Bacterial vaginosis or vaginal dysbiosis - a female doctor about thrush. Treatment of bacterial candidiasis

Only every third woman in the world can boast of normal vaginal microflora. This means that in 2/3 of the female population it is impaired. We often hear the phrase “bacterial candidiasis” and it sounds scary. But, in fact, there is no such diagnosis; there are two separate diseases - bacterial vaginosis and vaginal candidiasis. When you become ill with bacterial vaginosis, against the background of reduced immunity, all the conditions are created for the vagina to be affected by fungi of the genus Candida and candidiasis develops. That is why we call the combination of these two pathological conditions bacterial candidiasis.

To understand the essence of this diagnosis, it is better to consider these diseases separately.

It is a sexually transmitted infection caused by infection of the vagina by the bacterium Gardnerella vaginalis. This disease is not venereal and occurs without inflammation of the mucous membranes.

The vaginal microflora is normally represented by lactic acid bacteria (Doderlein bacilli, lactobacilli), epithelial cells and a small number of leukocytes. They are not determined by a smear, but fungi and opportunistic bacteria (gardnerella) are present in the vaginal flora. However, gardnerella is not the only culprit of vaginosis.

The main reason is vaginal dysbiosis (or dysbiosis), a condition in which the number of lactic acid bacteria sharply decreases (even until they disappear completely) and the content of opportunistic microorganisms increases, which in this case become pathogenic and cause diseases. Often, vaginal dysbiosis accompanies intestinal dysbiosis.

Causes of vaginal dysbiosis

There are quite a lot of them:

• long-term use of antibiotics;
• hormonal imbalances;
• inflammatory diseases of the genitourinary system;
• decreased immunity;
• stress;
• intrauterine or oral contraception;
• condoms containing spermicidal lubricant;
• poor nutrition and lack of fermented milk products in the diet;
• frequent douching;
• long-term wearing of synthetic tight underwear;
• frequent changes of sexual partners.

Manifestations of bacterial vaginosis

The initial stage of the disease is practically asymptomatic and the only sign is the unpleasant smell of rotten fish. Later, minor vaginal pain and discomfort appear. With the further development of the disease, characteristic foamy, viscous discharge of a yellowish-green or gray color with a sharp, unpleasant odor appears. Sometimes there may be a burning sensation, discomfort and itching, as well as pain during sexual intercourse. It is characteristic that the mucous membranes of the vagina remain calm, without inflammatory signs.

Why is bacterial vaginosis dangerous?

Gardnerella, having become pathogenic, can cause significant damage to a woman’s health. Approximately 80% of women aged 15 to 50 suffer from this disease. Of these, every fourth considers themselves healthy, since there are no symptoms of the disease. Bacterial vaginosis can complicate pregnancy, childbirth, and even cause infertility. Against this background, chronic diseases of the genitourinary system may develop. Women who do not treat vaginosis are at risk of genital diseases (ureaplasmosis, chlamydia, mycoplasmosis, etc.) and precancerous conditions of the cervix.

How is gardnerellosis diagnosed?

In addition to pronounced clinical manifestations, the following laboratory tests will help diagnose bacterial vaginosis:

• amine test;
• determination of pH of vaginal secretions;
• smear microscopy.

Microscopy can also detect other sexually transmitted infections, such as gonococcus, chlamydia, mycoplasma, trichomonas, fungi and genital herpes.

Principles of treatment of vaginosis

Since medications mainly combat the consequences of this disease, before starting treatment for bacterial vaginosis itself, its main cause – vaginal dysbiosis – should be eliminated. It is to restore the vaginal microflora that the use of probiotics (live lactobacilli) is recommended.

Also, complex therapy includes the use of antibacterial drugs and correction of the immune system. It is important to use condoms during the entire treatment period.

Vulvovaginal candidiasis (thrush)

More often, the simpler and more familiar term “thrush” is used to describe this genital candidiasis. This is such a common disease that many women are mistakenly convinced that it is not necessary to treat it. However, today it is known that untreated candidiasis can cause serious consequences, be transmitted from mothers to newborns and even cause their death.

Causes of the disease

What can cause the appearance of thrush:

• vaginal dysbiosis;
• changes in hormonal levels due to age and physiological conditions
• women (puberty, pregnancy, lactation, menopause);
• metabolic disorders, diabetes mellitus, thyroid diseases, etc.;
• decreased immunity;
• venereal diseases;
• mechanical or chemical damage to the mucous membranes;
• surgical interventions;
• taking antibiotics;
• taking contraceptives;
• frequent change of partners;
• geographical factor (in countries with hot climates, the incidence of vulvovaginal candidiasis is much higher).

How to recognize thrush

Since candidiasis provokes changes throughout the body, and the immune response is individual, symptoms can appear one at a time or all at once. They usually appear before menstruation and intensify during sexual intercourse or urination. The symptoms are so severe that they can cause nervous disorders.

