Bacterial vaginosis why. Bacterial vaginosis: causes, symptoms and treatment. Complications of bacterial vaginosis

Bacterial vaginosis is a disease associated with changes in the balance of vaginal microflora. Most often, women aged 25 to 40 suffer from this problem. According to statistics, every eighth girl had to face such a problem. Vaginal dysbiosis does not threaten the patient’s life, but can lead to disruptions in the functioning of the body’s reproductive system. Therefore, treatment for bacterial vaginosis should be started as soon as the first symptoms appear.

Features of the disease

A healthy woman's vagina contains a wide variety of bacteria. They form an acidic environment, which turns out to be unfavorable for the life of pathogenic microflora. Thanks to this, the reproductive system is protected from the development of inflammation.

Under the influence of negative external or internal factors, the number of lactic acid bacteria in the vagina decreases sharply, which leads to a decrease in the acidity of the environment. Thanks to this, pathogens of various diseases, including bacterial vaginosis, are able to actively reproduce.

Sometimes the disease occurs in a latent form. More often it is accompanied by a vivid clinical picture. The severity of symptoms will depend on the ratio of beneficial and pathogenic microorganisms in the vagina. The sooner adequate treatment is started, the greater the chance of quickly restoring health.

The disease does not belong to the group of venereal diseases. However, some pathogens of bacterial vaginosis are transmitted sexually. They do not become the main cause of the disease, but act as an aggravating factor.

Key reasons for the development of the disease

The causes of bacterial vaginosis lie in an imbalance of vaginal microorganisms. It is impossible to identify a specific pathogen that would provoke the development of the disease. More often, the appearance of pathology is affected by the active reproduction of the following microorganisms in the vagina:

Mycoplasmas.
Megaspheres.
Peptococci.
Gardnerellas.
Leptotrichus.
Bacteroides.
Atopobium.

Their entry into the human body does not cause bacterial vaginosis. Only in the presence of provoking factors does their active reproduction occur, which leads to the emergence of a problem.

Factors not related to disease

External factors that are not related to the woman’s health can give impetus to the development of the disease. Among them are:

Excessive hygiene of the genital organs, frequent douching with the use of products that have bactericidal properties. This leads to the death of most of the lactic acid bacteria and, as a consequence, the development of dysbacteriosis.
Use of an intrauterine device as a contraceptive. If the technology for its installation is violated, the risk of the inflammatory process spreading throughout all organs of the reproductive system increases significantly.
Poor nutrition. Eating large amounts of fatty foods, unhealthy foods and alcoholic beverages provokes severe dysbiosis.
Wearing tight synthetic underwear. Unnatural tissues contribute to the creation of a greenhouse effect in the genitals. As a result, an environment favorable for the active proliferation of microbes is formed.
Failure to comply with personal hygiene rules. If the genitals are washed too rarely, pathogenic microorganisms are able to multiply unhindered. It is important for women to toilet the vagina after each bowel movement to prevent infection from the intestines.

Treatment of the disease should begin with the elimination of provoking factors. It is important to accustom yourself to proper hygiene and a healthy lifestyle.

Diseases that cause vaginosis

The causes of vaginosis often lie in the progression of concomitant diseases. They provide comfortable conditions for the development of pathogenic microorganisms. These include:

Hormonal imbalances. Female hormones have a significant impact on the vaginal microflora. Related to this is the fact that dysbiosis often affects girls during adolescence and women who have entered the menopausal phase. Ladies carrying a baby often encounter this problem.
A sharp decrease in immunity. With such a problem, the body loses the ability to resist the vital activity of pathogenic microflora, against the background of which a strong inflammatory process develops.
Damage to the vagina or cervix. This often happens in emergency situations or during difficult births.
Intestinal dysbiosis. Changes in the microflora in the digestive system lead to the penetration of pathogenic microorganisms into the vagina, which gives impetus to the development of the disease.
Diseases for which long-term antibiotic therapy is used. The use of these provokes the death of beneficial bacteria, which stimulates the proliferation of dangerous microflora.

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Treatment of nonspecific colpitis in women

The presence of such pathologies complicates therapy. Long-term complex treatment will be required. It must be carried out under the strict supervision of a specialist.

Symptoms

The characteristic symptoms of bacterial vaginosis help to recognize the development of the disease. Among them are the following:

The appearance of severe itching in the genital area.
Increased urge to go to the toilet. When urinating, an unbearable burning sensation occurs.
Unnatural discharge from the genitals. The secretion is white or has a grayish tint. After sex, their volume increases significantly. The discharge is characterized by a sharp, repulsive odor, reminiscent of slave aroma.
During sexual intercourse, a woman experiences discomfort. Because of this, libido gradually decreases.
In advanced forms of vaginosis, vaginal discharge becomes sticky. They turn yellowish in color, and their consistency becomes denser and thicker.

In the presence of aggravating factors, symptoms of vaginosis appear a day after sexual intercourse with a carrier of pathogenic microflora. If the disease occurs against the background of other pathologies or external factors, then its manifestations will in no way depend on sexual contacts. In 50% of cases, the disease does not reveal itself at all. Regular examinations with a gynecologist help identify its presence.

If acute vaginosis is not treated in a timely manner, the problem becomes chronic. Against this background, significant changes in hormonal levels occur, as well as atrophy of the vaginal mucosa. Therapy in such a situation will be especially difficult.

