Vaginal dysbiosis: why can’t this condition be ignored? Causes of vaginal dysbiosis - first signs, symptoms and treatments

Vaginal dysbiosis is a disease that has several synonyms: vaginal dysbiosis and bacterial vaginosis. The pathology is characterized by an imbalance of microflora on the vaginal mucosa, which occurs due to various diseases and conditions of the body. For a certain reason, lactic acid bacteria living on the mucous membrane die and their number decreases significantly. The dead beneficial flora is replaced by opportunistic flora.

Vaginal dysbiosis is not sexually transmitted and is not an infectious disease. Recently, the disease has been spreading more and more throughout the world, mainly affecting women. over 35 years old.

Significant decrease in immunity (hypothermia, previous infections, and other immunosuppressive diseases);
Sudden climate change (during travel or quick transfers);
Venereal diseases;
Various infectious diseases of the genitourinary system;
Hormonal imbalance, both pathological and physiological (menopause, childbirth and pregnancy, adolescence);
Antibiotic therapy;
Pathologies accompanied by disturbances of microflora in the intestine;
Frequent douching;
Promiscuous sex life;
Violations of intimate hygiene rules, including improper use of a tampon during menstruation (untimely change).

When exposed to these factors, symptoms of vaginal dysbiosis do not always appear. The disease develops only with a significant impact of the aggression factor on the vaginal microflora. Immunity contributes to the body's high resistance to this pathology.

Pathogenesis of the disease

Normally, the mucous membrane of a woman’s vagina is populated with microorganisms. Their composition and percentage ratio is stable and can only change at different periods of a girl’s life.

Normal composition of microflora:

Lactobacilli (about 90%);
Bifidobacteria (less than 10%);
Conditionally pathogenic flora (candida, ureaplasma, E. coli, Klebsiella and others).

Minor changes in the ratio of bacteria do not lead to the appearance of signs of vaginal dysbiosis, since a compensatory mechanism is activated. However, as the situation worsens, there is a gradual decrease in the first two fractions of bacteria (lacto and bifido), but the percentage of opportunistic flora increases or pathogenic strains multiply.

Lack of treatment for vaginal dysbiosis leads to vaginitis and more serious pathologies. The risk of infectious exposure to opportunistic bacteria increases and the likelihood of infection with sexually transmitted pathogens increases.

Symptoms of vaginal dysbiosis

The clinical picture of this disease is poor and nonspecific. Most of the symptoms that arise indicate complications of vaginal dysbiosis. Often the pathology is asymptomatic.

Signs:

Whitish-yellow vaginal discharge with an unpleasant odor (normally, small amounts of discharge in girls should be colorless and odorless);
Unpleasant sensations during sex or after it ends;

There are no subjective sensations in the form of pain and itching in uncomplicated dysbiosis.

Complications

Lack of treatment for vaginal dysbiosis leads to inflammation of the mucous membrane - vaginitis. Further spread of the process to the cervix will cause cervicitis. Then the infection penetrates the uterus itself, causing endometritis and metritis, after which it invades the appendages and adnexitis (inflammatory process) occurs.

Common symptoms of the inflammatory process in the female reproductive system are:

Painful sensations in the projection of the affected organs;
Burning;
An increase in the amount and change in the nature of vaginal discharge;
Unpleasant sensations during and after sexual intercourse.

In advanced cases, the infection spreads to the woman's urethra and reaches the bladder, causing urethritis and cystitis.

Diagnostics

Criteria for diagnosing vaginal dysbiosis:

Clinical manifestations of the disease (discharge).
. The analysis is very simple, but at the same time imprecise and nonspecific. The study is carried out using indicator papers.
Vaginal smear. The material for research is taken from the mucous membrane of the vaginal wall and examined under a microscope. Dysbacteriosis will be manifested by a decrease in lactobacilli and bifidobacteria and a significant increase in other strains.
Sowing on nutrient media. To clarify the results, a cultural study is carried out, which will accurately show all types of microorganisms living in the vagina and their ratio.

If there is a significant increase in pathogenic and opportunistic organisms, a test is performed to determine the sensitivity of bacteria to antibiotics, which will help select medications for vaginal dysbiosis when it is complicated by infection.

How to treat vaginal dysbiosis?

Therapy for vaginal dysbiosis should be comprehensive, addressing the cause of the pathology, its mechanism and eliminating the symptoms.

