the vagina is populated by lactobacilli - short, thick rods. They break down glycogen, which is rich in vaginal epithelial cells, producing lactic acid.

Thus, an acidic environment is constantly maintained in the woman’s lower genital tract, which prevents the establishment and growth of pathogenic microflora.

To maintain normal conditions and the protective function of the vagina, a large number of lactobacilli are necessary, so their share in its biocenosis is 95-98%.

For various reasons listed below, lactic acid bacilli are displaced and replaced by other microorganisms. This situation facilitates the colonization of the vagina by pathogenic microorganisms - causative agents of sexually transmitted infections, but in most cases there is a change to nonspecific microflora.

It includes bacteria that live on the skin of the perineum, perianal folds, and in the lower part of the urethra. They freely occupy a new habitat, multiply intensively, but cannot perform the functions of normal microflora.

Their enzyme system is different from that of lactobacilli and does not break down glycogen to form lactic acid.

Nonspecific microflora causes a number of disturbances in the metabolic and immune processes of the vagina as a whole. The level of production of protective immunoglobulin A decreases, which prevents pathogenic agents from attaching to the vaginal epithelium.

Epithelial cells partially adsorb opportunistic bacteria on their surface and are intensively desquamated, which is associated with the appearance of discharge in bacterial vaginosis. Lactobacilli are replaced mainly by anaerobes - bacteria that function without access to oxygen.

Some of the products of their metabolism - volatile fatty acids and amino acids - are broken down in the vagina into volatile amines, which have a characteristic fishy odor.

The described changes lead to a shift in vaginal pH from acidic to alkaline values. This entails progressive changes in the protein, carbohydrate, mineral and lipid metabolism of epithelial cells.

Their production and production of mucus increases, which clinically manifests itself as heavy discharge - the main symptom of bacterial vaginosis.

It should be noted that there is no inflammatory reaction in the walls of the vagina and all changes are only functional in nature.

What causes the disease?

Bacterial vaginosis is not a sexually transmitted infection and does not have a single pathogen, so it is also called nonspecific vaginosis.

The root cause is a change in the vaginal environment, which entails disturbances in the microbiocenosis.

The microflora that replaces lactobacilli can be very diverse and is most often represented by associations of opportunistic bacteria. Among them are:

bacteroides;
peptococci;
peptostreptococci;
megaspheres;
leptotrichus;
atopobium;
gardnerella;
mycoplasma.

Their growth, as a rule, is excessive and the number of bacteria in vaginal secretions reaches 1010 per 1 ml. However, comfortable conditions for their reproduction arise only after the influence of certain factors of the external or internal environment of the body.

The main causes of bacterial vaginosis are divided into 2 large groups:

Internal (endogenous):

hormonal imbalance with a predominance of progesterone;
atrophy of the vaginal mucosa;
intestinal dysbiosis;
immune disorders in the body.

External (exogenous):

long-term treatment with antibiotics;
drug immunosuppression - taking cytostatics, glucocorticoids;
radiation therapy of tumors;
foreign objects in the vagina (hygienic tampons, pessary, contraceptive diaphragm, ring);
use of spermicides, frequent douching;
failure to comply with personal hygiene rules.

All of these factors in one way or another disrupt the normal functioning of the vaginal mucosa or cause the death of a large number of lactobacilli. Thus, a niche is freed up for opportunistic microflora and it immediately occupies it.

Bacterial vaginosis during pregnancy is among the main causes of changes in the hormonal status of a woman: normal childbearing requires high doses of progesterone, which reduces the glycogen content in epithelial cells.

The lack of nutrient substrate for lactobacilli leads to alkalization of the vaginal environment and the proliferation of nonspecific microflora. In addition, progesterone reduces the activity of the immune defense, which facilitates the growth of bacterial colonies.

How does bacvaginosis manifest?

Despite the fact that the disease is not a sexually transmitted infection, its occurrence is often associated with sexual intercourse, especially when changing partners.

Signs of bacterial vaginosis in women develop on average one day after intercourse, if it occurred without a condom.

If the cause of the disease is the use of antibiotics and other medications, changes in hormonal levels (menopause), then the symptoms of bacterial vaginosis develop regardless of sexual activity.

Acute vaginosis manifests itself:

discharge from the genital tract: it has a grayish-white color, uniform consistency, and an unpleasant “fishy smell.” Their quantity may vary, as a rule, they become more abundant after menstruation, intercourse, or the use of irritating detergents;
pain during sexual intercourse;
discomfort, itching and burning in the genitals. These signs are usually weak or absent;
Rarely, a woman experiences pain, pain when urinating, and abdominal pain in the suprapubic area.

Chronic bacterial vaginosis is a continuous course of the disease for more than 2 months, despite treatment. As a rule, it is combined with hormonal imbalance and atrophy of the vaginal mucosa.