Diagnostic measures

The symptoms of bacterial vaginosis are similar to those of other diseases. Only a doctor can make an accurate diagnosis after the patient has undergone an appropriate medical examination. It includes the following activities:

History taking and visual examination. The doctor must study the patient’s medical history and her lifestyle to identify factors that provoke the problem. The condition of the vaginal mucous surfaces, the presence of characteristic symptoms, as well as the consistency and color of the vaginal secretion are assessed.
Examination of a smear from the genital organs. Biological material is collected, which also includes vaginal discharge. It is studied using a microscope and the number of pathogenic microorganisms is assessed.
pH-metry. This test determines the acidity of the vaginal environment. In a healthy woman, this figure can vary from 3.8 to 4.5. When the normative indicators are significantly exceeded, the disease develops.
Amine test. Vaginal discharge is mixed with sodium hydroxide. After this, the smell of the resulting mixture is assessed. If it emits an unpleasant fishy aroma, a conclusion is drawn about the presence of pathology.
Bacteriological research. A smear from the genital organs is placed in a special nutrient medium and left for several days. If there is a disease in the test sample, bacteria begin to actively multiply, forming colonies. They become clearly visible under a microscope.

Diagnosis of bacterial vaginosis is complemented by studying the sensitivity of the identified pathogenic microflora to modern antibiotics. This allows you to more accurately determine the drugs that will help you quickly cope with the problem.

Drug treatment

As soon as the first symptoms of vaginosis appear, it is necessary to begin treatment. The main method is taking various medications. The following groups of funds are used:

Oral antibiotics. The most commonly prescribed tablets for vaginosis are Metronidazole, Clindamycin, and Tinidazole. They show the greatest activity against anaerobic bacteria. The dosage and duration of taking the drugs is chosen by the attending physician.
Local medications. The use of creams and suppositories for bacterial vaginosis is preferable. Such formulations allow you to quickly deliver the active substance to the site of infection. They have fewer side effects compared to oral medications. Clindamycin cream, Metronidazole suppositories, Neo-penotran, Fluomizin help cure the disease. The suppository is used mainly before bedtime. The cream is injected into the genitals using a special applicator.
Medicines to restore microflora. After defeating pathogenic bacteria, you need to make up for the deficiency of beneficial microorganisms. To do this, a couple of days after finishing taking antibiotics, they start taking probiotics. Linex, Bifiform, Bifiliz are often prescribed. To achieve a quick effect, lactobacilli are used in the form of suppositories.
Medicines to support immunity. Treatment of vaginosis weakens the body's protective properties. The drug Viferon or its analogues helps restore immunity.

Your doctor will advise you on specific treatments for bacterial vaginosis based on your test results. Hospitalization for this disease is not required, since there is no threat to the patient’s life. But therapy should be carried out under the constant supervision of a specialist. Repeated testing will help determine the effectiveness of the chosen regimen. If necessary, medications should be replaced with potent analogues.

The disease is prone to relapse. Even with proper treatment, in 30% of women the problem returns after some time. A multi-stage therapy program helps to avoid this.

If a woman suffers from bacterial vaginosis, then pathogenic microorganisms are found in her regular sexual partner. When they become pathogens of STIs, the man will need appropriate treatment.

An imbalance in the vaginal microflora can cause the development of bacterial vaginosis, an infectious disease that causes women significant discomfort. We tell you what kind of disease this is, how it manifests itself, and how doctors advise to treat it.

WHAT IS BACTERIAL VAGINOSIS

Bacterial vaginosis(vaginal dysbiosis, gardnerellosis, nonspecific vaginitis) is the most common cause of vaginal infections in women of childbearing age. Although the disease often develops after sexual intercourse with a new partner, bacterial vaginosis is not.

“This is one of the types of bacterial vaginitis, when the balance between normal and opportunistic microflora is disrupted under the influence of a number of factors,” says obstetrician-gynecologist Elena Berezovskaya. – The occurrence of bacterial vaginosis depends on the woman’s age, her sexual activity, hormonal balance, immunological status, genital hygiene, and the presence of skin diseases.

STIs, the use of antibiotics, hormones, endocrine disorders, surgical termination of pregnancy, surgeries, penetrative diagnostic and therapeutic procedures, intrauterine contraception and even environmental problems can also lead to an imbalance in the vaginal flora. Under the influence of these factors, there is a sharp decrease in the number of lactobacilli, which, in turn, leads to a decrease in lactic acid content and a shift in pH to the alkaline side. At the same time, conditions are created for the accelerated reproduction of opportunistic microflora and gardnerella.

Since it is Gardnerella vaginalis that in most cases causes vaginal dysbiosis, many doctors call bacterial vaginosis gardnerellosis.

CAUSES OF BACTERIAL VAGINOSIS

Obstetrician-gynecologist Vyacheslav Ivannikov told us about the causes of bacterial vaginosis:

The vaginal microflora is a mobile ecosystem. Normally, it is based on lactobacilli, which play a protective function. Lactobacilli convert glycogen into lactic acid, reducing vaginal acidity. In addition, lactobacilli produce hydrogen peroxide.

Acid and hydrogen peroxide suppress the growth of opportunistic microbes (staphylococci, streptococci, E. coli, anaerobic bacteria, gardnerella, etc.), which are detected in small quantities in the vagina of the vast majority of women. If the proportion of lactobacilli decreases, their place in the ecosystem is taken by opportunistic microbes (primarily Gardnerella).

Any woman can develop bacterial vaginosis.

