Gardnerellosis treatment in women and men. Symptoms and treatment regimens for gardnerellosis with drugs. Effective treatment of chronic gardnerellosis. Gardnerella in women - symptoms and treatment

During her life, the female body may encounter unpleasant symptoms, which are expressed in copious vaginal discharge with an unpleasant odor. The reason for this may be gardnerella, an anaerobic bacterium (that is, one that lives and reproduces in an oxygen-free environment).

Currently, doctors have different opinions about the causes of this infection, its course and the risk factors that contribute to its introduction. Let's try to understand what kind of disease this is, how it manifests itself and what treatment for gardnerella is considered optimal.

Gardnerella belongs to the group of opportunistic bacteria, which includes microorganisms that are constantly present in the human body without causing harm to it. But under unfavorable factors, their rapid reproduction can occur.

Some doctors consider gardnerella to be the cause of bacterial vaginosis in women. Therefore, the word “gardnerellosis” is sometimes used as a synonym for this disease.

This happened historically - the bacterium was discovered in 1955 in a woman who suffered from vaginitis. Then gardnerella was named the main reason for the imbalance in microflora.

After this, it was found that the bacterium is not always detected in this pathology. Thus, other microorganisms may become the culprit of the imbalance.

The bacterium can be detected in the tests of many healthy women and men, but this does not mean that gardnerellosis has developed and requires treatment. However, when it actively reproduces, it can change the acid-base balance of the vagina, promoting the appearance of other pathogens.

Infection

Doctors currently do not have a consensus on whether this disease is a sexually transmitted infection (STI).

On the one hand, the main method of transmission of gardnerellosis is sexual. On the other hand, men do not develop any negative reactions in the presence of Gardnerella, and they can be carriers of it for only a few days.

In addition, the presence of risk factors is necessary for gardnerella to begin to multiply in the female body. Thus, gardnerellosis does not always develop when the bacterium is transmitted.

However, this fact does not affect the treatment regimen: gardnerella requires the same treatment as sexually transmitted diseases.

Factors that contribute to the onset of the disease include:

• immunosuppression (due to autoimmune pathologies, pregnancy, radiation sickness, chemotherapy, HIV, alcoholism, etc.);
• disturbed intestinal microflora;
• hormonal imbalance;
• diabetes;
• inflammation of the genitourinary area;
• the use of condoms with lubricant containing 9-nonoxynol, and contraceptive suppositories with the same active ingredient (“Patentex-Oval”);
• long-term use of antibiotics;
• unjustified frequent vaginal douching;
• insufficient intimate hygiene.

Some doctors believe that risk factors themselves can act as a cause of gardnerellosis without sexual contact - through the multiplication of the bacterium that already lives in the vagina as an opportunistic flora. But they do not deny that in this case, treatment for gardnerella should be mandatory.

In addition to the vagina, gardnerella “loves” to live in the urinary organs. The incubation period usually lasts one week.

Rarely, another route of transmission is possible - during the passage of the child through the mother’s reproductive tract during natural childbirth. However, gardnerella takes root in newborns extremely rarely, which is due to the fact that its nutrition requires glycogen from epithelial cells, the presence of which depends on the work of estrogens. The level of this hormone before a girl reaches puberty is extremely low, so the bacterium quickly dies.

Household transmission of the microorganism is practically reduced to zero, but it cannot be completely eliminated.

Gardnerella does not take root in the male body; its short presence does not bring any unpleasant sensations. Being a carrier of the infection, a man can transmit it to a healthy woman.

Thus, the male body acts as a transit route of infection. It is for this reason that gardnerellosis requires treatment in men whose partners suffer from this pathology.

Tests can usually detect the presence of a microorganism in a man only in the first days after contact with an infected woman.

When a woman is confirmed to have the bacteria, but a man does not, this may become a reason to accuse the companion of infidelity, although the partner himself contributed to the infection.

