Bacterial vaginosis is pathological changes in the vagina that are not inflammatory in nature and occur against the background of dysbiotic changes with the participation of anaerobic microflora.
Bacterial vaginosis
The vaginal environment has the function of protecting the uterus and appendages from inflammatory processes that can provoke various infectious agents entering the vagina from the outside or already present there, which, rising upward, provoke inflammation. The vaginal environment has the property of constancy; pathogenic organisms cannot be present in it for a long time and multiply in its mucous layer. All this happens due to the constant level of acidity (pH) of the vaginal environment and its composition: as a rule, the female vagina has an acidity level that can range from 3.8 to 4.5, and lactobacilli predominate in its composition. If the number of lactobacilli decreases or the vaginal pH increases (more than 4.5), then favorable conditions are created in which opportunistic bacteria multiply well.
Nonspecific microflora can cause many disorders in the immune and metabolic processes vagina. The production of protective immunoglobulin A, which does not allow pathogenic agents to attach to the vaginal epithelium, is reduced. Epithelial cells begin to slough off rapidly, which explains the increased discharge that accompanies bacterial vaginosis. Lactobacilli are usually replaced by anaerobes - bacteria that function without oxygen. The products of their metabolism, for example, amino acids and volatile fatty acids in the vagina are broken down into volatile amines, which have a specific fishy odor.
Due to the changes described above, the pH of the vaginal environment shifts from acidic to alkaline values. These shifts lead to progressive changes in carbohydrate, protein, lipid and mineral metabolism of the epithelium. Mucus production increases significantly and this leads to heavy discharge, which is the main symptom of bacterial vaginosis. But all these changes are only functional in nature; there is no inflammatory reaction on the walls of the vagina.
Proceeding without pronounced inflammation, bacterial vaginosis can manifest itself with both bright and meager symptoms. If the process lasts for a long period and relapses occur, then chronic bacterial vaginosis already occurs.
Sometimes the disease lasts a long time and in an erased form, as if it fades away, and then returns again. Against the background of existing dysbiosis, under unfavorable conditions in the vaginal environment, an increase in the amount of pathogenic flora can occur, which leads to an inflammatory process. Like any other dysbiotic conditions, bacterial vaginosis, which does not receive special treatment, can become the basis for other, more serious diseases of the uterus and appendages.
Can you get bacterial vaginosis during sexual intercourse?
This disease is not a sexually transmitted disease. Its pathogens can be transmitted during sexual intercourse. But, nevertheless, their transmission from woman to woman will not cause the disease, because a small number of these microbes are part of the normal microflora in the vaginas of most women.
However, bacterial vaginosis can be transmitted during unprotected sexual intercourse. And here the reason is not infection at all. This is explained by the fact that if a woman changes her sexual partner or has many sexual partners, then her vaginal microflora changes.
Bacterial vaginosis: causes
The disease is not a sexually transmitted infection and it does not have a single pathogen, therefore it is also called nonspecific vaginosis. The main cause of the disease is changes in the vaginal environment, due to which a disturbance in the microbiocenosis occurs. Microflora that replaces lactobacilli occurs different types and quite often appears to be associations of opportunistic bacteria. For example like this:
- bacteriodes;
- megaspheres;
- peptococci;
- peptostreptococci;
- atopobium;
- leptotrichus;
- mycoplasma;
- gardnerella.
The growth of such bacteria is usually excessive and in vaginal secretions their number can reach 1010 per 1 ml. But such good conditions for the proliferation of bacteria can arise only due to the influence of certain factors in the internal or external environment of the female body.
The main reasons why the disease occurs can be divided into two main groups:
Internal or endogenous:
- The vaginal mucosa is atrophied.
- Hormonal balance is disturbed when progesterone predominates.
- Presence of intestinal dysbiosis.
- Immunity impairment.
- With long-term treatment with antibiotics that can kill bacteria, including milk bacteria.
- With poor nutrition and insufficient consumption of fermented milk products, which are necessary for the formation of lactic bacteria.
- The presence of chronic intestinal diseases that cause dysbiosis and dislocation in the intestines of lactic bacteria that enter with food.
- With immunodeficiency, when the immune system cannot cope with pathology in the body.
- Consequences of previous diseases of the pelvic organs, when there was a serious inflammatory process.
- The presence of concomitant diseases of the cervix (endometriosis, leukoplakia, pseudoerosion, endocervicitis).
- Hormonal disorders and menstrual phase disorders.
- Reception oral contraceptives, as well as contraceptives with 9-nonoxynol (suppositories, condoms, creams).
External or exogenous:
- after radiation therapy of tumors;
- with long-term use of antibiotics;
- foreign objects located in the vagina (contraceptive ring or diaphragm, sanitary tampons, etc.);
- frequent douching or use of spermicides;
- lack of personal hygiene;
- underwear from synthetic material, which fits tightly to the body, since it does not allow oxygen to penetrate to the external genitalia, and at the same time to the vaginal mucosa;
- the presence of an intrauterine device, pads and tampons, which, when worn daily, irritate and rub the mucous membrane.
Due to all of the above factors, the normal functioning of the vaginal mucosa is disrupted or a large number of lactobacilli die, thereby freeing up space, which is immediately occupied by opportunistic microflora.
Bacterial vaginosis: symptoms
Initially, bacterial vaginosis may occur for quite a long time without obvious signs, or one of the symptoms may be present. In this case, the presence of the disease can only be determined through laboratory tests of the discharge.
At acute form there may be complaints about the presence of:
- discharge that is grey-white, foamy and has an unpleasant odor of spoiled fish;
- urinary disturbance;
- burning and itching during urination in the vagina and external genitals;
- pain during sexual intercourse;
- more copious discharge before menstruation, as well as after sex;
- in case of further progression, the disease develops viscous, sticky and thick green-yellow leucorrhoea;
- the appearance of inflammation and irritation of the skin in the perineum, thighs, buttocks and anal area.
If the disease is not treated in time, then asymptomatic bacterial vaginosis quite often becomes chronic and manifests itself in a protracted course with periods of remissions and exacerbations. If the disease lasts a long time, then the lactobacilli in the vagina become less and less, and then they may disappear altogether. Protective function vaginal discharge is significantly reduced, which quite often becomes the cause of the addition of secondary pathogenic microflora and the occurrence of an inflammatory process. Inflammation rising higher can cause inflammatory changes in the cervix, on the uterus itself and in the appendages. Bacterial vaginosis in this case can become a background for already quite serious gynecological diseases.
Even healthy women experience quantitative changes in the composition of the vaginal microflora. But when a woman is healthy and the changes are not very significant, then the body is able to solve this problem on its own, that is, thanks to internal self-regulation mechanisms, it eliminates the violations that have arisen. It is believed that every woman experiences bacterial vaginosis at least once in her life, but not every woman develops a pathological process that requires drug treatment.