To suppress the growth of pathogenic microorganisms, antibiotics are used locally in the form of suppositories for vaginal dysbiosis. Anti-inflammatory and antiseptic agents are also administered.
Immunomodulators are used to enhance immunity.
Therapy should be aimed at treating the underlying disease (intestinal dysbiosis, genitourinary tract infections, hormonal imbalances).
To populate the mucous membrane with normal microorganisms, suppositories are used for vaginal dysbiosis, which include bifidobacteria and lactic acid bacteria. Additionally, physiotherapy and dietary supplements are used.

Even after restoring the percentage of bacteria in the vagina, you should use medications for vaginal dysbiosis containing beneficial strains of bacteria for some time.

Peculiarities

Vaginal dysbiosis during pregnancy.

The clinical picture of the disease in pregnant women is more pronounced and intense. The disease is manifested by a significant amount of pathological discharge and is more prone to complications. This occurs due to the fact that pregnant women have disrupted hormonal levels and all processes in the body (including immune) work to their limits.

The treatment regimen for vaginal dysbiosis in such patients changes somewhat, since it is inappropriate for them to use antibiotics and immunomodulators. Women most often try to contain the disease, not allowing it to become more complicated, and full treatment is carried out after childbirth.

Vaginal dysbiosis after antibiotic use.

Taking antibacterial drugs is always dangerous because the beneficial microflora of the body is destroyed. Most often, taking antibiotics leads to intestinal dysbiosis, which, in turn, causes vaginal dysbiosis.

The peculiarity in this case is that the woman has an excess of E. coli and enterococci in relation to other strains. The symptoms of the disease will be combined with signs of intestinal dysbiosis.

Since it is difficult to get rid of vaginal dysbiosis in such a situation, therapy is combined with the simultaneous restoration of intestinal flora. Otherwise, there is a high probability of relapse.

Vaginal dysbiosis with sexually transmitted diseases.

A disease transmitted through sexual contact is always combined with disturbances in the vaginal microflora. Moreover, the lack of adequate treatment for sexually transmitted diseases leads to aggravation.

Therefore, when treating sexually transmitted pathology, you should always additionally use drugs to treat vaginal dysbiosis. Otherwise, having gotten rid of a serious sexually transmitted disease, a woman’s genitourinary system will immediately be at risk of infection with opportunistic flora. Depending on the severity of the sexually transmitted disease, therapy is carried out either alternately or simultaneously.

Prevention

Treatment of the underlying pathology that can lead to dysbiosis;
Visit a gynecologist once a quarter after curing the disease;
Carrying out activities aimed at increasing the body's resistance to infections;
Compliance with personal hygiene rules;
Caution in the use of contraceptives;
Lack of frequent douching.

Since clinical manifestations are not specific and are quickly aggravated by inflammatory processes, if any unusual vaginal discharge appears, you should immediately contact a gynecologist in order to identify the problem as early as possible and begin therapy.

Oddly enough, most girls and women remember the vaginal microflora only when it begins to be disrupted. Leading experts rightly believe that maintaining normal vaginal microflora creates serious barriers to the occurrence of various infectious and inflammatory processes in the internal genital organs. As recent statistics show, from 20 to 30% of women of reproductive age have a violation of the vaginal microflora.

Normal vaginal biocenosis

Thanks to clinical studies, scientists have found that the natural microflora of the vagina is a combination of beneficial and opportunistic microorganisms. Normally, beneficial bacteria significantly outnumber opportunistic species. It is reliably known that approximately 95–97% of the vaginal biocenosis consists of lactobacilli, which, by producing lactic acid, provide an acidic environment in the vagina and protect it from infection. Opportunistic microorganisms (3–5%) are represented by the following types:

Gram-positive rods.
Gram-positive and gram-negative cocci.
Anaerobic rods.
Enterobacteriaceae.

The symbiotic relationship between beneficial and opportunistic microorganisms not only does not cause any harm, but even protects the internal genital organs from infection. Most infectious agents entering the vagina are neutralized in an acidic environment. However, it is worth noting that changes in microflora can occur during the menstrual cycle. For example, at the beginning of the cycle there is some deviation in vaginal pH towards the alkaline side. There will be a characteristic decrease in the number of lactobacilli, which is accompanied by an increase in opportunistic microorganisms. But immediately after menstruation, a rapid restoration of balance is observed.

If you notice any unnatural discharge from the genitals, do not delay visiting a doctor.

