Treatment of dysbiosis in women. Restoration of vaginal microflora: causes of disorders, treatment and further prevention

Violation of the vaginal microflora has bothered every woman at least once in her life. Girls who have never been sexually active also face this disease. The disease is asymptomatic, but can cause the most severe consequences, accompanied by an inflammatory process. Gynecologists call the pathology dysbiosis or dysbacteriosis.




Dysbiosis is defined as a violation of the microflora of the vaginal environment. If left untreated, the disease will progress, causing a number of very negative consequences.


Violation of the vaginal microflora does not manifest itself in any way at the first stage. The secretions change only slightly. In a normal state, a woman does not have them, and if they do, they are in small quantities. With a healthy microflora, there are no stings, pain, odor, burning sensation, dryness during sexual intercourse or discomfort.


An unpleasant odor and an increase in the amount of whitish-yellowish discharge indicate the presence of a pathology such as a violation of the vaginal microflora. Why is this happening? This will be discussed further.


Normal microflora consists of 90% lactobacilli and 9% bifidobacteria. The remaining 1% is made up of opportunistic microorganisms that rarely cause any disease. A woman’s body can easily tolerate minor changes, especially with good immunity. In case of serious disorders, where the number of lactobacilli and bifidobacteria decreases, and the percentage of opportunistic microorganisms increases, the reproductive system may fail. As a result, harmful bacteria such as fungus, gardnerella, streptococcus, proteus, E. coli, chlamydia, etc. multiply. Vaginal dysbiosis occurs and, as a result, an inflammatory process. The immune system continues to fight pathogenic bacteria, but without treatment, the body’s protective functions no longer provide the desired effect.


If dysbiosis occurs in a latent form, then pronounced symptoms are rarely observed. Without tests and a doctor’s examination, it can be difficult to recognize a disease of this type. Therefore, women are recommended to visit a gynecologist twice a year.



  • Single and constant hypothermia, which reduces immunity and contributes to the development of dysbacteriosis.

  • Changes in hormonal levels. Unsystematic sexual life, menopause, pregnancy, childbirth, abortion, menstrual irregularities, etc.

  • Change of climatic zones.

  • Stressful situations.

  • Chaotic sex life. Frequent change of sexual partners. Ignoring contraceptive methods.

  • Inflammatory and infectious diseases of the pelvis.

  • Infections acquired after sexual intercourse.

  • Long-term treatment with antibiotics.

  • Intestinal diseases.

  • Improper insertion and use of menstrual tampons.


The symptoms of the disease will help to recognize a violation of the vaginal microflora in time. Although in many cases, especially at the initial stage of the disease, they are simply absent. If bacteriosis begins to progress, the following may occur:


  • white and yellow discharge;

  • unpleasant odor;

  • discomfort in the genital area;

  • dryness during sex;

  • burning, itching and pain in the genital area.

These are the main signs of a violation of the vaginal microflora. If dysbiosis is not treated, endometritis, inflammation of the appendages, cervix or vaginal walls may occur. If the infectious process affects the genitourinary organs and urethra, then, as a rule, cystitis or urethritis develops.



Pregnancy and hormonal changes can provoke an acute stage of vaginal dysbiosis. During pregnancy, the symptoms of the disease worsen. There is an abundance of discharge, an unpleasant odor, itching and burning in the genital area, and pain occurs during sex.


Many drugs are contraindicated for women during pregnancy, so it is not possible to carry out full treatment here. All actions are aimed only at temporary elimination of symptoms, and the necessary treatment with antibiotics is carried out after delivery.


Vaginal microflora may be disrupted after childbirth. How to treat a patient in this situation? This issue can only be decided by a doctor. Often, young mothers are diagnosed with thrush, which is caused by a yeast-like fungus of the genus Candida. This process is influenced by hormonal changes in the body, as well as a number of medications that the woman giving birth was forced to take.


In this case, therapy is carried out with antifungal agents in combination with probiotics, which have a positive effect on the vaginal microflora and prevent the secondary appearance of the disease.



Often, an imbalance in the vaginal microflora does not affect a woman’s sex life and does not cause any special problems for her sexual partner. The exception is the advanced stage of dysbiosis. In this case, the man may develop signs of balanoposthitis or nonspecific urethritis, and then only if the stronger sex has a predisposition to the disease.


As a rule, diseases of the sexual partner do not affect the woman’s vaginal environment; of course, we are not talking about sexually transmitted diseases.


Treatment of vaginal dysbiosis is carried out only in women, without the involvement of a partner, unless the pathology is caused by a sexually transmitted infection.


If STDs occur, they are accompanied by severe dysbiosis. Cause an imbalance in the vaginal environment. They provoke the appearance of an inflammatory process and disrupt the microflora of the vagina. However, there are no situations where the causative agent is only a sexually transmitted infection. The disease is always accompanied by negative changes in the opportunistic microflora. This should be taken into account in the fight against the disease. Here, taking antibiotics alone is unlikely to help, since it will not restore the normal level of microflora.


The course of treatment should always end with pribiotics that restore the vaginal environment. Serious problems caused by chlamydia and trichomonas are solved through antibacterial therapy, after which it is necessary to restore the microflora. These courses must be divided and taken one after the other.


In situations where the disease is mild, a urogenital diagnosis should be performed. And the necessary background can be restored simultaneously with the elimination of sexually transmitted infections.



Violation of the vaginal microflora occurs even in girls who have never had sexual intercourse. A variety of factors come into play here. These include hormonal changes in the body during puberty, the structure of the hymen, non-compliance with hygiene rules (including improper washing of the genitals), and the use of antibiotics and other drugs. The reasons in this case are similar to the factors contributing to the development of dysbiosis in women who are sexually active. But there are also nuances.


Unlike women, girls rarely experience heavy discharge, since the hymen does not allow it to come out of the vagina in full. A certain part of them accumulates in the pelvis, which causes an inflammatory process. Also, at the beginning of the development of sexual activity in girls, a lot of bacteria enter the urethra from the vagina, which can cause “honeymoon cystitis.”


