Bacterial vaginosis (vaginal dysbiosis, gardnerellosis, anaerobic vaginosis) is a gynecological disease that is accompanied by a change in the vaginal microflora. The disease occurs against the background of an increase in pathogenic microflora and a decrease in the number of milk bacteria, which act as a natural barrier against the penetration of pathogenic microorganisms.
The content of the article:
Types of bacterial vaginosis
Causes of vaginal dysbiosis
Symptoms of gardnerellosis
Diagnosis of bacterial vaginosis
Treatment of vaginal dysbiosis in women
Therapy of bacterial vaginosis during pregnancy
Complications of bacterial vaginosis
Prevention of bacterial vaginosis
Bacterial vaginosis
Bacterial vaginosis is characterized by prolonged and abundant bleaching (discharge), in which gonococci, fungi, trichomonas and other pathogenic bacteria are absent. According to statistics, bacterial vaginosis is diagnosed in 20% of women under 30 years of age. Periodic detection of the disease occurs in 75% of cases when women go to the doctor.
Types of bacterial vaginosis
According to the severity of bacterial vaginosis , there are the following types:
Compensated vaginal dysbiosis — characterized by the absence of microflora and the presence of epithelial cells without changes. At the same time, the possibility of infection with other pathogenic microorganisms remains;
Subcompensated bacterial vaginosis — accompanied by a decrease in lactic acid bacteria, an increase in gram-positive and gram-negative flora;
Decompensated form of bacterial vaginosis is characterized by the absence of lactic acid bacteria, conditionally pathogenic or facultative microorganisms predominate.
Acute, asymptomatic or erased (torpid) vaginal dysbiosis is distinguished along the course.
Causes of vaginal dysbiosis
Each woman’s vagina has a characteristic microflora, the composition of which is stable in healthy patients. Normally, lactobacilli predominate in the microflora. If they are displaced by anaerobic microorganisms, there is an imbalance of the vaginal microflora with the subsequent development of bacterial vaginosis.
Specialists have not yet been able to establish the exact causes of vaginal dysbiosis. There are a number of factors that cause the replacement of normal bacteria with pathogenic ones. They are divided into 2 groups — endogenous (acting from within) and exogenous.
The endogenous causes of the formation of anaerobic vaginosis include:
The onset of menopause (low estrogen levels inhibit the reproduction and growth of fermented milk bacteria);
Pregnancy (increased progesterone production reduces immunity to prevent embryo rejection and causes a slight estrogen deficiency);
Consequences of abortions and miscarriages;
Atrophy of the mucous membranes of the vagina (vulva kraurosis);
Hormonal disorders;
Intestinal dysbiosis;
Endocrine disorders.
Exogenous causes of the development of vaginal dysbiosis are considered:
Long-term, uncontrolled treatment with antibacterial, cytostatic, antimycotic drugs;
Conducting radiation therapy, which significantly reduces the protective functions of the body;
Non-compliance with the rules of intimate hygiene;
Frequent douching, vaginal showers, washing;
Deformity of the muscles of the pelvic organs, cervix or vagina after labor, radiation, surgical interventions;
The presence of a foreign body in the vagina;
Prolonged use of sanitary tampons, intrauterine device, cervical cap, taking spermicides (non-hormonal contraceptives);
Change of sexual partner;
Existing or transferred inflammatory diseases of the reproductive system;
Active sex life.
Bacterial vaginosis is not considered a venereal pathology, that is, it is not transmitted through sexual contact. The activity of sexual relations only contributes to the settlement of pathogenic microflora in the vagina, its reproduction and inhibition of the growth of lactobacilli.
Symptoms of gardnerellosis
In most cases, the symptoms of vaginal dysbiosis do not have specific manifestations. Often, the only sign of the disease are abundant vaginal whites with an unpleasant rotten smell. At first, the discharge has a liquid consistency with a white or grayish tinge. If bacterial vaginosis continues for a long time (more than 2 years), vaginal whites begin to change:
They change the consistency, resemble a curd mass, become more viscous;
The color of whites turns dark green;
The volume of secretions increases to 0.02 liters per day (the norm of whites is 2-4 ml).
Over time, vaginal discharge becomes sticky and thick. They are evenly distributed along the walls of the vagina (the whites are easily removed with a cotton swab).
Bacterial vaginosis may also be accompanied by the following symptoms:
Constant itching in intimate places, which increases during menstruation;
Painful sexual intercourse caused by violation of the mucous epithelium of the vagina and aggressive properties of the vaginal microflora;
Clumping of the labia, which is associated with copious discharge of pus;
Burning sensation, pain when urinating. Such symptoms occur rarely and can be provoked by irritation of the mucous parts of the urethra.
Depending on the physiological characteristics and composition of the microflora, the severity of symptoms varies and has different intensity.
Diagnosis of bacterial vaginosis
The key to successful treatment of vaginal dysbiosis will be a competently diagnosed and correctly selected tactics of therapeutic action.
