– gynecological infectious non-inflammatory disease. The disease usually occurs as a result of sexual intercourse. According to statistics, vaginosis affects 20% of women of reproductive age. The disease is characterized by changes vaginal environment and flora, production decreases lactic acid and the pH of the vaginal environment decreases. Thus, the resulting neutral environment does not interfere with the development of various microbes, including trichomonas .
The vaginal microflora can be represented as mobile ecosystem. In normal condition, the vagina contains lactobacilli , which play a protective function. Lactobacilli processing glycogen (in women of reproductive age, vaginal epithelial cells contain large quantities of glycogen) into lactic acid, thereby reducing the acidity of the vagina. In addition, lactobacilli are capable of forming. Hydrogen peroxide and the acidic environment of the vagina suppress the proliferation of opportunistic bacteria ( streptococci , staphylococci , anaerobic bacteria , coli , Mobiluncus spp. , Gardnerella vaginalis .). Which are found in small quantities in the vaginal microflora of the vast majority of women.
If the proportion of lactobacilli in the body decreases, then instead of them they occupy opportunistic bacteria(Gardnerella vaginalis primarily). The latter contribute to the release of volatile amines, which have an odor comparable to the smell of rotten fish.
Bacterial vaginosis is not sexually transmitted because it is not venereal disease. The bacteria that cause bacterial vaginosis (primarily Gardnerella vaginalis) can be transmitted through sexual contact. But their transmission from woman to woman cannot be the main cause of the disease. Since in small quantities these microbes are part of the vaginal microflora of the vast majority of women.
Unprotected sex, however, may play a role in the development of bacterial vaginosis. The whole point here is not about infectious infection, but about the fact that sperm of sexual partner or several sexual partners cause changes in the vaginal microflora.
The main cause of the disease is not simply the presence of bacteria that cause bacterial vaginosis (they are present in almost every woman in small quantities), but a change in the proportions of opportunistic microbes (which cause bacterial vaginosis) and lactobacilli. The proportion of lactobacilli in bacterial vaginosis decreases, and the proportion of pathogens increases. Therefore, bacterial vaginosis in medicine is called vaginal dysbiosis.
The occurrence of bacterial vaginosis can be caused by both internal influences of the body and external influences, the so-called exogenous And endogenous factors . These may be changes in hormonal levels, decreased immune defense, disturbances in intestinal function, in particular microbiocenosis . The disease can also be caused by reasons such as the use of immunosuppressants, as well as previous inflammatory diseases of the genitourinary system.
The bacteria that cause bacterial vaginosis are not dangerous for men. Men who have been diagnosed with Gardnerella vaginalis, as well as sexual partners of women with bacterial vaginosis, do not need treatment.
Symptoms of bacterial vaginosis
Bacterial vaginosis has no specific symptoms. The disease is characterized by some clinical manifestations, these are abundant creamy discharge from the vagina. They are uniform, grayish-white in color, and often stick to the walls of the vagina. Due to the breakdown of amines produced by bacteria, vaginal discharge often has an unpleasant, so-called “fishy” odor. The discharge causes symptoms of bacterial vaginosis such as burning and itching in the vagina. Often this becomes the cause of inflammatory diseases of the female genital organs, sometimes unpleasant and painful sensations during sexual intercourse.
There are several types of vaginitis, each of them has its own symptoms:
- Aerobic vaginitis– appears as a result of contact with the mucous membrane of aerobic microflora, during a one-time decrease in the normal lactoflora of the vagina.
- Trichomonas vaginitis– is one of the most common types of vaginitis.
- Candidal vaginitis– an inflammatory fungus, the main causative agents of which are yeast-like fungi Candida .
- Allergic vaginitis- is one of the types of genital diseases, which is caused by the use of drugs to prevent unwanted pregnancy or treat diseases of the genital organs.
- Desquamative inflammatory vaginitis- one of the types of nonspecific vaginitis.
Diagnosis of bacterial vaginosis
Diagnosis of the disease is carried out in several stages. First of all, a laboratory examination of smears is carried out for the presence of key cells. When a smear is stained with methylene blue, one can detect flat epithelial cells to which gardnerella , which is why the cells take on a peppered appearance. In addition, laboratory analysis of smears includes amine test. During examination, vaginal discharge is diluted with a 5-10% solution potassium hydroxide . The resulting smell, fishy or, more precisely, an amine smell, indicates the presence of a disease.