Violation of vaginal biocenosis

Not so long ago, a violation of the vaginal microflora was considered a clinical syndrome. However, it is now classified as a separate nosological entity, which is given the name bacterial vaginosis. In this pathological condition, there is a sharp decrease or absence of lactobacilli and an increase in the number of opportunistic microorganisms, in particular gardnerella and gram-negative anaerobic bacteria. It should be noted that neither sexually transmitted bacterial infections, nor fungi or pathogenic protozoa cause bacterial vaginosis.

As a result of the development of vaginal dysbiosis, the pH of the environment in the vagina shifts to the alkaline side and becomes more than 4.5. Such changes are associated with the presence of a large number of anaerobic bacteria, which produce volatile amines that have an extremely unpleasant odor, reminiscent of rotten fish. Changes in the biocenosis and pH of the environment deprive the vagina of a biological protective barrier, creating all the conditions for the occurrence of infectious and inflammatory diseases of the woman’s reproductive system.

What causes dysbiosis?

Bacterial vaginosis does not appear out of nowhere. The following may act as a provoking factor leading to disruption of the vaginal microflora:

Hormonal imbalance. Often observed during pregnancy and breastfeeding, during abortion, menopause, irregular sex life, etc.
Taking antibacterial agents. If you use antibiotics, they destroy not only dangerous, but also beneficial bacteria and other microorganisms. Uncontrolled long-term use of antibacterial drugs is particularly harmful to health.
Constant hypothermia, physical fatigue, unbalanced psycho-emotional stress, leading to decreased immunity.
Failure of the menstrual function of the ovaries of various types.
Past infectious and inflammatory diseases of the reproductive system.
Too active sexual life (several sexual partners or frequent changes).
Both insufficient and overly thorough hygiene of the intimate area.
Use of hormonal oral contraception and/or use of intrauterine contraceptives.

Violation of the vaginal microflora is a disease that needs to be treated purposefully.

Manifestation of dysbiosis

In the vast majority of cases, bacterial vaginosis is manifested by local symptoms. In some patients, subjective sensations may be absent. Typical clinical picture of vaginal dysbiosis:

There is copious discharge from the internal genital organs (whitish-gray in color, strong unpleasant odor). Quite often observed after intimacy or during menstruation.
If the disturbance of the vaginal microflora is chronic, then the discharge becomes yellowish-green, more saturated and thick, and looks like a cheesy mass.
The amount of discharge can vary from slight to very heavy.
Women rarely complain of itching and problems with urination. If present, they usually appear periodically.
A characteristic symptom of bacterial vaginosis is the absence of inflammation of the vagina.
Sometimes there is heavy menstrual bleeding and a feeling of pain in the lower abdomen.

A woman who has a violation of the vaginal microflora can contribute to the development of inflammation of the head and foreskin in her sexual partner.

How to determine dysbiosis?

Basic clinical and laboratory criteria indicating bacterial vaginosis:

Abundant cheesy discharge with a whitish-gray tint and a very unpleasant odor, evenly covering the walls of the vagina.
The pH of the vaginal environment is more than 4.5.
Positive amine test. By mixing samples of vaginal discharge with a solution of potassium hydroxide in equal proportions, a characteristic fishy odor appears.
Microscopic examination identifies “key cells.” These are desquamated epithelial cells to which various opportunistic microorganisms are attached. Normally, key cells are not detected.

If at least three of the above criteria are detected, then we can safely talk about a violation of the vaginal microflora, characteristic of bacterial vaginosis. If necessary, the diagnosis is supplemented with a bacteriological research method, which makes it possible to determine the qualitative and quantitative composition of the vaginal biocenosis.

If the vaginal microflora has been disturbed for a long time, this can affect the woman’s reproductive function.

Restoration of vaginal biocenosis

To successfully eliminate bacterial vaginosis, two main tasks must be performed:

Suppress excessive growth and reproduction of opportunistic bacteria (especially anaerobes) through the use of antibacterial drugs.
Restore normal vaginal biocenosis with the help of eubiotics, which will help increase the proportion of beneficial microorganisms.

Currently, antibacterial therapy to suppress opportunistic flora includes the administration of the following medications:

Clindamycin.
Metronidazole.
Tinidazole.
Ornidazole.

The therapeutic course can last for 5–7 days. If a woman is pregnant and suffers from bacterial vaginosis, then Clindamycin in the form of a cream is usually used. After completion of antibacterial treatment, measures are taken to restore normal vaginal biocenosis. There are no special restrictions regarding sexual activity during therapy. To boost immunity, it is recommended to take vitamin-mineral complexes and biogenic stimulants (Actovegin, aloe extract, etc.).