However, cases where the bacterium penetrated the urethra and became the cause of inflammatory processes in a man are rarely detected. This happens when the immune system is severely suppressed due to serious illness or in the presence of other infections (chlamydia, etc.).

When they talk about sexual transmission of this microorganism, they most often mean traditional transmission. There is a chance of infection through other sexual practices, but it is low (the bacterium practically cannot survive on the mucous membranes of the pharynx or intestines). We can only talk about temporary carriage of microorganisms.

Symptoms of the disease and diagnosis

With gardnerellosis, a woman experiences: white or gray (less often transparent or yellowish) discharge with an unpleasant “fishy” odor on her underwear and on the walls of the vagina, itching in the perineum, pain during sexual intercourse. Sometimes the symptoms are not pronounced.

Gardnerellosis, if left untreated in a woman, can cause:

• infectious complications after childbirth;
• salpingitis;

The bacterium does not pose a danger to the fetus if the disease manifests itself during pregnancy, since the placenta is a reliable barrier. Only in very advanced cases, in the absence of treatment, inflammatory processes of the reproductive system can begin: uterine bleeding, the birth of a low-birth-weight child.

Gardnerella multiplies in men, as a rule, in the urethra, which leads to the appearance of urethritis. It may appear 5–6 days after infection or later. May be observed:

• greenish discharge from the urethra;
• burning and discomfort when urinating.

If you suspect a disease, you should contact a gynecologist (female), urologist (male) or dermatovenerologist.

The main diagnostic method is a general smear from the mucous membranes. In addition to this, the presence of key cells (on which gardnerella develop) is also determined; in women, the pH of the vaginal secretion is measured (under normal conditions it should be acidic, but in this disease it becomes alkaline).

Additionally, the doctor must conduct a study to identify concomitant infections that develop in the presence of gardnerellosis - treatment must be comprehensive. This pathology is often observed in conjunction with candidiasis, ureaplasmosis (which is also caused by a common household bacterium) or other sexually transmitted diseases.

Treatment of the disease

The basis for the treatment of gardnerellosis in women and men is drugs with the active ingredient metronidazole. It is used topically in the form of gels or suppositories and orally (tablets).

Due to its action against obligate anaerobic bacteria, which includes gardnerella, treatment with drugs such as Metronidazole, Trichopolum, Trickside, Klion, turns out to be the most effective.

In addition, products with doxycycline, clindamycin, levofloxacin, and azithromycin can be used.

Since antibiotics often cause a fungal infection, fluconazole (Flucostat, Diflucan), natamycin (Pimafucin) or nystatin are used to prevent it during the treatment of gardnerellosis.

Some doctors consider it necessary during a woman’s therapy to use medications that normalize the vaginal microflora (“Vagilak”, “Bioselak”, “Acilakt”, “Lactonorm”, etc.).

Treatment of gardnerellosis in women expecting a child differs little from that prescribed to non-pregnant women, but with some restrictions (for example, metronidazole cannot be used in the first trimester, in the remaining two - under medical supervision). In addition, topical remedies are preferred over oral ones.

It must be remembered that immunity against the disease is not developed, so re-infection is possible even during therapy: for this reason, doctors recommend sexual rest during the course of treatment or the use of condoms during sexual intercourse.

If the condom breaks, it is necessary to wash off the secretions from the mucous membranes with water and introduce a local antiseptic (for example, Miramistin).

During treatment for gardnerellosis, it is necessary to take smears to determine the dynamics of the decrease in the number of bacteria. A control test is taken 4–6 weeks after therapy.

Prevention

The main preventive measures are: selectivity of sexual contacts, use of barrier contraceptives during casual meetings or at the beginning of a new relationship, when there is no confidence in the partner.

So, gardnerella is a bacterium that can be present in small quantities in the female body. When its elevated level is detected, therapy should be prescribed that will reduce it.

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When a woman suddenly discovers strange discharge and itching of the genitals, it causes bewilderment, even fear. "What is this? Where did it come from? Such manifestations are observed in a disease called bacterial vaginosis or gardnerellosis in medicine.