Diagnosis of bacterial vaginosis also includes determining the pH level of the vaginal microflora. To do this, directly during an examination on a gynecological chair, the doctor inserts pH paper into the secretion of the vaginal vault using tweezers. The presence of the disease is determined at pH 4.5.
The presence of all these signs, as well as the symptoms of bacterial vaginosis, accurately confirm the diagnosis. The disease can also be diagnosed by isolating a pure culture of bacteria, but such diagnostics is ineffective. This is due to the fact that more than 58% of healthy women have high levels of germs Gardnerella vaginalis in vaginal secretions.
Treatment of bacterial vaginosis
The disease requires conservative treatment. Antibiotics are prescribed, such as,. They are produced in preparations for oral and vaginal use. This , metrogel
, cleocin
, Tindamax
. Vaginal medications are more effective and are often included in the treatment of bacterial vaginosis. They cause fewer side effects, but the risk remains.
The best treatment for bacterial vaginosis is metronidazole (for example,) take 500 mg orally for 7 days, 2 times a day. Sometimes the drug is difficult to tolerate (may cause nausea). Completely incompatible with alcohol. But systemic treatment can reduce the likelihood of complications caused by bacterial vaginosis.
Reserve drugs:
Clindamycin ( , climycin ) for 7 days, 2 times a day, 300 mg orally. Clindamycin inhibits the growth of more than just bacteria Gardnerella vaginalis, but also lactobacilli ( Lactobacillus spp.). Clindamycin is prescribed in case of intolerance to metronidazole by patients.
Clindamycin cream , with a concentration of 2% ( dalacin ) is inserted into the vagina using the supplied applicator for 5 days, 1 time per day (at night). Of course, local treatment is much better tolerated, but less effective systemic treatment reduces the risk of complications of bacterial vaginosis.
Gel Metronidazole , 0,75% ( , flagyl ) is inserted into the vagina using the supplied applicator for 5 days, 2 times a day. As with the previous drug, local treatment is much better tolerated, but less effective systemic treatment reduces the risk of complications of bacterial vaginosis.
There is another treatment for bacterial vaginosis, its system consists of two stages. First, it is necessary to suppress reproduction pathogens . For these purposes, irrigation with solutions of boric and lactic acids is used, but there are also more modern medical preparations. Namely, the drug - an antiseptic medicine with a wide spectrum of effects - is used intravaginally once (one tablet) for 6 days.
It is worth noting that this drug can be used during pregnancy to sanitize the birth canal. It is performed according to the same scheme, the beginning of therapeutic treatment is 6-7 days before the PDR.
At the second stage, restoration is carried out vaginal biocenosis. For these purposes they are used locally eubiotics , medicinal products containing strains of lacto- and bifidobacteria.
Complications of bacterial vaginosis: unpleasant odor of discharge, discomfort, itching; development (after cesarean section, post-abortion, postpartum); risks of premature birth and late pregnancy.
Many women at least once in their lives have to face the diagnosis of bacquaginosis. What is this? This is the name given to a specific type of vaginal inflammation caused by an overabundance of bacteria. Microorganisms themselves are not dangerous; they always live in the vagina and perform useful functions. However, exceeding their normal amount leads to a disruption of the natural balance of microflora, and subsequently to bacterial vaginosis.
Most often, this pathology is detected, although the imbalance can be diagnosed in everyone. The causes of the disorder are still unknown to science; Only certain ones can be identified - for example, unprotected sexual intercourse or frequent douching. Taking certain medications can also trigger bakvaginosis.
Symptoms
In women of all ages, the disease manifests itself equally. Contact your gynecologist if you are concerned about:
- watery grey, white or from the vagina;
- unpleasant from the vagina;
- itching in the groin;
- burning sensation during urination.
In some cases, bacterial vaginosis is asymptomatic.
When to see a doctor
Make an appointment at a clinic or medical center if:
- Vaginal discharge looks new or unusual, has a foul odor, or is accompanied by a fever. A gynecologist will help identify the cause and diagnose the disease based on signs and symptoms.
- You have treated vaginal infections before, but this time the discharge has a different color and consistency.