Thus, the cause of the disease is not simply the presence of pathogens of bacterial vaginosis (almost every woman has them in small quantities), but a change in the ratio of the proportion of lactobacilli and opportunistic microbes that cause bacterial vaginosis. With bacterial vaginosis, the proportion of lactobacilli decreases, and the proportion of bacterial vaginosis pathogens increases. This is why bacterial vaginosis is called vaginal dysbiosis.

Bacterial vaginosis can develop in any woman, although some factors disrupt the natural microflora and increase the risk of developing the disease:

douching with water or medicinal solutions to cleanse the vagina;
having a new sexual partner;
having multiple sexual partners;
using scented soap;
smoking;
use of intrauterine devices (IUDs) made of plastic and copper;
use of vaginal deodorants;
washing underwear using some detergents.

You can NOT get bacterial vaginosis from a swimming pool, toilets, bedding or other items.

SYMPTOMS OF BACTERIAL VAGINOSIS

About 50% of women with bacterial vaginosis have no symptoms. Moreover, sometimes bacterial vaginosis can appear and disappear for no apparent reason. Statistically, even if antibiotic treatment is effective in 90% of cases, 25% of women may develop bacterial vaginosis again within the next four weeks.

The main symptom of bacterial vaginosis is vaginal discharge: thin and watery, gray or white, odorless or with a strong unpleasant “fishy” odor.

Burning during urination can also indicate vaginal dysbiosis, but is much less common.

Typically, bacterial vaginosis is diagnosed during: the gynecologist, in addition to the patient’s complaints, will pay attention to the presence of white or gray discharge and an unpleasant odor. If the patient is sexually active, there is a chance that she may have an STI, and the doctor may order some additional tests.

HOW TO TREAT BACTERIAL VAGINOSIS

“The treatment of bacterial vaginosis is quite simple - it is the use of antimicrobial drugs containing metronidazole,” says Elena Berezovskaya. – In some cases, treatment must be cyclical. After antimicrobial treatment, it is advisable to restore normal vaginal microflora with lactobacilli preparations. It is important to remember that eliminating or reducing the influence of factors that provoke the growth of opportunistic flora is the key to successful treatment. Since vaginal dysbiosis is often associated with intestinal dysbiosis, correction of the intestinal bacterial flora helps reduce the number of relapses of the disease.

Treatment of male partners does not reduce the number of relapses of vaginal dysbiosis in women.

It is noteworthy that men generally do not require treatment for bacterial vaginosis: studies have shown that simultaneous treatment of partners does not reduce the number of relapses of vaginal dysbiosis in women. Treatment of bacterial vaginosis is especially important for women, since the disease increases the risk of premature birth. Women who have previously had preterm labor or low birth weight babies should see a gynecologist even if they do not have any symptoms.

ANTIBIOTICS AND PROBIOTICS FOR THE TREATMENT OF BACTERIAL VAGINOSIS

Bacterial vaginosis can be treated with antibiotics. When used correctly, they are 85% to 90% effective.

Metronidazole– the most common antibiotic for the treatment of bacterial vaginosis.

He is appointed:

in the form of tablets taken orally 2 times a day for 7 days. This is the preferred treatment method if a woman is breastfeeding or expecting a baby;
in the form of tablets that are taken orally once. Compared with a seven-day course of treatment, a single dose of metronidazole may lead to a relapse of bacterial vaginosis;
in the form of a vaginal gel, which is applied once a day for 5 days;
in the form of probiotics with metronidazole.

In a Cochrane systematic review, researchers reported that probiotics together with antibiotics increase the effectiveness of treating vaginal dysbiosis. Important: metronidazole does not interact well with alcohol, so when taking this antibacterial drug, you should not drink alcohol for at least 48 hours after finishing treatment.

Clindamycin is an antibiotic that is often used to treat bacterial vaginosis if metronidazole does not work or the disease has returned.

He is appointed:

in the form of a vaginal cream, which is applied once a day for 7 days;
in the form of a capsule, which is taken orally 2 times a day for 7 days.

This method is rarely used nowadays due to the risk of developing pseudomembranous colitis.
Important: when treated with clindamycin, some barrier methods of contraception become less effective (latex condoms, diaphragms), so women are advised to use additional contraceptives (polyurethane condoms).

Tinidazole- another antibiotic that will help get rid of bacterial vaginosis if metronidazole is ineffective. It is taken orally 1 time. You should not drink alcohol while taking this medicine.

TREATMENT OF BACTERIAL VAGINOSIS WITH FOLK REMEDIES

On the Internet you can find a lot of advice on alternative treatment for bacterial vaginosis. Most often it is recommended to douche with infusions of chamomile, decoctions of oak bark, bird cherry, coltsfoot leaves and juniper fruits. There are also recipes for baths made from herbal decoctions.

It is categorically not recommended to treat bacterial vaginosis on your own using unverified folk recipes: firstly, a woman may miss the accompanying inflammation, in which heating is contraindicated, and secondly, scientists have proven that douching increases the risk by 2 times and can contribute to the development of candidiasis () and some sexually transmitted infections.

Improper treatment of vaginal dysbiosis can lead to dangerous consequences. If you want to cure bacterial vaginosis without antibiotics, be sure to consult a gynecologist.

Improper treatment of vaginal dysbiosis can lead to dangerous consequences:

make a woman more susceptible to HIV infection, chlamydia, gonorrhea and HPV;
increase the risk of developing certain pregnancy complications: premature birth, miscarriage, chorioamnionitis and postpartum endometritis, pelvic inflammation and upper genital tract infection.

