Symptoms of vaginal dysbiosis and methods of treating the disorder

Symptoms and causes of vaginal dysbiosis. How to cure dysbacteriosis (baquaginosis, candidiasis). Exclusively for the site svetulka.ru

Vaginal dysbiosis is a violation of the microflora of the urogenital tract. Vaginal microflora is a complex system of interaction between a large number of different microorganisms. They are divided into obligate (beneficial bacteria and conditional pathogens), facultative (individual carriage of certain bacteria) and transient (bacteria not typical for a given environment, brought from outside).

Normally, the vagina is predominantly inhabited by lactobacilli (Doderlein bacilli). A small amount of microflora consists of bifidobacteria, non-pathogenic staphylococci and streptococci, Escherichia coli and enterococci. In some women, yeast (fungi), gardnerella and other anaerobic microorganisms may also be present.

But under unfavorable factors, the balance is disrupted, opportunistic microorganisms begin to prevail over lactobacilli, which leads to the appearance of unpleasant symptoms and, if untreated, threatens with inflammatory processes in the pelvis.

Causes of vaginal dysbiosis

The cause of the development of vaginal dysbiosis is a combination of factors that negatively affect a woman’s intimate health.

These include:

• intestinal dysbiosis
• changes in hormonal levels (during pregnancy, menopause, after abortion or childbirth)
• taking antibiotics
• violation of the rules of intimate hygiene (neglect of them or, conversely, excessive use of perfumed products)
• frequent wearing of pads
• decreased immunity (hypothermia, colds or infectious diseases, etc.)
• stress
• climate change
• active sexual life without protection
• change of sexual partner
• diseases of the pelvic organs (genital infections, erosion, etc.)
• atrophic processes on the mucous membrane of the genital organs
• wearing synthetic underwear
• use of certain medications (corticosteroids and cytostatics)

Symptoms of vaginal dysbiosis

Vaginal dysbiosis is a condition when pathogenic microflora begins to prevail over beneficial ones, and the symptoms of the pathological process depend on which bacteria begin to multiply more than expected. When there is an abundant growth of gardnerella and other anaerobic flora in the vagina, we can talk about the presence of bacterial vaginosis in the patient.

In a flora smear, it is designated by the words “key cells.” The symptoms of bakvaginosis are quite specific: first of all, it is profuse white-gray vaginal discharge with an unpleasant smell of rotten fish, sometimes accompanied by burning and itching, including in the urethra. Discharge increases after sexual intercourse and menstruation.

If the cause of dysbiosis is the proliferation of fungal flora, especially the genus Candida, it is customary to talk about vaginal candidiasis. Symptoms of candidiasis are manifested by copious discharge with cheesy contents, severe itching in the vagina, as well as burning and irritation of the genital mucosa.

With the predominance of coccal flora in the vagina, the number of lactobacilli decreases, and the number of E. coli, staphylococci, streptococci, Klebsiella and other opportunistic microorganisms increases. Such dysbacteriosis does not have any special manifestations.

A woman may suspect something is wrong when these bacteria penetrate the urethra and bladder, causing urethritis and cystitis (burning during urination, pain and pain in the pubis), or into the uterus and fallopian tubes, provoking such serious diseases as salpingoophoritis and endometritis, manifested by increased body temperature, purulent discharge, severe pain in the lower abdomen.

As mentioned above, the microflora can be disrupted due to a woman having a sexually transmitted infection (chlamydia, ureaplasma, mycoplasma, trichomonas, etc.). The infection changes the acidity of the vagina, promoting the development of inflammation, and therefore the microflora is further disrupted.

Diagnosis of vaginal dysbiosis

To determine which particular bacterium caused vaginal dysbiosis, it is necessary to undergo a series of diagnostic procedures, including examination by a gynecologist, taking a smear for flora, and bacterial culture of discharge. If a sexually transmitted infection is suspected, a smear is also taken from the cervical canal for STDs (sexually transmitted infections).

A flora smear will allow you to determine the presence of an inflammatory process in the urethra, vagina or cervix, diagnose key cells and fungi, and determine the type of flora inhabiting the vagina - rod, mixed or coccal. If coccal flora is present, a bacterial culture is taken.

It shows the growth of bacteria such as staphylococci, streptococci, Escherichia coli, Klebsiella, Proteus, Gardnerella, etc. The huge advantage of this study is not only the determination of the causative agent of the disease, the degree of its growth, but also the identification of sensitivity to antibacterial drugs and bacteriophages.

Treatment of vaginal dysbiosis

As soon as the bacteria that caused the appearance of vaginal dysbiosis are identified, the patient is prescribed treatment, which consists of several important steps:

1. Suppression of pathogenic bacteria in the vagina.

2. Population of the vagina with beneficial microflora, normalization of pH levels.

3. Strengthening the immunity of the mucous membrane of the genital organs.

To eliminate pathogenic bacteria, drugs are prescribed that suppress the proliferation of infection. They can be either systemic or local, depending on the pathogen.

If vaginal dysbiosis is associated with a sexually transmitted infection, broad-spectrum antibiotics are prescribed (Vilprafen, Unidox, Tavanik, etc.

) and vaginal suppositories with an antibacterial component (Hexicon, Polygynax, etc.).

It is necessary to be treated for a sexually transmitted disease together with a sexual partner, otherwise re-infection will occur in the future.

Also, antibiotics may be needed if a large titer of opportunistic bacteria is detected (more than 10 in 4 CFU/ml) or if dysbiosis has developed into more serious diseases, such as cystitis, adnexitis, pyelonephritis, etc.