- You have had sex with multiple partners or have recently changed partners. Sometimes the symptoms of sexually transmitted diseases are similar to those of bacterial vaginosis.
- You tried to treat a yeast infection yourself with over-the-counter medications, but you ended up with bacterial vaginosis, the symptoms of which don't go away.
Causes
The inflammatory process in the vagina begins as a result of excessive growth of several types of bacteria that live in the female body. In a normal microflora state, beneficial lactobacilli outnumber “harmful” microorganisms (anaerobes). But if there are more anaerobes, the natural balance is disrupted and leads to a disease called “baquaginosis”. Is this an accident or a pattern generated by poor personal hygiene? Unfortunately, medicine is not yet able to give a definite answer to this question.
Risk factors
There are circumstances that increase the risk of developing pathology. These include:
- Frequent change of sexual partners or relationship with a new sexual partner. Doctors do not fully understand the connection between sexual activity and bacterial vaginosis, but the disease is more often diagnosed in women who have entered into a relationship with a new man. Representatives of non-traditional sexual orientation are at even greater risk.
- Douching. The practice of cleaning the vagina with water or cleanser (douching) disrupts the natural balance of the vagina. This can lead to the growth of anaerobic bacteria, which, in turn, threatens the development of pathology. Since the vagina is capable of self-cleaning, douching is not necessary.
- Lactobacilli deficiency as an individual characteristic of the body. Sometimes completely healthy women who do not change sexual partners and do not douche are diagnosed with bakvaginosis. What kind of scourge is this and why does it develop, seemingly out of nowhere? In fact, there are times when a woman's vagina is naturally unable to produce enough lactobacilli. The lack of “good” microorganisms over time leads to the appearance of unpleasant symptoms.
Complications
Usually this inflammatory process does not entail complications. In rare cases, the following are noted:
- Premature birth. Bakvaginosis during pregnancy can lead to premature delivery and the birth of a child with low weight and height.
- Sexually transmitted infectious diseases. If a woman does not take any measures to alleviate her condition, her body becomes more vulnerable to HIV, herpes simplex virus, chlamydia and gonorrhea. If the patient has HIV, there is an increased risk of transmitting the virus to a partner.
- Risk of infection after surgery. Untreated disease increases the risk of post-operative infection after procedures such as hysterectomy or dilation and curettage of the uterus.
- Inflammatory diseases of the pelvic organs. Bakvaginosis, the causes of which remain a mystery, in some cases causes inflammatory processes in the pelvis (usually the uterus and fallopian tubes are affected), which can, in turn, lead to infertility.
Diagnostics
To make an accurate diagnosis, the doctor:
- Ask questions about your medical history. The specialist will ask if you have had vaginal infections or sexually transmitted diseases before.
- During this test, the doctor examines the vagina for signs of infection and places two fingers inside while pressing on the abdomen with the other hand to check if the pelvic organs are healthy.
- Take a sample of vaginal discharge for analysis (smear). This procedure is performed to detect an excess of anaerobic bacteria in the vaginal microflora. The specialist will examine the discharge under a microscope, looking for "clue cells" - vaginal cells covered in rod-shaped microbes.
- Check the pH level in the vagina. The acidity of the vagina is checked by placing a special test strip inside. If the pH reaches 4.5 or higher, the doctor diagnoses bakvaginosis (photo).
Treatment
Use only those medications prescribed by your gynecologist. To treat the inflammatory process in the vagina, the following is usually used:
- Metronidazole. This medication is convenient because it comes in tablets - you can simply drink the tablets with water. It is also available in the form of a topical gel, a small amount of which is placed in the vagina. To avoid side effects from taking the pills (which may include upset stomach, abdominal pain, or nausea), avoid drinking alcohol during therapy. It is also advisable to refrain from drinking alcohol for 24 hours after completing the course of treatment.
- Clindamycin. This product comes in the form of a vaginal cream. It should be borne in mind that this drug has a destructive effect on latex condoms - both during treatment and for at least three days after the end of therapy.
- Tinidazole. This drug comes in tablet form and has properties similar to those of metronidazole, the most common medication used to treat bakvaginosis. What does it mean? Follow the instructions for use and remember that you should also not drink alcohol during the course of tinidazole.