Therapy for dysbiosis in virgins is quite complicated, since the hymen does not allow for thorough treatment of the vagina. In some cases, even a hymenectomy is indicated, in which the hymen is broken.


Often, some diseases of the stomach and intestines lead to disruption of the microflora both in the intestinal walls and in the vagina.


The rectum is in close contact with the vaginal cavity, as a result, bacteria easily pass through the walls of the organs. When intestinal dysbiosis develops and progresses, bacteria (Escherichia coli, enterococci, etc.) that cause this disease easily penetrate the walls of the vagina, where they also disturb the background. What to do in such a situation? Of course, contact a specialist, in no case resorting to “amateur” and the help of folk remedies.


Treatment of vaginal microflora disorders in this case is a complex process, since the likelihood of a new infection is quite high. Here simultaneous therapy of both the vagina and intestines should be carried out. This is the most severe form of dysbiosis.



In order for treatment to produce results, the disease must be correctly diagnosed. First of all, a gynecological examination of the patient is performed. Then tests are ordered. Typically this is:


  • PCR diagnostics, which allows you to verify the absence or presence of sexually transmitted infections;

  • a smear on the flora, indicating the state of the vaginal microflora;

  • culture of vaginal discharge;

  • The patient's sensitivity to antibiotics is determined.

The laboratory data obtained allows us to establish the cause of the disease and the degree of its complexity.



  • Destroying pathogenic bacteria that caused this disease.

  • Restoration of vaginal microflora.

  • Boosting immunity.

If dysbiosis occurs due to sexually transmitted infections, then the causative agent of the disease is first eliminated by prescribing a course of antibiotics. If a violation of the vaginal microflora is caused by another reason, then antibiotics may not be used. And if such therapy is prescribed, it is for a period of no more than five days.


It is very important to carry out external procedures in case of dysbiosis. These are various baths and tampons. Such measures inhibit the development of pathogenic microorganisms and restore immunity. Treatment of vaginal microflora disorders with antiseptics - in this case they are used topically - is much more effective than antibiotics, and their area of ​​influence is much wider. Almost all bacteria are susceptible to their influence. Antiseptics also help develop the immunity of the vaginal walls and normalize its microflora. Inhibits the proliferation of pathogenic bacteria.


An advanced form of dysbiosis is difficult to cure with immunomodulatory therapy alone; in addition, antibiotics are almost always prescribed.



Violation of the vaginal microflora (drugs are usually prescribed in the form of ointments, suppositories, vaginal tablets and creams) is a rather complex disease that often requires an integrated approach.


Dalatsin cream, which is an antibiotic with a broad spectrum of action, is often used to treat dysbiosis. The active ingredient is clindamycin phosphate 2%. He

intensively affects the vaginal microflora. Dalatsin suppositories also effectively restore the background in case of pathologies such as disturbances of the vaginal microflora. They contain up to 100 mg of antibiotic.

Flagyl suppositories provide good results for vaginal dysbiosis. The drug is used once a day, at night. Also, to treat the disease, doctors recommend using Hexicon - these are suppositories with chlorhexidine. They are inserted into the vaginal cavity once a day. Course - 10 days.


To treat vaginal dysbiosis, many today choose Betadine and Terzhinan suppositories. Metronidazole gel also gives a good effect.


If the disease is advanced, and only topical drugs cannot be used, then tablets are prescribed for oral administration. This:


  • "Ornidazole".

  • "Naxojin."

  • "Meratin".

  • "Tiberal".

  • "Tinidazole."

  • "Trichopol" or "Metronidazole".

  • "Clindamycin."

Medicines are taken for a week. It should be remembered that when using oral medications, alcohol consumption is prohibited. This is especially true for Trichopolum.


In combination with other medications to normalize the microflora, the following are prescribed: “Linex”, “Probifor”, “Bifidumbacterin”, “Bifiform”, “Bifidin” or “Bifiliz”. To increase the number of lactobacilli in the vaginal environment, Acylact, Lactobacterin, Acepol, etc. are prescribed. It is recommended to take the medicine in a course, starting from the second day of taking antibacterial agents. They also prescribe drugs to maintain immunity - “Immunal”, “Cycloferon”, etc.


If the cause of microflora disturbance is sexual intercourse, then the sexual partner should also be examined and treated.


Treatment of dysbiosis can take up to four weeks. In some cases, it can be difficult to prevent this disease, since the real cause of the disease is difficult to establish. The only thing a woman can do is strengthen her immune system and follow the necessary rules of hygiene.


After restoring the vaginal microflora, you should visit a gynecologist every three months for a year. This is necessary in order to detect a relapse in time and take appropriate measures. In the future, under normal circumstances, you can see a doctor once a year.



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09.02.2013 DISTURBANCE OF VAGINAL MICROFLORA: CAUSES, SYMPTOMS, TREATMENT

What is a violation of the vaginal microflora? Disturbance of the vaginal microflora (vaginal dysbiosis, vaginal dysbiosis) is a phenomenon associated with the functioning of the female reproductive system. Violation of vaginal microflora: symptoms, treatment depend on many factors. Such factors include the general condition of the patient, the course of concomitant diseases, diet, quality of sexual life, etc. Disturbance of the vaginal microflora is manifested by whitish discharge from the vagina. Such discharge may have different consistency, odor and abundance. Such discharge may be a normal part of the vaginal cleansing process of a healthy woman. But vaginal discharge may also indicate a pathological process, including vaginal dysbiosis.

According to statistics, a violation of the vaginal microflora occurs in every second woman. Such a disorder can occur in mature women after the onset of menopause, in middle-aged women with an established sex life, in girls before the onset of sexual activity, in girls before the onset of the menstrual cycle. Vaginal dysbiosis often goes unnoticed. A woman may not suspect a violation of the vaginal microflora for a long time. An asymptomatic course is dangerous due to its complications. It is complications in asymptomatic cases that force the patient to go to a specialized clinic.