For each woman, the amount of vaginal discharge is individual, and it can change with age and depends on whether there are gynecological diseases, on the condition nervous system, hormonal levels, sexual activity and other factors.
A large amount of discharge from a woman who is absolutely healthy may be associated with her upcoming period. As a rule, a woman knows how much discharge is normal for her, especially for those who regularly visit antenatal clinic. If the amount of discharge increases, this does not always indicate some kind of pathological process. What is the reason here is determined after examination by a doctor and laboratory tests.
Bacterial vaginosis in men
In infected men, the disease manifests itself as follows:
- Inflammation urethra(urethritis);
- Inflammation of the foreskin of the skin of the head of the penis (balanoposthitis);
- Frequent urge to urinate and pain during urination.
If a woman is pregnant, various physiological changes occur in her body, thanks to which a successful gestation of the fetus is ensured and a successful birth occurs. Sometimes there are cases that such changes lead to the occurrence of bacterial vaginosis. During pregnancy, a different system of hormonal regulation appears in the female body, in which gestagens, the so-called “pregnancy hormones,” predominate. Thanks to them, the amount of cervical mucus increases and the pH of the environment fluctuates. The result is a violation of the mechanism of self-regulation of the vaginal microflora, the number of opportunistic bacteria increases, and then the development of bacterial vaginosis occurs.
But this disease is not observed in all pregnant women. On the contrary, the number of people who became ill outside of pregnancy exceeded those who became ill during pregnancy. Experts believe that this is due to an increase in the content of lactobacilli in the vagina of the expectant mother.
In the case where pregnancy is the cause of bacterial vaginosis, the disease usually does not cause the woman any particular inconvenience and is quite easy to treat, and after childbirth it completely disappears. The situation may be different if, even before pregnancy, a woman was diagnosed with bacterial vaginosis. During pregnancy, the pathological process can only worsen and ultimately lead to undesirable consequences.
In expectant mothers, bacterial vaginosis has the same symptoms as in non-pregnant mothers. The severity of the disease will depend on whether there are other underlying or concomitant diseases and on the duration of the process. Often the only complaint is the presence of discharge of varying intensity from the genital tract. In pregnant women, bacterial vaginosis may not cause any symptoms at all.
Even if the pathological process in a pregnant woman is asymptomatic, in no case should you ignore it, since against the background reduced immunity Pathogenic flora may join, and then an inflammatory process may develop. Then pathogenic microorganisms rise to the cervix and then enter the pregnant uterus, where the developing fetus is located. This can result in intrauterine infection of the fetus, complications of the birth process, as well as the postpartum period. Despite the fact that such complications occur very rarely, doctors still carry out full examination regarding the detection of bacterial vaginosis in pregnant women and, if necessary, prescribe appropriate treatment.
How can the disease affect conception and pregnancy?
Since bacterial vaginosis affects women of fertile age, many of them ask the question: will this diagnosis prevent them from getting pregnant? The changed microflora in the vagina does not cause inflammatory changes in the genital tract and therefore no problems with conceiving a child arise. Normally, sperm has alkaline environment. Spermatozoa, entering the vagina with an increased pH, find themselves in fairly comfortable conditions.
What is the danger of bacterial vaginosis in case of pregnancy? Often, when penetrating the pregnant uterus, nonspecific microflora can infect the developing fetus. This condition is called intrauterine infection of the fetus, it can lead to developmental delays and lack of body weight. There are cases when the infection becomes the impetus for spontaneous miscarriage, premature rupture of amniotic fluid, as well as the birth of a premature baby. With this disease, the risk of developing purulent complications and sepsis in women in labor increases, especially in those who have undergone a cesarean section.
Diagnosis of bacterial vaginosis
A gynecologist, after listening to the patient’s complaints, examining her in a gynecological chair and studying laboratory data, makes a diagnosis. The following evidence suggests that the disease is bacterial vaginosis:
- age – the disease most often occurs in women of sexually active, reproductive age;
- medium or mild severity clinical signs diseases;
- change of sexual partner, previous surgery, treatment of any other diseases.
When examining the patient, the doctor assesses the condition of the external genitalia, vagina and, of course, the cervix. The mucous membrane with nonspecific changes has pink color, not inflamed, discharge is unevenly distributed. In the presence of acute bakvaginosis, the discharge is white-gray in color and has an unpleasant odor. In the chronic form of the disease, when it has lasted for several years, the discharge becomes yellow-green, more viscous and thick, reminiscent of cottage cheese. A gynecologist, examining a woman, uses an indicator strip to measure the pH of the vagina: in the presence of bacterial vaginosis, its value is above six.
In males, the presence of gardnerella is determined by examining prostate secretions.
Sometimes bacterial vaginosis hides other infections and viruses and increases the risk of sexually transmitted diseases, such as chlamydia, mycoplasmosis, trichomoniasis. Gardnerella begins to actively develop and destroys microflora beneficial to the vagina, thereby creating favorable conditions for the development of sexually transmitted infections, which are more dangerous for the body.
The diagnosis is made based on:
1. Carrying out an amino test.
2. PCR and cytological examination.
3. Smear microscopy.
4. Cultural sowing.
Bacterial culture is done to determine the composition of the vaginal microflora: quantitative and qualitative. The diagnosis of bacterial vaginosis is confirmed based on positive result the diagnostic methods indicated above, especially with regard to the smear. After confirming the diagnosis, a special course of treatment is prescribed.
How to treat bacterial vaginosis
Treatment of bacterial vaginosis occurs in two stages.
At the first stage, the bacterial infection (gardnerellosis) is destroyed with the help of antibacterial and various combination drugs for local and general use.
At the second stage, thanks to biological drugs and medications local application(baths, tampons, etc.), the normal microflora of the vagina is restored.
It is very important when a woman receives treatment in a timely manner, since in the case of a prolonged course of the disease, inflammation can occur in the uterus and appendages, which will ultimately lead to salpingitis (infectious inflammation of the fallopian tubes), endometritis, complications during pregnancy and during childbirth. This may be chorioamnionitis - inflammation of the walls of the amniotic sac, infection of the amniotic fluid, and may also cause premature birth or intrauterine infection of the fetus and a decrease in its weight.
The consequence of the disease can be pneumonia, postoperative infectious complications, pathological uterine bleeding, neuropsychiatric disorders, disorders of the sexual and reproductive function of women and decreased performance.
The first stage of treatment for vaginosis is antibacterial therapy.
To destroy the causative agent of the disease, the following treatment is carried out within 7-10 days:
1. Oral tablets: metronidazole (Trichopol), miramistin, tinidazole, clindamycyt, polycresulene (vagotil), terzhinan, metrogil, betadine, chlorhexidine.
2. Ointments, gels, suppositories or creams that contain the above drugs (except tinidazole). They are inserted into the vagina.