What is gardnerellosis - bacterial vaginosis

The disease gardnerellosis is a bacterial infection caused by the opportunistic bacillus Gardnerella vaginalis. It is called “opportunistic” because its presence in the vagina is normal, it all depends on the quantity and speed of its reproduction.

The fact is that the human body is constantly home to more than 10,000 microorganisms. Some of them are useful, some not so much, but they all perform a strictly designated function. If the balance is upset and one species dies, another takes its place, thus increasing its numbers.

The vagina contains an acidic internal environment, this prevents the increase in the number of pathogenic microorganisms, and the presence of gardnerella does not manifest itself in any way. But when, for some reason, the pH shifts, rapid proliferation of bacteria begins, including gardnerella.

Causes of the disease

There are many reasons leading to an imbalance in the internal environment of the vagina:

1. Hormonal imbalance (menopause, pregnancy, puberty).
2. Long-term antibiotic therapy, hormone therapy.
3. Frequent use of tampons and pads with fragrances.
4. Uncontrolled sexual intercourse.
5. Chronic diseases of the kidneys, endocrine glands.
6. Surgical interventions, especially abortions.
7. As a secondary symptom in Z.P.P.
8. Prolonged stress conditions.
9. Mycoplasmosis (description of symptoms of mycoplasmosis).

It is very difficult to miss the appearance of gardnerellosis. Women experience unpleasant nagging pain in the lower abdomen; itching and burning of the genitals and perineum; yellowish discharge that smells like rotten fish. The intensity of these signs varies and depends on the depth of the process and the state of the woman’s immune system.

Since gardnerella is a resident of the vaginal microflora, in men the manifestations are less vivid and short-lived (unless a secondary infection occurs): burning during urination; difficulty urinating due to slight swelling of the mucous membrane; possible discharge from the penis.

There are several methods for diagnosing the disease, but the most accurate of them, which allows one to determine not only the presence of the pathogen, but also its number, is a vaginal smear. It is also possible to prescribe a microflora test and a general blood test. Gardnerellosis may be a harmless sign of sexually transmitted diseases, so additional examinations for concomitant infections are often prescribed.

How to treat gardnerellosis in women and men?

There are fundamental differences in the treatment of this infection in men and women.

Gardnerella does not take root in the male genital area, so men cope well with this bacterium.

You just need to follow some nutritional rules:

• Avoid acute
• Fried food,
• From drinking alcohol
• Introduce fermented milk products into your diet,
• Increase the vegetable content.
• Taking immunostimulating drugs and vitamin complexes will help.

In women, treatment is carried out in a complex in several directions at once:

Antibacterial therapy to suppress the source of the disease. Moreover, both tablet forms and vaginal suppositories are used.

The second direction is the restoration of vaginal microflora.

An approximate treatment regimen for gardnerellosis in women:

1. Broad-spectrum antibiotic “Clindamycin” in tablets 300 mg twice a day.
2. Antibacterial drug "Metronidazole" or its analogues in tablets 500 mg twice a day.
3. Vaginal suppositories “Terzhinan” or “KlionD” once a day at night. The course of treatment is designed for a week.
4. To restore the microflora, use: Lactobacterin tablets for a month and Acylact suppositories for 21 days. A control smear is carried out after 1.5 - 2 months.

Folk remedies for gardnerellosis

• An infusion of chamomile flowers is used for douching twice a day, and a decoction of oak bark is prepared for the same purpose.
• Self-prepared gauze swabs are soaked in sea buckthorn oil and inserted into the vagina overnight.
• Tincture to boost immunity: tbsp. l. chokeberry is boiled in a glass of water for 15 minutes, then cooled and combined with a tablespoon. and finely grated onion. Use 1 tbsp. l. three times/day.