The most common manifestations of thrush:

• white, cheesy discharge with a faint odor of sour milk;
• itching and burning in the vaginal area, usually worsening in the evening;
• swelling and redness of the mucous membranes of the vagina.

The diagnosis is confirmed only by a medical examination with the obligatory taking of smears.

How to treat vaginal candidiasis

Treatment of thrush is necessarily comprehensive and includes the use of antifungal suppositories, creams, gels, as well as oral medications. It is recommended to correct the functioning of the immune system and eliminate provoking factors.

To reduce itching and discomfort, do not use soap when washing. A solution of baking soda or furacillin, as well as a decoction of chamomile flowers, are better suited for this.

Since vaginal candidiasis is transmitted sexually, from the moment the first symptoms appear and during treatment, you should avoid sexual intercourse.

Often women self-medicate and are not aware of the risk of complications. Untreated thrush can become a chronic form of the disease, which in turn leads to serious inflammatory processes in the pelvis, adhesions, infertility or intrauterine infection of the fetus.

How to protect yourself from bacterial candidiasis

Prevention of bacterial candidiasis is based on measures that can prevent the development of dysbiosis and the occurrence of sexually transmitted infections. It includes a balanced diet, personal hygiene and the use of barrier contraceptives.

Women make this diagnosis for themselves when they are bothered by discharge. And gynecologists understand thrush as a strictly defined disease caused by a known pathogen - a fungus of the genus Candida. But discharge, itching and burning are caused not only by fungi.

T What are the symptoms of vaginal inflammation? (colpitis) are possible with gonorrhea, trichomoniasis, bacterial vaginosis (gardnerellosis), genital herpes, chlamydia, mycoplasmosis, ureaplasmosis and other infections. Therefore, when the described complaints bother you, you need to go to the doctor for examination and find out the causative agent, and not self-medicate, because advertised drugs are effective only against real thrush - candidiasis.

The set of studies for complaints of discharge is standard and is carried out in a certain sequence:

1. Smear (bacterioscopy).

2. If necessary, culture (bacteriological examination)

3. PCR (DNA diagnostics).

Following this sequence will allow you to save money by starting with a simpler and cheaper study. The most common causative agents of colpitis (fungi, trichomonas, gonococci, gardnerella) are detected in a regular smear if it is made in a qualified laboratory and do not require PCR. Conversely, pathogens detected by PCR (chlamydia, ureaplasma, mycoplasma, herpes, papillomavirus) are less likely to cause symptoms of colpitis, and their detection and specific treatment does not always lead to the disappearance of complaints, because The vaginal flora remains disturbed. Moreover, if there is a large discharge with a large number of white blood cells (pus), the PCR reagents are inactivated, and the result may be false negative (i.e. the result will be negative despite the presence of infection). Therefore, it is first necessary to identify and treat disorders of the vaginal flora, and only then, if indicated, do PCR.

Normal vaginal microflora:

Daderlein bacilli (lactic bacteria). They should be detected in a smear along with epithelial cells (the superficial exfoliating layer of the vaginal walls) and a small number of leukocytes (up to 20 in the field of view of the microscope).

Other microorganisms that normally live in the vagina (fungi, gardnerella) are present in small quantities that do not allow them to be seen in a smear.

Leukocytes are protective cells that fight infectious agents. Their number increases in inflammatory diseases; they are a sign of the presence of infection, but do not allow identifying a specific pathogen.

I. INFECTIONS DETECTED BY BACTERIOSCOPE:

1. Candidiasis- true thrush. Caused by fungi of the genus Candida. These fungi normally live in the vagina of a healthy woman without requiring treatment.

Treatment is required when complaints appear: white discharge, often cheesy, in lumps, with a sour odor; itching that increases after sexual intercourse, water procedures, at night, during a certain phase of the menstrual cycle.

These complaints occur periodically and are provoked by poor diet, fasting, hypothermia, stress, illness, a certain period of the menstrual cycle, or taking hormonal medications (birth control pills). Sometimes the symptoms go away on their own or with self-medication (various suppositories), but after a while they resume.

Candidiasis is not a classic sexually transmitted disease (STD); it is an internal condition caused by decreased immunity. Therefore, with long-term, recurrent, difficult-to-treat candidiasis, it is necessary to look for pathology in the body that can cause immunodeficiency, manifested, in particular, by candidiasis.

Causes of persistent candidiasis:

The presence of a chronic infection of the reproductive system or any other system of the body.

The immune system is exhausted in the fight against chronic inflammation, and this also manifests itself in candidiasis.

Chronic diseases, for example, kidneys, liver, for the same reason.

Hormonal disorders: ovarian dysfunction, decreased thyroid function, diabetes mellitus, obesity.

Taking hormonal medications: birth control pills, prednisolone (for the treatment of immune diseases).

