Bacterial vaginosis is a vaginal dysbacteriosis, i.e. a condition in which the ratio of microorganisms that normally live in the vagina is disturbed. Those that should be more (lactic bacteria), becomes smaller, and vice versa, those who normally should be few, multiply.
Bacterial vaginosis occurs on the background of immune disorders, inflammatory diseases of the reproductive system, menstrual disorders, prolonged use of the intrauterine device, unsystematic administration of antibiotics and hormonal drugs.
Accompanied by copious secretions with an unpleasant odor. Sometimes asymptomatic. The diagnosis is established on the basis of complaints, anamnesis and data of special tests. Treatment - local and general pharmacotherapy. It is worth noting that this infectious disease is not sexually transmitted as such, but can be transmitted by a man from a partner to another partner.
Causes of bacterial vaginosis
The factors leading to the development of bacterial vaginosis should be attributed primarily to long-term, sometimes uncontrolled use of antibiotics, which leads to dysbiosis not only of the vagina, but also of the gastrointestinal tract. According to a number of authors, practically every second patient with bacterial vaginosis reveals violations of the intestinal microecology.
Also, doctors identify several factors that presumably provoke the development of the disease:
- Hormonal factors: female hormones affect the state of the vaginal microflora. Bacterial vaginosis is rarely found in adolescent girls and women in menopause, when the level of sex hormones in the blood is reduced.
- Acceptance of cytostatics, antimycotic drugs and radiation therapy (weakening of the immune system).
- The presence of intrauterine device - the risk of infection increases twice.
- Excessive desire for cleanliness (douching, frequent washing with soap and vaginal showers).
- Reduced immunity - treatment of bacterial vaginosis may be required after serious illnesses, since they lead to a weakening of the protective functions of the body and contribute to the reproduction of harmful bacteria.
- Deformation of the vagina, cervix, and pelvic floor muscles after childbirth, surgery, or radiation.
- Intestinal dysbiosis is a violation of the intestinal microflora and is a factor contributing to the development of bacterial vaginosis.
- Pregnancy (an increase in progesterone synthesis causes a relative lack of estrogen, reduced immunity to prevent rejection of the fetus).
As a rule, in bacterial vaginosis, the following bacteria are found in the vagina: Gardnerella (Gardnerella vaginalis), bacteroids, fusobacteria, Klebsiela, etc. Due to the presence of Gardnerella in the vaginal discharge, bacterial vaginosis is often called Gardnerella.
Vaginal dysbacteriosis is dangerous for its consequences and complications for both the wife and the future baby:
- In the early stages of the disease can cause spontaneous abortion.
- In 2 - 3 trimesters, infection of the fetus and / or fetal membranes can occur, leading to their premature rupture and prenatal pouring of water.
- Premature birth, complications of the birth process and the occurrence of purulent-septic diseases after childbirth - this is an incomplete list of the dangers that gardnerellezis conceals.
Treatment of bacterial vaginosis during pregnancy is prescribed only by the attending physician and is performed under his supervision.
Symptoms of bacterial vaginosis
In women with bacterial vaginosis, the main symptom is copious discharge with an unpleasant fishy smell, creamy consistency, white or gray. Itching, burning, discomfort during intercourse are possible.
In the case of bacterial vaginosis, an acute or torpid, asymptomatic, monosymptomatic (only with secretions) or polysymptomatic disease course is distinguished. In some women, the symptoms of bacterial vaginosis persist for a long time, while others periodically occur under the influence of adverse factors.
When collecting the history, it turns out that more than 90% of patients with suspected bacterial vaginosis used to turn to a gynecologist and other specialists with complaints of secretions and other symptoms. Three quarters of patients were repeatedly treated for nonspecific vaginitis, using antibacterial suppositories and taking various oral antibacterial agents.
Before determining how to treat bacterial vaginosis, it is worth undergoing examination and determine the causes of its occurrence. The diagnosis is based on the presence of three symptoms from the following four:
- the specific nature of the discharge;
- acidity> 4.5 (normal 3.8-4.5);
- positive aminotest;
- the presence of “key” cells. The so-called “key cells” are mature epithelial cells (superficial
- layer of the vaginal epithelium), over the entire surface of which microbes are tightly and in large numbers attached.
Depending on the severity and severity of symptoms of bacterial vaginosis, the scheme and duration of treatment are determined.
How to treat bacterial vaginosis
Depending on the extent and nature of the pathological process, women who have bacterial vaginosis have been diagnosed with local or systemic antibiotic therapy. In this situation, using etiotropic agents with anti-anaerobic effect.
The main treatment for bacterial vaginosis is the use of antibiotics (Metronidazole or Clindamycin), which suppress the development of pathogenic bacteria in the vagina and create conditions for the restoration of normal flora.
In rare cases, against the background of the treatment of bacterial vaginosis, the fungal flora begins to develop in the vagina. For the prevention of vaginal candidiasis, especially in the presence of episodes of "thrush" in a patient in history, antimycotic drugs may be prescribed. After 1 to 2 weeks after the end of treatment, the examination and laboratory tests are repeated to evaluate the effectiveness.
After eliminating the pathogenic bacteria, it is necessary to restore the normal microflora of the vagina. Restoration of the vaginal microflora is carried out using a group of drugs called probiotics.
Probiotics include the following medications:
- Lactobacterin, Bifidumbacterin is recommended to enter into the vagina one candle before bedtime, for 10 days.
- Linex - available in capsules, which are recommended to take after a meal, two capsules 3 times a day.
Separately, it must be said about the treatment of sexual partners of women with bacterial vaginosis. In almost all cases, it is impractical because the disease is not sexually transmitted. The exceptions are men with infectious diseases of the genitourinary system, and those who make active complaints.