Source Zvezda - socio-political newspaper of the Khvalynsky district. Khvalynsk: https://hvzvezda.ru/zdorove/kak-lechit-bakterialnyi-vaginoz.html

Bacterial vaginosis is a violation of the natural microflora of the vagina caused by infectious diseases. In other words, a woman has vaginal dysbiosis. If you follow the statistics, this disease is most often observed in young girls (18–27 years old) and in women during menopause.

Etiology

The main provoking factors for bacterial vaginosis are the following:

long-term use of antibiotics;
douching;
wearing synthetic, tight underwear;
lack of personal hygiene;
use of contraceptives of questionable quality;
use of contraceptive suppositories.

Bacterial vaginosis develops most actively in those women who often change sexual partners. Also at risk are women who are often in stressful situations, have hormonal imbalances and weakened immunity. In fact, there are quite a few reasons for the development of the infectious process.

Symptoms

Bacterial vaginosis has pronounced symptoms. But you can begin to treat such a disorder only after an accurate diagnosis by a gynecologist. Self-medication is unacceptable, as it can only worsen the course of the disease.

As bacterial vaginosis develops, the following symptoms may be observed:

sharp, unpleasant odor from the vagina;
burning, especially when urinating;
itching and burning during sexual intercourse;
pain in the lower abdomen.

The discharge is quite abundant (up to 30 mg per day). They have a sharp fishy smell, grayish color and liquid consistency. Symptoms and discharge are especially intensified after sexual intercourse.

It is also worth noting that in some cases the disease may not show any symptoms at all, which greatly complicates diagnosis.

At the same time, it is important to understand that the presence of such symptoms is not always a harbinger of bacterial vaginosis. Symptoms of this nature may also indicate other ailments of a woman’s genitourinary and reproductive system.

Pathogenesis

Every woman's vagina has its own set of bacteria, which is called microflora. The main bacteria in a healthy microflora are lactobacilli.

When a foreign infection enters the microflora, lactobacilli are replaced by anaerobic microorganisms. As a result of this, an infectious process begins to develop, that is, bacterial vaginosis or. An earlier name for this pathology was .

As official medical statistics show, today bacterial vaginosis is diagnosed in 20% of the entire female population of the planet. Age group – from 18 to 50 years.

Diagnostics

To accurately diagnose bacterial vaginosis, symptoms alone are not enough, even if they are pronounced. A complete diagnosis of the disease is carried out through a personal examination by a gynecologist, clarification of medical history, and analysis of symptoms. Based on this, the doctor writes a referral for laboratory tests. Only after completing all the procedures described above can an accurate diagnosis be made and the correct treatment for vaginal dysbiosis be prescribed.

Laboratory research methods include the following procedures:

vaginal smear;
study of infectious cells.

It is worth noting that diagnostics is aimed not only at confirming the diagnosis, but also at identifying the number of infectious cells and establishing the true cause of the formation of the pathological process.

Bacterial vaginosis during pregnancy

It is necessary to treat bacterial vaginosis during pregnancy. And the sooner, the better for both mother and child, because... Illness during pregnancy can lead to complications such as:

infection of the fetus in the womb;
premature contractions;
premature birth;
rupture of amniotic fluid ahead of schedule.

Pathogenesis during pregnancy

Microflora bacteria are a catalyst for the biochemical reaction between the fetus and the biological mother. As a result, the production of a substance called prostaglandin begins. Its composition is very similar to hormones, which leads to premature contractions. In addition, such a disturbance in the microflora can cause infection of the amniotic fluid and the fetus itself. The consequences of this can be the saddest - from severe pathology of the child to death.

Bacterial vaginosis during pregnancy requires immediate treatment and constant monitoring by a doctor. In the early stages, treatment of vaginal dysbiosis is effective and if done correctly, no complications develop.

Treatment

Before you begin treatment for bacterial vaginosis, you must accurately determine the cause of the disease. Treatment is usually carried out in two stages. First of all, therapy is carried out aimed at eliminating pathogens that provoked the onset of the infectious process. At the second stage of treatment of bacterial vaginosis, the microflora is populated with healthy lactobacilli.

The basis of drug treatment is the use of suppositories - metronidazole and clindamycin. Such antibiotics in the form of vaginal suppositories give good results even at the first stages of use. Pain and burning almost completely disappear after the introduction of 2-3 suppositories. But this does not mean that the disease has completely receded. Treatment should not be interrupted under any circumstances.

It is also worth noting that vaginal suppositories can only be used for vaginal dysbiosis as prescribed by a doctor. The dosage and duration of taking tablets and suppositories is prescribed only by a gynecologist, taking into account the general condition of the patient and the severity of her illness.

Treatment of bacterial vaginosis can lead to the progression of other underlying diseases. Most often this is . Therefore, along with suppositories, against vaginal dysbiosis, drugs are prescribed to prevent thrush.

If, after a course of treatment, bacterial vaginosis makes itself felt again, the symptoms become more pronounced, you should undergo a re-examination and repeat the course of treatment.

It is also important to review your diet during treatment. Proper nutrition in combination with drug therapy gives good results. The diet should include the following foods:

biokefir;
yogurt;
sauerkraut.

It is also important to give the body the necessary vitamins to strengthen the immune system.