Genital herpes.

Taking antibiotics that cause intestinal dysbiosis. The reservoir of candidiasis in the body is the intestines, from there the fungi spread to other habitats.

Poor nutrition, in particular, excess sweets, can also lead to the development of dysbiosis and the proliferation of fungi.

Chronic intestinal diseases - colitis.

Incorrect use of eubiotics: after (or instead of) treatment of disorders of the vaginal flora, for example, bacterial vaginosis, drugs containing lactic bacteria (lactobacterin, acylact) are often prescribed. These bacteria should normally live in the vagina, maintaining an acidic environment in it, and if there are sufficient numbers of them, alkali-loving bacteria that cause bacterial vaginosis cannot settle. But fungi coexist perfectly with lactic bacteria in an acidic environment and multiply under these conditions. Therefore, it is possible to prescribe eubiotics only if the absence of fungi is confirmed (by smear, or better yet by culture).

Thus, candidiasis is a marker of trouble in the body, and in addition to specific treatment with antifungal drugs, it requires a full examination and elimination of the root cause of immunodeficiency.

Occurring as an internal condition, candidiasis can be transmitted sexually. Therefore, both partners undergo treatment at the same time.

2 Bacterial vaginosis ( gardnerellosis). These terms are not complete synonyms.

Bacterial vaginosis is vaginal dysbiosis, i.e. a condition in which the ratio of microorganisms normally living in the vagina is disrupted. Those that should be more numerous (lactic bacteria) become smaller, and vice versa, those that should normally be few in number multiply. Gardnerella is one of those that should be fewer in number, but not the only one. Thus, vaginosis is not an infection (not only not an STD, but not an infection at all); the bacteria do not come from outside, but only regroup their own. Features of the bacterioscopic picture in vaginosis is a small number of leukocytes, because no infectious agents. Therefore, bacterial vaginosis (gardnerellosis) is not contracted, and this is the only condition that does not require treatment of the partner.

Normally, the vagina maintains an acidic, oxygen-rich environment, favorable for the proliferation of lactic bacteria. When environmental conditions change—the absence of oxygen and alkalization—lactic bacteria are replaced by those for whom these conditions are favorable: gardnerella and other bacteria that live in an alkaline environment and do not use oxygen.

Reasons The development of bacterial vaginosis can be:

Wearing tight-fitting synthetic underwear, tight-fitting synthetic trousers, i.e. creating barriers to oxygen penetration.

Abuse of daily pads and tampons is for the same reason.

Long-term use of antibiotics, which also kill lactic bacteria.

Poor nutrition is a lack of fermented milk products in the diet, which are a source of lactic bacteria for the body.

Chronic intestinal diseases and other conditions that cause dysbiosis - lactic bacteria come with food and live in the intestines.

Symptoms of bacterial vaginosis: discharge is whitish-gray, homogeneous, sticky, with a strong unpleasant odor.

The diagnosis of bacterial vaginosis is made only on the basis of complaints and bacterioscopy. PCR for gardnerella should not be carried out: firstly, gardnerella is not the only bacterium that multiplies during vaginosis, i.e. the absence of gardnerellosis does not mean the absence of bacterial vaginosis; and secondly, gardnerella can normally be present in the vagina, and a positive result of such a highly sensitive method as PCR indicates only its presence, and not its predominance.

A bacterioscopic examination of a smear allows one to detect changes in the flora: the predominance of small rods over normal lactic acid bacteria, and the presence of “key” cells - a picture that occurs only in bacterial vaginosis: these are epithelial cells. “covered” with a small stick.

More accurately, bacterial vaginal vaginosis is determined using bacteriological examination. At the same time, the quantitative ratio of lactic bacteria, gardnerella and other bacteria is determined. This method is especially useful for monitoring the effectiveness of treatment.

3. Trichomoniasis. Refers to STDs. Caused by flagellated protozoa - Trichomonas.

Symptoms: copious, liquid, foamy discharge, accompanied by itching, pain during sexual intercourse. As a rule, the appearance of symptoms is associated with a change in sexual partner.

The diagnosis is made based on complaints and detection of trichomonas in a smear.

Treated with antibacterial drugs together with partners. During treatment you must use a condom.

4. Gonorrhea. It still remains the most common cause of inflammatory diseases of the female genital organs. It often occurs asymptomatically, without exacerbations.

Symptoms: yellow discharge accompanied by itching; itching and pain during urination. The appearance of symptoms may be associated with a change of partner.

The diagnosis is made on the basis of complaints and the detection of diplococci in the smear - bacteria that resemble double balls in appearance, located inside or extracellularly.

Treated with antibiotics at the same time as your partner. For acute gonorrhea, a single dose of antibiotics is sufficient; for chronic gonorrhea, a course is sufficient. Until the fact of cure is established, a condom must be used.