Diagnostics

The diagnosis is made by a gynecologist after collecting the patient’s medical history, studying her complaints, examining her in a gynecological chair and obtaining laboratory data. In favor of bacterial vaginosis they say:

age – sexually active women of reproductive age are most often affected;
relationship with a change of partner, treatment of other diseases, surgical intervention;
moderate or mild severity of clinical signs of the disease.

During the examination, the doctor assesses the condition of the vagina, cervix, and external genitalia. With nonspecific changes, the mucous membrane is pink, not inflamed, and unevenly covered with secretions. In acute bakvaginosis they are white-gray, with an unpleasant odor.

If the disease has become chronic and lasts for several years, the discharge changes its color to yellowish-green, becomes thicker, more viscous, resembles cottage cheese or has a foamy appearance.

During the examination, the gynecologist measures the pH of the vagina with an indicator strip: with bacterial vaginosis, its value is above 6.

There is a simple but informative test for the rapid diagnosis of bakvaginosis. The doctor places a small amount of discharge on a glass slide and mixes it with a 10% solution of potassium hydroxide. If the reaction is positive, the unpleasant odor intensifies and resembles rotten fish.

Laboratory diagnosis of bacterial vaginosis involves microscopy of stained vaginal smears. Key cells are found in them - epithelial cells of the mucous membrane with microbial bodies adhered to their surface.

The cell takes on a granular appearance, its boundaries become fuzzy and dotted. Also, microscopy reveals a sharp decrease in the number of lactobacilli, up to complete disappearance from the population.

Instead, nonspecific microflora is found: single cocci, streptococci, small bacilli.

Bacteriological seeding of secretions is carried out in rare cases when it is necessary to accurately determine the composition of the altered microflora. The PCR method is used to search for the most common pathogens of sexually transmitted infections (mycoplasma, herpes virus, trichomonas), since they often join opportunistic microflora.

How does the disease affect conception and pregnancy?

Since bacterial vaginosis is a pathology of women of fertile age, many of them are concerned about the question: is it possible to get pregnant with such a diagnosis? Changes in the vaginal microflora do not entail inflammatory changes in the genital tract, and therefore do not pose a problem for conceiving a child. Sperm normally has an alkaline environment and when it enters the vagina, with the pH changed upward, the sperm find themselves in conditions that are comfortable for them.

Why is bacterial vaginosis dangerous in this case? Nonspecific microflora often penetrates the pregnant uterus and affects the developing child.

This condition is called intrauterine infection of the fetus and entails consequences in the form of lack of body weight and developmental delay.

In some cases, the infection leads to spontaneous miscarriage, premature rupture of amniotic fluid, and the birth of a premature baby. With bakvaginosis, the risk of sepsis and purulent complications in women in labor increases, especially after cesarean section.

Treatment

Treatment of bacterial vaginosis is carried out by a gynecologist; if necessary, the patient is additionally observed by an endocrinologist and gastroenterologist. Hospitalization for this disease is not required, since it does not affect the woman’s well-being, does not threaten her life and is not contagious to others.

Therapy is aimed at sanitizing the vagina from opportunistic microflora, colonizing it with lactobacilli and correcting the provoking factors of the disease.

Acute bacterial vaginosis recurs in 35-50% of women in the first six months after one-stage treatment, so it must be carried out stepwise, observing the timing of each stage.

Initially, the woman is prescribed antibiotics: they have a detrimental effect on nonspecific bacteria and cleanse the vaginal mucosa of them.

The drugs of choice are Metronidazole, Tinidazole, Clindamycin, as they are active against anaerobes.

Local use of antibiotics is preferable to avoid systemic side effects, but in some cases the gynecologist is forced to resort to tablet forms. The treatment regimen is selected individually:

Metronidazole in the form of a 0.75% gel is administered into the vagina once a day for 5 days;
a cream with 2% Clindamycin content is injected into the vagina once a day for 7 days;
Tinidazole 2.0 in tablet form is taken orally 1 time per day for 3 days;
suppositories with Clindamycin 100 mg are inserted into the vagina once a day for 3 days;
Metronidazole 2.0 tablets are taken orally once.

In pregnant women suffering from bacterial vaginosis, the use of antibiotics is possible starting in the second trimester. They are prescribed in the form of tablets, the course of treatment lasts no more than 7 days.

During antibacterial therapy and a day after its completion, it is necessary to avoid drinking alcohol, even in minimal doses.

The drugs disrupt the metabolism of ethyl alcohol in the body, which causes the accumulation of toxic metabolites and severe intoxication.

In its course, it resembles a severe hangover: the woman experiences severe weakness, limbs shake, blood pressure rises, a severe throbbing headache occurs, and painful nausea and vomiting develop.

Clindamycin cream contains fat, so it can damage the condom or latex contraceptive membrane. All local forms of drugs are administered immediately before bedtime to prevent them from flowing down the vaginal walls.