Normally, a woman’s vagina is inhabited by normal, non-pathogenic microflora. This microflora ensures the functioning of the genital organs. The vaginal microflora consists of approximately 90% lactobacilli, 9% bifidobacteria and less than 1% other opportunistic microorganisms. Opportunistic microorganisms normally do not provoke the development of the disease, but under the influence of predisposing factors they can cause the disease. Opportunistic microorganisms cover the walls of the vagina. These include fungi of the genus Candida, Gardnerella and some other microorganisms. The body of a healthy woman controls the ratio of microorganisms in the vagina and does not allow the appearance of uncharacteristic microflora. At the same time, the immune system does not react in any way to representatives of the characteristic microflora of the vagina. If minor changes occur in the vaginal microflora, the microflora will resume on its own. This process does not affect the woman’s health in any way. Exposure to predisposing factors and disruption of the vaginal microflora reduces the number of lactobacilli and bifidobacteria. At the same time, there is an increase in the amount of opportunistic microflora, and pathogenic microorganisms also appear. Such a microorganism can be gardnerella, a fungus of the genus Candida, a sexually transmitted infection (trichomoniasis, chlamydia, gonorrhea, etc.), as well as another pathogen from the environment (staphylococcus, streptococcus, Proteus, E. coli, etc.). Such microorganisms, when multiplying and living, cause inflammation of the vagina. Inflammation depends on the woman’s level of immunity, the general condition of her body, the number of pathogenic microorganisms, etc. In the absence of treatment for inflammation and in the absence of therapy against pathogenic microorganisms, the disease will progress.

Symptoms of vaginal microflora disorders

Violation of the vaginal microflora, as mentioned above, is often asymptomatic. For a long time, a woman may not even be aware of a violation of the vaginal microflora. But still, a violation of the vaginal microflora provokes a number of symptoms. Thus, various types of vaginal discharge may be observed. Often women ignore this symptom or do not notice it at all. The discharge is not accompanied by dryness of the vagina and external tissues of the genital organs, or discomfort during sexual intercourse. Over time, the amount of discharge increases and such discharge acquires a characteristic odor. If other symptoms are observed, they refer to symptoms of concomitant diseases. After all, dysbacteriosis is often the cause and predisposing factor to the development of sexually transmitted diseases, erosion processes, inflammatory processes, tumor growth, etc.

Complications of microflora disturbances include: inflammation of the vaginal walls (vaginitis), inflammation of the cervix (cervicitis). These complications occur most often. Symptoms of inflammation include an increase in vaginal discharge, the appearance of unpleasant sensations when urinating, the appearance of unpleasant sensations in the perineal area (itching, burning, pain, stinging, etc.), pain during sexual intercourse or after sexual intercourse, and other symptoms. Pain during sexual intercourse occurs due to vaginal dryness and insufficient secretion. Long-term infection can spread to all internal genital organs. This can cause inflammation of the uterus (endometriosis), inflammation of the uterine appendages (adnexitis). Infection and pathogenic bacteria can enter the urethra. Penetration of pathogenic bacteria into the urethra provokes the development of cystitis and urethritis.

There are many reasons for the development of vaginal microflora disorders. Violation of vaginal microflora: symptoms, causes, treatment - every woman needs to avoid predisposing factors. It is better to prevent the development of a disease than to treat its consequences.

Violation of vaginal microflora - causes:

Local or general hypothermia. Hypothermia causes a decrease in immunity and is reflected in the ratio of microorganisms in the vagina.

Hormonal imbalances. Hormonal imbalances occur with irregular sexual activity, menstrual irregularities, puberty, pregnancy, after childbirth, abortion, with the onset of menopause, etc. A sharp change in hormonal levels is reflected in the condition of the genital organs.

Change of climate zone. A change in climate zone or a sharp change in climate provokes an exacerbation of dysbacteriosis.

Sexual infections. Sexual infections can be both a cause and a consequence of disturbances in the vaginal microflora.

Inflammatory process of the pelvic organs. The inflammatory process of the pelvic organs provokes the occurrence of specific symptoms, and the cause of inflammation can be an imbalance of microorganisms in the vagina.

Taking antibiotics. Long-term use of antibiotics disrupts the vaginal microflora and destroys not only harmful microorganisms, but also beneficial microorganisms. Therefore, with long-term use of antibiotics, it is necessary to colonize beneficial microorganisms in the vagina (which should be done by an experienced gynecologist).

Failure to comply with the rules of personal hygiene or sexual hygiene. Failure to maintain hygiene can cause the introduction of pathogenic microflora into the vagina.

Intestinal disease (intestinal dysbiosis). The intestinal microflora is associated with the vaginal microflora. Therefore, the presence of one of them causes a violation of the other.

Poor hygiene during menstruation. Poor menstrual hygiene involves the improper use of tampons and pads during menstruation. It is recommended to replace menstrual hygiene products every two hours. If you ignore the recommendations, then favorable conditions are created for the proliferation of opportunistic vaginal microflora, as well as for the development of inflammation.

The above factors do not always lead to disruption of the vaginal microflora. After all, a woman’s immune system is able to control and regulate the vaginal microflora if it changes. But still, it is better to avoid predisposing factors.

Violation of vaginal microflora - treatment

Treatment of vaginal microflora disorders is based on the results of preliminary diagnostics. For diagnostic purposes, the following tests are carried out: flora smear, PCR test, culture of vaginal discharge with determination of sensitivity to antibiotics. A flora smear allows you to determine the state of the vaginal microflora and identify inflammation. The PCR test allows you to determine the type of microorganism that caused the microflora disturbance. Bacterial culture also allows one to identify the pathogen and determine its sensitivity to antibiotics. In parallel with laboratory tests, an ultrasound examination of the pelvis and calposcopy are performed. Ultrasound examination of the pelvis allows you to assess the condition of the genital organs, their shape, the presence of tumors, etc. Cytoscopy allows you to assess the condition of the vaginal walls and identify uncharacteristic changes in the epithelial cover of the vagina. High-quality diagnostics are simply necessary. After all, 90% of treatment depends on the results of the diagnosis.