With proper adherence to the regimen and compliance with all the instructions of the attending physician, the normal microflora of the vagina is restored within several weeks.

Preparations for normalization of biocenosis

How to improve vaginal microflora? Having effectively dealt with opportunistic bacteria, they move on to taking eubiotics that help restore the vaginal biocenosis. This group of drugs includes:

Lactobacterin.
Lactonorm.
Bifidumbacterin.
Acylact.
Ecofemin.
Gynoflor.

Lactobacterin

One of the most popular eubiotics used to correct vaginal biocenosis is Lactobacterin. Live bacteria contained in the drug ensure the normalization of microflora, maintaining the pH of the vaginal environment at a level of no more than 4.5. In the acidic environment created by lactobacilli, many pathogenic and opportunistic microorganisms cannot grow and reproduce. Allergy to the components of the drug, vulvovaginal candidiasis and childhood are considered contraindications for use.

Side effects in the form of allergic reactions are very rare. Due to a decrease in the therapeutic effect, the simultaneous use of Lactobacterin and antibacterial drugs is not recommended. Restorative therapy using intravaginal suppositories can last 10–14 days. If necessary, repeated courses of treatment may be prescribed after 2–3 weeks. The cost of the drug Lactobacterin ranges from 130–150 rubles.

Gynoflor

Gynoflor is widely used to normalize vaginal microflora. Unlike the previous drug, this medicine contains not only lactobacilli acidophilus, but also a small amount of estrogen (estriol). Lactobacilli successfully cope with pathogenic and opportunistic flora. Estriol ensures the restoration of the vaginal epithelium, maintaining the biocenosis and pH of the environment, without having a systemic effect on the female body. In healthy epithelium, glycogen accumulates, which is necessary for the normal functioning of lactobacilli. Contraindications include the following conditions and diseases:

Allergy to the main and auxiliary components of Gynoflor.
Neoplasms sensitive to estrogen (tumors of the breast, reproductive system, etc.).
Any form of endometriosis.
Bloody discharge from the genitals of unknown origin.
Young age.

I would like to note that Gynoflor does not change the level of natural hormones in the blood. In the early stages of pregnancy (1st trimester) it is not recommended to prescribe the drug. At the same time, in later stages its use is allowed if there are appropriate indications and there are no contraindications. However, there is no reliable data on the effect of Gynoflor on the course of pregnancy and fetal development, since long-term clinical studies have not been conducted.

Side effects are recorded quite rarely. Some women experienced local adverse reactions, such as redness and a burning sensation in the genital area. In addition, simultaneous use with antibiotics may lead to a decrease in the effectiveness of the drug. Spermicidal agents are also not recommended to be combined with Gynoflor. The course of treatment is determined solely by the attending physician, but on average it can last 1–2 weeks. During therapy, it is better for girls and women to use sanitary tampons.

In most pharmacies, the price for the domestically produced drug Gynoflor does not exceed 950 rubles per package (6 vaginal tablets). Packs of 12 tablets are also available for sale, costing about 1,300 rubles.

Solcotrichofac

In case of prolonged and recurrent forms of bacterial vaginosis, the immunostimulating vaccine Solcotrichofac is used to normalize the vaginal microflora. The use of this specific drug not only helps to stabilize vaginal biocinosis, but also prevents the likelihood of relapses and mixed infections in approximately 80% of women. Solcotrichofak is actively used as both a therapeutic and prophylactic agent for bacterial vaginosis.

Vaccination with this drug should only be carried out by a doctor. The course includes 3 intramuscular injections. The interval between each administration is 14 days. The exact time of vaccination is calculated in advance so that injections do not coincide with menstruation. Revaccination is carried out after 12 months. The main contraindications to the use of Solcotrichofac are:

Allergy to vaccine components.
Various infections in the acute stage.
Tuberculous organ damage.
Diseases of the blood system.
Severe cardiovascular pathology.
Serious kidney problems.
Immunodeficiency states.

During pregnancy, whether to vaccinate with Solcotrichofak or not is decided by the doctor, taking into account the benefits for the woman and the possible risk for the child. There are practically no side reactions. In rare cases, headaches, chills, fever, general weakness, etc. were observed. The drug is also effective for recurrent trichomoniasis. You can purchase the Solcotrichofac vaccine in pharmacies with a prescription.