If antibiotics are intolerant or there are contraindications to their use, the first stage of treatment is carried out with local antiseptics:

Hexicon 1 suppository is administered 2 times a day for 7-10 days;
Miramistin in the form of a solution is irrigated into the vagina once a day for 7 days.

The drugs used in the second stage of treatment contain lactobacilli and create favorable conditions for restoring the vaginal microflora. They are used 2-3 days after completion of antibacterial therapy:

Acylact 1 suppository 2 times a day is inserted into the vagina for 5-10 days;
Bifiliz 5 doses are taken orally 2 times a day for 5-10 days.

Lactobacilli, which make up up to 98% of the biocenosis of the intimate zone, can exist normally only under certain conditions, for example, at a pH of 3.8 to 4.5. In order to maintain this pH level, it is necessary to use products with lactic acid.

Among the products in this group, Biofam stands out. It contains lactic acid, which maintains the necessary conditions for the existence of lactobacilli, and glycogen for their successful nutrition and reproduction.

The most important component of Biofam is also thyme oil, which, due to the content of thymol and carvacrol in its composition, has a pronounced antiseptic effect against 120 strains of microorganisms, including Candida.

Thyme oil prevents pathogenic microflora from adhering to the surface of the vaginal epithelium and creating biofilms, which reduces the likelihood of relapse of bacterial vaginosis.

Antifungal suppositories, as a rule, are not prescribed. The need for them arises if candidiasis, a fungal infection, joins the opportunistic microflora. In this case, Clotrimazole suppositories are prescribed intravaginally once a day for 6 days.

Self-treatment at home is not recommended, since an incorrectly selected dose of the drug or duration of the course leads to the development of resistance in bacteria.

In the future, it will be extremely difficult to cure such an infection and there will be a high risk of its chronic course.

How to treat bacterial vaginosis in each specific case can best be determined only by a specialist - a gynecologist.

How to prevent it?

Despite the negative answer to the question “is bakvaginosis transmitted sexually,” the influence of changing sexual partners and unprotected sex on the development of the disease is clearly visible.

Therefore, the main prevention is to use barrier contraception - a condom, which can be supplemented with local antiseptics. Douching with Miramistin must be carried out no later than 2 hours after sexual intercourse.

In addition, preventive measures include timely treatment of chronic diseases, taking antibiotics strictly as prescribed by the doctor, and correcting hormonal disorders.

Source: https://ginekolog-i-ya.ru/bakterialnyj-vaginoz.html

Bacterial vaginosis

Bacterial vaginosis (or gardnerellosis) is a common disease of women, especially young women of 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 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 (normally almost 90%) - lactic acid bacteria, perform a primary task - they 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 mechanism” of bacterial vaginosis is always a decrease in the number of beneficial lactobacilli in the vaginal environment (or their complete disappearance), which reduces the concentration of lactic acid in the vagina.

Opportunistic (not dangerous under normal conditions) anaerobic microorganisms are activated, primarily Gardnerella vaginalis, which occupy the vacated niche. Their number increases 5-6 times.

Gardnerellas inhabit the vagina in the form of colonies, and the volatile compounds they produce - amines - have a characteristic odor (rotten fish).

Opportunistic (not dangerous under normal conditions) anaerobic microorganisms are activated, primarily Gardnerella vaginalis, which occupy the vacated niche. Their number increases 5-6 times.

Gardnerellas inhabit the vagina in the form of colonies, and the volatile compounds they produce - amines - have a characteristic odor (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 copious, sometimes foaming, vaginal discharge that smells like rotten fish. The smell may intensify before and after menstruation, and during sexual 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 with a thin-mucous consistency; with a prolonged course, they become thick and viscous. The color of the discharge may turn yellowish-green. As a rule, the process drags on for 2-3 years.

Often the only sign of gardnerellosis in women is the appearance of gray-whitish discharge (leucorrhoea) from the genital tract. The smell of leucorrhoea, similar to the smell of rotten fish, also attracts attention. But quite often, bacterial vaginosis does not appear at all. In approximately 45% of cases, bacterial vaginosis occurs in women asymptomatically, and this complicates the diagnostic process.

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

With such symptoms, it is easy to suspect bacterial vaginosis.

However, in approximately half of patients the disease is asymptomatic: positive laboratory signs of bacterial vaginosis and the absence of clinical symptoms.

In this case, the idea of possible bacterial vaginosis is suggested by frequent and severe inflammatory diseases and regularly occurring relapses after 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 sexual intercourse. But, unlike women, gardnerellosis in men is more often observed in the carrier format.

This is explained by the features of the urogenital tract, into the lower sections of which gardnerella enters and remains.

During this period, without knowing it (since there are no symptoms), the man is dangerous for his partners, since he infects them through sexual contact.

If, against the background of Gardnerella vaginalis, inflammation develops in a man’s genitourinary system, 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 nonspecific inflammation help the doctor quickly make a diagnosis and prescribe treatment.

Source: https://medica24.ru/zabolevaniya/bakterialnyj-vaginoz-gardnerellez