Treatment of vaginal microflora disorders includes:

Suppression of pathogenic and opportunistic microorganisms. If a violation of the vaginal microflora is associated with a sexually transmitted infection, then treatment is aimed at the complete destruction of such an infection. In this case, treatment includes a course of antibiotics. But if genital infections are not caused by a violation of the vaginal microflora, antibiotics are not prescribed. Sometimes a short course of antibiotics is prescribed. Local procedures are considered very effective in treating vaginal microflora disorders. This is how special tampons, suppositories, creams, ointments, special baths, etc. are prescribed. Such drugs combine all the objectives of treatment: suppression of pathogenic microflora, restoration of normal vaginal microflora, correction of immunity. It is worth noting that in the treatment of vaginal microflora, the use of antiseptics is much more effective than the use of antibiotics. The effectiveness of antiseptics is explained by the broad action and immunity of bacteria to antiseptics.

Restoration of normal microflora. In order to restore the vaginal microflora, special vaginal preparations are used. Such drugs allow you to populate the vagina with useful and necessary microorganisms, as well as restore the vaginal walls.

Restoring the immune system of the vagina. Restoring the immunity of the vaginal wall will help maintain the normal composition of the vaginal microflora. For this purpose, various systemic and local drugs are used. It is not recommended to restore immunity on your own. Drugs that correct immunity have contraindications for use and specific application. Advanced forms of the disease require a serious approach to treatment. Immunostimulants are often combined with antibiotics. This treatment takes on average several weeks (2-4 weeks). It is worth noting that when treating vaginal microflora disorders, it is recommended to conduct a study of the health status and sexual partner of the sick woman. After completion of treatment, control studies are carried out. Control studies make it possible to confirm the quality of treatment and confirm the elimination of predisposing factors to relapse of vaginal dysbiosis.

You can prevent disruption of the vaginal microflora by following the rules of prevention. For the purpose of prevention, all women are recommended to visit the office of a gynecologist-endocrinologist at least 1-2 times a year. So, when visiting a specialist, you should report changes in the body, previous diseases, bad habits, etc. This information allows you to timely assess changes in the state of the vaginal microflora. If the gynecologist detects the influence of predisposing factors, he prescribes a number of necessary studies. Also, measures to prevent violations of the vaginal microflora include: timely treatment of sexually transmitted infections; timely treatment of acute diseases; proper nutrition; rejection of bad habits; use of mechanical contraceptives; having one sexual partner, etc.

Experienced doctors, including a gynecologist-endocrinologist, practice at the Hippocrates clinic. With us you can undergo the necessary examinations, as well as undergo treatment of gynecological diseases using modern methods. Our specialists accept appointments by appointment. You can make an appointment at any time by phone. Take care of your health.

Flora smear in women- a laboratory test that determines the types of bacteria that are present in the vagina. This is the most common and simplest method for detecting inflammation and STDs (sexually transmitted diseases).

The examination is absolutely painless. It is performed during a routine gynecological examination. The doctor takes the material with a disposable spatula from the walls of the vagina and cervix. The contents of the vagina (vaginal secretions) are applied to the glass. In the laboratory, the material is stained so that the bacteria become clearly visible.

Purpose of the study

  • determine the state of the vaginal microflora;
  • identify sexually transmitted infections and their causative agent;
  • determine the degree of the inflammatory process;
  • assess the degree of cleanliness of the vagina, which is mandatory before further diagnostic studies and gynecological operations - cauterization of erosions, removal of polyps, curettage;
  • assess the health status of pregnant women.

When does a gynecologist take a smear for flora?

  • complaints of itching or vaginal discharge, other symptoms of inflammation;
  • preventive examinations;
  • control of the treatment;
  • taking hormonal drugs and immunosuppressants;
  • control of microflora during long-term use of antibiotics;
  • pregnancy. It is carried out 3 times during pregnancy (at registration, at the 30th and 36th week).
This study has many names: smear for flora, general smear, bacterioscopy, smear for cleanliness. There are also smears on the flora from the urethra and cervical canal. Usually these three types of smears are performed together.

Normal vaginal microflora

A healthy woman's vagina is not sterile. It contains many types of microorganisms, their totality is called microflora. Bacteria constantly compete with each other for habitat on the walls of the vagina and for food.

The most numerous are lactobacilli and bifidobacteria, which attach to the vaginal epithelium. They produce alcohols, peroxide, lactic and other acids, which provide an acidic reaction in the vaginal secretion. As well as lysozyme and other enzymes that inhibit the proliferation of other types of bacteria.

Microorganisms that make up the microflora of a healthy woman

Microorganisms Number of CFU/ml
Lactobacilli or Doderlein sticks Lactobacillus spp. 10 7 -10 9
Bifidobacterium Bifidobacterium spp. 10 3 -10 7
Clostridia Clostridium spp. Up to 10 4
Propionibacterium spp. Up to 10 4
Mobiluncus Mobiluncus spp. Up to 10 4
Peptostreptococcus Peptostreptococcus spp 10 3 -10 4
Corynebacterium spp. 10 4 -10 5
Staphylococcus Staphylococcus spp. 10 3 -10 4
Streptococci Streptococcus spp. 10 4 -10 5
Enterobacteriaceae 10 3 -10 4
Bacteroides spp. 10 3 -10 4
Prevotella spp. Up to 10 4
Porphyromonas Porphyromonas spp. Up to 10 3
Fusobacterium Fusobacterium spp. Up to 10 3
Veilonella spp. Up to 10 3
Mycoplasma M.hominis Up to 10 3
Ureaplasma U.urealyticum 10 3
Candida - yeast-like fungi 10 4

Abbreviation CFU/ml means - colony-forming units in 1 ml of nutrient medium. Each colony-forming unit is a microorganism from which a colony can form.