Vaginal dysbiosis is expressed in disruption of the normal vaginal microflora. This disease occurs in most representatives of the fair sex. In most cases, this disease manifests itself to a minor extent, but can cause the development of a number of serious inflammatory diseases of the female genital area of an infectious nature.

It is worth mentioning right away that several terms can be used to refer to vaginal dysbiosis. Vaginal dysbiosis or vaginal dysbiosis is considered the most accurate of the existing terms, since literally translated it means a violation of the vaginal microflora. But despite all this, this term is used extremely rarely. As a rule, this disease is called bacterial vaginosis, which also means a violation of the vaginal microflora. Meanwhile, many doctors define bacterial vaginosis as gardnerellosis, which is a special case of vaginal dysbiosis. As a result, when using this term it is not always possible to be sure that vaginal dysbiosis is meant.

In addition, quite often any kind of manifestation of a violation of the vaginal microflora is considered “candidiasis” (thrush), which is completely unfounded. Candidiasis, or thrush, is a manifestation of one type of microflora disorder, expressed in an increase in the number of fungi of the genus Candida, which happens extremely rarely. As a rule, women and many doctors call any vaginal discharge thrush, often without understanding the nature of its occurrence.

Causes of vaginal microflora disturbances.
Various factors can provoke the development of vaginal dysbiosis. Let's name the most common of them:

The predominance of fungi of the genus Candida in the vagina, and dysbiosis will be called thrush.
This can be either a one-time severe or frequent hypothermia of the female body, which reduces general and local immunity, which, naturally, cannot but affect the vaginal microflora.
Any hormonal changes or disruptions in the body, in particular: puberty, irregular sex life, pregnancy and childbirth, menstrual irregularities, abortion, premenopausal period, menopause, etc.
Change of climate zone.
Constant stress.
Promiscuous sexual relations with different partners, neglect of contraceptives.
Any diseases of the pelvic organs of an infectious-inflammatory nature.
Sexual infections (ureaplasmosis, trichomoniasis, chlamydia).
Long-term or frequent treatment with antibiotics.
Intestinal diseases, constant problems with stool, intestinal dysbiosis.
Incorrect use of tampons during menstruation. Not everyone knows that during menstrual bleeding, when using tampons, they should be changed every two hours, even at night. This is not only inconvenient, but contributes to the development of perfect conditions in the vagina for the growth of various infections. Using sanitary pads will eliminate this problem.
It could be Gardnerella. In this case, the disease will be called gardnerellosis (bacterial vaginosis). This type of disease most often develops asymptomatically. Only rarely can it manifest itself as itching and profuse vaginal discharge with an unpleasant fishy odor.
Any microorganisms with pathogenic activity.

Of course, these factors may not always immediately cause bacterial vaginal vaginosis, since the immune system is responsible for maintaining the microflora in a normal state, helping it recover in case of a minor disturbance. But since there are a lot of factors that provoke the occurrence of bacterial vaginosis and they occur quite often, and the immune system cannot always cope with its task, the development of the disease in women still occurs.

Mechanism of disease development.
Violation of the vaginal microflora occurs due to an imbalance of bacteria that live in the vagina. Normally, a woman’s vagina contains about 90% of beneficial lactobacilli (the so-called Dederlein bacilli), about 10% - bifidobacteria, and less than 1% of the “key cells of the vagina” (leptothrix, gardnerella, fungi of the genus Candida, mobiluncus and some other representatives). It is one of the representatives of the key cells that can become the causative agent of dysbiosis. In addition, they can be one of the sexually transmitted infections or any saprophytic pathogen (streptococci, E. coli, Proteus, staphylococci, etc.). When the vaginal microflora is disrupted, there is a significant reduction in the number of beneficial bacteria and a predominance of pathogenic microflora.

The microorganisms that inhabit the vagina never behave hostilely towards the walls of the vagina; they do not allow a negative change in the ratio of beneficial organisms and pathogens. In this case, the immune system provides active support. It is the immune system that helps restore normal microflora in case of minor disturbances. But this does not always happen, unfortunately.

Any pathogen that leads to dysbacteriosis can provoke a serious complication in the form of vaginitis or colpitis (inflammation of the vagina). The occurrence of this complication occurs depending on the number and pathogenicity of the pathogen, as well as on how strong the immunity of the vaginal walls is. Initially, the protection copes with its task and prevents the progression of the disease and its complications. However, if you do not undertake timely and competent treatment, then inflammation in this situation is simply inevitable.