In other cases, local treatment with vaginal suppositories is sufficient.

Suppositories will help suppress the proliferation of pathogens, eliminate the inflammatory process, normalize the functioning of the mucous membranes and correct the state of the microflora.

Backvaginosis (gardnerellosis) is treated with suppositories such as Neo-penotran, Betadine, Terzhinan, Fluomizin.

Dysbacteriosis caused by the proliferation of fungi of the genus Candida (thrush) can never be treated with antibiotics. To treat candidiasis, a course of antifungal suppositories, such as Pimafucin, Livarol, Candid b6, is prescribed. For persistent exacerbations, it is also recommended to take Pimafucin tablets or Enterol capsules. They will help suppress the proliferation of fungal flora in the intestines.

For those who have vaginal dysbiosis due to the growth of opportunistic microorganisms such as E. coli, enterococci, staphylococci, etc.

, Polygynax, Hexicon, Elzhina, Ginalgin suppositories are prescribed.

In case of a complicated course or transition of dysbiosis into diseases such as cystitis, salpingoophoritis, systemic oral medications are required, most often strong antibiotics.

Sometimes gynecologists prescribe tampons to patients with medications such as Chlorophyllipt, Dioxidin, douching with Miramistin, Malavit, Tantum Rose. The disadvantage of this method is the impossibility of maintaining complete sterility when making homemade tampons and the inconvenience of use.

The next stage is the restoration of the microflora of the vagina and intestines by colonizing it with lacto- and bifidobacteria. For these purposes, drugs such as Normoflorin, Bifiform, Hilak-Forte are used orally. They help strengthen the body's defenses, supporting the mucous membrane of the gastrointestinal tract.

Vaginal suppositories with beneficial bacteria are required to normalize the acidity of the vaginal environment. The most popular of them: Acylact, Bifidumbacterin, Laktozhinal, Femilex, Laktonorm. The course of application is at least 10-14 days.

Quickly and effectively populate the vaginal microflora of the Vagilac capsule. Despite the fact that they are consumed orally, lactobacilli contained in the drug are able to penetrate into the vagina through the intestinal walls and actively multiply there, creating a special protective film on the mucous membrane.

With the help of these actions, the required concentration of lactic acid bacteria is restored, and the balance of bacteria in the urogenital tract returns to normal. But, unfortunately, dysbiosis really likes to come back and in order to prevent it, you need to help your body a little.

For these purposes, it is recommended to maintain local immunity with drugs such as Epigen Intim spray, Panavir, suppositories with immunomodulatory properties - Galavit, Genferon, Polyoxidonium. They will help stimulate the immune system, protect the mucous membranes of the genital organs from the proliferation of harmful bacteria and avoid relapses of the disease.

Many people are interested in whether it is necessary to treat a sexual partner if a woman has vaginal dysbiosis. Typically, treatment is not prescribed for a sexual partner, because Dysbiosis is a violation of the vaginal flora and it is not transmitted sexually. However, with chronic persistent infection, sometimes the sexual partner also has to be treated.

Does vaginal dysbiosis affect the ability to conceive?

It is reliably known that a violation of the flora, accompanied by a decrease in the number of lactobacilli in the vagina, can affect the ability to conceive.

Why is it impossible to get pregnant due to a lack of lactobacilli in the vagina? For successful fertilization of an egg, the activity and motility of sperm are important.

If their ability to move is reduced, a woman's chances of becoming pregnant are also reduced to a minimum.

In addition to male factors, sperm activity is also influenced by the acid-base balance of the female genital organs (pH). If it shifts to the acidic side, sperm may lose the ability to move and even die.

Lactobacilli, which make up about 95% of the total vaginal flora, are responsible for maintaining the natural physiological level of acidity in the vagina. When there are sufficient quantities of them in the vagina, favorable conditions are created for fertilization. Disruption of microflora can lead to problems with conception.

Therefore, when planning pregnancy, women need to cure vaginal dysbiosis.

Prevention of the development of vaginal dysbiosis

The success of treating dysbiosis is prevention. To consolidate the result, you must follow some recommendations.

First of all, you need to carefully monitor your intimate hygiene: take a shower at least 1-2 times a day, including after bowel movements (if it is impossible to use wet toilet paper), use only special means for washing (more about the best gels for intimate hygiene).

Maintaining an orderly sex life and using barrier methods with casual partners plays an important role.

It is worth visiting the fresh air more often, avoiding stagnant processes in the pelvis, and engaging in active sports.

Women who are prone to frequent relapses of vaginal microflora disorders within a year after treatment need to undergo a smear and culture every 3 months and, in case of suspicious changes, take immediate action.

The best gels for intimate hygiene The most effective and popular gels for intimate hygiene. Why can't you wash yourself with regular soap?

Preparations for restoring vaginal flora The most effective suppositories and tablets for vaginal dysbiosis and after taking antibiotics.

Source: http://www.svetulka.ru/s1/x1/disbakterioz-vlagalischa-simptomy-i-lechenie/

Vaginal dysbiosis

This disease is treated by a Gynecologist.