3. Immunocorrectors – vaferon and kipferon.
4. Antihistamines and estrogens.
During the period of use of metronidazole or tinidazole, alcohol consumption is not allowed, otherwise abdominal pain and vomiting may occur. Metronidazole can also cause the following: side effects:
- pain in the lower abdomen, nausea and vomiting;
- anorexia (the drug is often used by women who want to lose weight);
- dryness or metallic taste in the mouth;
- allergic reactions, diarrhea or constipation;
- candidiasis, stomatitis, pancreatitis, glossitis;
- insomnia, weakness, hallucinations, convulsions;
- cystitis, urinary incontinence, polyuria;
- increased excitability, irritation, peripheral neuropathy.
Metronidazole is contraindicated in patients with organic lesions of the nervous system, leukopenia, severe liver failure, during pregnancy and lactation.
Patients under 18 years of age should not be prescribed this drug together with amoxicillin. Pregnant women are given a special course of drugs that are allowed at this stage of fetal development.
The second stage is the restoration of microflora
The microflora is restored by colonizing bacteria beneficial to the vagina. Probiotics and toothiotics are used for this purpose. More often than others, Linex, Bifiform, Bifidumbacterin, Acylact are used.
In particularly severe cases, treatment is carried out according to the scheme.
While undergoing antibacterial therapy and for another day after its completion, alcohol should be excluded even in the smallest doses, because the metabolism in the body is disrupted due to medications ethyl alcohol, toxic metabolites accumulate and severe intoxication develops. It's like a really bad hangover: severe weakness, severe throbbing pain in the head, increased arterial pressure, painful nausea and even vomiting, shaking limbs.
Clindamycin cream contains fat that can damage the condom or latex birth control membrane. To local forms no drugs
flow down the walls of the vagina, they are inserted immediately before the woman goes to bed.
If there is intolerance to antibiotics or there are contraindications to their use, then at the first stage, treatment is carried out using local antiseptics:
Hexicon – one suppository twice a day for 7-10 days;
Miramistan (solution) – the vagina is irrigated once a day for 7 days;
At the second stage of treatment for bacterial vaginosis, drugs are used that contain lactobacilli and create favorable conditions to restore the vaginal microflora. They begin to be used 2-3 days after the end of antibacterial therapy:
Bifiliz - taken twice a day, 5 doses for 5-10 days;
Acylact - one suppository is inserted into the vagina twice a day, treatment lasts 5-10 days.
Antifungal suppositories are not usually prescribed for the treatment of bacterial vaginosis. They are necessary only when added to the opportunistic microflora fungal infection– candidiasis. Then treatment with clotrimazole is prescribed intravaginally once a day for 6 days.
It is strictly not recommended to treat yourself at home, because an incorrectly chosen dose of the drug or duration of treatment can lead to the development of resistant bacteria, which will subsequently be very difficult to get rid of, which will further lead to chronic course diseases. Only a specialist doctor can determine how to properly treat bacterial vaginosis.
Prevention of vaginosis
To avoid getting bacterial vaginosis, you must:
- regularly, at least once a year, be examined by a gynecologist;
- do not douche with hygiene products that contain antiseptics;
- during sexual intercourse, use protective equipment, do not abuse douching, and maintain genital hygiene;
- Do not take antibacterial and hormonal medications on your own without a doctor’s prescription;
- do not be treated with antibiotics for a long time;
- eat healthy food.
Bacterial vaginosis is a violation of the microecology of the vagina. This is the most common condition in women of childbearing age.
Predisposing factors leading to the development of bacterial vaginosis include the following:
- use of antibacterial drugs;
- long-term use of intrauterine contraceptives;
- use of tablet contraceptives;
- previous inflammatory diseases of the urogenital tract;
- violation hormonal status accompanied by menstrual irregularities;
- change in the state of local immunity;
- exposure to low doses of ionizing radiation;
- stress effects on the body.
In 60% of women suffering from bacterial vaginosis, disturbances in the microecology of the colon are detected (intestinal dysbiosis).
Manifestations of bacterial vaginosis
The main symptom is complaints of discharge with an unpleasant odor, which is noted by only 50% of women. Discharge is often moderate, less often abundant, and in some cases it may be completely absent. Discharge from bacterial vaginosis is grayish-white in color, homogeneous, without lumps, and has a specific “fishy smell”, which can be constant, absent, or appear during menstruation and sexual intercourse.
The duration of these symptoms can be years. During a long-term process, the discharge acquires a yellowish-green color, becomes thicker, often resembles a cheesy mass, has the property of foaming, is slightly viscous and sticky, and is evenly distributed over the walls of the vagina.
Other complaints, mainly itching and urinary disorders, are rare: they may be completely absent or appear periodically. Often women with bacterial vaginosis complain of heavy menstrual bleeding, pain in the lower abdomen, and adnexitis.
At the same time, in some cases, some patients do not show any manifestations of the disease.
Irritation of the vulva and vagina is rare, which distinguishes bacterial vaginosis from candidiasis and trichomoniasis, which are usually accompanied by severe itching.
Diagnostics
A preliminary diagnosis of bacterial vaginosis can be made already during a gynecological examination. After the examination, discharge is taken from the posterior inferior vaginal vault.
The diagnosis can be made if 3 of the 4 listed signs are present:
- specific nature of the discharge;
- acidity >4.5 (normal 3.8-4.5);
- positive amino test;
- presence of "key" cells. The so-called “key cells” are mature epithelial cells (the superficial layer of the vaginal epithelium), along the entire surface of which microbes are densely and in large numbers attached.
Completing one of the 4 tests is not sufficient to make a diagnosis.
Treatment of bacterial vaginosis
For bacterial vaginosis, local therapeutic measures are considered optimal. Good healing effect indicated for drugs from the group of nitroimidazoles (metronidazole, trichopolum, metrogil, etc.), which are prescribed intravaginally in the form of tablets, tampons or suppositories.
Exist various schemes complex treatment of bacterial vaginosis, consisting of the use of nitroimidazoles prescribed in tablets and topical agents (1% hydrogen peroxide, antiseptic solution "tomicide", benzalkonium chloride compounds, etc.), which are used for vaginal irrigation.
When prescribing nitroimidazoles in tablet form, it is necessary to take into account the possibility of side effects such as gastrointestinal dysfunction, dizziness and headache.
In severe cases of bacterial vaginosis, the fundamental principle of treatment is the use of broad-spectrum antibiotics for the purpose of general sanitation of the vaginal mucosa (clindamycin, oleandomycin, cephalosporins).
When prescribing broad-spectrum antibacterial drugs, a large number of side effects may occur, including dysbiosis of other cavities (intestines, etc.).
The effectiveness of treatment for bacterial vaginosis is assessed by the disappearance of subjective manifestations, the dynamics of clinical symptoms of the disease, and the 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.
During treatment and follow-up, the use of barrier methods of contraception (condoms) should be recommended.