The effectiveness of treatment is assessed 7-10 days after cessation of treatment using bacterioscopy and culture. Smears are taken after 24, 48 and 72 hours, and cultures are taken 72 hours after provocation. Provocation of an exacerbation is carried out with a gonovaccine, a chemical method (lubricating the urethra with Lugol's solution in glycerin), a nutritional (food) method (eating smoked, spicy, salty foods, alcohol), and a thermal method (hot bath). The criterion for cure is the absence of gonococci three times (with an interval of 10 days) in the smear and culture after provocation. Then observation is continued for another 3 months with examination once a month.

II. WHEN A LARGE IS DETECTED IN A smear

white blood cell count without an obvious pathogen; cocci and bacilli that do not form a clear picture of the infections described above are subject to bacteriological examination (culture) to determine sensitivity to antibiotics.

The second indication for conducting a bacteriological study is to establish a criterion for the cure of gonorrhea, bacterial vaginosis and candidiasis. Under the influence of treatment, these pathogens find themselves in unfavorable conditions, their number sharply decreases, and they stop reproducing, so a smear can show their absence, while they only quieted down for a while. Sowing is done on a nutrient medium, in which they again “come to life” and begin to multiply. Therefore, this is a more reliable method of determining the fact of cure.

III. IF AFTER DETERMINATION

causative agents of colpitis and treatment of inflammation, the symptoms remain, and the smear shows the normal state of the vaginal flora with an increased number of leukocytes; the PCR method is used to determine the causative agent.

It allows you to detect microorganisms living inside epithelial cells, therefore not getting into the secretions. In addition, these organisms are very small (smaller than a normal cell), so they are not visible when examined under a microscope. PCR makes it possible to determine the DNA of these microbes in the material, the main molecule that ensures the vital functions of any organism, and on this basis to judge their presence.

To obtain a reliable result, many conditions must be met, in particular, obtaining cell scrapings rather than secretions for research, because The studied microorganisms are intracellular; the use of high-quality reagents, etc. For the diagnosis of the infections listed below, this method is the most sensitive and specific.

However, the PCR method is unsuitable for determining the effectiveness of treatment. Viral diseases are incurable; treatment only makes exacerbations less frequent and complaints less pronounced. Therefore, treatment control is not carried out. And after treatment of chlamydia, myco- and ureaplasmas, their DNA remains in the genital tract for quite a long time (at least a month, but maybe more), which does not indicate the presence of living pathogens. Therefore, to assess the effectiveness of treatment of these diseases, a cultural method (seeding) is used. It allows you to detect only living, reproducing microorganisms, which is a sign of undertreatment. Or they take a PCR test a month later or after the next menstruation.

The definition of the following infections is the last in line when complaining about discharge, because these microorganisms live in higher parts of the reproductive system: in the tubes, uterus, cervix, and do not cause colpitis (inflammation of the vagina). Therefore, first, the most common causes of colpitis are searched for and treated (see above), and only then, if complaints persist, can we say that the discharge is caused not by colpitis (or not only), but by salpingo-oophoritis (inflammation of the uterine appendages), endometritis (inflammation of the uterine mucosa ) or cervicitis (inflammation of the cervical canal).

1. Chlamydia . The second most common disease (after gonorrhea), causing inflammation of the female genital organs. Chlamydia are absolute pathogens, i.e. are not normally present in the genital tract, and their detection, even in the absence of complaints, is an indication for treatment.

Discharge with chlamydia is usually scanty, may be accompanied by itching, and is often combined with pain and itching during urination.

The diagnosis is made using PCR, the effectiveness of treatment is assessed a month after its completion using PCR or culture.

As with all STDs, both partners are treated at the same time, and a condom is used during treatment.

2. Mycoplasmosis . Caused by microorganisms similar to chlamydia, but unlike them, they are non-absolute pathogens, i.e. may be present in the genital tract normally, be detected by PCR and not cause symptoms. Only the presence of symptoms in the confirmed absence of other, more likely infections, and the confirmed presence of mycoplasmas can be an indication for their treatment.

Symptoms and treatment are the same as for chlamydia.

Subtlety: There are several types of mycoplasmas. T.N. genital mycoplasma (mycoplasma genitalium) causes inflammation of the genitourinary system (urethritis, prostatitis) in men and does not cause diseases in women. The causative agent of mycoplasmosis in women is human mycoplasma (mycoplasma hominis). Now it is fashionable to be examined for “everything” using PCR. Do not pay extra money and do not test for genital mycoplasma. Leave it to the men. And it’s even easier to determine not the species, but the genus of mycoplasmas.

3. Ureaplasmosis. Ureaplasma is a close relative of ureaplasma and has the same features.

However, ureaplasma more often than mycoplasma causes inflammation of the genitourinary system. Ureaplasma has 2 biovars, one of which (T960) is often resistant to the traditional antibiotic used for these diseases, doxycycline.