The number of bacteria is expressed in decimal logarithms in order to avoid writing numbers with a large number of zeros.

In the description of vaginal microflora one can often find the names gram-positive or gram-negative bacteria. These terms mean that the first bacteria are stained according to the method developed by the microbiologist Gram, while the others do not change their color.

Gram-positive rods in a smear, which include lactobacilli, are a good sign. Normally, they predominate in women of reproductive age. During menopause (menopause) and postmenopause, gram-negative bacteria come first.

Depending on their oxygen demand, bacteria are divided into

  • aerobic- those that develop in the presence of oxygen;
  • anaerobic- which do not require oxygen to function.
In the vagina of a healthy woman, most bacteria are anaerobes 10 8 -10 9

CFU/ml.

How to make a smear on the vaginal microflora?

A smear is taken in the gynecologist's office. A woman can also undergo this test in a private laboratory.

The procedure includes several stages.

  1. The woman is placed in a gynecological chair.
  2. Insertion of sterile speculum to gain access to the vaginal walls and cervix.
  3. Collection of material from the posterior wall of the vagina. This procedure is absolutely painless. Unpleasant sensations can only occur when the spatula touches the inflamed area.
  4. Applying material to a glass slide. The vaginal secretion is distributed with streaking movements over the skim glass in the thinnest possible layer so that the cells are arranged in one row and do not cover each other.
  5. Fixation of the smear is necessary if it is delivered to the laboratory after more than 3 hours. The treatment avoids cell deformation during drying and makes it possible to preserve the drug.
  6. Smear staining using the Gram method. Methylene blue is used as a dye. After staining, it is easier to establish the type of bacteria and determine the composition of the microflora.
  7. Evaluation of the result, which consists of 3 parts: counting leukocytes, species composition of microflora, assessment of vaginal cleanliness.
Often, a smear is taken from three points at once:
  • openings of the urethra and paraurethral passages (narrow canals located parallel to the urethra);
  • vaginal walls;
  • cervical canal.
The anatomical proximity of these areas leads to the fact that infections and inflammations occur interconnectedly. For each area, use a separate sterile spatula, brush or cotton swab. The taken material is applied to 3 sterile glass slides, separately for each area.
A vaginal flora smear is an absolutely harmless procedure that is allowed, including for pregnant women. During the collection of material, the mucous membrane is not injured, so there are no restrictions after the procedure. It is allowed to take a bath, swim, have sexual intercourse, etc.

How to prepare for this smear?

It is necessary to take a smear for flora no earlier than 3 days after the end of menstruation. Menstrual blood cells in the smear can interfere with the results. The optimal period is considered to be from the 10th to the 20th day of the cycle.
The result of the analysis will be as reliable as possible if you adhere to the following rules.
  • stop taking antibiotics and antifungal drugs 14 days before;
  • 2 days in advance, stop administering any vaginal forms of drugs - solutions, suppositories, tablets, tampons, ointments, creams;
  • abstain from sexual intercourse for 2-3 days;
  • Before the procedure, you should not douche or wash the inside of the vagina.

What does a smear show on the vaginal microflora?

A smear on the vaginal microflora shows the presence of a number of diseases and pathological conditions.
  • Sexually transmitted infections (sexually transmitted infections). They are evidenced by the presence in the smear of a significant number of ureaplasmas, mycoplasmas, gardenella, gonococci, trichomonas and other pathogenic bacteria.
  • Inflammation vagina(vaginitis, colpitis) or cervical canal(cervicitis and endocervicitis). Evidence of the inflammatory process is a large number of leukocytes in the smear.
  • Vaginal dysbiosis. Violation of the composition of microflora contributes to the development of diseases of the genital area. Dysbacteriosis is diagnosed when the number of lactobacilli decreases and other types of microorganisms begin to predominate.
  • Candidiasis or thrush. Normally, single fungi of the genus Candida are acceptable. With a fungal infection, their number increases sharply, and pseudomycelium is found in the smear - threads of elongated cells and bud cells sitting on them.
The flora smear evaluates the following indicators:


4 degrees of vaginal cleanliness

Degree Identified changes What is he talking about?
I The environment is acidic.
Leukocytes - up to 10.
Epithelial cells - 5-10.
Most microorganisms are lactobacilli (Dederlein bacilli). Other bacteria - sporadically.
Mucus - a small amount.
Ideal state of vaginal microflora. It is extremely rare in women of childbearing age who are sexually active.
II The environment is slightly acidic.
Leukocytes - up to 10.
Epithelial cells 5-10.
Most are Dederlein sticks. Gram-positive cocci in small numbers.
Small amounts of mucus.
Normal condition. Occurs in most healthy women.
III The environment is neutral.
Leukocytes - over 10.
Epithelial cells - over 10.
Microorganisms in moderate or large quantities. Gram-negative and gram-negative rods and cocci are present. Single Dederlein sticks.
"Key" cells are present.
Mucus - moderate amount.
Inflammation of the vagina - colpitis. Symptoms may occur: creamy vaginal discharge, itching, burning, discomfort during sexual intercourse.
Some women are asymptomatic with this condition.
IV The medium is neutral or alkaline, pH over 4.5.
Leukocytes - over 30 or the entire field of view.
Epithelial cells - in large numbers.
Microorganisms in massive quantities. The microflora is represented by various opportunistic and pathogenic microorganisms. Dederlein's rods may be absent.
There is a lot of mucus.
Severe inflammatory process. Symptoms: copious vaginal discharge (white, yellowish, greenish), often with an unpleasant odor. Itching, burning, dryness, discomfort. Unpleasant sensations, pain during sexual intercourse.

What is the norm for a smear on the vaginal microflora?