Treatment of the disease during pregnancy is important for the health of the woman herself. This bacterium is not dangerous for a child; it is not able to penetrate the placental barrier and infection during childbirth is rare. It is worth mentioning right away that self-medication during pregnancy is not acceptable; all prescriptions must be carried out by a gynecologist. Even traditional medicine cannot be completely safe. Pregnant women are allowed to use only local therapy (suppositories, gels) and only in the second and third trimesters.

Prevention of gardnerellosis

To protect yourself from this disease, it is enough to follow some rules:

• Maintain sexual hygiene;
• Women should not use intrauterine contraception and visit a gynecologist once every six months.
• Stop unauthorized use of antibiotics.
• Eat healthy.

In case of questionable sexual intercourse, you can use the drug "Hexicon", which is available both in the form of suppositories and in the form of a special solution used for douching. Its use is advisable in the first two hours after the act has occurred.

Summarize:

1. The disease gardnerellosis is not a venereal disease, it is the result of an imbalance in the vaginal microflora;
2. Gardnerellosis can and should be treated, both for women and men;
3. It has long been known that any disease is easier and cheaper to prevent.

Gardnerellosis is a fairly common disease that affects both women and men. Therefore, many are interested in questions about how gardnerella gets into the human body, what it is and what problems it can lead to. Is there an effective treatment for the infection?

Gardnerella: what is it?

Gardnerella vaginalis is an anaerobic bacterium that lives in humans. Until recently, it was believed that the most common cause of nonspecific vaginitis was the activity of the Causes, of course, may be associated with the growth and reproduction of these microorganisms. But at present, such a bacterium is considered to be opportunistic.

Infection does not always lead to the appearance of inflammatory processes - microorganisms can live in the genitourinary system for many months without causing any external signs. By the way, latent carriage is more common among men.

Recent studies have shown that the activity of Gardnerella in women leads to changes in acidity and disruption of the normal microflora of the vagina. Against the background of such disorders, intensive growth and reproduction of others is observed. Therefore, gardnerellosis is most often associated with other infectious diseases - the cause of the inflammatory process can be several types of pathogenic bacteria.

Gardnerella: what is it and how does it enter the body?

Most often, a person becomes infected during unprotected sexual intercourse. Moreover, not only vaginal, but also oral and anal contacts pose a danger. Household transmission is also possible, but only in cases where purely personal items are shared, for example, underwear, intimate hygiene products, etc. Transmission of infection from mother to fetus or childbirth is possible.

Gardnerella: what is it and what diseases does its activity lead to?

As already mentioned, an infection can exist in the body without manifesting itself in any way. The appearance of an inflammatory process is usually associated with weakened immunity, hormonal imbalances, hypothermia, stress and any other factors that weaken the immune system.

In women, the activity of Gardnerella often leads to the development of nonspecific vaginosis. Patients complain of uncharacteristic appearance with an unpleasant odor, itching of the external genitalia, pain during sexual intercourse or even at rest.

In men, such an infection can lead to inflammation of the walls of the urethra. As you know, urethritis is accompanied by severe pain and pain during urination, an increased urge to empty the bladder, as well as redness and swelling of the head of the penis.

How to treat gardnerella?

Of course, patients with such a problem need medical help. Indeed, if left untreated, the infection can spread higher through the genitourinary tract, leading to inflammation of other organs.

Therapy primarily involves taking antibacterial drugs. Since Gardnerella is resistant to most antibiotics, patients are prescribed metronidazole. In addition, it is appropriate to use some external products, in particular, vaginal suppositories or gels, for example, Metrogyl or Flagin. Of course, it is necessary to take medications containing live cultures of beneficial bacteria, since it is extremely important to restore normal vaginal microflora. Sometimes immunotherapy is additionally performed.

Gardnerellosis is a disease that develops when a pathogenic bacterium enters the human body. The causative agent is Gardnerella, which is easily transmitted sexually. Men and women who are sexually active and do not have a regular partner are at risk.