If chlamydia is treated regardless of conditions and complaints, then mycoplasmosis and ureaplasmosis require mandatory treatment only for a planned or ongoing pregnancy. During pregnancy, these organisms become real pathogens and can cause infection of the fetus, miscarriage, and complications of childbirth.

Culture testing for ureaplasmosis and mycoplasmosis is very expensive and is carried out in few laboratories. Therefore, the effectiveness of treatment is assessed by the disappearance of complaints, a favorable course of pregnancy, or, in extreme cases, by the PCR method, carried out no earlier than a month after taking the last pill.

3. Genital herpes. It has specific manifestations, but often occurs atypically, for example, manifesting itself only as periodic itching and pain during sexual intercourse, and minor discharge. Often a herpetic infection is the cause of constantly recurring, incurable candidiasis.

Detection of the genital herpes virus requires periodic monitoring of the condition of the cervix, because it is the second most common cause of the development of its malignant lesions.

Genital herpes needs to be treated if it occurs with frequent exacerbations and complaints, if it is the cause of persistent candidiasis, if pregnancy is planned. Herpes, like any viral infection, is not completely cured, but is suppressed enough to not bother you. The main component of treatment is the specific antiviral drug acyclovir (Zovirax).

4. Human papillomavirus infection . Infection caused by the human papillomavirus. It manifests itself as genital warts on the external genitalia and in the vagina. However, condylomas are not a mandatory sign. Often this infection manifests itself as minor discharge and the development of cervical pathology, even malignant.

There are several types of the virus, the most oncogenic (with the highest frequency of causing malignant diseases of the cervix) are types 16 and 18.

If human papillomavirus is detected, it is necessary to be examined every six months for the presence of cervical pathology, do colposcopy and cytological examination. If pathology is detected, remove it surgically, just like genital warts. Local administration of interferon drugs reduces the likelihood of recurrence of condylomas.

Conclusion:

Thrush is not just a word that means discharge and itching. This is a specific disease caused by fungi .

Discharge and itching (colpitis) can be caused not only by thrush, but also by a number of other infections. Therefore, you cannot diagnose yourself and self-medicate; you need to go to a doctor and determine the specific pathogen. If candidiasis is detected, in addition to prescribing antifungal drugs, you need to examine the body, find the root cause of immunodeficiency, and take measures to increase immunity (vitamins, immunomodulators). Both partners must undergo treatment at the same time, because this disease is sexually transmitted, even if it initially occurs as a sign of immunodeficiency. To be clearer: if you have candidiasis, this does not mean that someone else has infected you, but it does mean that you can infect someone else.

If bacterial vaginosis (gardnerellosis) is detected, in addition to prescribing antibiotics, measures are taken to eliminate the conditions for its occurrence (underwear made from natural fabrics, avoidance of sanitary pads every day, fermented milk diet). The partner is not treated because it's not an infection.

If an STD is detected (gonorrhea, trichomoniasis, chlamydia), treatment is mandatory, regardless of complaints.

When ureaplasmosis and mycoplasmosis are detected, treatment is prescribed only if there are complaints, preparation for pregnancy or pregnancy.

If any infection is detected, all partners are treated simultaneously, regardless of test results. A condom is used during treatment.

The effectiveness of treatment is determined after 7-10 days, for chlamydia, mycoplasmosis and ureaplasmosis - after a month using bacteriological (cultural) research.

Viral diseases (herpes, human papillomavirus infection) are not treated, but are controlled.

Symptoms of colpitis can be caused not only by a vaginal infection. but also inflammatory diseases more than other organs of the reproductive system: uterus, appendages. In this case, treatment is more complex.

Bacterial candidiasis is the common name for a complex of symptoms of two diseases: bacterial vaginosis (gardnerellosis) and thrush (candidiasis). Often, due to the similarity of symptoms, bacterial and uncomplicated vaginal thrush are considered identical concepts, but this is incorrect.

It is believed that bacterial candidiasis is a complex of two mucosal lesions at once: microbial and fungal in nature. However, the occurrence of these diseases does not occur simultaneously. Bacterial vaginosis and candidiasis act as stages in the development of a complex disease.

With a decrease in immunity and an imbalance of microflora, active proliferation of pathogenic microflora occurs, affecting the mucous membrane and provoking an increase in the population of the Candida fungus. Thus, thrush can develop not as an independent disease, but against the background of a weakening of the body’s defenses and bacterial vaginosis.

The causes of bacterial vaginosis are:

• long-term antibacterial therapy without taking probiotics;
• hormonal imbalances associated with chronic diseases of the endocrine system, taking OCs, pregnancy or menopause;
• diseases of the genitourinary system;
• digestive and metabolic disorders;
• systemic diseases of the body;
• frequent douching.