During treatment, you should completely avoid sexual intercourse, even with a condom. If you still have sex, you should take into account the following - vaginal suppositories destroy the condom. Therefore, it is better to use birth control pills during this period.

Forecast

Violation of the vaginal microflora is not a life-threatening disease. But if left untreated, it can cause serious complications. Women who have suffered from the disease are more susceptible to inflammatory processes of the genitourinary system and infections. But, if drug treatment is started in a timely manner and completed, there can be no complications.

Prevention

It is almost impossible to completely exclude a disorder of this kind. But you can minimize the risk of its formation. To do this, you need to apply the following rules in practice:

examination by a gynecologist at least 2 times a year;
You cannot wear tight, synthetic underwear;
you need to take care of personal hygiene;
It is advisable to completely eliminate frequent changes of sexual partners.

If you have any symptoms, you should seek medical help, and not resort to the advice of friends, forums, or self-medicate.

Bacterial vaginosis ( gardnerellosis, vaginal dysbiosis, vaginal dysbiosis) is a common disease in women associated with a disruption of the normal microflora of the vagina and an increase in the number of other microbes, including gardnerella.

Bacterial vaginosis does not cause irritation or itching in the vagina, but it does lead to an unusual vaginal discharge called leucorrhoea. With this disease, vaginal discharge acquires the following symptoms:

strong fishy odor, especially after sexual intercourse;
white or gray color;
become liquid and watery.

For most women, bacterial vaginosis is not a serious condition. Symptoms of bacterial vaginosis in a woman during pregnancy may be a cause for concern if the pregnancy previously had complications.

About half of women with bacterial vaginosis experience no symptoms. In such cases, the disease does not threaten your health or pregnancy.

Contact your gynecologist if you notice unusual vaginal discharge, especially during pregnancy. It is important to undergo examination to rule out other infectious diseases and prevent complications.

Typically, vaginosis is easily treated with a short course of antibiotics, but the disease often recurs. More than half of women who have recovered from vaginal dysbiosis again experience symptoms of vaginosis, usually within three months after recovery.

The causes of bacterial vaginosis are not completely clear, so there is no guaranteed effective method of preventing this disease. However, you can reduce the risk of vaginal microflora disturbances in the following ways:

Avoid using perfumed soaps, scented bubble baths, and antiseptic bath liquids;
do not use vaginal deodorants;
do not douche without a doctor’s prescription;
Do not wash your underwear with strong detergents.

If these rules are often neglected, the natural bacterial balance of the vagina can be disrupted, which increases the likelihood of developing bacterial vaginosis.

Causes of bacterial vaginosis

Bacterial vaginosis occurs when the natural bacterial balance in the genital tract is disrupted. Lactobacilli (milk bacteria) live in the vagina and produce lactic acid. This creates a slightly acidic environment, preventing the growth of other bacteria. In women with bacterial vaginosis, the number of lactobacilli is temporarily reduced, causing the acidity level in the vagina to become lower, creating a favorable environment for the proliferation of “bad bacteria”.

It's still not entirely clear what causes bacterial imbalance, but the following factors may increase your susceptibility to it:

active sex life, new sexual partner or several partners;
use of an intrauterine device - a means of contraception;
smoking;
scented soaps, antiseptic bath liquids or bubble baths;
washing the vagina with water or other liquids (douching) without a doctor’s prescription;
vaginal deodorants;
washing underwear with aggressive detergents.

For unknown reasons, vaginal dysbiosis is more common in black women than in any other ethnic group.

Typically, bacterial vaginosis is not considered a sexually transmitted infection (STI), but opinions differ on this matter. There are the following arguments in favor of the fact that vaginal dysbiosis is an STI. Bacterial vaginosis:

more common in women who have multiple sexual partners;
less common in women who have sex with a condom.

There is also evidence that women with bacterial vaginosis can pass the disease to other women during sexual intercourse, but it is not clear how this happens.

There are also arguments in favor of the fact that vaginal dysbiosis is not an STI:

There is no such disease in men, and there is no evidence that the bacteria that causes bacterial vaginosis in women can be transmitted sexually to men.
treatment of a male sexual partner with antibiotics does not prevent recurrence of the disease in a woman;
The prevalence of bacterial vaginosis in different ethnic groups can vary significantly, which cannot be explained solely by sexual activity;
Sometimes vaginal dysbiosis occurs in women who are not sexually active.

Many experts believe that sexual activity plays a role in the development of bacterial vaginosis, but other factors likely play a role in its development.

Diagnosis of bacterial vaginosis

If you experience unusual vaginal discharge, contact your gynecologist as soon as possible. This is necessary primarily in order to exclude more dangerous diseases with similar symptoms, for example, trichomoniasis or gonorrhea. Both of these conditions can cause vaginal leucorrhoea.

A gynecologist can make a diagnosis based on your symptoms and after examining your vagina. However, additional tests are needed to confirm the diagnosis.

During a gynecological examination, the doctor will take a smear from the vaginal wall using a plastic stick - a sample of cells and secretions. The procedure takes only a few seconds and is painless, although it may cause discomfort for a short time.

The sample taken is examined for the presence of various microbes, which allows us to judge the state of the vaginal microflora and the presence of vaginosis. Some clinics may receive results immediately, but if the sample is sent to a laboratory, the wait for results may take up to a week.

Your doctor may also measure the pH level of your vagina. A swab will be taken from the vagina and then passed over specially treated paper. The color of the paper will change depending on the acidity level. A pH level above 4.5 may indicate the presence of vaginosis.