If the infected woman's sexual partner is a man, he usually does not require treatment. The situation is different for representatives of non-traditional sexual orientation; they are recommended to undergo diagnostic examinations and, if inflammation is detected, to begin a course of therapy. Timely treatment is of particular importance for pregnant women, as bacterial vaginosis can lead to premature birth.
Take medications or use a cream or gel strictly for the period prescribed by your gynecologist, even if the symptoms disappear earlier. Terminating therapy prematurely may increase the risk of relapse.
Relapse
Even if you asked your doctor exactly how to treat bakvaginosis and strictly followed his recommendations, the disease can recur after a period of three months to a year. Research is currently underway into methods to prevent recurrent vaginal inflammation. Be sure to consult a doctor if symptoms of infection recur; You may be given an additional course of metronidazole.
There is a scientifically unsubstantiated but widespread belief that eating foods rich in lactobacilli helps restore the natural balance. Proponents of this point of view suggest that women suffering from recurrent bacterial vaginosis add more natural yogurt and other foods containing probiotics to their daily diet. Although this assumption may have a rational basis, scientists cannot yet give a definite answer to the question of the usefulness of menu changes.
Prevention
It is better not to treat, but to prevent bakvaginosis. Reviews of special intimate hygiene products will help you make your choice - buy mild, unperfumed liquid soap and tampons or pads without fragrances.
It is not recommended to resort to douching, since the vagina does not need special cleaning - just taking a bath or a regular shower is enough. Frequent douching disrupts the balance of microflora in the vagina and increases the risk of developing infectious diseases. In addition, deliberately “cleaning” the vagina will not help in any way to calm down the inflammatory process that has already begun.
Avoid contracting sexually transmitted infections. Use male latex condoms, limit the number of sexual partners you have, or temporarily abstain from sexual activity to minimize your risk of contracting a sexually transmitted disease.
Bacterial vaginosis is one of the most common vaginal diseases and a common cause of unpleasant odor, vaginal discharge and itching in the intimate area.
Symptoms of bacterial vaginosis
Bacterial vaginosis often causes the following symptoms:
- Unpleasant “fishy” odor from the vagina. The smell may be constant or appear during or after sex.
- , sometimes resembling mucus. Discharge can be heavy or moderate.
- Irritation, itching, discomfort, redness of the skin in intimate areas.
- Pain and cutting during urination.
- Dryness and...
You are more likely to have bacterial vaginosis if:
- Have you recently taken antibiotics?
- You recently changed your sexual partner
- You have had two or more sexual partners in the past few weeks
- You have
- Have you recently used a jacuzzi or taken a bath?
- Have you recently douched?
- You don't comply
All of the above factors are not the direct cause of inflammation, but they disrupt the vaginal microflora and predispose to the development of bacterial vaginosis.
When does a smear indicate bacterial vaginosis?
Most women find out that they have bacterial vaginosis precisely by the result. If a woman has bacterial vaginosis, the following changes are detected in the smear:
- many key cells
- many cocco-bacillary forms (bacteria that look like rods and cocci)
- abundant coccal flora
- leukocytes are elevated or within normal limits
- presence of mobiluncus
- The pH of the secretions is above 4.5
Bacterial vaginosis is often combined with other infections, so the smear may contain changes characteristic of other diseases, for example, candidiasis (),.
Gardnerella and bacterial vaginosis
Sometimes bacterial vaginosis is mistakenly called gardnerellosis, since most often it is the bacterium Gardnerella vaginalis that causes inflammation in this disease.
However, gardnerella is often found in the vagina in healthy women who do not have inflammation. That is why, if you have been diagnosed with gardnerella, but there are no signs of inflammation (there are no symptoms of inflammation and the smear result is normal), then there is no question of any bacterial vaginosis, and you are fine.
Why is bacterial vaginosis dangerous?
The bacteria that cause inflammation in bacterial vaginosis are very sensitive to standard antibiotic treatment, and the disease is easily treatable. But if bacterial vaginosis is not treated, it can cause complications:
- - inflammation of the uterus.
- Salpingitis is inflammation of the fallopian tubes.
- Adnexitis is inflammation of the uterine appendages (fallopian tubes and ovaries).
- Infertility.
Bacterial vaginosis during pregnancy can lead to premature birth.
How to treat bacterial vaginosis?