If a person suspects the progression of bacterial vaginosis, a consultation and examination by a doctor who treats sexually transmitted diseases is needed. Particular attention should be paid to the choice of medications. If treated negligently, the course of the disease may be aggravated by the occurrence and development of complications. When answering patients’ questions about how to treat gardnerellosis, doctors are of the same opinion: local therapy can defeat the bacterium. It is enough to correctly use ointment, capsules, tablets, gel or suppositories prescribed by a specialist.

note

Self-medication can have a detrimental effect on the general condition of the body and reduce the effectiveness of therapy.

The final diagnosis is made after studying the patient's test results. The pharmaceutical industry offers a wide range of medications to treat the disease. The drug Trichopolum for gardnerellosis is considered one of the effective ones. Vaginal tablets are prescribed for use once a day with a dosage of 500 milligrams for 1–1.5 weeks.

Treatment with Metronidazole gel at a concentration of 0.75% (injection into the vagina) is no less effective, and the course of treatment does not exceed 5 days (if the procedure is performed twice a day).

Of the oral medications, Tinidazole is most often prescribed for gardnerellosis that has been progressing for a long time in the body. The dosage and course of therapy are determined by the attending physician, which is due to the presence of side effects of the medication. If Clindamycin has been prescribed, it should be taken for a week at a dosage of 300 milligrams.

Bacterial vaginosis is also diagnosed in women during pregnancy. Most of them avoid therapy, fearing harm to the fetus and convincing themselves that the bacteria will leave the body on their own. Unfortunately, this statement is not true, and the microflora is not capable of independent recovery.

A leading gynecologist will tell you exactly how to treat gardnerellosis during pregnancy. Doctors also note that with gestation and the correct selection of medications, the disease is easily treatable, but the exception is antibacterial therapy.

If there is a sharp increase in the number of gardnerella, the doctor may prescribe antibiotics. If a dilemma arises regarding how to treat gardnerellosis in pregnant women, then suppositories or the drug Klion are better suited. Traditional medicine methods are no less effective in treating pregnant women, but only after approval by a doctor.

Baths and douching are excluded from the possible options, and only washing with antiseptic solutions prepared with herbs is practiced. After delivery, the woman must undergo a full course of treatment for the disease. When a doctor diagnoses gardnerellosis, it is almost impossible to do without antibiotics. Drugs in this group are indicated to combat the disease, which occurs in acute or chronic form.

When a patient comes to the clinic in a timely manner, the first thing he is prescribed is tablets (they are effective in the initial stage of the disease). The next stage is restorative, aimed at increasing the number of lactobacilli. Depending on the rate of reduction of bacteria causing harm to the body, the duration of the course of treatment will be determined. When the number of microorganisms is reduced to a minimum, the antibiotics will be completed.

In each clinical case, the doctor will determine how to cure gardnerellosis based on the general condition of the patient and after studying the tests. This approach will protect against drug intolerance in patients with hypersensitivity to certain components. To consolidate the result, immunotherapy and procedures to restore the natural microflora are performed. To protect the body from re-infection, you should adjust your diet and lifestyle.

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You can find out exactly how gardnerellosis is treated from the list below:

• Azithromycin - broad-spectrum tablets. Long-term use leads to the accumulation of the active component in the blood with its subsequent activation in the affected area.
• Tiberal is an antimicrobial and anti-inflammatory drug, released in tablet form.
• Ornidazole is effective in the fight against anaerobic microbes and is produced in the form of tablets, capsules and injection solution.
• Imidazole is an effective antimicrobial medication, available in the form of cream, injection solution and vaginal tablets.
• Metronidazole is an antiprotozoal drug with antibacterial activity, produced in the form of tablets with a dosage of 250 milligrams.

When treating a disease, a balanced diet is very important. In order for the body to receive all the necessary elements and recover, it needs: fermented milk products, poultry and fish. Don't skimp on fresh fruits and vegetables. Cereals, nuts, beans, oils (linseed, olive, corn) are very useful.

note

To preserve all the components in the right form, it is better to give preference to steaming or practice a raw food diet.