Symptoms of the development of the disease and its main complications.
As already noted, at first the disease is practically asymptomatic. The changes concern the nature of vaginal discharge, but, as a rule, women do not pay much attention to this. Normally, a woman may experience slight transparent discharge without an unpleasant odor; there should be no other kind of discharge, just as there should be no unpleasant sensations of dryness in the vagina during intimacy, pain, itching and burning in the vagina. As a rule, with vaginal dysbiosis, the amount of discharge increases sharply, and it may have a whitish or yellowish tint with an unpleasant odor, reminiscent of rotten fish. There are no other symptoms for this disease. Itching and burning, vaginal dryness indicate the duration of the disease and the lack of treatment, as a result of which complications have developed.

In general, this disease is chronic, accompanied by periods of exacerbations and remissions. In the absence of adequate therapy, constant infection of the uterus with bacteria from the vagina can lead to the development of inflammation of the uterine mucosa (endometritis) and its appendages (adnexitis). In addition, long-term untreated treatment can contribute to the development of vaginitis or colpitis, in which the discharge becomes purulent, pain and pain occur in the genitals, and often an increase in body temperature. Another complication of dysbacteriosis can be cervicitis - inflammation of the cervix, in which pain in the lower abdomen is observed, and intimacy becomes very painful. In addition, with this disease, constant infection of the urethra occurs, which ultimately leads to the development of cystitis, the main symptoms of which are pain and burning when urinating.

Bacterial vaginosis of the vagina during pregnancy.
Quite often, pregnancy causes an exacerbation of bacterial vaginosis. Since during this period the female body undergoes enormous hormonal changes, immunity decreases, nutrition and lifestyle changes, against this background discharge, itching or burning in the genitals, pain during sexual intercourse, etc. may appear or intensify.

Since any drug therapy is generally contraindicated during pregnancy, it is not possible to receive full treatment. Any treatment for this disease, even if without the use of antibiotics, is always accompanied by immunocorrection, which is unacceptable during pregnancy. That is why local therapy is prescribed to eliminate the symptoms of this disease.

Taking antibiotics after childbirth can provoke dysbacteriosis, which also manifests itself in increased discharge, dryness, itching and burning, and pain. Treatment of this disease in women during breastfeeding is undesirable, therefore local therapy is prescribed, which reduces to symptomatic treatment or, in other words, elimination of the manifestations of the disease. This includes vaginal sanitation and antibacterial suppositories. Then, at the end of breastfeeding, if necessary, treatment is repeated using other drugs.

Bacterial vaginosis and sexually transmitted infections.
In any case, sexually transmitted infections are associated with a violation of the vaginal microflora. The appearance of a genital infection in the vagina shifts the pH, contributing to the occurrence of an inflammatory reaction and further progression of the disease.

Sexual infection is always associated with opportunistic microflora, so this must be taken into account when treating STDs, since there may be a situation when antibiotic treatment completely kills the STD pathogen, while the number of opportunistic infections only increases.

The final stage of treatment for STDs in women should be restoration of the vaginal microflora. In case of serious infections or the presence of several STDs, antibacterial therapy should be carried out and only then restore the vaginal microflora. In simple cases, you can first carry out a comprehensive diagnosis of the entire urogenital microflora, and then begin to restore it while simultaneously eliminating sexually transmitted infections.

Bacterial vaginosis and intestinal diseases.
In the presence of severe intestinal dysbiosis, bacterial vaginosis should also be expected. This is due to the fact that the wall of the rectum is in close contact with the wall of the vagina, as a result of which bacteria can easily pass through it. As a rule, one of the intestinal infections is cultured from the vagina - E. coli, enterococci, etc.

In this case, treatment is complex, since there is a high probability of relapse. In this case, restoration of normal vaginal microflora is carried out while simultaneously treating intestinal diseases.

Bacterial vaginosis of the vagina in girls.
This disease occurs very often in girls who are not yet sexually active, which is due to many factors: hormonal instability, the formation of the menstrual cycle, and the anatomical features of the structure of the hymen.

Bacterial vaginosis in girls only in rare cases occurs with heavy discharge, since the small opening of the hymen does not allow it to be completely removed from the vagina. Because of this, stagnation of vaginal discharge occurs, which sharply increases the risk of developing inflammatory diseases. Meanwhile, during the first intimate relationship, a large number of bacteria are thrown from the vagina into the bladder, which can provoke the so-called “honeymoon cystitis.”