Currently, one of the effective drugs for the treatment of bacterial vaginosis is dalacin vaginal cream, used once a day for 3 days. The course of treatment is 3 days. One full applicator corresponds to a single dose of the drug.
Among the most common complications when using the above drugs, vaginal candidiasis should be noted. To prevent it, it is necessary to prescribe antifungal drugs- nystatin 2000 mg per day orally, simultaneously with the start of treatment. Most effective drug for non-pregnant women is fluconazole. At the same time, for the treatment of vaginal candidiasis during pregnancy, drugs such as clotrimazole, pimafucin, gino-pevaril, dafnedzhin, etc. are widely used.
To others effective means for bacterial vaginosis, the antiseptic drug povidone-iodine (Betadine) is used.
Forecast
With all of the above treatment methods, relapses may occur, occurring at various times after treatment. Apparently, this is due to the fact that antibiotic therapy, while eliminating pathogens, often does not create conditions for the rapid restoration of beneficial bacteria.
In this regard, in the complex of therapy within 10 days after the main course of treatment, it is necessary to include such biological products as acylact, bificol, bifidum- and lactobacterin, due to their specific action aimed at restoring the normal ratio of lactobacilli in the vagina, and thereby preventing the frequency of relapses of this diseases.
Today we will talk about:
Vaginosis is a pathological condition of the vaginal mucosa of non-inflammatory origin, caused by the replacement of normal microflora anaerobic microorganisms. There is no specific pathogen for vaginosis. Among the causes that provoke it, there are many different microorganisms, but their presence does not provoke local inflammatory changes in the vagina. It is on this feature of the course of the disease that the differential diagnosis vaginosis.
The causes of vaginosis have not been sufficiently studied, and the question of whether it belongs to diseases continues to be discussed. The only condition for the development of vaginosis is considered to be a change in the indicators of normal vaginal microbiocenosis and, as a consequence, a violation of the mechanism of protection of the mucous membranes from unwanted microorganisms.
To understand the essence of pathological processes in vaginosis, it is necessary to have a clear understanding of how the vaginal epithelium functions and through what mechanisms it protects the reproductive system from potential infection.
The vagina connects the uterus (and indirectly the appendages) with external environment and is therefore in a constant state of counteracting its negative effects in order to protect the internal genitals from inflammation.
The vaginal wall is formed by three layers: connective tissue, muscle and epithelial. The vaginal epithelium is formed by layers of flat-shaped cells, its most upper layer(the one that lines the inside of the uterine cavity) is in a state of constant renewal. Every month, in accordance with cyclical changes in other genital organs, the surface layer of the vaginal epithelium is sloughed off (desquamated) and replaced by new cells. Thus, the mucous membrane is “cleansed” of potential cause inflammation and protects upstream organs from infection.
The key to successful barrier function of the mucous membranes is the constancy of the vaginal microenvironment. In a healthy vagina, it is represented by a dominant amount (98%) of lactobacilli and a small population of opportunistic microorganisms. The quantitative superiority of lactoflora ensures reliable protection mucous membranes from infection. If there are fewer lactobacilli, opportunistic microbes take their place.
To ensure a numerical advantage, lactobacilli create conditions that are unsuitable for the growth of “harmful” microorganisms. They attach to the membranes of desquamated cells of the surface epithelium and “extract” glycogen from them, and then synthesize lactic acid from the latter. As a result, a constant level of acidity is maintained in the vagina (3.8 – 3.5). In an acidic environment opportunistic flora is not able to compete with lactobacilli, therefore it remains small and safe.
Vaginosis is formed if, against the background of a quantitative decrease in lactobacilli and changes in acidity (pH), populations of opportunistic microorganisms begin to multiply in the vagina, i.e. in essence, it is a local dysbiotic disorder.
Thus, vaginosis is formed due to “its own” microflora, which is constantly present in the vagina of any healthy woman. It is impossible for them to “get infected” or betray their partner during intimacy.
Acute vaginosis is rarely diagnosed. Since vaginosis does not provoke pronounced inflammation, the disease often does not have active subjective complaints. The pathological process in the vaginal mucous membranes can proceed gradually, either exacerbating or fading again.
Chronic vaginosis depletes local immunity and can cause inflammation when, against the background of a significant decrease (or complete disappearance) of lactoflora in the vagina, unwanted microorganisms begin to multiply excessively.
Perhaps the only symptom of vaginosis is pathological discharge. Their color and consistency depend on what microflora displaces lactobacilli, how long vaginosis exists, and what background processes occur in the surrounding tissues.
Diagnosis of vaginosis is based on visual examination of the mucous membranes and laboratory examination of vaginal discharge. By studying the microbial composition of vaginal leucorrhoea, the severity of the disease is determined: the fewer lactobacilli in the material, the more severe the vaginosis.
Therapy for vaginosis does not have a clearly defined plan. Each treatment regimen for vaginosis is the result of an individual study of the clinical situation. As a rule, treatment is aimed at eliminating unwanted microbial flora and restoring the lactobacilli population. Oral tablets for vaginosis are prescribed according to indications. Preference is given to a topical drug (ointments, creams, suppositories).
Vaginosis often recurs. Prevention of vaginosis and its relapses lies in the exclusion of provoking factors and a reasonable attitude towards sexual life.
The reason for the formation of vaginosis is its own opportunistic microflora present in the vagina of a healthy woman. Perhaps this is the uniqueness of vaginosis: the body independently provokes the disease without attracting external resources.
The microbial composition of the vaginal environment is individual for each individual woman, so it is impossible to name the only culprit in the development of vaginosis. It is provoked by polymicrobial complexes, which consist predominantly of anaerobic microorganisms (mainly coccal in nature). More often, with vaginosis, corynebacteria, mycoplasmas, epidermal staphylococcus, lactic acid streptococci and other microbes prevail in the vaginal contents. It should be noted that the previously existing idea of the dominant role of Gardnerella in the pathogenesis of vaginosis has now been refuted by numerous studies. It turned out that Gardnerella colonizes the vagina in more than 50% of healthy women, without causing pathological dysbiotic changes in the habitat. Obviously, this microorganism acts as a pathological agent only if it is associated with other microflora.
Factors that provoke dysbiotic disorders in the vagina are:
Incorrect hygiene measures. Some patients use douching too often, during which the “beneficial” microflora is simply mechanically washed off from the surface of the mucous membranes. Aggressive agents also have a negative effect on the vaginal epithelium. cosmetical tools(soaps, gels) that are not suitable for intimate care.
Lack of proper intimate hygiene can also provoke vaginosis, since many unwanted microbes and their waste products accumulate on the mucous membranes.
Irrational antibiotic therapy. Free access to the purchase of antibiotics (including very “strong”) has very Negative consequences: Without the participation of a qualified medical examination, patients are treated independently, not always choosing and taking medications correctly.