If bacterial vaginosis appears for the first time:
- Metronidazole 500 mg (Trichosept): one tablet 2 times a day for a week, or
- Vaginal gel Metronidazole 0.75% (Rozex): insert one applicator into the vagina before bed for 5 days, or
- Clindamycin vaginal cream 2% (Clindacin): insert one applicator into the vagina before bed for 7 days.
If bacterial vaginosis does not go away with the prescribed treatment, the gynecologist will prescribe an alternative treatment:
- Tinidazole: 2g per day for 2 days, or 1g per day for 5 days, or
- Clindamycin 300 mg: one tablet 2 times a day for a week.
Probiotics in the treatment of bacterial vaginosis
Probiotics are preparations that contain the same beneficial bacteria, which make up the normal microflora of the vagina and help protect against infections.
The following probiotics are used for bacterial vaginosis:
- Gynoflor: vaginal tablets
- Vagilak: tablets for oral administration
The regimen for taking probiotics for bacterial vaginosis is as follows:
- 7 days of daily use
- 7 days break
- 7 days of re-appointment
This regimen of taking probiotics will avoid the return of infection several months after the end of antibacterial treatment. According to the manufacturers, taking these drugs is not prohibited during pregnancy and breastfeeding.
Treatment of bacterial vaginosis during pregnancy
Bacterial vaginosis during pregnancy can cause it, so treatment is necessary. It is recommended to take medications prescribed to pregnant women from the second trimester of pregnancy (not earlier than 13 weeks):
- Metronidazole 500 mg: one tablet 2 times a day for 7 days
- Metronidazole 250 mg: one tablet 3 times a day for 7 days
- Clindamycin 300 mg: one tablet 2 times a day for a week
Local treatment (vaginal ointments or creams) helps eliminate the symptoms of bacterial vaginosis, but does not reduce the risk of complications of the disease during pregnancy (premature birth).
Attention: These treatment regimens are indicative and may be changed by your doctor. Before using medications, be sure to consult your gynecologist!
Does my husband (sexual partner) need treatment?
It is known that in 80% of men whose sexual partners suffer from bacterial vaginosis, the main causative agent of this disease is found in the urethra Gardnerella vaginalis and other bacteria. This means that the bacteria "move" from the vagina into the man's urethra during unprotected sex.
And, nevertheless, men should be treated No need. Numerous studies have shown that treatment of sexual partners does not affect the recovery of women and does not reduce the chances of relapse.
Treatment for your partner necessary if this is not the first time you have developed bacterial vaginosis, or if you have been diagnosed with sexually transmitted diseases.
Bacterial vaginosis - first symptoms and treatment regimen
The nature of the disease depends on many factors, so when your health improves, the symptoms completely disappear. The disease is not sexually transmitted and does not affect men. Unprotected sexual intercourse has a certain role in the occurrence of the disease. Frequent changes of partners contribute to changes in the vaginal microflora.
What it is?
Bacterial vaginosis is a condition of the vaginal microflora in which the number of beneficial lactobacilli is significantly reduced, and the number of pathogenic ones increases. It can develop for many reasons - from the presence of a sexually transmitted infection to a banal decrease in immunity.
Causes
To date, science does not fully have information about what actually provokes the development of non-inflammatory syndrome. However, the relevance of this problem is increasing every year.
Factors that provoke the development of the disease include:
- weakening of local and general immunity;
- poor nutrition;
- long-term antibacterial and hormonal therapy;
- frequent douching;
- the use of local contraceptives (condoms, creams and suppositories) that contain 9-nonoxynol;
- frequent change of sexual partners;
- wearing synthetic underwear;
- endocrine and gynecological pathologies;
- failure to comply with basic rules of personal hygiene;
- intestinal diseases.
Currently, bacterial vaginosis is one of the most common diseases among women of active reproductive age (from 23 to 33 years). According to statistics, about 30-35% of women suffer from vaginosis, but only half of the total number of patients know about their problem due to the presence of a characteristic odor. The rest, as a rule, don’t even know about it.
Symptoms
Often the only symptom of bacterial vaginosis is the presence of copious vaginal discharge with an unpleasant smell of stale fish, which can bother you for a long time. At the beginning of the disease, the discharge is thin, white or grayish.