Normally, the vaginal microflora is 95% lactobacilli, which produce lactic acid and endobiotics (substances with antibacterial properties), and also stimulate the synthesis of immunoglobulins. If, as a result of the action of one or more of the factors listed above, vaginal dysbiosis develops, then against the background of a low number or absence of lactobacilli, active reproduction of opportunistic microflora begins: gram-negative anaerobes and Gardnerella.

Their vital activity causes alkalization of the vagina (normally, due to the production of lactic acid by lactobacilli, its pH ranges from 3.8 to 4.5), and the alkaline environment is optimal for the rapid growth of the population of the Candida fungus.

In addition to microflora disturbances, factors stimulating the development of candidiasis are:

• Diabetes mellitus (sweet environment is favorable for fungal growth).
• Immunodeficiency states.
• Wearing synthetic tight underwear and untimely changing of sanitary pads.

Since disturbances in the vaginal microflora can even be caused by hormonal imbalances due to poor nutrition and stress, bacterial vaginosis and candidiasis are becoming increasingly common diseases. Their complex treatment requires the use of a number of potent agents.

Symptoms of bacterial candidiasis

Bacterial candidiasis and vaginosis differ significantly in symptoms. Thrush, which develops against the background of gardnerellosis, has more obvious and painful manifestations, characteristic of a fungal infection of the mucous membrane. Treatment must begin at the stage of bacterial vaginosis in order to prevent the development of a complex disease.

Symptoms of vaginosis:

• clear or whitish foamy discharge;
• slight burning sensation;
• unpleasant “fishy” smell.

Vaginosis refers to diseases that are individual in nature and are not transmitted through sexual contact. Due to the mildness of symptoms, absence of pain and swelling, the disease can proceed almost unnoticed, creating a favorable environment for the fungus. If you notice at least two symptoms, you should consult a doctor to prevent the development of bacterial candidiasis.

Symptoms of bacterial candidiasis:

• pronounced itching, burning;
• weak sour smell, similar to kefir;
• white cheesy and creamy discharge;
• pain in the lower abdomen;
• swelling and redness of the labia and vagina;
• pain during urination and sexual intercourse.

Swelling of the vagina, itching and burning with candidiasis intensify at night. Due to severe inflammation caused by the activity of fungi and pathogenic bacteria, the mucous membrane becomes loose and thins, which is the cause of pain during intimacy and urination.

Treatment methods

Treatment of thrush, which has developed against the background of a bacterial infection, requires the use of not only antifungal drugs, but also antibiotics. First of all, the specialist conducts an initial examination and takes a smear for analysis to determine the state of the vaginal microflora.

The patient is prescribed local or systemic antimycotic agents that relieve the symptoms of thrush. The most effective and safest are:

Vaginal suppositories act on the site of the disease, relieving inflammation, removing unpleasant odor and discharge due to a sharp decrease in the population of Candida fungi. When treating the disease, it is very important to follow the instructions and instructions of the doctor: a relapse can only be avoided if you complete the full course. Antifungal creams can be used to relieve symptoms early in treatment and to make therapy more intense. They relieve swelling and inflammation of the external genital organs. The following remedies are considered the most effective:

• Nystatin;

For chronic thrush and fungal infection against the background of diseases associated with immunodeficiency, a specialist may prescribe oral medications. This will help suppress the growth of Candida fungi and prevent future exacerbations of the disease.

Treatment of vaginosis must be carried out in parallel with antimycotic therapy. To destroy opportunistic microflora, antibacterial drugs are used in the form of tablets, suppositories, gels, creams and douching solutions. The following tools have proven themselves well:

Products that contain both antibacterial and antifungal components are highly effective: for example, Metrogyl Plus. This ointment contains metronidazole, which eliminates pathogenic bacteria, and clotrimazole, which destroys the colony of Candida fungi.

After completing a course of treatment for bacterial candidiasis, it is necessary to restore the beneficial microflora of the vagina. Bifidobacteria and lactobacilli are taken systemically (orally) and locally (on tampons).

Treatment with topical drugs during pregnancy is not contraindicated.

Prevention and folk recipes for the treatment of bacterial candidiasis

The risk of developing thrush due to vaginosis is very high, so it is very important to follow the rules of hygiene and try to maintain immunity. Prevention of bacterial candidiasis is especially important during pregnancy, when hormonal imbalance creates physiologically favorable conditions for the proliferation of pathogenic microflora and fungi.

To reduce the risk of developing the disease, you need to:

• adhere to proper nutrition, take vitamin and mineral complexes;
• use barrier contraception during casual sexual intercourse and do not use other people’s hygiene products;
• carry out the prevention of acute respiratory viral infections and promptly treat systemic diseases;
• take lacto- and bifidobacteria during antibiotic therapy;
• normalize your daily routine, eliminate lack of sleep and stress;
• observe hygiene standards (wash genitals and change underwear daily);
• Do not use douching as a method of contraception or vaginal cleansing.