Antibiotic therapy prescribed by specialists always involves measures to prevent dysbiotic disorders and rarely leads to the formation of vaginosis.
Hormonal dysfunction. All processes occurring in the vaginal mucosa are closely related to cyclic hormonal fluctuations. The state of the vaginal microflora is influenced by the level of estrogen; they support the renewal processes of the surface mucous layer, providing lactobacilli with a sufficient amount of glycogen. Under conditions of hypoestrogenism (especially long-term), the mucous layer becomes thinner, the population of lactobacilli decreases, and opportunistic microorganisms begin to actively vegetate.
Vaginosis in pregnant women, menopausal women, or those who have recently had an abortion is often explained by changes in normal hormonal levels.
Taking hormonal medications or contraceptives can also contribute to the appearance of vaginosis.
- Unprotected intimate relationships with different partners. In addition to the increased likelihood of getting a sexually transmitted infection, indiscriminate sex life leads to serious changes in the composition of the vaginal microflora and depletes local immunity. Moreover, the number of sexual partners increases the risk of vaginosis much more than the number of unprotected sexual intercourse.
- Intestinal dysbiosis. Symmetrical dysbiosis of the intestinal and vaginal mucosa is often diagnosed, especially against the background endocrine diseases or antibiotic therapy. Every second patient with vaginosis has diagnosed intestinal dysbiosis.
- Immunological reactivity disorders. Vaginosis can be caused by systemic allergic diseases or short-term local allergic reactions, for example, to hygiene products (vaginal tampons, soap, etc.), intimate lubricants, latex or talc contained in condoms.
- Intrauterine contraception (spiral). It provokes the appearance of vaginosis quite often (52%). Obviously, the spiral is perceived by the mucous membranes as a foreign body, and they respond to its presence with a local allergic reaction. In addition, any (even the “good”) intrauterine contraception serves as a source of local non-infectious inflammation. So that the intrauterine contraceptive fulfills its direct purpose without accompanying negative manifestations, it is necessary to follow simple medical recommendations and not leave it in the uterine cavity longer than prescribed.
Whatever the causes of vaginosis, short-term changes in the normal composition of the vaginal microflora in most healthy patients are eliminated through self-regulation mechanisms. The disease develops only if the body is unable to eliminate local dysbiosis on its own.
Symptoms and signs of vaginosis
Vaginosis is characterized by scant symptoms and the absence of specific clinical signs. Often the disease occurs without pronounced subjective symptoms and does not prompt the patient to see a doctor.
The leading, and sometimes the only, symptom of vaginosis is pathological discharge (leucorrhoea). Their number and appearance depend on several factors, one of which is the duration of the disease.
Acute vaginosis is accompanied by copious white liquid leucorrhoea; sometimes the vaginal discharge has a grayish tint and an unpleasant odor. More often, an acute process occurs after hypothermia, severe emotional shock, allergic reactions, as a result of antibiotic therapy.
Chronic vaginosis can persist for years. If dysbiotic disorders in the vagina last more than two years, the discharge becomes thick and sticky, and its color changes to yellow-green. The change in the nature of leucorrhoea in chronic vaginosis is associated with the degree of local dysbiosis: the longer vaginosis lasts, the less lactobacilli remain in the vagina, and the more pronounced the influence of opportunistic microflora. Long-existing vaginosis significantly depletes the local defense mechanism of the mucous membranes and can often cause the addition of secondary pathological microflora and the development of infectious inflammation.
Vaginosis discharge has one specific difference - an unpleasant odor, reminiscent of the smell of stale fish. It is “provided” by anaerobic bacteria competing with lactoflora. They synthesize substances (amines) that decompose, releasing an unpleasant, “rotten” odor. Often what brings a patient to the doctor is not the presence of leucorrhoea, but its unusual smell.
The clinical picture of vaginosis also depends on the state of hormonal function, in particular on the level of estrogen. Lower (compared to progesterone) concentrations of estrogen lead to a decrease in glycogen content in the vaginal epithelium. Since fewer lactobacilli are required to process a small amount of glycogen, their number decreases, and the free space is competitively occupied by anaerobic microflora. A prolonged absence of proper estrogenic influence provokes thinning of the vaginal mucous layer (peat). The vagina becomes “dry” and easily vulnerable, so the amount of leucorrhoea due to vaginosis decreases, and the patient develops subjective complaints of discomfort, dryness, burning and/or itching. These are typical for women with physiological (old age) or artificial (removal of the ovaries) menopause.
Diagnosis of vaginosis does not require a large number of examinations, however, the analysis of the data obtained is associated with some difficulties. Vaginosis should be distinguished from vaginitis, which, unlike the latter, is a consequence of infectious inflammation of the vaginal mucosa. Patients often treat non-existent vaginitis for years using antibiotics, which only worsen vaginal dysbiosis and lead to the development of chronic vaginosis.
The diagnosis of vaginosis is confirmed by several reliable criteria:
- Absence of inflammatory changes in the vaginal mucosa. Upon visual examination, the mucous membrane has a normal “healthy” appearance and pink color. There is an increased amount of light discharge in the vagina without external signs of the presence of pus; often (87%) an unpleasant odor is felt upon examination.
- Changes in the acidity of the vaginal environment. To measure pH quantitatively, special indicator test strips are used. The division scale applied to them for vaginosis indicates a characteristic shift in acidity to the alkaline side (more than 4.5).
Changes in the microbial composition of vaginal discharge according to the results laboratory diagnostics. The smears do not show an increased number of leukocytes, which is characteristic of inflammatory diseases, but there is a quantitative shift in the microbial composition: against the background of a decrease (or complete absence) of lactoflora, excessive growth populations of opportunistic microorganisms.
Among other anaerobic bacteria, large numbers of Gardnerella are often found. IN permissible quantities their population is completely harmless to mucous membranes, but under conditions of severe dysbiosis, gardnerella become part of microbial associations and “help” maintain the pathological process. The simple detection of Gardnerella in a smear has no independent significance.
The presence of so-called “key cells” in the smear. When microscopy of vaginal discharge with vaginosis, a large number of desquamated epithelial cells with microbes adhered to their membranes are often visualized. They are called “key”.
Thus, the diagnosis of vaginosis is confirmed:
- specific vaginal discharge (usually with a “fishy” smell);
- vaginal pH increased above 4.5;
- positive "amine test";
- key cells in the smear.
In 40% of patients with signs of vaginosis, upon examination, background diseases are detected on the cervix (cervicitis, ectropion, scars), most often pseudo-erosion. They often change the clinical picture of vaginosis and require additional colposcopic examination.
Despite the scanty symptoms, the presence of vaginosis can be suspected at the stage of studying clinical symptoms. Often in conversations, patients point out long-term, unsuccessful treatment of the so-called “inflammation” of the vagina. They may also note that the next course of anti-inflammatory therapy does not eliminate, but rather worsens, negative symptoms.