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Vaginal dysbiosis (dysbacteriosis) is a disruption of the normal microflora of the vagina. Most women suffer from this disease to one degree or another. Most often, its manifestations are minor, but sometimes vaginal dysbiosis leads to very serious problems. Vaginal dysbiosis, or vaginal dysbiosis , is the most accurate term; it is precisely translated as a violation of the vaginal microflora. Particular cases of vaginal dysbiosis are bacterial vaginosis (gardnerellosis) and candidiasis (thrush). In the first case, a violation of the vaginal microflora is associated with excessive proliferation of the bacterium Gardnerella vaginalis, in the second with a predominance of fungi of the genus Candida. However, traditionally, women, and many doctors, call any vaginal discharge “thrush” without really understanding their nature. Normally, a woman’s vagina is inhabited by the so-called normal microflora. It consists of approximately 90% lactobacilli (the so-called Döderlein rods), slightly less than 10% bifidobacteria, and less than 1% are the so-called “clue cells of the vagina.” These include gardnerella, mobiluncus, Candida fungi, leptothrix and some other bacteria. Normal microflora is in constant balance with each other and with the environment. It does not allow the appearance of any other infection, and does not allow a change in the ratio of pathogens living in the vagina normally.

When the microflora is disturbed, the balance between the bacteria that are normal inhabitants of the vagina changes. At the same time, the number of lacto- and bifidobacteria decreases and the number of some other pathogen increases.

This other pathogen may be one of the key cells (then gardnerellosis, candidiasis, etc. develop.

), there may be one of the sexually transmitted infections (trichomoniasis, chlamydia), or there may be any saprophytic pathogen (Escherichia coli, Proteus, streptococci, staphylococci, etc.).

If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health. Phone for appointment +7 (495) 172-01-33

Symptoms of vaginal dysbiosis

, vaginal discharge of a whitish-yellowish color with an unpleasant odor appears Vaginal dysbiosis itself does not manifest any other symptoms; all other symptoms (itching, urination problems, pain) are associated with its complications.

There are many causes of vaginal dysbiosis. Almost any impact on a woman’s body can lead to disruption of the microflora. Let's list just a few factors.

• hypothermia of the body. Both one-time severe hypothermia and constant freezing. All this leads to a decrease in general and local immunity, which also affects the vaginal microflora.
• changes and hormonal imbalances. This may include irregular sex life, pregnancy, childbirth, abortion, any type of cycle disorders, puberty, premenopause and menopause, etc.
• change of climate zone. Exacerbations of vaginal dysbiosis occur during trips to warm countries.
• stress, both one-time severe stress and a chronic stressful situation.
• promiscuous sex life, a large number of sexual partners, neglect of contraception.
• any infectious and inflammatory diseases of the pelvic organs.
• sexually transmitted infections.
• treatment with antibiotics, especially long-term or repeated.
• intestinal diseases, chronic stool problems, intestinal dysbiosis. The vaginal microflora is very closely related to the intestinal microflora.
• improper use of tampons during menstruation. Tampons should be changed strictly every 2 hours, both day and night. This is quite inconvenient, but otherwise good conditions are created in the vagina for infection to grow.

Of course, all these factors do not always lead to disruption of the vaginal microflora. The immune system maintains normal microflora and helps it recover in case of minor disruption. However, there are so many of these factors, they occur so often that in most cases, a woman still develops vaginal dysbiosis. The presence of a large number of pathogenic bacteria in the vagina will sooner or later cause inflammation of the vaginal wall and inflammation of the cervix - those organs with which they are in constant contact. This is manifested by a sharp increase in the amount of vaginal discharge, the appearance of unpleasant sensations in the genitals (itching, stinging, burning, pain) and pain during sexual intercourse. One of the first symptoms of inflammation is often the lack of sufficient lubrication during sexual intercourse.

In addition, bacteria from the vagina constantly infect the uterus, which can lead to the development of endometritis, and the uterine appendages, with the prospect of developing adnexitis. Also, with vaginal dysbiosis, there is a constant infection of the urethra and bladder, which can lead to symptoms of urethritis and cystitis.

• general flora smear,
• PCR diagnostics of sexually transmitted infections, 
• sowing vaginal discharge,
• special study of vaginal microflora.

A smear gives a general idea of ​​the state of the vaginal microflora and allows you to identify the degree of disturbance and severity of the inflammatory process.

Diagnosis of sexually transmitted infections and culture make it possible to find out which pathogens caused the microflora disturbance, as well as to determine the sensitivity of bacteria to antibiotics.

Antibacterial therapy should never be started without these tests.

Treatment of vaginal dysbiosis

SM-Clinic uses a comprehensive approach to the treatment of vaginal dysbiosis, which includes several stages:

• eliminating or suppressing bacteria found in the vagina.
• population of normal vaginal microflora.
• restoring the immunity of the vaginal wall so that it again takes control of the vaginal microflora.

Suppression of disturbed microflora

If vaginal dysbiosis is associated with a sexually transmitted infection, then the goal of treatment is to completely eliminate the causative agent of a sexually transmitted disease (STD) from the woman’s body. In this case, treatment necessarily includes a course of antibacterial therapy, simultaneously or after which all other measures are carried out.

If we are not talking about sexually transmitted infections, then taking antibiotics is not a mandatory component of treatment. As a rule, in this case, either a very short course of antibacterial therapy is used (3-5 days), or no antibiotic treatment is carried out at all.

The use of local procedures is much more effective. They allow you to simultaneously combine all treatment objectives - suppression of pathogenic flora, population of normal inhabitants of the vagina, and local immunocorrection.

The use of antiseptics for local procedures is much more effective than the use of antibiotics.

The spectrum of action of antiseptics is wider, and bacteria almost never develop resistance (immunity) to them.

Population of normal vaginal microflora

This is the most important part of the treatment. All other measures are carried out only to create conditions for the engraftment and growth of normal flora.