Among folk remedies for the prevention and treatment of bacterial candidiasis, herbal baths made from decoctions of sage, oak bark, calendula, yarrow, oregano and nettle are effective. Chamomile infusion reduces inflammation and swelling of the genital organs.

Infusions of berries rich in vitamin C, which stimulates the immune system, as well as carrot juices and purees with onions and garlic are taken internally.

Bacterial thrush is a very common disease, especially in women. This disease can bring a lot of trouble. This disease is also known as candidiasis. The pathology develops due to an increase in the number of yeast-type fungi, which are constantly present in the human microflora - in the intestines, oral cavity, and vaginal area (specifically in women). When a person’s immunity weakens, the number of fungi increases.

The bacterial form of the disease is a common ailment, however, in a normal healthy state, the immune system will not allow a sharp increase in the concentration of opportunistic or pathogenic microflora units. This also applies to Candida fungi. However, sometimes the living conditions change in the human body. This is the starting point for the entire process of pathology development to take off. Which is typical for a disease such as generalized candidiasis. So basically, thrush develops due to the action of various factors, but the most important reasons are weak immunity and an increase in the number of pathogens.

In addition, the reason may be the occurrence of various violations in the integrity of the mucous layers and skin. Changes in the level of acidity in the internal environment of the vagina have an adverse effect. Hot climatic conditions will have a bad effect on your health. Because of this, a person sweats more, which also creates favorable conditions for the proliferation of fungal and bacterial cultures.

Systemic candidiasis can develop not only in adults, but also in newborns. They can become infected during fetal development or during labor, when the baby passes through the vagina. If the integrity of the skin of the mother’s nipple is damaged, then the child can catch a fungal infection while breastfeeding. Children at this age have a weak immune system, so bacterial candidiasis will quickly develop.

Another fungus that causes candidiasis can enter the human body along with food. For example, most often it is meat and poultry, sour cream, cottage cheese. This also happens when sharing household items.

Symptoms and types

Urogenital candidiasis is not only unpleasant, but also a rather insidious disease. In general, thrush can appear on any part of the body, and it does not depend on gender or age. Symptoms of the disease will depend on the location of the pathological processes, as well as on the individual characteristics of each person’s body.

The types of thrush are quite varied. Depending on where the disease manifests itself, the following varieties are distinguished:

• urogenital candidiasis;
• oral disease;
• disease of the skin and periungual area.

In addition, there is also a congenital form.

Urogenital candidiasis manifests itself in the organs of the urinary and reproductive systems, both in women and men. In women, the vulva, uterus and nipples can usually be affected. In men, the disease provokes urethritis, balanitis, balanoposthitis. In more rare cases, prostatitis of a fungal nature develops.

The visceral form is, in other words, systemic candidiasis. The peculiarity of this type of disease is that not only the superficial layers of organs are affected, but also the various internal organs and systems themselves. For example, yeast fungi adversely affect not only the organs of the urinary and reproductive systems, but also the digestive tract and respiratory system. Generalized candidiasis requires a more careful approach to therapy.

can lead to stomatitis, glossitis or cheilitis. This form of the disease most often manifests itself in childhood. But the fungus can affect the skin on any part of the body. Most often these are the palms and soles, especially the skin around the nails.

There are several forms of the disease. Firstly, candidiasis is not a separate disease, so special therapy is not needed. The acute form of candidiasis is characterized by rapid development and pronounced symptoms. But it heals very quickly. An advanced form can lead to the disease subsequently becoming chronic. This usually occurs due to improper or untimely treatment. In turn, chronic pathology is of the following types: recurrent or persistent thrush. The first type appears as a sharp outbreak. For example, this happens after menstruation or childbirth. The second type is characterized by a sluggish course. It is impossible to completely cure such a disease.

A separate form is deep candidiasis. It is considered the most severe in the course of the disease. This disease requires complex therapy. The deep form of candidiasis can have different symptoms depending on which organ or system is affected. For example, this is candidal meningitis, pericarditis, endocarditis, bronchopulmonary candidiasis and other severe types.

Treatment

Regardless of the form of the disease or what infection it is caused by, it is imperative to start treatment as early as possible. Moreover, therapy should only be prescribed by a specialist; self-medication is prohibited. It is better not to delay going to the hospital, as the disease will develop, expand the affected areas, or later become chronic, when therapy will be less effective.

Now urogenital candidiasis is treated by two methods. Firstly, you need to take the drugs in tablet form. Typically, drugs with antifungal properties and, if necessary, antibiotics are prescribed. The doctor can first determine the type of infection and select the means that will most effectively influence such microflora. For example, Lomexin, Polygynax, Betadine, Clotrimazole, Livarol, Pimafucin, Terzhinan, Macmiror will help eliminate a fungal infection. In addition, medications are prescribed that will help strengthen the immune system - these are immunomodulators and vitamin-mineral complexes.