In smear microscopy for flora, the following is considered normal:
  • flat cells of the vaginal epithelium - up to 10 in the field of view;
  • single leukocytes - up to 10 in the field of view;
  • cells of the intermediate layer are single;
  • “false key” cells - rare;
  • the total number of microorganisms is “moderate”, sometimes “large”;
  • mucus - in small quantities;
  • Lactobacilli predominate among bacteria; other types of microorganisms are rare and rare.
The smear should not contain:
  • Large numbers of destroyed epithelial cells. This indicates cell lysis, which occurs with abnormal growth of lactobacilli.
  • Key cells. These are epithelial cells covered with various bacteria.
  • Parabasal cells. Cells of the lower layers of the mucosa. Their appearance indicates significant inflammation or atrophy of the mucosa.
  • "Massive" amount of bacteria, except lactobacilli.
  • Yeast cells with pseudomycelium and blastopores (bud cells). Their presence indicates thrush.
  • Strict anaerobes - most of them are pathogens.
  • Gonococcus - pathogens of gonorrhea.
  • Trichomonas - causative agents of trichomoniasis.
  • Atypical cells which are a sign of precancerous or oncological changes .
Some microorganisms (chlamydia, various viruses) are not detected when examined under a microscope due to their small size. To identify them, a blood test for ROC is necessary.

What do leukocytes indicate in a smear on vaginal flora?

Leukocytes- These are white blood cells that are designed to fight infection. They can exit through the wall of blood vessels and move independently. Leukocytes have the ability to phagocytose - they engulf bacteria and digest them. Once the bacterium is digested, the white blood cell is destroyed. This releases substances that cause inflammation, manifested by swelling and redness of the mucous membrane.
Normally, the number of leukocytes in the vagina should not exceed 10. A large number of leukocytes indicates inflammation. The higher the number of leukocytes, the more pronounced the inflammatory process.

Why is sensitivity to antibiotics performed when examining a smear?

Antibiotic sensitivity or antibiogram- determining the sensitivity of bacteria to antibiotics. The study is carried out simultaneously with smear culture if pathogenic bacteria that cause inflammation or sexually transmitted infections are detected in the vagina.

There are a large number of antibiotics, but not all of them are equally effective against different groups of bacteria (antibiotics do not affect viruses). It happens that after a course of antibiotics the patient does not recover or the disease returns after a few days/weeks. This happened because antibiotics that had little effect on the causative agent of the disease were prescribed for treatment.
In order for treatment to be as effective as possible, it is necessary to determine which antibiotics:

  • completely destroy the bacteria that causes the disease;
  • stop the growth of the pathogen;
  • do not affect the life activity of this bacterium.
Based on the research carried out, a antibiogram. This is a list of antibiotics to which bacteria are sensitive.

How is antibiotic sensitivity testing performed?

After the bacteria that caused the disease have been identified, they are distributed into several test tubes with nutrient media. A specific antibiotic is added to each tube. The test tubes are placed in a thermostat, where optimal conditions are created for their reproduction.

After cultivation (about 7 days), the growth of bacteria in test tubes is analyzed. Where bacteria are sensitive to the antibiotic, colonies do not form. This drug is optimal for treating the patient. In a test tube where drugs to which antibiotics are insensitive are added, the growth of bacteria is the most intense. Such drugs cannot be used to treat this disease.

What is smear culture?

Smear culture or bacteriological culture (bacteriological culture) of a smear is a laboratory test in which the contents of the vagina are placed in a nutrient medium and optimal conditions are created for the growth of bacteria.

Objectives of the study:

  • identify the causative agent of genital infection;
  • establish the degree of contamination - the number of bacteria in the vagina;
  • monitor the state of microflora after long-term treatment with antibiotics and cytostatic drugs. It is carried out 7-10 days after discontinuation of the drug.
In what case is smear culture prescribed?
  • to all pregnant women upon registration;
  • with inflammatory processes in the genital organs;
  • Gram-negative diplococci were found in the smear - to confirm gonococcal infection (gonorrhea);
  • with vulvovaginitis, recurrent or chronic.

How is microbiological testing performed?

Vaginal discharge is placed in nutrient media - solutions or jelly-like masses that contain nutrients for bacteria. Test tubes and Petri dishes are placed in a thermostat for 3-5 days, where the temperature is constantly maintained at about 37 degrees, optimal for the proliferation of microorganisms.

After cultivation, the laboratory assistant evaluates the results. From each microorganism, during the process of division, a whole colony of bacteria grows. Based on its appearance, the laboratory technician determines the type of pathogen. And by the number of colonies one can judge the concentration of these microorganisms in the vagina. Next, the concentration is compared with normal values.
Those bacteria whose concentration exceeds 10 4 CFU/ml are considered significant. At this concentration, microorganisms can cause disease. If such a quantity of bacteria is detected, the result of the analysis is considered positive.

The conclusion issued by the laboratory states:

  • view microorganism that predominates in the smear;
  • pathogenicity microorganism - ability to cause disease:
  • Pathogenic - the presence of which can only be caused by disease.
  • Opportunistic - bacteria that cause disease only when immunity decreases, with a significant increase in their number.
  • concentration microorganism in the vagina. In numerical terms and in the form of verbal characteristics: “meager”, “moderate growth”, “abundant growth”.
In a laboratory report, the number and growth of bacteria can be characterized by the degree of:
Degree Features of bacterial growth
Liquid culture medium Dense nutrient medium
I Growth is very poor. There is no bacterial growth.
II Moderate growth Up to 10 bacterial colonies.
III Abundant growth. From 10 to 100 colonies.
IV Massive growth. Over 100 colonies.