IN last years patients are often faced with the conclusion “cytological vaginosis”. Unlike the usual, cytological vaginosis is a consequence of excessive proliferation of lactobacilli. This condition is often provoked by intimate hygiene products with an acidic pH, especially if they contain lactobacilli. Sometimes this type of vaginosis can appear against the background of hyperestrogenism. Excess estrogen stimulates excessive glycogen production, which requires more lactobacilli to be utilized.
Clinically, cytological vaginosis resembles candidal vaginitis, when profuse white “curdled” discharge appears against the background of vaginal discomfort, burning or itching. Both conditions are clinically so similar that diagnostic errors often occur.
It is possible to differentiate cytological vaginosis from it according to the following criteria:
- vaginal pH less than 3.5;
- microscopically: many cells of destroyed epithelium in the form of fragments against the background of a large number of lactobacilli;
- false key cells: instead of opportunistic microbes, lactobacilli attach to the surface of epithelial cells, imitating true key cells;
- cultures and smears for the presence of candida fungi are negative;
- no signs of inflammation (leukocytes are normal) in smears.
Vaginosis during pregnancy
Pregnancy is sometimes (20 – 46%) one of the physiological reasons vaginosis, as it creates favorable conditions for the formation of local dysbiotic disorders: a decrease in the amount of estrogen and a significant depletion of immune defense mechanisms.
In half of the cases, the disease does not cause pathological subjective sensations, and an increased amount of vaginal discharge is accepted by the pregnant woman as normal.
The only reliable symptom of vaginosis in pregnant women is profuse, loose leucorrhoea with an unpleasant odor. If the discharge continues for a long time, the patient may notice a change in its consistency from liquid to thick, and in color from white to yellowish. Often in a conversation it turns out that episodes of the appearance of such leucorrhoea were observed before pregnancy.
Diagnosis of vaginosis in pregnant women is similar to that in non-pregnant women and includes the study of complaints (if any), visual examination of the vaginal mucous membranes and laboratory examination of vaginal contents. An amine test and vaginal pH measurement are also performed.
Pregnant women are examined for the presence of vaginosis three times: at the first visit, before maternity leave(27 – 30 weeks) and on the eve of childbirth. If the result is positive, after the course of therapy, additional examination to control cure.
Vaginosis during pregnancy can provoke infectious inflammation. Against the background of reduced immunity, an infection from the vagina can rise into the cervical cavity and uterus. And although the likelihood of such a scenario is low, vaginosis in pregnant women cannot be ignored.
The treatment regimen for vaginosis in pregnant women is characterized by the predominance of local therapy. Systemic drugs used infrequently and only in the second half of pregnancy.
Treatment of vaginosis
Unfortunately, many women ignore the signs of vaginosis or try to get rid of it on their own. Self-medication based on the principle of therapy inflammatory diseases vagina not only does not help, but also aggravates the course of vaginosis. Randomly selected antibacterial agents only aggravate the course of vaginosis, and “useful” douching literally washes away the remnants of microflora from the surface of the vagina.
To cure vaginosis, it is necessary to consistently eliminate its causes: remove the unfavorable background that provokes dysbiosis in the vagina; destroy excessively multiplied opportunistic microflora and restore the normal number of lactobacilli.
To choose the right treatment strategy, it is necessary to take into account the severity of vaginosis. It is measured by the amount of lactoflora remaining in the vagina and the microbial composition of the vaginal environment.
Conventionally, there are three significant degree severity of vaginosis:
- The first degree of severity (compensated vaginosis) is characterized by the complete absence of microflora in the studied material, the presence of unchanged, normal vaginal epithelium. The cause of such vaginosis may be excessive intimate hygiene or antibiotic therapy. Compensated vaginosis does not always require detailed therapy; sometimes the body independently copes with a temporary disturbance in microbial balance after the cause of its appearance disappears.
- The second degree (subcompensated) of vaginosis severity is characterized by a decrease in the number of lactobacilli, a quantitative increase in the population of anaerobic bacteria and the appearance of key cells in a small number (up to five in the field of view).
- Decompensated (third) degree of severity is manifested by a pronounced clinical picture of vaginosis, the complete absence of lactobacilli against the background of a large number of microbial populations and a significant number of key cells (covering the entire field of view).
After the unwanted infection is eliminated, a niche is released in the vaginal environment, which should be occupied by lactobacilli. At the second stage of treatment, favorable conditions are created to restore normal microbial balance with the help of eu- and probiotics containing lacto- and bifidobacteria.
Two-stage treatment of vaginosis is successful in 90% of cases, but it does not guarantee the absence of relapses of the disease. Recurrent vaginosis is treated similarly to the acute process. To avoid the return of vaginosis, simple preventive measures should be followed. Prevention of vaginosis involves:
- adequate intimate hygiene;
- rational antibiotic and hormonal therapy;
- prevention (or treatment) of intestinal dysbiosis;
- culture of sexual life: restriction of sexual partners and use of barrier contraception;
- regular examinations in antenatal clinics.
- Suppositories and drugs for vaginosis
The choice of medicine depends on what microorganisms are found in the material during laboratory testing.
The local method of drug administration is preferable, so the following are most often prescribed: Chlorhexidine in solution or Hexicon vaginal suppositories; suppositories or cream Clindamycin (Metronidazole), Flagyl suppositories.
An alternative local treatment is to take Metronidazole, Tinidazole, Ornidazole tablets according to the regimen chosen by the doctor.
Thank you
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
Bacterial vaginosis is one of the most common obstetric and gynecological diseases. IN Lately occupies 30–50% of all vaginal pathologies and requires great attention from gynecologists. The incidence of bacterial vaginosis in non-pregnant women during puberty ranges from 4 to 61%. Such wide range incidence must be associated with insufficiently objective criteria used to diagnose bacterial vaginitis. The likelihood of occurrence in pregnant women is 14–20%. Bacterial vaginosis most often occurs in women under the age of 35–40 years.Pathogens
Many experts are of the opinion that bacterial vaginosis is nothing more than a violation of the vaginal ecosystem, which is provoked increased growth pathogenic, often anaerobic bacteria. A very rapid decrease in vaginal acidity and the quantitative concentration of lactobacilli (inhabitants of the normal vaginal microflora) is carried out not by one pathogenic microorganism, which later becomes predominant, but by a combination of several microorganisms at once. For example, they may be: Gardnerella vaginalis, Bacteroides sp., Peptococcus sp., Mycoplasma hominis, Mobiluncus and other representatives. Bacterial vaginosis is a polymicrobial disease, so it is impossible to isolate any dominant pathogen from this group of microorganisms - any of them can be contained in small quantities in the vaginal contents of healthy women. Vaginal discharge normally contains from 105 to 107 microorganisms per 1 ml.What is bacterial vaginosis?