It was also said that the disease can be treated with traditional medicine. The basis of therapy is oral administration of tinctures, installation of medicinal tampons and baths. The given recipes are suitable for treating men and women.

Suitable for decoctions: sweet clover, marshmallow root, pine and birch buds, nettle, mint, St. John's wort and eucalyptus leaves. Prepare according to the directions on the package and take half an hour before meals three times a day. The recommended single dose is 100 milliliters.

Tampons are made from a mixture of apple cider vinegar (1 teaspoon) and carrot juice. The resulting solution is applied to gauze folded into a tampon and inserted into the vagina for 20 minutes. It is not recommended to do the procedure more than once a day. The second version of the mixture includes aloe juice and sea buckthorn oil in equal proportions. It is recommended to leave this tampon overnight. Baths made from oak bark, chamomile and walnut leaves will help relieve unpleasant symptoms (pain, itching, burning). Treatment of gardnerellosis in men is prescribed by a doctor after a thorough examination of patients and study of test results.

As with female representatives, in the absence of complications, local therapy is sufficient. The duration of treatment is 14–21 days (the drug is determined by the doctor). For clearly defined symptoms, Doxycycline or Tricaside is prescribed and taken until complete recovery. A man must follow a diet: no spicy, fatty, spicy and salty foods, as well as alcohol. Sexual contact and prolonged exposure to the sun are also prohibited. Hilak, Laktovit or Bifilakt are indicated as immunotherapy.

Suppositories for gardnerellosis: treatment regimen and duration

The medical name for the well-known thrush is gardnerellosis. Candles are best suited to combat it. They differ from tablets in that they have a targeted effect, which means they cope better with the disease.

Below are suppositories for gardnerellosis, which are often prescribed by doctors:

• McMiror;
• Terzhinan;
• Clindamycin;
• Suppositories with metronidazole;
• Betadine.

With their help, an optimal environment is created in the vagina, and pathogenic microorganisms gradually die. Vaginal suppositories for gardnellosis are approved for use by women during pregnancy. Thus, the birth canal is cleaned in the third trimester.

Suppositories with metronidazole or tinidazole are highly effective for gardnellosis. They are recommended to be administered once a day, in the morning or evening for three hours. The duration of therapy is at least 7 days, depending on the patient's condition.

It is recommended to start treatment no earlier than 2 days after the end of menstruation. On the forum, patients who were treated for gardnerellosis with suppositories leave only positive reviews about the drug. To prevent sexually transmitted infections, doctors recommend always using protection when contacting a new partner. Also, not the last role in the prevention of disease is assigned to the control of the state of immunity, because infections do not attach to a strong body. You should beware of hypothermia, because any inflammation of the genitourinary system will provoke dysbacteriosis, and against its background gardnerellosis will progress.

An integral part of prevention is genital hygiene. If a man or woman suspects the development of thrush, or gardnerellosis, you should immediately consult a doctor. The disease is easily transmitted sexually, so it is very important to protect yourself from promiscuity. The effectiveness of therapy largely depends on the patient’s approach to following medical recommendations.

Bacterial vaginosis is an infectious non-inflammatory process of polymicrobial etiology caused by dysbacteriosis of the vaginal microbiota. The disease is characterized by the appearance of specific, copious discharge associated with a significant decrease in the number of normal vaginal lactobacilli and an increase in the activity of opportunistic microorganisms.

With bacterial vaginosis, fungi, gonococci and trichomonas are not found in the discharge. The disease is also not accompanied by inflammatory damage to the mucous membranes of the vagina (this is its difference from vaginitis). Bacterial vaginosis is not an infection in the strict sense of the word and is classified as a condition of severe vaginal dysbiosis.