I degree is the norm. In degree II, they speak of a violation of the vaginal microflora. III-IV degrees indicate a disease caused by this type of bacteria.

every woman needs at least twice a year. In a woman’s life, situations often arise when good advice from an obstetrician-gynecologist, an answer to a question, or a consultation are needed. But even if a woman has no complaints, it must be borne in mind that recently the asymptomatic course of gynecological diseases, including sexually transmitted infections and gynecological tumors, has become very common. Even pathological vaginal discharge does not always occur with such diseases. Without tests, it is difficult to distinguish them from normal discharge. With the hidden course of female diseases, there is no abdominal pain, bleeding, menstrual irregularities and other symptoms. Therefore, every woman needs preventive gynecological examinations and basic tests (general blood test, urine test, smear for flora and cytology), the results of which allow us to identify the presence of hidden asymptomatic gynecological diseases and infections in the early stages. The number of preventive gynecological examinations depends on previous diseases and other factors.

When you need good advice from a doctor, you can come for a consultation with a gynecologist at our gynecological clinic, ask the doctor questions about your health, undergo an initial gynecological examination and, if necessary, further examination and treatment.

Consultation with a gynecologist for early diagnosis of pregnancy

A consultation with a gynecologist and a gynecological examination are also necessary for early diagnosis of pregnancy. The first signs of pregnancy are inaccurate and often mislead women. During pregnancy, menstrual-like vaginal discharge is possible, and pregnancy tests may be falsely negative. For an accurate early diagnosis of pregnancy, a consultation with a gynecologist, pelvic ultrasound and determination of the hCG level in a blood test are necessary.

A good gynecologist is, first of all, a good diagnostician. Diagnosis of gynecological diseases is based on experience and knowledge. During the initial gynecological examination, the gynecologist will determine whether there is a need for more detailed diagnostics and consultations with other doctors. According to your indications, you will receive all the necessary treatment recommendations and referrals for tests. This will allow you to dispel many fears and doubts, notice unfavorable changes in women’s health in time, take measures to correct them, and begin treatment on time.

A woman is sometimes scared or ashamed to come to a consultation with a gynecologist and a gynecological examination. She is frightened by the examination procedure, and even by the sight of the gynecological chair. However, it is advisable for even a healthy woman to visit a gynecological clinic twice a year. The main task of an obstetrician-gynecologist at a gynecological clinic is to preserve the health of a woman, which is only possible through the prevention of gynecological diseases and their timely detection in the initial stages. At an appointment with a gynecologist in our gynecological clinic, you will forget about the fear of a gynecological examination. The polite staff of the clinic does everything possible to quickly and efficiently provide you with the necessary medical services.

Features of gynecologist consultation. Gynecological examination

Every healthy woman should undergo a gynecological examination twice a year to maintain her health, prevent and identify gynecological diseases in the early stages. To avoid the development of sexually transmitted diseases, infectious diseases and gynecological tumors, it is better not to postpone a visit to the doctor, but to come for a preventive examination and consultation with a gynecologist.

The gynecologist must know the individual characteristics of your body, all the gynecological diseases that you have suffered. Communication with a gynecologist at an appointment should be easy and confidential. Every woman should have her own obstetrician-gynecologist.

It is advisable to come to a gynecologist’s consultation for the first time at the age of 15-16 years, especially if the girl has not yet started her menstrual cycle. It is also necessary to come to an appointment with a gynecologist if a woman has already begun or plans to begin sexual activity. Gynecologists advise not only to undergo a preventive gynecological examination twice a year, but also to undergo basic tests, especially when a new sexual partner appears, to do colposcopy and gynecological ultrasound, because the asymptomatic (hidden) course of gynecological diseases is very common and difficult to diagnose. Many gynecological diseases, if not treated promptly, can lead to infertility, ectopic pregnancy or miscarriage.

Stages of consultation with a gynecologist and gynecological examination

Questions for a gynecologist

You can come for a consultation with a gynecologist and a preventive gynecological examination if you have no complaints or already have certain complaints. A consultation with a gynecologist begins with a conversation. First, the gynecologist asks questions and fills out a medical record. By asking questions, the gynecologist will find out what problem the woman came to the doctor’s office with. It is important for a gynecologist to know what diseases a woman has had throughout her life, which will tell him about her predisposition to certain diseases. Some questions may seem too intimate or unnecessary, but they must be answered absolutely honestly. Answer all the gynecologist's questions and do not hesitate to ask him questions, because the state of your health depends on it.

External gynecological examination

A consultation with a gynecologist may include procedures such as measuring blood pressure, determining weight, and examining the mammary glands. After which the gynecologist proceeds to a gynecological examination of the female genital organs. To do this, the woman needs to lie down in a special gynecological chair. The gynecologist conducts an external examination to identify possible discharge, irritation, rashes, condylomas, gynecological tumors and other pathological changes in the external female genitalia. Having completed the external gynecological examination, the gynecologist proceeds to the internal gynecological examination.

Internal gynecological examination

During an internal gynecological examination, an obstetrician-gynecologist inserts disposable plastic speculum into the vagina to examine the cervix. The gynecologist also evaluates the presence of discharge and other pathological processes. After removing the speculum from the vagina, the gynecologist performs a vaginal examination. The gynecologist inserts the fingers of one hand, dressed in sterile disposable gloves, into the vagina. The gynecologist places his other hand on the anterior abdominal wall. Thus, the doctor notes the size, shape, position, mobility, pain of the uterus and appendages, and draws attention to the presence of pathological space-occupying formations in the pelvis. If you experience pain when palpating, you should immediately inform your gynecologist, as this may be a sign of an inflammatory or other gynecological disease. Sometimes a gynecologist can perform a rectal examination (for example, when examining virgins) when the data from other examinations is insufficient.

Taking a smear for flora during an internal gynecological examination

A mandatory stage of a preventive gynecological examination should be taking a smear. A bacteriological study is a study of a smear of gynecological discharge. The number of leukocytes is counted in the smear and pathogens are looked for. More than 10 leukocytes in the field of view may indicate the presence of a sexually transmitted infection or inflammation of the female genital organs. Based on the results of the smear, fungi (candidiasis), “key cells” (bacterial vaginosis), changes in the normal flora in the discharge due to vaginal dysbiosis can be detected. The gynecologist prescribes culture of discharge and PCR diagnostics of discharge to clarify the causative agent of the infectious process if a smear shows the presence of infection, but does not identify its causative agent.