The population of normal vaginal microflora is carried out mostly in the second stage of the course, when the pathogen living in the vagina is maximally suppressed.

For this purpose, massive doses of eubiotics (preparations containing live bacteria) of both general and local action are used.

The use of eubiotics alone to restore the vaginal microflora is unjustified and, as a rule, useless.

While a large amount of, say, E. coli lives in a woman’s vagina, a woman can eat a kilogram of lactobacilli, but none of them will take root in the vagina.

It is imperative that you first suppress the bacterium (or bacteria) that caused the disease, and only then repopulate the normal microflora of the vagina.

Restoring the immune system of the vaginal wall

In simple cases, immunocorrection can be limited to the use of local immunomodulators. In advanced forms of the disease, restoration of immunity requires more serious measures, and sometimes in very difficult situations, a course of immunomodulatory therapy should be carried out before all other treatment.

Typically, treatment of vaginal dysbiosis takes 3 weeks. Before this, the patient is thoroughly examined, and if necessary, her sexual partner is also examined. After treatment, a follow-up examination is carried out and control tests are performed. If no symptoms of the disease are detected, then the treatment can be considered complete and in the future we can only deal with the prevention of vaginal dysbiosis.

Prevention of vaginal microflora disorders

It is advisable for all patients who have undergone a course of restoration of vaginal microflora to visit the clinic every 3 months for 1 year after treatment. During these visits, the woman talks about her condition, an examination is carried out, and tests are taken, if necessary.

This allows you to assess the state of the vaginal microflora and monitor changes compared to the end of treatment.

If there is a tendency to disrupt the microflora, then a short preventive course of treatment is carried out.

Restoring the vaginal microflora in the initial stages of its disturbance is quite simple. 

If no problems are noted during the first year after treatment, further observations are carried out less frequently, once every six months to a year. This scheme makes it possible to assess and control tendencies towards relapse of the disease and prevent its development again.

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Source: https://www.smclinic.ru/diseases/d/disbakterioz-vlagalishcha/

Vaginal dysbiosis: causes, symptoms, treatment

Inflammation of the vagina

11.04.2018

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Vaginal dysbiosis is a microflora disorder with an increase in the number of pathogenic bacteria. Accompanied by uncharacteristic discharge, unpleasant odor and itching.

Treatment is carried out in several stages and includes: suppression of the growth of infectious agents, colonization of normal microflora and stabilization of the immune system.

Depending on the pathogen, antiviral or antibacterial drugs may be prescribed.

Vaginal dysbiosis is a non-inflammatory infectious disease characterized by the replacement of normal microflora with associations of anaerobic bacteria.

The disease is widespread: the diagnosis is made in 21-33% of all women who come with complaints to an appointment with a gynecologist. Depending on the degree of severity, bright or blurred symptoms are observed. The disease is often recurrent. According to the classification, it does not apply to sexually transmitted diseases.

In the lumen of the vagina, the growth of fungal and bacterial microflora occurs constantly.

The main part of the latter consists of lactobacilli (Doderlein bacilli). Their share should normally be about 95%. They create an acidic environment that makes it impossible for other bacteria to reproduce.

If a failure occurs in the control system, vaginal mucus changes and the number of Doderlein bacilli decreases, conditions favorable for the proliferation of pathogenic microflora are created.

The cause of the development of pathology cannot be a single microorganism. Dysbacteriosis is formed as a result of the influence of microbial associations. The most common pathogenic agents are:

• mycoplasma;
• mobiluncus;
• gardnerella.

They belong to the genus of anaerobic bacteria, that is, they do not require oxygen for growth and development.

There are external and internal causes that lead to the predominance of pathogenic microflora and the development of vaginal dysbiosis. The internal ones are described in the table:

Cause	Description
Menopause	Reduced estrogen production in the body leads to suppression of the growth and reproduction of lactic acid bacteria
Pregnancy	Under the influence of an increasing amount of progesterone, the growth of lactobacilli decreases. The woman’s immune system weakens: this is necessary so that the body does not reject the fetus as foreign
Vaginal atrophy	The processes of atrophy of the mucous membrane contribute to the disruption of microflora
Intestinal dysbiosis	Violation of intestinal microflora leads to dysbiosis in the vaginal area
Other	Hormonal disorders, polyps, cysts, congenital disorders of the anatomical structure of the vagina, malformations of the reproductive system, diseases of the pancreas and thyroid gland

External reasons:

Cause	Description
Antibiotics	Pathology occurs when they are taken uncontrolled for a long time. Antibiotics do not have a selective effect and destroy any bacterial flora
Medications	A similar effect can be provoked by drugs from the group of antimycotics, cytostatics, as well as radiotherapy. Pathology develops due to a significant decrease in immune defense
Intimate hygiene	Insufficient intimate hygiene or, conversely, too thorough, including douching, use of antibacterial soap or products with an alkaline pH
Deformation of the vaginal muscles	Occurs after childbirth or surgery
Presence of foreign bodies in the vagina	Hygienic tampons, diaphragms, intrauterine device
Other	Changing a permanent partner, using spermicides, being sexually active, having inflammation in the reproductive system

Separately, it is worth noting the disruption of the immune system. There can be many reasons that lead to this (infectious and non-infectious inflammation, exogenous and endogenous factors). Any exposure can become a trigger for the development of dysbiosis.