Secondly, complex therapy includes the use of not only systemic agents, but also drugs with local action. For example, candles, creams, ointments are suitable. Solutions for rinsing (douching) are used. You can use not only pharmaceutical drugs, but also traditional medicine recipes.

You can't do without a diet either.

Dishes need to be steamed, boiled or baked in the oven. It is best to temporarily remove fatty meat and fish from your diet. It is also prohibited to eat dishes that are prepared with the addition of yeast. This also applies to bread and various flour products. It is necessary to reduce the consumption of sweets, as such food creates ideal conditions for the development of a fungal infection. If a person has a chronic form of the disease, then the diet should be constant so as not to provoke a relapse. In addition, it is recommended to walk outdoors and play sports more often. It is imperative to maintain hygiene and bathe every day, and wash your private parts after each urination or defecation.

Bacterial candidiasis is a very common disease. It is caused by the active reproduction of fungal cultures of the Candida class in the microflora. This occurs due to a weakening of the immune defense under the influence of unfavorable factors. There are several types of this disease, but their symptoms are almost the same: itching, white cheesy discharge, redness, sour, unpleasant aroma. The doctor selects the therapy. Basically, agents with antifungal properties are used, as well as drugs to strengthen the immune system and stabilize the microflora.

Many women take the occurrence of burning and itching in the intimate area as signs and immediately begin treatment. However, the disease, despite all the actions taken, does not go away or returns again, accompanied by additional complications. The reason for this in most cases is incorrect diagnosis. According to statistics, thrush is most often confused with bacterial vaginosis. Carrying out a full diagnosis will also help to avoid such a mistake and its consequences.

Bacterial vaginosis

Bacterial vaginosis is a disease that affects the vaginal mucosa due to changes occurring in the composition of its microflora. The following bacteria are most often the causative agents:

• Klebsiella;
• fusobacteria;
• bacteroides;

Symptoms of bacterial vaginosis:

• gray or having an abundant character, an unpleasant odor;
• discomfort and burning during sexual intercourse;
• itching in the area of ​​the external genitalia;
• pain and burning during emptying the bladder, frequent urination.

Thrush (candidiasis)

Thrush is an inflammatory disease caused by uncontrolled or excessive proliferation of Candida fungi.

Symptoms of thrush:

• cheesy white discharge on the skin of the perineum and labia;
• swelling, redness of the genitals;
• unpleasant odor (sometimes);
• burning, discomfort, itching in the area of ​​the external genitalia and vagina;
• exacerbation of discomfort at night, after sexual intercourse, or emptying the bladder.

The symptoms and signs of vaginosis and thrush are indeed very similar, so to correctly diagnose the disease you should definitely consult a good gynecologist.

Diagnosis of bacterial vaginosis

The research methods discussed below will help a gynecologist accurately determine bacterial vaginosis.

• Determination of acidity (pH-metry) of vaginal discharge. If the pH level exceeds 4.5, the presence of bacterial vaginosis can be determined.
• Amine test. Vaginal discharge is mixed with a special substance. If there is an unpleasant odor (“fishy”), this indicates bacterial vaginosis.
• Microscopic examination of a smear of the vaginal mucosa. This method is considered the most accurate; in case of vaginosis, a deficiency or absence of lactobacilli and an increase in the number of other microorganisms are revealed in the smear.

Diagnosis of thrush

The studies discussed below allow the gynecologist to determine thrush.

• Microscopic examination of stained vaginal smears.
• Microscopic examination of unstained vaginal smears.
• Mycological research, which allows you to accurately determine the type of fungus that led to the appearance of thrush.

Modern treatment of thrush

Nowadays, the pharmaceutical industry produces a large number of effective drugs, the use of which allows you to quickly cope with thrush. You should not self-medicate; only a doctor can choose the right set of medications depending on the form of the disease.

Current treatment options:

• vaginal tablets (Polygynax, Neotrizol);
• vaginal capsules (Lomexin);
• Fluconazole (Flucostat, Mikosist, Diflucan);
• elimination of conditions that stimulate the development of thrush.

Modern treatment of bacterial vaginosis

If bacterial vaginosis is left untreated or treated incorrectly, complications are guaranteed to develop, so do not delay a visit to the gynecologist. The destruction of vaginosis pathogens is carried out by two methods: locally, through suppositories, vaginal tablets, gels and by taking antimicrobial drugs.

Optimal treatment options:

• Metronidazole (Metrogyl, Trichopolum, Flagyl);
• Clindamycin;
• Metrogyl Plus;
• vaginal gels (Metrogil);
• vaginal tablets (Flagyl, Klion).

As you can see, with similar symptoms, the diagnosis and treatment of these diseases are completely different. If any of the pathologies are not treated, you can get a whole bunch of serious complications, so if you notice any of the above symptoms, do not self-medicate.