The cause of bacterial vaginosis is polymicrobial bacterial microflora: gardnerella, bacteroides, veillonella, prevotella, etc. In the overwhelming majority of cases, bacterial vaginosis is caused by gardnerella, so the term gardnerellosis can be considered synonymous with bacterial vaginosis.

Gardnerellosis is a nonspecific bacterial vaginosis caused by Gardnerella. In the ICD10 classification, gardnerellosis and bacterial vaginosis do not have their own code, since these terms appeared later than the classification.

In this regard, bacterial vaginosis or urogenital gardnerellosis can be classified according to ICD 10 as:

• B96.8 - diseases described in other sections and caused by specified bacterial agents;
• T76.8 - like other specified inflammatory diseases affecting the vagina and vulva.

According to statistics, gardnerellosis in women is the most common infectious disease of the female genital area. Previously, gardnerellosis was included in the group of sexually transmitted diseases (STDs or STIs). It has now been proven that bacterial vaginosis is not sexually transmitted because:

• gardnerellosis is caused by opportunistic bacteria, which are normally found in minimal quantities in the vaginal microflora;
• Gardnerellosis practically never occurs in men. In men, gardnerella can only be detected transiently, while their temporary carriage is asymptomatic and only in isolated cases is accompanied by the development of inflammatory complications.

However, in women who have a large number of sexual partners, this disease occurs more often, since in the presence of vaginal dysbiosis and unprotected sexual contact with a carrier of gardnerellosis, the risk of developing bacterial vaginosis is higher.

Gardnerellosis in women does not pose a direct threat to life, but can cause:

• development of infertility;
• recurrent miscarriage;
• postpartum or post-abortion inflammatory complications;
• complicated course of pregnancy.

Gardnerellosis during pregnancy poses the greatest danger, as it can cause:

• spontaneous abortion;
• premature discharge of amniotic fluid;
• early birth;
• birth of low birth weight babies.

In the postpartum period, gardnerellosis in women significantly increases the risk of developing:

• endometritis (especially during delivery by cesarean section);
• pelvioperitonitis;
• abscesses;
• sepsis, etc.

It should also be noted that, in the absence of treatment, often recurrent bacterial vaginosis is a risk factor for the development of neoplastic processes in the cervix and increases susceptibility to various infectious agents (including, especially, herpesvirus type 2 (genital herpes)).

How is gardnerellosis transmitted?

The disease is not an STD, but uncontrolled unprotected sex increases the risk of developing gardnerellosis. Normally, gardnerella are present as part of the normal vaginal microflora, however, with the development of dysbacteriosis, they begin to actively multiply, suppressing the activity of lactobacilli.

Causes of gardnerellosis in women

The cause of gardnerellosis is vaginal dysbiosis. Risk factors contributing to the development of gardnerellosis are:

• hormonal imbalances (including during menopause;
• age-related or inflammatory hypotrophic or atrophic processes in the vaginal mucosa;
• frequent change of sexual partners;
• vaginal cysts or polyps;
• pathologies of the vaginal epithelium;
• the presence of defects or anomalies in the development of the genital organs;
• reducing the number of lactobacilli producing hydrogen peroxide;
• change in vaginal pH to the alkaline side;
• frequent douching;
• use of aggressive sulfate soaps or gels for personal hygiene;
• frequent use of spermicides;
• decreased immunity;
• presence of immunodeficiency conditions;
• long-term treatment with antibacterial agents, antifungal drugs, immunosuppressants, glucocorticosteroids, etc.;
• carrying out radiation or chemotherapy;
• the presence of chronic inflammatory processes in the pelvic organs (pelvic organs);
• hypovitaminosis, exhaustion;
• anorexia nervosa;
• performing endoscopic or surgical gynecological procedures;
• alcoholism;
• presence of diabetes mellitus.