The general symptoms of bacterial vaginosis are as follows:
- discharge with an unpleasant odor (fishy), which occurs as a result of the breakdown of amines produced by anaerobic bacteria.
- copious, homogeneous, creamy vaginal discharge of a grayish-white color, adhering to the walls of the vagina.
- sometimes vulvovaginal irritation appears in the form of itching and burning, discomfort during sexual intercourse.
- signs of vaginal inflammation (addition of vaginitis) are observed in half of the patients.
- rarely - urination disorders and pain in the perineum.
If the disease continues for a long time, more than 2 years, then the following symptoms occur:
- the color of the discharge becomes dark green;
- leucorrhoea changes its consistency, becomes more viscous or resembles a curdled mass;
- Also, discharge due to vaginal dysbacteriosis is characterized by the following symptoms: over time they become thick and sticky, and their distribution along the vaginal walls is even. Leucorrhoea is easily removed from the walls with a cotton swab;
- with a long-term process, a number of patients complain of minor or moderate itching/burning in the vulva area (see vaginal itching);
- pain during sexual intercourse (see pain during intercourse);
- the volume of vaginal discharge reaches 0.02 liters per day (taking into account that the normal amount of leucorrhoea is no more than 2 - 4 ml);
- in a number of situations, pathogenic flora joins the described infectious process, which contributes to the development of vaginitis;
- Sometimes urinary disorders occur (frequent and painful urination in women).
A distinctive feature of the disease is the absence of visible signs of inflammation. That is, upon visual examination, a physiological pink color of the vaginal mucosa is observed. Only in some cases, single reddish dots are observed in menopausal women.
Severity
According to the severity of vaginal dysbiosis, there are:
According to the flow, acute, torpid or erased and asymptomatic vaginal dysbiosis is distinguished.
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.
How to treat bacterial vaginosis?
Initially, a woman is prescribed antibiotics to treat bacterial vaginosis: they have a detrimental effect on nonspecific bacteria and clear the vaginal mucosa of them.
The drugs of choice are Metronidazole, Tinidazole, Clindamycin, as they are active against anaerobes. Local use of antibiotics is preferable to avoid systemic side effects, but in some cases the gynecologist is forced to resort to tablet forms.
The treatment regimen is selected individually:
- Tinidazole 2.0 in tablet form is taken orally 1 time per day for 3 days;
- Metronidazole in the form of a 0.75% gel is administered into the vagina once a day for 5 days;
- Clindamycin suppositories 100 mg are administered into the vagina once a day for 3 days;
- A cream containing 2% Clindamycin is injected into the vagina once a day for 7 days;
- Metronidazole 2.0 tablets are taken orally once.
During antibacterial therapy and a day after its completion, it is necessary to avoid drinking alcohol, even in minimal doses. The drugs disrupt the metabolism of ethyl alcohol in the body, which causes the accumulation of toxic metabolites and severe intoxication. In its course, it resembles a severe hangover: the woman experiences severe weakness, limbs shake, blood pressure rises, a severe throbbing headache occurs, and painful nausea and vomiting develop.
Clindamycin cream contains fat, so it can damage the condom or latex contraceptive membrane. All local forms of drugs are administered immediately before bedtime to prevent them from flowing down the vaginal walls.
If antibiotics are intolerant or there are contraindications to their use, the first stage of treatment is carried out with local antiseptics:
- Hexicon 1 suppository is administered 2 times a day for 7-10 days;
- Miramistin in the form of a solution is irrigated into the vagina once a day for 7 days.
Preparations for bacterial vaginosis, used in the second stage of treatment, contain lactobacilli and create favorable conditions for restoring the vaginal microflora. They are used 2-3 days after completion of antibacterial therapy:
- Acylact 1 suppository 2 times a day is inserted into the vagina for 5-10 days;
- Bifiliz 5 doses are taken orally 2 times a day for 5-10 days.
Antifungal suppositories for bacterial vaginosis are usually not prescribed. The need for them arises if candidiasis, a fungal infection, joins the opportunistic microflora. In this case, Clotrimazole suppositories are prescribed intravaginally once a day for 6 days.
Treatment during pregnancy
How to treat bacterial vaginosis in case of pregnancy? In the first trimester of gestation, systemic therapy for the disease is not performed (metronidazole and other drugs are toxic to the embryo). Local administration of etiotropic drugs in the early stages is used with caution.