Treatment of this disease in virgin girls is complicated by the structure of the hymen, which does not make it possible to treat the vagina with medicine as much as necessary. Therefore, sometimes doctors are forced to resort to artificial disruption of the integrity of the hymen (hymenectomy) in order to provide optimal treatment.

Bacterial vaginosis and sexual partner.
The disturbed microflora of a woman during intimate intimacy with a man does not affect his health in any way, even without the use of contraceptives. Very rarely, in cases of severe vaginal dysbiosis, a man may experience balanoposthitis and nonspecific urethritis. However, this happens if the man had a clear predisposition to these diseases. An absolutely healthy male body is not afraid of these inflammatory diseases. They will not develop in a completely healthy body.

It is worth noting that no diseases of the partner affect the microflora of a woman’s vagina, except for sexually transmitted diseases. Treatment of disturbed microflora in a woman does not require mandatory treatment of the sexual partner, unless he has a sexually transmitted infection. Therefore, the sexual partner must also undergo examination.

Diagnosis of the disease.
For an experienced specialist, diagnosing bacterial vaginosis will not be difficult. In addition to a visual examination, the diagnosis of this disease includes taking a general flora test, PCR diagnosis of sexually transmitted infections and culture of vaginal discharge or a special study of the vaginal microflora. A smear shows the state of the microflora of the vagina and vaginal wall, the degree of their disturbance and the severity of the inflammatory process, and the diagnosis of sexually transmitted infections and culture make it possible to identify the pathogens that caused the disturbance of the microflora and to identify the sensitivity of bacteria to antibiotics. The correct course of treatment cannot be determined from just one smear.

Treatment of bacterial vaginosis should be comprehensive and include three areas:

Suppression of bacteria.
If a violation of the microflora is associated with the presence of a sexually transmitted infection, then first treatment should be aimed at completely eliminating the causative agent of the infection. In this case, treatment consists of taking antibiotics while carrying out other measures. If there are no sexually transmitted infections, then antibiotic therapy is not necessary. In this situation, either a short course of antibacterial therapy is used, about three to five days, or local application of antibiotics and antiseptics is used. Their action simultaneously fulfills all treatment objectives (suppression of pathogenic flora, population of normal inhabitants of the vagina and local immunocorrection). And the use of antiseptics generally eliminates the possibility of bacteria being immune to them. To suppress pathogenic bacteria, antibiotics (Amoxiclav, Sumamed, Doxacycline, Trichopolum, etc.), local antiseptics (Miramistin, Chlorhexidine), and antibacterial suppositories (Terzhinan, Ginopevaril, etc.) are most often prescribed.

Population of normal vaginal microflora.
This point is the main one in the treatment of dysbiosis. The remaining measures are aimed at creating conditions for the engraftment and growth of normal flora. However, in practice, most doctors neglect this stage of treatment. For the population of normal vaginal microflora, massive doses of eubiotics (preparations with live bacteria) of general and local action are used. But using only eubiotics to restore microflora without suppressing pathogens is simply useless.

Restoring the immunity of the vaginal walls.
Local immunocorrection should also be one of the stages in the treatment of dysbiosis, otherwise other measures taken will not have the expected effect. In simple situations for immunocorrection, as a rule, they are limited to the use of local immunomodulators (Polyoxidonium, Cycloferon, Genferon, Immunal), as well as taking any probiotics with lactobacilli (Lactobacterin, Linex, Narine, Normoflorin-b, etc. In addition, it is recommended to include add as many fermented milk products as possible to your diet. In cases where the disease is advanced, restoring the immunity of the vaginal walls will require the implementation of more complex measures.

According to traditional medicine, douching with lemon juice diluted with water, lactic acid, as well as inserting tampons soaked in kefir into the vagina are effective for treating dysbiosis. All this contributes to the creation of an acidic environment in the vagina, without which there can be no growth and activity of good lactobacilli bacteria.

Prevention of vaginal microflora disorders.
Those who have been treated for this disease should be examined every three months for a year. At the appointment, the patient talks about her condition, is examined and, if necessary, tests are taken. If a tendency to microflora disturbance is detected, a short preventive course of treatment is prescribed. Restoring microflora at the initial stage of its disturbance is very easy.

If no serious problems arise during the year, then you can see a doctor once every six months. This allows you to assess and identify the presence of a tendency to relapse and prevent the disease from developing again.