Symptoms of the disease can vary greatly. The woman notes the following signs that may indicate the presence of pathological processes:

• Discharge from the genital tract. They can be both scanty and abundant, often have an unpleasant odor, which becomes stronger after sexual intercourse or during menstruation. The smell of rotten fish or ammonia occurs due to the active activity of pathogenic flora, in particular gardnerella. At an early stage, the discharge will have a grayish tint.
• Itching. This symptom may often be absent, but many women feel it during menstruation.
• Painful sensations during sexual intercourse.
• Feeling of burning and stinging during urination.
• Possible sticking of the labia minora due to purulent discharge.

Discharge color characteristic of vaginosis

When the pathological process exists for a long time, the symptoms become more pronounced:

• The discharge begins to change consistency: it becomes more viscous, similar to curd mass.
• Their color takes on a green tint.
• The discharge is distributed evenly over the walls of the vagina, becomes sticky, and its quantity increases (up to 20 ml per day).
• If pathogenic flora joins, the risk of bacterial vaginosis increases. Moderate itching appears in the vulva area. There may be a disruption in the process of emptying the bladder: urination becomes frequent and painful.
• Signs of the inflammatory process may not be observed: the mucous membrane does not change, has a pinkish tint, colposcopy does not give positive results.

In some women, signs of vaginal dysbiosis persist for a long time, while others notice any changes periodically, only under the influence of unfavorable factors.

Diagnosis of dysbacteriosis falls within the competence of a gynecologist. He collects anamnesis and finds out the patient’s complaints. During the examination, he visualizes discharge on the walls of the vagina. They may have a grayish or white tint.

It is imperative to take a vaginal smear. It allows you to see the epithelial cells to which pathogenic bacteria are attached. Normally they shouldn't be there.

In addition, the sample will have a predominance of epithelial cells over leukocytes and a reduced number of Doderlein rods.

Using a special test strip, the acidity of the medium is determined. A value greater than 4.5 indicates the presence of dysbacteriosis. Another sign is the appearance of a rotten fish smell when potassium alkali is added to leucorrhoea.

The diagnosis is made if three positive criteria out of four are present:

1. 1. The smell of rotten fish when reacting with leucorrhoea.
2. 2. Visualization of specific secretions during examination.
3. 3. Presence of key cells in the smear.
4. 4. Acidity above 4.5.

If there are indications, the woman is sent for consultation to related specialists. This could be: gastroenterologist, venereologist, endocrinologist and others.

An integrated approach is used for treatment, which includes several stages:

1. 1. Suppression of the activity of pathogenic bacteria.
2. 2. Population with normal microflora.
3. 3. Restoration of immunity to normalize microflora.

If dysbiosis is associated with the presence of a sexually transmitted infection, the main task is to eliminate the STD pathogen from the patient’s body. In this case, a course of antibacterial therapy must be prescribed, simultaneously with which other therapeutic measures are carried out.

If there are no sexually transmitted infections, taking antibiotics is not a mandatory component of therapy. It is much more effective to use local antiseptics: their spectrum of action is wider, and bacterial resistance to them practically does not arise.

Treatment of dysbiosis is carried out with the following drugs described in the table:

Type of drugs	Description
Pills	Most often, Trichopolum is prescribed with the active ingredient metronidazole. This medicine helps eliminate anaerobic bacteria. Clindamycin, Tinidazole, Ornidazole can also be prescribed. Duration of treatment - no more than 10 days
Suppositories	Possible side effects from taking medications by mouth can be avoided by using the medications topically. Vaginal suppositories such as Trichopolum, Neo-Penotran, Klion-D, Flagyl, Clindacin are prescribed. Tampons with cream or gel applied to them can be used: Metrogyl-gel, Rozeks, Rozamet, Dalatsin
Vitamin therapy	During treatment with antibacterial drugs, it is recommended to take vitamin C in an increased dosage: this helps activate the immune system and reduces vascular permeability
Vaginal installations	For a week, once a day, tampons soaked in boric or lactic acid with a concentration of 2% are inserted into the vagina. This allows you to create an acidic environment that prevents the growth of anaerobic bacteria
Antihistamines	Often, in addition to general treatment, antihistamines are prescribed: Suprastin, Tavegil, Cetrin. They are especially necessary if antibiotic therapy is carried out.

Colonization with normal microflora is carried out from the second stage of the course of treatment, when the pathogenic pathogen is maximally suppressed. For this purpose, high doses of eubiotics (preparations with live bacteria) of both general and local action (Linex, Bifidumbacterin) are used.

The use of eubiotics alone is unjustified and even useless. It is necessary to first suppress the infection that caused the disease, and only then correct the vaginal microflora.

The immune system of the vaginal wall controls the microflora, preventing the growth of other bacteria. Violation of the microflora is always associated with a decrease in wall immunity, so local immunocorrection must be part of the therapy, otherwise other measures may be ineffective.

In complex cases, immunomodulatory therapy is carried out at the very beginning of treatment. Biological products for intravaginal administration can be used. Suppositories Bifikol, Bifidumbacterin, Laktozhinal, Acylact are used.

The course of treatment with them is no more than 10 days.

As a rule, treatment of the disease takes about 3 weeks. Before this, the patient is examined, and if necessary, the sexual partner is also examined. After completion of therapy, a follow-up examination is carried out and tests are performed. If no symptoms of dysbiosis are detected, treatment can be considered complete and further prevention can be undertaken.

Traditional medicine can be used as an addition to the main treatment after consultation with a specialist.