Diagnosis of anaerobic vaginosis includes the following measures:
Consultation of a gynecologist. During the conversation, the attending physician collects information about past, chronic and venereal diseases in the anamnesis;
Gynecological examination. During the examination, the doctor examines the genitals for the presence of manifestations of vaginal infection. A manual examination is also carried out to assess the condition of the pelvic organs;
Analysis of a sample of vaginal whites. Laboratory examination of secretions reveals excessive growth of anaerobic bacteria and the level of acidity of the vagina. An increased pH level (over 4.5) is considered an additional sign of bacterial vaginal dysbiosis.
Also, as part of the diagnosis of the disease, blood tests, urine and ultrasound examination of the pelvis can be shown.
Treatment of vaginal dysbiosis in women
The principles of bacterial vaginosis therapy are aimed at the return of the natural microbiocenosis of the vagina, the formation of an acidic (natural) environment in it, as well as the suppression of the growth and reproduction of bacteria that are not characteristic of the vaginal microflora. The therapy of bacterial vaginosis is carried out in two stages. The first stage of treatment involves the elimination of opportunistic bacteria (Gardnerella) and pathogenic microorganisms. The second stage is the colonization of normal lactobacilli in the vagina. The fight against pathogenic microbes is carried out using vaginal candles and gels with antiseptic and antibacterial properties. In some situations, according to the doctor, antibiotics are used in tablets.
The choice of dosage forms (solutions, candles, tablets) and specific drugs is carried out by a gynecologist. At the same time, it takes into account the patient’s condition, the manifestations of bacterial vaginosis and the results of tests. Properly selected treatment tactics at this stage will increase its effectiveness and prevent the development of adverse consequences.
Bacterial vaginosis at the second stage is treated by internal administration of lactobacilli or intravaginal administration of special biological preparations. The therapeutic course lasts 7-10 days. In addition, immunocorrecting and desensitizing medications should be included in the treatment regimen for vaginal dysbiosis in women. At the same time, a woman is recommended to adhere to a balanced diet with the inclusion of bio-kefirs, yoghurts and sauerkraut in the diet.
The main indicators of the cure of bacterial vaginosis include the cessation of vaginal discharge and normalization of the vaginal smear. Therefore, after completing the therapeutic course, the patient undergoes a control examination.
Therapy of bacterial vaginosis during pregnancy
According to statistics, every 5 pregnant women suffer from vaginal dysbiosis. Such a frequent occurrence of bacterial vaginosis is due to a decrease in the number of beneficial lactobacilli during gestation and a weakening of the immune system. As a result, the vaginal microflora is not able to resist the pressure of pathogenic microorganisms, which leads to the development of dysbiosis.
Treatment of vaginosis during pregnancy is carried out using drugs that contain metronidazole. Vaginal remedies in this case are preferable to pills. The most convenient to use is a gel that is injected with a special syringe into the vagina. The drug is used for 7 days once a day at night. No less effective are vaginal pills that are inserted into the vagina 10 days before bedtime.
These drugs are used after 20-22 weeks of pregnancy. Then they cannot harm the developing fetus. In the early stages of gestation, treatment of dysbiosis with the use of antimicrobial drugs is prescribed only for special indications (threat to the health of the fetus or the expectant mother).
In addition to specific drugs, in the treatment of vaginal dysbiosis in pregnant women, drugs containing lactobacilli are prescribed. They can be used in the form of douches and inside. Such drugs are useful both for the vaginal microflora and for the female body as a whole.
Treatment of vaginal dysbiosis in pregnant women is carried out only by appointment and under the supervision of a doctor.
Complications of bacterial vaginosis
Despite the fact that vaginal dysbiosis is not considered a dangerous disease, the lack of timely treatment can provoke the development of a number of side effects. These include:
Inflammation of the vagina, urinary system organs;
Premature birth;
Nervousness, irritation;
Depressive states;
Insomnia;
Unstable psychoemotional state;
Inflammation of the fallopian tubes, ovaries.
In women with unstable mentality, the forced rejection of sexual life and constant doubts about the smell of underwear and body can lead to prolonged depressions and nervous breakdowns. Therefore, the therapy of bacterial vaginosis should be carried out as early as possible.
Prevention of bacterial vaginosis
Since anaerobic vaginosis has not been fully studied, no doctor can provide specific preventive measures. To prevent the occurrence of vaginal dysbiosis, a woman needs to follow the general rules for the prevention of infectious pathologies of the reproductive system. These include:
Competent intimate hygiene (wash regularly, do not douche without a doctor’s appointment);
Timely diagnose and treat inflammatory processes of the genitourinary system and venereal diseases;
Avoid hypothermia (do not sit on concrete structures, wet sand);
In the case of prescribing medications (for example, in the treatment of diseases of the genitourinary system), follow the drug regimen and do not stop therapy yourself.
In addition, a woman should avoid casual sexual contact and use contraceptives. Also, in the prevention of bacterial vaginosis, it is important to pay attention to lifestyle: proper nutrition (not constant diets) will provide the body with a uniform supply of micronutrients and vitamins, and physical exercises will help strengthen the immune system.
Bacterial vaginosis lends itself well to therapeutic effects and is not dangerous for the female body. However, it is not necessary to ignore the manifestations of the disease, since any pathological process in the reproductive system in a neglected form reduces reproductive function. If the first manifestations of bacterial vaginosis occur, contact the specialists of the private clinic “name”, who, taking into account the causes and severity of the disease, prescribe an individual course of therapeutic action.