Each disease can have different symptoms, this also applies to intestinal dysbiosis, and it has its own symptoms. Signs of vaginal dysbiosis are not numerous. A woman may not even be aware of its occurrence. Microflora disruption does not occur suddenly. A certain amount of time must pass for one row of bacteria to destroy the second row.

Signs of vaginal dysbiosis do not appear immediately. After some time, a woman may be bothered by the appearance of itching, burning in the perineum, and white discharge.

The discharge may have a strong, unpleasant odor. Symptoms of dysbiosis may include loss of interest in sex and irritability.

pain in the lower abdomen

This disease is characterized by two stages of development - from the moment of exacerbation to remission. This disease is not going away. It simply turns into a chronic form of the disease. In order to prevent inflammation of the pelvic organs, vagina and urinary tract, it is necessary to urgently take measures and treat this disease.

Signs of dysbacteriosis in an acute form of the disease:
the uterine mucosa and its appendages become inflamed;
purulent vaginal discharge appears;
pain in the genitals;
the occurrence of colpitis, cystitis or vaginitis;
pain when urinating;
pain in the lower abdomen;

sexual intercourse accompanied by pain

Every fifth woman may have absolutely no signs of vaginal dysbiosis. Only a gynecologist can make a diagnosis after a preventive examination.

What is vaginal dysbiosis

Normally, a woman has a large number of lactic acid bacteria in her vagina. With the onset of bacterial vaginosis, the number of lactic acid bacteria decreases and pathogenic and opportunistic bacteria begin to develop. They are the ones who can cause the disease. This applies to women with reduced immunity. As a result, there is a decrease in the level of acidity in the vagina.

In the past, many people believed that only one type of bacteria could cause bacterial vaginosis. Therefore, this disease is still called hemophilic or gardnerella dysbacteriosis. It has been established that this disease can be caused not only by some microbe. This disease occurs as a result of a violation of the ratio of different types of bacteria. Therefore, vaginal dysbiosis is not an infectious disease and is not sexually transmitted.

This disease is observed mainly in women aged 35-40 years. It is impossible to determine how common this disease is. According to statistics, vaginal dysbiosis affects every third woman throughout her life.

Today there are many causes of dysbiosis. For example, stress contributes to the occurrence of disturbances in the vaginal microflora. The most common causes of dysbiosis include:

When the above factors occur, the vaginal microflora is disrupted. Of course, a woman’s immune system is capable of maintaining normal microflora and restores it when minor disturbances occur.

Preventive actions

To prevent the occurrence of this disease, the following preventive measures must be taken:

implement measures aimed at the general prevention of dysbacteriosis. To do this, you need to eat properly and adhere to a healthy lifestyle;
do not use douches and contraceptives that contain nonoxynol;
if you have casual sexual contact with a non-regular sexual partner, you must use condoms;
do not take Terzhinan, Polygynax, Betadine tablets. This can lead to vaginal dysbiosis. These drugs contain antibacterial agents that have a wide spectrum of action. They also help suppress the normal vaginal microflora;
during treatment it is necessary to limit yourself from sexual intercourse;
For prevention, men also need to take special medications. The action of these drugs is aimed at improving the microflora.
This disease is not a sexually transmitted disease and cannot be transmitted sexually.

Diagnosis of the disease includes:

microscopy - vaginal smear;
determination of vaginal discharge;
test based on potassium hydroxide.

What treatment is prescribed for vaginal dysbiosis

First, the woman undergoes a gynecological examination and undergoes a series of tests. Most doctors prescribe only antibiotics. But treatment must be comprehensive. We need to get rid of bad bacteria and restore the number of good bacteria. The following treatment is used:

use of vaginal suppositories;
taking tablets that have an antiseptic effect;
the use of physiotherapy;
use of bioadditives.

Many people consider dysbiosis not such a dangerous disease. The occurrence of this disease is accompanied by miscarriage, termination of pregnancy, and premature birth. Infection occurs in the fetus after childbirth. Dysbacteriosis causes discomfort in your personal life, negatively affects your mood, and much more.

Some patients resort to traditional methods of treatment. But folk recipes only help relieve the symptoms of the disease. Medicinal herbs only help strengthen the immune system. In this case, this applies to herbal infusions and teas.

To restore the acidic environment of the vagina, douching is used. A solution of boric acid is used. Douching is carried out daily for a week. Douching using herbal infusions has a good effect.