Taking metronidazole or clindamycin begins in the second trimester and is carried out in short courses. Metronidazole 0.5 g. (2 tablets) twice a day for 3–5 days, and clindamycin is prescribed in a dosage of 0.3 g. 2 times a day for 5 days.
Pregnancy complications that may occur due to the disease include:
- miscarriage - loss of a fetus during the first 23 weeks;
- premature birth - when a baby is born before the 37th week of pregnancy;
- chorioamnionitis - infection of the chorion and amnion membranes (the membranes that make up the fetal sac) and amniotic fluid (the fluid surrounding the fetus);
- premature rupture of the amniotic sac - a bladder containing fluid in which the fetus develops;
- postpartum endometritis - infection and inflammation of the uterine tissue after childbirth.
If you are pregnant and experience symptoms of vaginosis, contact your gynecologist as soon as possible. Although the risk of complications is low, treatment will help reduce it further.
Prevention
- using barrier methods of contraception, wearing underwear only made from natural fabrics;
- regular examination by a gynecologist and timely treatment of diseases;
- treatment of chronic pathologies of internal organs;
- strengthening the immune system in natural ways: physical activity, hardening, etc.;
- avoiding douching and other similar procedures.
Bacterial vaginosis is a pathology that reflects a decrease in the body’s level of defense at the moment. Often occurring asymptomatically, gardnerellosis is always detected during examination by a gynecologist. Only a doctor can prescribe the most effective tablets for bacterial vaginosis, suppositories or other forms. Don't delay treatment!
How to treat bacterial vaginosis? Gardnerellosis is considered an infectious disease and is non-inflammatory in nature, often with distinct symptoms in women and vague symptoms in men.
Today we’ll talk about what medications to treat, whether pregnant women need therapy, and whether it’s safe.
Both the weak half of humanity and the strong half can face this disease. Moreover, bakvaginosis is not necessarily sexual in nature, although this is often how it is transmitted.
Vaginosis is a pathogenic microorganism that affects the epithelium of the vaginal mucosa and urethral canal.
Symptoms of the disease are copious discharge, which has a characteristic fishy odor, itching and burning. This happens due to the proliferation of microbes, adversely affecting the opportunistic flora of the genital tract.
Many people believe that PP cannot be infected, but this is not true. In acute form this is possible. At the initial stage, men have practically no symptoms, but they are carriers.
The risk group is everyone who is sexually active. It is imperative to get rid of the infection to avoid complications.
Therapy
The treatment regimen for bacterial vaginosis takes place in several stages.
- Regeneration of normal flora of the genital tract, restoration of immune forces, stabilization of hormonal balance, destruction of pathogens.
- Taking lactobacilli to establish a normal acid-base environment in the vagina and urethral canal. It is prescribed to both sexual partners.
| A drug | Dosage | Course of therapy |
| "Ornidazole" Ornidazole | 500 mg | 2 times/day/7 days |
| "Metronidazole" Metronidazole | 300 mg | 2 times/day/7 days |
| "Clindamycin" Clindamycinum | 300 mg | 2 times/day/7 days |
| Suppositories and creams for vaginal use | ||
| "Neo-Penotran" Neo-Penotran | candles | 2 times/day/7 days |
| "Terzhinan" | candles | 2 times/day/5 days |
| "Clindamycin" Clindamycin | Cream, suppositories, gel | 1 time per day/7 days |
Gardnerellosis
His treatment must be mandatory. This disease is fraught with complications that can lead to inflammation of the prostate gland, damage to the urethral canal and genitourinary system.
| Medicines | Dosage | A course of treatment |
| "Metronidazole" Metronidazole | 300 mg | 2 times/day/3-5 days |
| "Tiberal" Tibera | 500 mg | 2 times/day/3-5 days |
| "Ornidazole" Ornidazole | 500 mg | 2 times/day/3-5 days |
| "Tinidazole" Tinidazol | 500 mg | 2 times/day/3-5 days |
| "Clindamycin" Clindamycin | Gel | 1 time/day/3-5 days |
Depending on the severity of the disease, treatment is prescribed for a course of 3-10 days. urologist. If there is no result from therapy with one drug, change to another, but you should not do it yourself.