The following baths are an effective remedy for the treatment and prevention of vaginosis:

• Alkaline . Dissolve a spoonful of soda in a liter of water, add 50 drops of iodine solution, and pour it into a bath of warm water. You need to take it for 30 minutes daily.
• With propolis tincture . Pour propolis with medical alcohol in a ratio of 1:10, leave for 5 days, add 2 tbsp per 5 liters of water. l.
• With a decoction of oak bark . 200 g of oak bark is poured with cold water, left for 3 hours, the mixture is boiled and poured into a bath of warm water. It should be taken for 15-20 minutes 2-3 times a week.

Herbs with an antiseptic effect are suitable for douching. These include:

• chamomile;
• sage;
• calendula;
• St. John's wort.

It is necessary to pour 1 tbsp. l. herbs with a glass of hot water, cool and strain. The procedures are carried out in the morning and evening.

To prepare a decoction from a collection of different plants, mix sage, oak bark, and yarrow in equal parts, pour cold water over the mixture and leave for 4 hours.

The most popular recipes are:

• Grate one quince and 2 apples along with the peel. Grind 2 cups of cherries, finely chop a clove of garlic and one lemon, removing the seeds. Mix all the ingredients and add water, strain the infusion after half an hour. Drink 1 glass every 4 hours.
• 2 tbsp. l. add 0.5 liters of water to the rowan fruit and put on fire. After the broth boils, boil it for 20 minutes. Add 2 tablespoons of honey and boil for another 5 minutes. Once cooled, grate 2 large onions and add to the mixture.
• Pour 50 g of propolis into 100 g of alcohol, leave for 10 days in a dark place, shaking occasionally. Take a teaspoon once a day with milk.

It is advisable for all patients who have completed the course of treatment to visit a doctor every 3 months for a year. This makes it possible to assess the state of the microflora and track changes that have occurred since the end of treatment. If there is a tendency to violations, a preventive course of therapy is carried out. Restoring vaginal flora in the initial stages of the disease is quite simple.

If no problems are noted during the first year, further monitoring is carried out less frequently: once every 6 months to a year. This scheme allows you to minimize the risk of relapse.

Source: https://fraumed.net/stds-infections/inflammation-vagina/disbakterioz-vlagalischa.html

Violation of vaginal microflora: causes, diagnosis, treatment

Table of contents

The number of bacteria inhabiting the vagina is enormous - 108-1010 bacterial bodies per gram of liquid. Normally, 95-98% of them are lactobacilli, the remaining 2-5% are staphylococci, corynebacteria, bacteroides, prevotella, micrococci, eubacteria, gardnerella and some others. You can get an idea of ​​the main inhabitants of the vagina by studying a smear taken from its walls. Some microorganisms, such as ureaplasma and mycoplasma hominis, can also be detected in small quantities in completely healthy women. They are detected by inoculation on nutrient media or by polymerase chain reaction (PCR). Although it has been established that these two microorganisms are sexually transmitted, there is no strict evidence that they can cause illness (vaginitis, cervicitis, etc.).

Lactobacilli attach to the surface of vaginal epithelial cells, forming a kind of biofilm. Their importance in the formation of normal vaginal microecology is very great: they produce hydrogen peroxide, antibiotic-like substances, lactic acid, which reduces the vaginal pH to 4.0-4.5.

The acidic reaction is favorable for the growth and reproduction of lactobacilli, but not other microorganisms (for this reason the latter are called acidophobic). It is also known that lactic acid bacteria stimulate local immunity.

Due to these factors, lactobacilli prevent the colonization of the vagina by pathogenic microorganisms and the excessive proliferation of opportunistic bacteria that are part of the normal microflora.

Factors influencing the state of the vaginal microflora

The vaginal microflora is influenced by various factors, both external and internal. Not the least role belongs to hormonal changes during the menstrual cycle, during pregnancy and during the decline of reproductive function.

In the first days of the cycle, a large number of dead endometrial cells and blood elements appear in the vagina, as a result of which the pH of its contents increases to 5.0-6.0. This leads to a decrease in the number of lactobacilli and an increase in the number of opportunistic microflora.

It is not surprising that during this period, women's susceptibility to contracting sexually transmitted diseases increases.

In the middle of the cycle, the number of lactic acid bacteria reaches a maximum - during this period the glycogen content in the vaginal epithelium is highest.

Glycogen is a nutrient substrate for lactobacilli; when processed, lactic acid is obtained. Therefore, in the middle of the cycle and in the second half, the pH of the vaginal contents decreases to 3.8-4.5.

The number of opportunistic bacteria decreases.

On the one hand, pregnancy has a beneficial effect on the state of the vaginal microflora. During this period, its mucous membrane becomes thickest, and its glycogen content is high. Therefore, the population of lactobacilli increases, and the opportunistic microflora decreases.

However, the acidic environment of the vagina (during pregnancy, the pH is on average 3.8-4.2) is favorable for the life of yeast-like fungi. It is not surprising that the first episode of candidiasis in some women occurs during pregnancy.

The occurrence of the latter is also predisposed by the immunosuppression inherent in pregnancy.

As a woman’s reproductive function declines, less and less estrogen is synthesized in her body. Due to the decrease in these hormones, the glycogen content in the vagina decreases, and accordingly, the content of lactobacilli decreases.

In addition, estrogens, regardless of glycogen deposits, can directly influence the number of lactic acid bacteria.

Any stress (both sudden strong and chronic), hypothermia, unbalanced nutrition, lack of vitamins and microelements, exposure to ionizing radiation (for example, radiation during the treatment of cancer), decreased immunity, a sharp change in climate zone, etc. can also lead to vaginal dysbiosis. d.