This is a disease that occurs as a result of the replacement of lactobacilli of the normal microflora of a woman’s vagina with opportunistic anaerobic microorganisms. This is a qualitative change in the composition of the vaginal flora under the influence of various factors. Bacterial vaginosis creates favorable conditions for the occurrence of various infectious processes in the vagina.How does the disease develop?
Lactobacilli dominate in the normal vaginal microflora. When the microecology of the vagina is disrupted, the number of predominant lactobacilli sharply decreases, and the rate of growth and development of opportunistic anaerobic bacteria increases. Previously, scientists claimed that the causative agent of bacterial vaginosis is Gardnerella vaginalis. But later it turned out that there are other causes of vaginosis and that gardnerella is part of the normal microflora of the vagina. Factors predisposing to the development of bacterial vaginosis include:
Long-term treatment antibacterial drugs, including antibiotics
Past inflammatory diseases of the genital organs
Oral and intrauterine contraception
Frequent change of sexual partners
Hormonal disorders
Decreased immunity
Chronic diseases intestines and other diseases that can cause dysbiosis
Poor nutrition – lack of fermented milk products in the diet
Excessive use of panty liners and tampons
Frequent wearing of tight-fitting, tight-fitting synthetic underwear and trousers.
If the balance of the vaginal microflora is disturbed, the pH of the vaginal contents changes from 4.5 to 7.0 - 7.5. As a result of the activity of pathogenic microorganisms, complex chemical compounds (volatile amines) are formed in the vagina, which contributes to the release unpleasant odor"rotten fish" Data pathological mechanisms disrupt the normal functioning of natural biological barriers in the vagina and favor the development of various inflammatory diseases of the genital organs and postoperative infectious complications.
Clinical manifestations
- The main complaint is numerous homogeneous creamy grayish-white foamy vaginal discharge, slightly viscous. Discharge sticks to the walls of the vagina and is evenly distributed along its walls. The discharge is accompanied by an unpleasant smell of “rotten fish”
- Itching and burning in the vaginal area
- Dyspareunia – discomfort and pain during sexual intercourse
- Urinary dysfunction
How to diagnose bacterial vaginosis?
A diagnosis of bacterial vaginosis can be made if at least 3 of the following 4 signs are present:1. Homogeneous vaginal discharge
2. The pH of the vaginal discharge is above 4.5
3. positive amine test
4. the presence of “key cells” (desquamated vaginal epithelial cells densely covered with gram-variable rods) in smears of vaginal discharge, stained with Gram and examined under a microscope. Normally, “key cells” are not found in the vagina.
- The bacterioscopic method can also detect a small number of leukocytes in the field of view, a reduced number or complete absence Dederlein sticks
- Culture of vaginal microflora
- Antibioticogram - determination of pathogen sensitivity to antibiotics
- Polymerase chain reaction - to determine the genetic material of Gardnerella vaginalis
Complications of the disease
Frequent uterine bleeding Development of pelvic inflammatory diseases ( reproductive system and genitourinary tract)
Infertility
Premature rupture of membranes during childbirth and their inflammation
Endometritis in the postpartum period
Stopped development of the newborn
How to treat bacterial vaginosis?
Treatment of bacterial vaginosis must be carried out under the strict supervision of the attending physician. All attempts at self-medication are excluded. There are two directions in the treatment of this disease:
The first direction is to destroy pathogenic and pathogenic microorganisms and restore the balance of normal vaginal microflora. For this, vaginal suppositories and gels are used, which contain antibiotics and antiseptics - Metronidazole, Ornidazole, Clindamycin. They use drugs such as Macmiror and Terzhinan in the form of vaginal suppositories or tablets.
The second direction involves the use of eubiotics - drugs containing lactobacilli (Lactobacterin, Bifidum-bacterin, Acylact). Use internally or locally - in the vagina. Yoghurts and biokefirs are recommended.
Vitamin therapy and biogenic stimulation - to increase the overall resistance of the body.
Immunotherapy and immunoprophylaxis - the Solko Trikhovak vaccine containing special strains of lactobacilli. As a result of the introduction of the vaccine, antibodies are formed that successfully destroy the causative agents of the disease, normalize the vaginal microflora and create immunity that prevents the development of relapses of bacterial vaginosis.
Basic medications, used for the treatment of bacterial vaginosis:
Metronidazole (Metrogyl, Trichopolum, Flagyl) helps stop the growth of harmful bacteria. This kind medicines Five hundred milligrams are prescribed in the morning and evening. The course of treatment is seven days. When using these medications, side effects such as allergic reactions, digestive disorders, vomiting, nausea and others may become apparent.
Clindamycin is an antibiotic drug that tends to inhibit both the growth and reproduction of pathogenic bacteria. You can purchase this medication both in the form of capsules and in the form of vaginal cream or vaginal suppositories. As for vaginal cream, it should be inserted into the vagina using a special applicator once a day before going to bed. The course of therapy is six days.
Prevention
- Maintaining genital hygiene
- Proper and nutritious nutrition
- Timely treatment of inflammatory diseases of the genitourinary organs
- Elimination of abuse in antibiotic treatment
- Wearing comfortable underwear made from natural fabrics
Reviews
I “brought” bakvaginosis from the sea, not the first time, by the way, such nonsense. They prescribed treatment in two stages: first vaginal tablets, and then lactozhin capsules. Everything went away without consequences, otherwise it happened that later the thrush came out again. I’ll understand this thanks to dlactoginal, because... he restores the flora.
I have treated vaginosis several times, I know firsthand what kind of disgusting thing it is. At first they prescribed courses for ten days, but there were still relapses. The most successful treatment was the last time, only salvagin gel was prescribed, but there was no relapse after this prescription, although almost a year had passed
Vaginosis is, of course, terrible, especially when you don’t have time to be treated, and after a couple of months it appears again. Salvagin helped me get rid of it, it’s an intravaginal gel. Five tubes were enough to completely restore the flora, the immune system has strengthened quite well, apparently copes with bacteria and there are no more relapses.
I treated vaginosis with Metronidazole, it helped well, although it also requires a good probiotic, because it kills all microflora indiscriminately.
Please tell me I had a medical examination and found out that I had vaginosis. Are they allowed to work with such a diagnosis? Or only after treatment?
Hello! Please tell me! Can bacterial vaginosis contribute to the development of ovarian cysts?
Julia,
Vaginosis is NOT sexually transmitted! This is a natural disease (infection) of the vagina, or rather, vaginal dysbiosis. And yet, a man cannot suffer from vaginosis, vaginosis and the name from “vaga” - vagina, vagina. The man doesn't have it.
Pauline,
In my observations, the patients did not experience chest pain. Go to a mammologist or gynecologist about your breasts. A compaction may be present.