Symptoms and treatment of gardnerellosis in women

The main symptoms of gardnerellosis in women are:

• the appearance of copious thick whitish-gray (sometimes foamy) discharge with a specific “fishy” odor. The appearance of a large amount of leucorrhoea (about twenty milliliters per day) is the main and obligatory symptom of gardnerellosis in women;
• pain or discomfort during sexual intercourse;
• increased discharge of discharge after sexual intercourse or during menstruation;
• the appearance of itching, burning, discomfort in the genital area or burning during urination (these symptoms are quite rare);

In some cases, the discharge may not have an odor. There are no streaks of blood or pus in Gardnerella secretions. Their microscopy does not reveal signs of an inflammatory reaction - leukocytes. When examined in the mirror, the vagina is not inflamed or swollen.

In chronic gardnerellosis (long-term course of bacterial vaginosis, more than 2 years), leucorrhoea may have a yellowish tint and a sticky, viscous, foamy and viscous consistency.

Gardnerellosis in men, as a rule, does not occur or is asymptomatic, in the form of transient carriage. In rare cases, signs of gardnerellosis in men may include balanoposthitis and urethritis.

Diagnosis of gardnerellosis

To confirm or refute the diagnosis, smear microscopy, speculum examination and medical history are performed.

The diagnosis can be made based on the Amsel criteria:

• the presence of specific secretions;
• positive amino test (sharp increase or appearance of the smell of rotten fish when 10% KOH is added to the secretions);
• increased vaginal pH above 4.5;
• identification of “key” cells during smear microscopy.

Microscopy can also be used to assess the vaginal biocenosis in points from 0 to 10 (Nugent points). The diagnosis of bacterial vaginosis is made when the score is more than 6 points. At the moment, Nugent is considered the gold standard for diagnosing gardnerellosis.

The Hay-Ison scale can also be used, in which the results of smear microscopy are recorded in the form of five levels of dysbiosis of the vaginal microflora.

Treatment of gardnerellosis in women

Gardnerellosis is not treated with folk remedies. Bacterial vaginosis is treated with antibacterial therapy and drugs that restore the normal balance of lactobacilli in the vaginal microflora.

During treatment, it is recommended to avoid drinking alcoholic beverages, fatty, fried and spicy foods. It is recommended to increase the drinking regime, as well as consume more fresh fruits, vegetables, kefir, yoghurts, etc. Additionally, multivitamin complexes may be prescribed.

Douching for gardnerellosis is contraindicated, as it increases the risk of developing an ascending infection (introduction of bacteria into the uterine cavity).

Antibiotics for gardnerellosis should be prescribed exclusively by a gynecologist based on tests. Systemic antibacterial therapy is indicated in the absence of effect from local treatment (suppositories for gardnerellosis).

Treatment regimen for gardnerellosis in women

Metronidazole and clindamycin are the drugs of choice for gardnerellosis. As initial therapy, local use (intravaginal) of gels or suppositories with metronidazole (1-2 times a day) or clindamycin (once a day) for a course of five to seven days is recommended.

According to indications, Terzhinan can be used for gardnerellosis (the drug contains ternidazole, which is highly effective against gardnerella).

Polygynax is not used for gardnerellosis, due to the lack of effectiveness against gardnerella in its components (polymyxin B, neomycin and nystatin).

It is also possible to use Hexicon for gardnerellosis, but it is preferable to use the drug not as monotherapy, but as an addition to systemic antibacterial therapy in the presence of a mixed infection.

If there is no effect from local therapy, the use of metronidazole tablets (500 mg twice a day) or clindamycin for seven days is indicated. Ornidazole for gardnerellosis in women is prescribed for severe bacterial vaginosis, as well as for the combination of gardnerellosis with other gynecological inflammatory diseases.

In the future, patients are prescribed drugs that restore the normal balance of lactobacilli. It is recommended to take preparations of acidophilus lactobacilli, bifidobacteria (Linex, Bifidumbacterin, etc.). Local use of lyophilized cultures of lactobacilli (vaginal capsules Laktozhinal) is highly effective.

Treatment of gardnerellosis in men

Article prepared
Infectious disease doctor A.L. Chernenko