Treatment of bacterial vaginosis

Bacterial vaginosis can be successfully treated with antibiotics. There is currently no evidence that probiotics, which are found in some yogurts, help treat or prevent vaginal dysbiosis.

The most commonly prescribed antibiotic for treatment is metronidazole. It comes in three forms:

tablets, which should be taken twice a day for 5-7 days;
one higher strength tablet, taken only once;
a gel that is applied to the vaginal walls once a day for five days.

In most cases, metronidazole tablets are recommended and should be taken for 5-7 days, as they are considered the most effective treatment. They can be taken if you have symptoms of bacterial vaginosis during pregnancy. If you are breastfeeding, you will likely be recommended metronidazole gel, as metronidazole tablets may pass into breast milk.

In some cases, another antibiotic, such as clindamycin cream, is recommended instead of metronidazole, which should be applied to the vaginal walls once a day for seven days. The cream may be prescribed, for example, if you have had a negative reaction to metronidazole in the past.

Whatever course of antibiotics you are prescribed, it is important to complete it, even if you start to feel better. This will help reduce the risk that your symptoms will not go away or will return.

Metronidazole may cause nausea, vomiting, and a mild metallic taste in the mouth. It is better to take the drug after meals. If you start vomiting after taking the drug, consult your doctor; they may recommend another treatment method. Do not drink alcohol while taking metronidazole and for at least two days after finishing your course of antibiotics. Mixing alcohol with the drug may increase side effects.

If you are being treated for bacterial vaginosis (BV), there are a few things you should avoid doing to increase the potential effectiveness of your treatment. For example, you should not wash your vagina or use antiseptics, scented soaps, or bubble baths.

Some women cannot cure bacterial vaginosis with one course of antibiotics. If the first course of treatment does not help you, your doctor will check to see if you took the medications correctly. If so, one of the alternative treatments listed below may be recommended for you.

If you have been placed with an intrauterine device, which your doctor thinks may be causing problems with your vaginal flora, you may be advised to remove it and use another method of contraception.

Correction of vaginal acid-base balance- a relatively new method of treating vaginal dysbiosis. Typically, this involves applying a gel to the vaginal walls, which will change the acid-base balance, making the vaginal environment less favorable for the growth of harmful bacteria. Most products for correcting the acid-base balance of the vagina can be bought at the pharmacy without a prescription, but the effectiveness of such treatment has not yet been confirmed. Some studies have shown that it helps treat vaginosis, while others suggest that it is ineffective or less effective than antibiotics.

Complications of bacterial vaginosis

Most women can treat bacterial vaginosis without any complications. However, there is a small risk of complications if the disease is not treated.

There is evidence that if left untreated, bacterial vaginosis that causes symptoms during pregnancy may increase your risk of developing pregnancy-related complications, especially if you have had similar complications in the past.

Pregnancy complications that may occur due to bacterial vaginosis include:

premature birth - when a baby is born before the 37th week of pregnancy;
miscarriage - loss of a fetus during the first 23 weeks;
premature rupture of the amniotic sac - a bladder containing fluid in which the fetus develops;
chorioamnionitis - infection of the chorion and amnion membranes (the membranes that make up the fetal sac) and amniotic fluid (the fluid surrounding the fetus);
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. If bacterial vaginosis does not cause any symptoms, there is no reason to believe that it will increase the risk of complications during pregnancy. Therefore, if you are pregnant and you have been diagnosed with a violation of the vaginal microflora, but it does not manifest itself clinically, you may be advised to refrain from treatment.

There is evidence that vaginosis may increase the risk of STIs such as chlamydia. This may be because changes in the number of bacteria in your vagina reduce your defenses against infection.

There is evidence to suggest that bacterial vaginosis may increase the risk of developing pelvic inflammatory disease (PID). PID involves infection and inflammation of the upper part of the female genital tract, including the uterus, fallopian tubes and ovaries.

Symptoms of PID include:

pain in the pelvic area or lower abdomen;
discomfort or pain deep in the pelvic area during sexual intercourse;
bleeding between periods and after sex.

If diagnosed early, PID can usually be successfully treated with a course of antibiotics. However, approximately one in five women who have this condition will become infertile due to severe scarring of the fallopian tubes.

If you notice any symptoms of PID, consult your gynecologist. Delaying treatment or recurrence of PID may increase the risk of infertility.

Women with vaginal dysbiosis who undergo in vitro fertilization (IVF) have a lower chance of success and a higher risk of early miscarriage. Therefore, if you are undergoing IVF, timely restoration of the normal composition of the vaginal microflora is necessary.

Which doctor should I consult for bacterial vaginosis?

Using the NaPravku service, you can treat and diagnose bacterial vaginosis.

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All site materials have been checked by doctors. However, even the most reliable article does not allow us to take into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. The articles have been prepared for informational purposes and are advisory in nature.

Bacterial vaginosis is a non-inflammatory disease of the vagina associated with changes in its microflora. This condition is extremely widespread among women of fertile age (20-45 years), its occurrence in this group reaches 80%. That is, out of ten women, 8 experience bacterial vaginosis at least once in their lives. The disease does not pose a danger to the patient herself, but can negatively affect her reproductive function. Bakvaginosis often causes miscarriages, intrauterine infection of the fetus, complications after childbirth, abortions and invasive interventions on the genitals. How the disease is transmitted and how to get rid of it, read on.

How does bacterial vaginosis develop?