• Wearing tight synthetic underwear, poor personal hygiene (improper use of tampons, frequent douching, excessive use of personal hygiene products), as well as genital infections (sexually transmitted infections, pelvic inflammatory diseases) or taking antibiotics (especially long or repeated courses) can also disrupt the microbial balance and lead to undesirable consequences.
• Since 6 out of 10 women with vaginal microflora disorders also have intestinal dysbiosis, perhaps these two processes are somehow interrelated.
• Patients with diabetes mellitus are at risk for developing vaginal dysbiosis.
• Diagnostics

Vaginal dysbiosis is a laboratory concept. There is no such diagnosis. A woman may be healthy, or she may have bacterial vaginosis or vaginitis. The classification of degrees of vaginal cleanliness (table), proposed in 1996 by E.F., successfully connects the clinic with laboratory diagnostics. Kira.

Microscopic characteristics of the vaginal biocenosis

State of the biocenosis	Signs	Nosological forms
Normocenosis	Dominance of lactobacilli, absence of gram-negative microflora, spores, mycelium, pseudohyphae, leukocytes, single “pure” epithelial cells	Typical state of a normal vaginal biotope
Intermediate type	Moderate or reduced number of lactobacilli, the presence of gram-positive cocci, gram-negative rods. Leukocytes, monocytes, macrophages, epithelial cells are detected	Often observed in healthy women, rarely accompanied by subjective complaints and clinical manifestations
Vaginal dysbiosis	A small amount or complete absence of lactobacilli, abundant polymorphic gram-negative and gram-positive rod and coccal microflora, the presence of “key cells”. The number of leukocytes is variable, the absence or incompleteness of phagocytosis. Polymicrobial smear pattern	Bacterial vaginosis
Vaginitis	A large number of leukocytes, macrophages, epithelial cells, pronounced phagocytosis when gonococci, trichomonas, mycelium, pseudohyphae, spores are detected	Nonspecific vaginitis, gonorrhea, trichomoniasis or mycotic vaginitis

So, nothing bothers a healthy woman, and her smear corresponds to normocenosis or an intermediate type.

Bacterial vaginosis is one of the most common infectious diseases of the lower reproductive system. This pathology occurs in 20-65% of women of reproductive age, including 10-25% of pregnant women.

It is based on a pronounced decrease in the number or absence of lactic acid bacteria and excessive proliferation of anaerobic conditionally pathogenic bacteria, including gardnerella.

In small quantities, this microorganism is detected in almost 70% of healthy women; with bacterial vaginosis, its number increases significantly.

These small bacteria stick to the epithelial cells (such cells are called “key cells”), and they take on the appearance as if they had been sprinkled with ground black pepper on top.

Since “key cells” are detected in bacterial vaginosis in 99% of cases, this disease is sometimes called gardnerella, although this is incorrect - gardnerella is not the only culprit.

Very often, with bacterial vaginosis, mobiluncus, peptostreptococci, bacteroides, eubacteria, fusobacteria, mycoplasma, ureaplasma, etc. multiply intensively.

In addition to the results of microscopy of vaginal discharge from the posterior fornix, another criterion for diagnosing bacterial vaginosis is the pH value of vaginal discharge, measured using a litmus strip (with vaginosis, it shifts to the alkaline side and is usually 5.0-6.0).

Symptoms of bacterial vaginosis are observed in only three out of four women. The main one is copious liquid discharge of white or gray color with an unpleasant odor of rotten fish.

Some patients are periodically bothered by vaginal itching.

With vaginitis, there is also a decrease in the number of lactobacilli, an increase in the number of opportunistic microorganisms, and a shift in the pH of the vaginal contents to the alkaline side. The main microscopic sign that distinguishes vaginitis from vaginosis is signs of inflammation (a large number of leukocytes, phagocytosis). Vaginitis is literally translated as inflammation of the vagina.

An external examination of the vaginal vestibule by a gynecologist may also reveal signs of inflammation - redness and swelling of the external genitalia and vaginal walls.

This disease can be asymptomatic or with a pronounced clinical picture - itching, burning, pain, discomfort in the vagina, copious discharge from it.

The latter can have a different character: white crumbly with candidal vaginitis, foamy with trichomonas, transparent with chlamydial, greenish with gonorrheal.

Vaginitis can be nonspecific, if a conditionally pathogenic microflora is suspected in its development, or specific - mycotic (candidal), gonorrheal, trichomonas, chlamydial. The role of myco- and ureaplasmas in the occurrence of inflammatory diseases of the female genital organs is discussed.

Consequences of disruption of vaginal microbiocenosis

Bacterial vaginosis is by no means a harmless disease. This pathological condition has a certain relationship with cervical dysplasia (precancerous disease) - nitrosamines produced by anaerobes have a carcinogenic effect.

Infection of the upper parts of the reproductive system of patients suffering from bacterial vaginosis can lead to the development of inflammatory processes of the uterus and its appendages. Their consequences are well known - these are infertility, ectopic pregnancy, adhesions in the pelvis.

After gynecological operations, women with bacterial vaginosis are more likely to develop postoperative complications. Also, with vaginal dysbiosis, there is a constant infection of the urethra and bladder, which can lead to symptoms of urethritis and cystitis.

Pregnant women should be especially responsible for the state of the vaginal microflora.

If they have bacterial vaginosis, their risk of premature termination of pregnancy and premature rupture of amniotic fluid increases 2.6 times, and the risk of developing postpartum endometritis increases 10 times.