- Avoid intimate relationships during therapy.
- Drinking alcohol.
- Visiting public baths and saunas.
- Excessive physical activity.
- Prevent stressful situations and nervousness.
To prevent the disease from occurring in the future, you need to follow some tips:
- Use condoms.
- Don't neglect hygiene.
- Drink vitamin complexes that strengthen the immune system.
- See a doctor promptly if there is an unpleasant odor in your intimate areas.
How to treat
Based on the symptoms, antibacterial therapy is prescribed to eliminate acute signs of the disease.
The regimen for bakvaginosis often includes the main drug “Metronidazole”. Available in various forms. Which is very convenient.
- Tablets: 0.5 g * 2 times / day.
- Candles: twice.
- Gel: 1 time.
The course varies from 5-10 days, is prescribed by a doctor, do not self-medicate. Analogues of the drug are Metrogyl.
It is available in the form of a solution for intravenous use and tablets. Flagyl is also prescribed; it is available in capsules, suppositories and solution for intravenous administration. Along with the usual regimen, suppositories and creams for vaginal use are often used. 
To restore the vaginal microflora, it is necessary during treatment and after to take drugs to increase lactobacilli - Dederlein bacillus:
- "Lactoginal" Lactoginal.
- "Bioselac".
- "Lacidophile."
- "Vaginorm."
- “Beefed.”
- "Baktisubtil".
The duration of treatment and the daily amount are prescribed by the doctor. You may be wrong with the dose, and the therapy will not bring results. When treating gardnerellosis, it is necessary to strengthen the immune system, so vitamin complexes are prescribed, including:
- "Viferon".
- "Ruferon".
- "Genferon."
- "Interal".
- "Altevir."
The doctor prescribes antifungal medications for candidiasis and specific pathologies of the genital area. These include gonorrhea, chlamydial infection, and gonorrhea. Therapy will be with the use of etiotropic drugs.
Pregnancy
If the disease is detected in the first term, treatment is not carried out; it begins in the second trimester.
Bakvaginosis tablets:
- "Metronidazole" Metronidazole: 2 r./day * 3-5 days.
- "Clindamycin" Clindamycin: 2 times a day - 3-5.
Suppositories and gels are successfully used in the treatment of vaginosis in pregnant women. They are safer and non-toxic to the fetus. The course of therapy and the amount of medication is prescribed by the gynecologist who is managing the pregnancy.
Candles and ointments:
- "Betadine" or "Povidone-iodine";
- "Hexion";
- "Chlorhexidine";
- "Terzhinan";
- "Polygynax".
It is contraindicated to take medications without the supervision of a gynecologist. The instructions are provided for a general idea of the treatment of the disease.
Drugs
These drugs for bacterial vaginosis are used after the main one and should be prescribed by a specialist.
- "Bactisubtil" Bactisubti: 1 tablet * 4 rubles / day before meals.
- "Linnex" or "Probifor".
- "Bifidumbacterin Forte".
- "Immunal".
Suppositories to combat vaginal discharge:
- "Ecofemin" vaginal capsules.
- "Hexicon".
At home
Use healing herbs in the initial stages of the disease in combination with basic antibacterial drugs, as an alternative to expensive suppositories and ointments for vaginal administration.
Some believe that with bacterial vaginosis, if you douche with lactic acid products, you can independently get rid of unpleasant symptoms and improve the vaginal flora.
But this is not so, under no circumstances should this be done. In addition to important lactobacilli, you can also catch harmful ones. During the course of treatment, use one of the recipes below.
You can make douches or tampons based on tinctures and decoctions. For procedures such as baths and douching, you need to devote at least 10 minutes of your time. It is advisable to use tampons at night.
Folk remedies
Recipe No. 1
- Chamomile: 1.0 tbsp.
- Goose foot: 1.0 tbsp.
Mix everything, cook in a water bath with 1.0 liters of boiling water, cool, strain, put in the refrigerator, and use warm.
Recipe No. 2
- Oak bark: 1.0 tbsp..
- Pour boiling water (1 glass), let it brew, strain, apply warm, consume within 24 hours.
Recipe No. 3
- Common bird cherry: 1.0 tbsp.
Pour (2 cups), cook in a water bath for up to 8 minutes, let it brew and cool.