Human existence is inseparable from the activities of various microorganisms. Those of them that, in the process of evolution, have adapted to productive cooperation with people are called normal microflora/biocenosis. Its composition is constant: some microorganisms are found only on the skin, others in the mouth and intestines. In their habitat, they perform essential functions: they protect the host’s body from pathogenic bacteria, produce vitamins, and stimulate the immune response.

Normally, the vagina is populated by lactobacilli - short, thick rods. They break down glycogen, which is rich in vaginal epithelial cells, producing lactic acid. Thus, an acidic environment is constantly maintained in the woman’s lower genital tract, which prevents the establishment and growth of pathogenic microflora. To maintain normal conditions and the protective function of the vagina, a large number of lactobacilli are necessary, so their share in its biocenosis is 95-98%.

For various reasons listed below, lactic acid bacilli are displaced and replaced by other microorganisms. This situation facilitates the colonization of the vagina by pathogenic microorganisms - causative agents of sexually transmitted infections, but in most cases there is a change to nonspecific microflora. It includes bacteria that live on the skin of the perineum, perianal folds, and in the lower part of the urethra. They freely occupy a new habitat, multiply intensively, but cannot perform the functions of normal microflora. Their enzyme system is different from that of lactobacilli and does not break down glycogen to form lactic acid.

Nonspecific microflora causes a number of disturbances in the metabolic and immune processes of the vagina as a whole. The level of production of protective immunoglobulin A decreases, which prevents pathogenic agents from attaching to the vaginal epithelium. Epithelial cells partially adsorb opportunistic bacteria on their surface and are intensively desquamated, which is associated with the appearance of discharge in bacterial vaginosis. Lactobacilli are replaced mainly by anaerobes - bacteria that function without access to oxygen. Some of the products of their metabolism - volatile fatty acids and amino acids - are broken down in the vagina into volatile amines, which have a characteristic fishy odor.

The described changes lead to a shift in vaginal pH from acidic to alkaline values. This entails progressive changes in the protein, carbohydrate, mineral and lipid metabolism of epithelial cells. Their production and production of mucus increases, which clinically manifests itself as heavy discharge - the main symptom of bacterial vaginosis. It should be noted that there is no inflammatory reaction in the walls of the vagina and all changes are only functional in nature.

What causes the disease?

Bacterial vaginosis is not a sexually transmitted infection and does not have a single pathogen, so it is also called nonspecific vaginosis. The root cause is a change in the vaginal environment, which entails disturbances in the microbiocenosis. The microflora that replaces lactobacilli can be very diverse and is most often represented by associations of opportunistic bacteria. Among them are:

bacteroides;
peptococci;
peptostreptococci;
megaspheres;
leptotrichus;
atopobium;
gardnerella;

Their growth, as a rule, is excessive and the number of bacteria in vaginal secretions reaches 10 10 per 1 ml. However, comfortable conditions for their reproduction arise only after the influence of certain factors of the external or internal environment of the body.

The main causes of bacterial vaginosis are divided into 2 large groups:

Internal (endogenous):

hormonal imbalance with a predominance of progesterone;
atrophy of the vaginal mucosa;
intestinal dysbiosis;
immune disorders in the body.

External (exogenous):

long-term treatment with antibiotics;
drug immunosuppression - taking cytostatics, glucocorticoids;
radiation therapy of tumors;
foreign objects in the vagina (hygienic tampons, pessary, contraceptive diaphragm, ring);
use of spermicides, frequent douching;
failure to comply with personal hygiene rules.

All of these factors in one way or another disrupt the normal functioning of the vaginal mucosa or cause the death of a large number of lactobacilli. Thus, a niche is freed up for opportunistic microflora and it immediately occupies it.

Among the main causes of bacterial vaginosis during pregnancy is a change in the woman’s hormonal status: normal childbearing requires high doses of progesterone, which reduces the glycogen content in epithelial cells. The lack of nutrient substrate for lactobacilli leads to alkalization of the vaginal environment and the proliferation of nonspecific microflora. In addition, progesterone reduces the activity of the immune defense, which facilitates the growth of bacterial colonies.

How does bacvaginosis manifest?

Despite the fact that the disease is not a sexually transmitted infection, its occurrence is often associated with sexual intercourse, especially when changing partners. Signs of bacterial vaginosis in women develop on average one day after intercourse, if it occurred without a condom. If the cause of the disease is the use of antibiotics and other medications, changes in hormonal levels (menopause), then the symptoms of bacterial vaginosis develop regardless of sexual activity.

Acute vaginosis manifests itself:

discharge from the genital tract: it has a grayish-white color, uniform consistency, and an unpleasant “fishy smell.” Their quantity may vary, as a rule, they become more abundant after menstruation, intercourse, or the use of irritating detergents;
pain during sexual intercourse;
discomfort, itching and burning in the genitals. These signs are usually weak or absent;
Rarely, a woman experiences pain, pain when urinating, and abdominal pain in the suprapubic region.

Chronic bacterial vaginosis is a continuous course of the disease for more than 2 months, despite treatment. As a rule, it is combined with hormonal imbalance and atrophy of the vaginal mucosa.

Diagnostics

The diagnosis is made by a gynecologist after collecting the patient’s medical history, studying her complaints, examining her in a gynecological chair and obtaining laboratory data. In favor of bacterial vaginosis they say:

age – sexually active women of reproductive age are most often affected;
relationship with a change of partner, treatment of other diseases, surgical intervention;
moderate or mild severity of clinical signs of the disease.