During the birth process, the fetus encounters maternal microflora, which then colonizes the skin and mucous membranes of the newborn child, so it is necessary to strive to ensure that its condition is not disturbed by the onset of labor.

How to treat vaginal microflora disorders?

Correcting vaginal microflora disorders is not an easy task. First of all, you should establish the cause of dysbiosis and try to eliminate it. If the cause is not eliminated, the disease may recur. Relapses develop in every third woman within 3 months after completion of treatment, and in 8 out of 10 patients - within 9 months.

If a woman is not worried about anything, she is not planning a pregnancy and gynecological surgery is not indicated for her, you can temporarily take a wait-and-see approach: perhaps the lost microbial balance will be restored on its own.

The traditional treatment regimen for vaginal dysbiosis involves 2 stages: the first uses antibacterial and antiseptic drugs that suppress the proliferation of opportunistic microflora, the second uses drugs that help restore normal microflora.

If vaginal dysbiosis is associated with a sexually transmitted infection, then you need to start with its treatment. It is carried out using antibacterial drugs.

Since several microorganisms are usually responsible for the development of vaginal dysbiosis, broad-spectrum drugs are usually used (including gram-positive and gram-negative bacteria, Candida fungi and Trichomonas vaginalis).

If sexually transmitted infections are not identified, the doctor does not always prescribe antimicrobial drugs.

If he nevertheless comes to the conclusion that they are necessary, the choice most often falls on antimicrobial agents used locally (they are better tolerated and cause fewer side effects).

The disadvantage of most antibacterial drugs is that they suppress the growth of not only “harmful” microflora, but also lactobacilli. Therefore, they can aggravate vaginal dysbiosis, and often provoke the appearance of thrush.

There is no ideal drug; the doctor chooses one or another of them, weighing the pros (benefits) and cons (possible risks).

At the second stage of treatment, drugs are used that represent the biomass of lacto- or bifidobacteria in an active or lyophilized state. Some drugs for the correction of vaginal dysbiosis contain vitamin C. It reduces the pH of the vagina and also has an antioxidant effect.

Sometimes immunomodulators are used in the complex treatment of vaginal dysbiosis: drugs based on interferons (in suppositories), intimate gels.

The criteria for the effectiveness of treatment of bacterial vaginosis are the disappearance of clinical symptoms of the disease and normalization of laboratory parameters. The first control clinical and laboratory examination should be carried out a week after completion of therapy, and a second one after 4-6 weeks.

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Source: https://uroclinica.ru/disbakterioz-vlagalishcha-prichiny-profilaktika-i-lecheniye

Vaginal dysbiosis - microflora disturbance: causes, complaints, diagnosis and treatment methods on the website of the Alfa Health Center clinic

Signs of vaginal dysbiosis are familiar to 75 - 90% of women of different ages. These are disturbances of the microflora, which normally consists of 90% lactobacilli, 9% bifidobacteria and up to 1% opportunistic microorganisms.

These include Candida fungi, gardnerella, mycoplasma, and other organisms. With this composition, the microflora itself limits the growth of the number of pathogens and resists infections on the mucous membrane.

Causes and symptoms of vaginal dysbiosis

The balance of microflora is sensitive to internal and external factors. Violations may occur against the background of:

• Gynecological diseases;
• hormonal changes during puberty, pregnancy, irregular sexual intercourse, menopause;
• stress;
• hypothermia, which affects the immune system;
• sudden climate change;
• insufficient compliance with hygiene rules, rare changes of pads and tampons;
• long-term or self-medication with antibiotics;
• intestinal infections;
• unprotected sexual contacts with different partners;
• systemic diseases, weakened immunity.

Any of these reasons or their combination leads to the appearance of signs of vaginal dysbiosis. However, this does not mean that every vacation trip or experience when taking an exam will end in dysbacteriosis. The body's defenses successfully maintain balance and restore balance. But the likelihood that someday a failure will occur is high.

The peculiarity of vaginal dysbiosis is in symptoms that are almost invisible. White or yellowish discharge is the only change noticeable at the initial stage. The growth of pathogenic microorganisms leads to inflammatory processes, and then other signs appear:

• burning, pain in the genitals;
• reduction of lubrication;
• redness, swelling of the mucous membrane.

How to identify and treat vaginal dysbiosis

For diagnosis, a consultation-examination by a gynecologist with speculum and laboratory tests are carried out:

• smear analysis to assess microflora and degree of inflammation;
• PCR test to determine the type of microorganisms present and their sensitivity to groups of antibiotics;
• microbiological examination - counting the number of lacto-, bifido-, and other bacteria.

Based on the test results, the doctor will determine how to treat vaginal dysbiosis. Therapy is carried out comprehensively, step by step:

• suppression of pathogenic microflora with antibiotics and antiseptics;
• restoration of the concentration of lacto- and bifidobacteria;
• strengthening the immune system by taking immunomodulators.

For vaginal dysbiosis, treatment takes about 3 weeks. In some cases, therapy will also be required for the sexual partner. The course ends with a repeat test to monitor the effectiveness of the measures taken.

It is important to entrust the treatment of vaginal dysbiosis to a doctor and complete the course to the end. Self-medication or simply inattention to the situation that has arisen can lead to infection of the genitourinary system. Cystitis, urethritis, endometritis, adnexitis, and other diseases are not a complete list of the consequences of microflora imbalance.

Source: https://www.alfazdrav.ru/zabolevania/nevospalitelnye-zabolevaniya-ginekologiya/disbakterioz-vlagalishcha/