Hello! I am a specialist in gynecology. Write questions, I will answer. About vaginosis! My daughter (11 years old) has a whitish and transparent discharge, without gas bubbles, not foamy, no itching, no burning, urination, according to my observations, is normal. She put her finger in there and let me smell it. Stupid, of course...I didn’t smell anything! And she says either some kind of onion, or garlic, or she already stinks of iron. If anyone knows what this is, please tell me!! Even though I am a gynecologist myself, I still can’t figure it out completely. In my opinion, this is normocenosis.
Hello, I would like to know if there are chest pains and bloating in the lower abdomen with vaginosis? (Other symptoms of vaginosis are present)
It’s not true that microflora can be restored! I drank Lactofiltrum + Terzhinan vaginal suppositories. and everything will be fine! I advise...
Girls, most of you here advise you to definitely consult a doctor. They say that the doctor will definitely help to properly cure this very vaginosis. Doctors haven’t been able to cure him for three years now. Various antibiotics are prescribed, then probiotics. That's all. The same scheme with the difference only in the names of the drugs. In my case, Acylact, on the contrary, provokes thrush (although, in theory, it should prevent it), sometimes I have to give up everything halfway because terrible itching and discomfort begins. In general, the microflora is not restored to anything. This is precisely why I wander around the forums to read at least some other options for possible treatment (and healing, without relapses), because the regimens prescribed by doctors do not bring any benefit.
Vaginosis is a very nasty thing, I suffered from it myself =(((Oh, how I suffered with it... I ran around to doctors until Vaginorm-S was prescribed. It was my savior! I was already tired of the unpleasant-smelling discharge, and Vaginorm eliminated it in just 6 days! I recommend it to everyone!
Vaginosis is a terrible scourge!! I had it several times in my life, there were, so to speak, relapses, I was treated with Vagilak. Until one fine day I went to the doctor and they prescribed Vaginorm for me for a week - it doesn’t cause any inconvenience, nothing gets in the way “there”)) A week later I was terribly glad that it was all over!! Six months have already passed, and so far, pah-pah, no relapses... I recommend it in general))
Thanks to the authors for the article! It’s a shame they didn’t mention oral probiotics, which restore the vaginal microflora. Because yoghurts and kefir are, of course, good, but from the stomach they enter the intestines and affect the microflora of the intestines, not the vagina. Eat modern drugs(for example, Vagilak), which restore female microflora!
The structure of the female reproductive system determines the frequency infectious diseases reproductive organs. Bacterial vaginosis is a common non-inflammatory pathology. According to statistics, every second patient who consults a gynecologist about unusual discharge suffers from herdnerellosis.
Women, upon hearing about their diagnosis, often make claims to their partner and believe that they received the infection from him. In reality, the transmission routes of bacterial vaginosis differ from the stereotypical ones.
How is bacterial vaginosis (gardnerellosis) transmitted?
The patient thinks about whether bacterial vaginosis is transmitted during sexual intercourse only after the doctor has announced the diagnosis. Women frantically remember sexual relationships, and those who have not changed partners may doubt his honesty. Completely in vain! Before blaming others, you should understand the nature of the origin of vaginal dysbiosis.
Until a certain time, it was believed that bacterial vaginosis could be transmitted sexually. The disease was placed on a level with genital infections and sexually transmitted diseases. It later turned out that this stereotype was a grave mistake.
Bacterial vaginosis (dysbacteriosis, dysbiosis or gardnerellosis) is a disease of the genital area, which begins as a result of an imbalance of beneficial and opportunistic microorganisms.
The latter normally inhabit a woman’s vagina, but are not active. Thanks to lactobacilli, which break down glycogen, lactic acid is formed. As a result of natural processes, the correct vaginal microflora is maintained with a predominant acidic environment.
If the number of lactobacilli decreases, then opportunistic organisms, whose growth was previously restrained, will take on an active form.
Based on the principle of development of bacterial vaginosis, we can say with confidence that the disease itself is not sexually transmitted.
Can a woman get bacterial vaginosis from her sexual partner?
Gardnerellosis cannot be transmitted in its true form through sexual contact. However, if a sexual partner has an STI, then during unprotected sex they will be passed on to the woman.
The further development of events in the patient’s body does not depend in any way on the man. With good body resistance, gardnerella, microplasma, bacteroides, candida and other microorganisms will remain in a latent form.
Most of them already inhabit the girl’s vagina by the time of puberty, the rest are acquired during sexual activity.
Having received the infection from her partner, a woman may develop bacterial vaginosis immediately or only after a few months. In this case, the cause of the pathology will not be the sexual contact that took place, but internal and external factors.
Factors contributing to the development of the disease
The root cause of vaginal dysbiosis is a decrease in the number of lactobacilli, which make up about 98% of the microflora of the genital tract. There are many known factors that help reduce the body’s resistance:
- Long-term use of antibiotics, chemotherapy;
- Use of hormonal medications, including oral contraceptives;
- Frequent application of spermicidal substances to the vaginal mucosa;
- Douching;
- Abuse of hygiene products (soap, perfume for the intimate area, pads);
- Surgical operations.
Despite the fact that it is impossible to directly obtain dysbiosis through sexual contact, frequent changes of sexual partners contribute to the occurrence of this disease. The reason is that with each new unprotected sex, microorganisms are transmitted. The constant exchange of flora changes the quantitative ratio of bacteria inhabiting the vagina.
Can a man get infected from a woman with bacterial vaginosis?
The sexual partner, having learned about the woman’s diagnosis, also begins to worry. Men immediately have thoughts that they can’t have sex, otherwise they might get infected. However, this statement is not entirely correct.
The disease is not transmitted through direct sexual contact; bacterial vaginosis can develop in men in another form. The cause will be a decrease in immunity, and the causative agents will be infections acquired through sexual contact (candida, gardnerella, mycoplasma, ureaplasma).
Transmitted through unprotected sex, opportunistic microorganisms can just as easily be present in a man’s body for a long time. Under the influence of unfavorable factors, they will provoke urethritis, prostatitis, balanitis or balanoposthitis.
Sex with bacterial vaginosis: how to protect yourself?
When asked whether it is possible to have sex with bacterial vaginosis, doctors answer in the affirmative. You should avoid intimacy while using vaginal medications, if specified in the instructions.
After sex, bacterial vaginosis can manifest itself with increased symptoms, in particular discharge and an unpleasant odor. This reaction is due to the interaction of vaginal mucus with sperm.
Sexual partners of women with bacterial vaginosis do not require treatment. The converse is also true. To protect yourself from the development of vaginal dysbiosis, women should follow simple rules:
- Support immunity;
- Maintain intimate hygiene;
- Strengthen the body's protective properties;
- Eat right and lead an active lifestyle;
- Avoid thongs and tight pants;
- Use condoms with a new partner.
As a preventative measure, you can use antiseptics: Miramistin solution or Hexicon suppositories. You should consult your doctor before using medications.