During the examination, the doctor assesses the condition of the vagina, cervix, and external genitalia. With nonspecific changes, the mucous membrane is pink, not inflamed, and unevenly covered with secretions. In acute bakvaginosis they are white-gray, with an unpleasant odor. If the disease has become chronic and lasts for several years, the discharge changes its color to yellowish-green, becomes thicker, more viscous, resembles cottage cheese or has a foamy appearance. During the examination, the gynecologist measures the pH of the vagina with an indicator strip: with bacterial vaginosis, its value is above 6.

There is a simple but informative test for the rapid diagnosis of bakvaginosis. The doctor places a small amount of discharge on a glass slide and mixes it with a 10% solution of potassium hydroxide. If the reaction is positive, the unpleasant odor intensifies and resembles rotten fish.

Laboratory diagnosis of bacterial vaginosis involves microscopy of stained vaginal smears. Key cells are found in them - epithelial cells of the mucous membrane with microbial bodies adhered to their surface. The cell takes on a granular appearance, its boundaries become fuzzy and dotted. Also, microscopy reveals a sharp decrease in the number of lactobacilli, up to complete disappearance from the population. Instead, nonspecific microflora is found: single cocci, streptococci, small bacilli.

Bacteriological seeding of secretions is carried out in rare cases when it is necessary to accurately determine the composition of the altered microflora. The PCR method is used to search for the most common pathogens of sexually transmitted infections (mycoplasma,), since they often join opportunistic microflora.

How does the disease affect conception and pregnancy?

Since bacterial vaginosis is a pathology of women of fertile age, many of them are concerned about the question: is it possible to get pregnant with such a diagnosis? Changes in the vaginal microflora do not entail inflammatory changes in the genital tract, and therefore do not pose a problem for conceiving a child. Sperm normally has an alkaline environment and when it enters the vagina, with the pH changed upward, the sperm find themselves in conditions that are comfortable for them.

Why is bacterial vaginosis dangerous in this case? Nonspecific microflora often penetrates the pregnant uterus and affects the developing child. This condition is called intrauterine infection of the fetus and entails consequences in the form of lack of body weight and developmental delay. In some cases, the infection leads to spontaneous miscarriage, premature rupture of amniotic fluid, and the birth of a premature baby. With bakvaginosis, the risk of sepsis and purulent complications in women in labor increases, especially after cesarean section.

Treatment

Treatment of bacterial vaginosis is carried out by a gynecologist; if necessary, the patient is additionally observed by an endocrinologist and gastroenterologist. Hospitalization for this disease is not required, since it does not affect the woman’s well-being, does not threaten her life and is not contagious to others. Therapy is aimed at sanitizing the vagina from opportunistic microflora, colonizing it with lactobacilli and correcting the provoking factors of the disease. Acute bacterial vaginosis recurs in 35-50% of women in the first six months after one-stage treatment, so it must be carried out stepwise, observing the timing of each stage.

Initially, the woman is prescribed antibiotics: they have a detrimental effect on nonspecific bacteria and cleanse 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:

Metronidazole in the form of a 0.75% gel is administered into the vagina once a day for 5 days;
a cream with 2% Clindamycin content is injected into the vagina once a day for 7 days;
Tinidazole 2.0 in tablet form is taken orally 1 time per day for 3 days;
suppositories with Clindamycin 100 mg are inserted into the vagina once a day for 3 days;
Metronidazole 2.0 tablets are taken orally once.

In pregnant women suffering from bacterial vaginosis, the use of antibiotics is possible starting in the second trimester. They are prescribed in the form of tablets, the course of treatment lasts no more than 7 days.

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.

The drugs 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.

Lactobacilli, which make up up to 98% of the biocenosis of the intimate zone, can exist normally only under certain conditions, for example, at a pH of 3.8 to 4.5. In order to maintain this pH level, it is necessary to use products with lactic acid.

Among the products in this group, Biofam stands out. It contains lactic acid, which maintains the necessary conditions for the existence of lactobacilli, and glycogen for their successful nutrition and reproduction. The most important component of Biofam is also thyme oil, which, due to the content of thymol and carvacrol in its composition, has a pronounced antiseptic effect against 120 strains of microorganisms, including Candida. Thyme oil prevents pathogenic microflora from adhering to the surface of the vaginal epithelium and creating biofilms, which reduces the likelihood of relapse of bacterial vaginosis.

Antifungal suppositories, as a rule, are not prescribed. The need for them arises if a fungal infection joins the opportunistic microflora. In this case, Clotrimazole suppositories are prescribed intravaginally once a day for 6 days.

Self-treatment at home is not recommended, since an incorrectly selected dose of the drug or duration of the course leads to the development of resistance in bacteria. In the future, it will be extremely difficult to cure such an infection and there will be a high risk of its chronic course. How to treat bacterial vaginosis in each specific case can best be determined only by a specialist - a gynecologist.

How to prevent it?

Despite the negative answer to the question “is bakvaginosis transmitted sexually,” the influence of changing sexual partners and unprotected sex on the development of the disease is clearly visible. Therefore, the main prevention is to use barrier contraception - a condom, which can be supplemented with local antiseptics. Douching with Miramistin must be carried out no later than 2 hours after sexual intercourse. In addition, preventive measures include timely treatment of chronic diseases, taking antibiotics strictly as prescribed by the doctor, and correcting hormonal disorders.