Taking a smear for cytology during an internal gynecological examination

Cytological examination (cytology) is a mandatory stage in the early diagnosis of cervical diseases and a mandatory analysis carried out before its treatment. Even if nothing bothers the woman and the cervix seems unchanged to the naked eye, the woman should regularly (every year) undergo a cytological examination of cervical scrapings. The gynecologist takes a scraping during an internal gynecological examination. The scraping is taken with slight pressure, while the deeper layers of cells are scraped off. This is a painless procedure. This is done because the malignant process begins from the lower layers of the cervical epithelium and progresses to the surface of the mucous membrane. Therefore, if only the superficial layer is included in the analysis, a diagnosis can only be made when the disease is already at a late stage of development.

Colposcopy

Colposcopy is an examination of the cervix under a special microscope - a colcoscope. The gynecologist uses colposcopy during an internal gynecological examination in order not to miss the initial signs of a malignant tumor, if nothing bothers the patient and the cervix seems unchanged to the naked eye.

Colposcopy has enormous diagnostic value in cases of suspected cervical cancer, for diagnostics erosions cervix, dysplasia, leukoplakia. Only extended colposcopy can help make an accurate diagnosis of cervical disease in the early stages and determine its malignancy.

Extended colposcopy is an examination of the cervix after treatment with a 3% acetic acid solution. The action of acetic acid lasts about 4 minutes. After studying the collopscopic picture of the cervix treated with acetic acid, the gynecologist performs the Schiller test - smearing the cervix with a cotton swab moistened with 3% Lugol's solution. The iodine contained in the solution stains glycogen in the cells of healthy, unchanged squamous epithelium of the cervix dark brown. Thinning cells (atrophic age-related changes), as well as pathologically altered cells in various dysplasias of the cervical epithelium (precancerous conditions) are poor in glycogen and are not stained with iodine solution. Thus, a gynecologist during colposcopy identifies areas of pathologically altered epithelium and, if necessary, marks areas for cervical biopsy.

Ultrasound of the pelvis and fetus

In gynecology, pelvic ultrasound complements the gynecological examination and is used very widely, because with its help, with a high degree of reliability, you can examine the pelvic organs and monitor the development of pregnancy (fetus). Pelvic ultrasound is an examination method that allows a gynecologist to get an idea of ​​all the pelvic organs, including the uterus and ovaries, which is of great importance in the diagnosis of gynecological tumors and inflammation of the female genital organs, and abnormalities of the uterus.

A pelvic ultrasound makes it possible to determine the causes of pathological discharge, uterine bleeding, pain in the lower abdomen and menstrual irregularities that are not visible during a routine gynecological examination.

Ultrasound allows you to determine the presence of pregnancy and fetal abnormalities. Ultrasound also plays a decisive role in the diagnosis of ectopic pregnancy and is necessarily performed before the abortion procedure to confirm the presence of a fertilized egg in the uterine cavity.

Consultation with a gynecologist based on the results of a gynecological examination and tests

To make a diagnosis, a gynecologist compares the results of a gynecological examination with data from anamnesis (the history of the woman’s life and illness), gynecological tests, complaints and the results of other examinations. Therefore, in order to make a diagnosis or ensure the absence of gynecological diseases, a woman needs at least two consultations with a gynecologist.

At the first consultation, the gynecologist performs the gynecological examination described above, colposcopy, pelvic ultrasound and collects material for gynecological tests. If a woman has complaints and symptoms of gynecological diseases, the gynecologist, during the first consultation, recommends to the woman what tests (except smears) she needs to undergo and prescribes symptomatic treatment to reduce the symptoms of the disease (pain in the lower abdomen, bleeding, itching, etc.).

A woman can take many tests during her first gynecological examination, but to take some tests she needs to come to the gynecologist again for fence material for analysis on a certain day of the menstrual cycle, after the necessary preparation or on an empty stomach.

At a follow-up appointment, the gynecologist advises the woman on the results of smears and other tests, if they were taken during the first gynecological examination. Test results may indicate the presence of a gynecological disease in the absence of symptoms, confirm a preliminary diagnosis made during the first examination, or indicate the need for further examination to make a diagnosis.

A complete treatment regimen for a gynecological disease is signed by a gynecologist after diagnosis. After treatment, and sometimes during treatment, a woman needs to come for a consultation with a gynecologist and take gynecological tests again to monitor the results of treatment.

Preparing for a gynecological examination

A woman needs to visit a gynecologist’s office several times a year if she cares about her health. The most optimal period for a preventive examination by a gynecologist is after menstruation. One day before consulting a gynecologist, it is not recommended to be sexually active. It is necessary to take a shower before examining a gynecologist, but douching has a negative effect, because... the doctor needs to see the real condition of the vaginal discharge and take a swab. There is no need to shave your hair before examining a gynecologist. If a woman has taken antibiotics and other medications, then it is necessary to warn the doctor about this. Sometimes testing for infections should take place no earlier than two weeks after the end of treatment in order to get the correct results. If you have to get tested for chronic infections, it is better to do this before or immediately after your period.

A consultation with an obstetrician-gynecologist and examination usually takes about 30 minutes. Try not to be nervous during the examination. Answer all the doctor's questions and do not hesitate to ask him questions, because... The state of your health depends on this.

It is necessary to come to see a gynecologist in the following situations:

    Recently, the asymptomatic course of gynecological diseases, including sexually transmitted diseases, has become very common. Vaginal discharge occurs in such diseases, but more often they are the only symptom and appear periodically. Without analyzes It is difficult to distinguish them from normal discharge. Therefore, every woman needs a preventive examination by a gynecologist at least twice a year.

    Pathological vaginal discharge is the main symptom of almost all gynecological diseases, including sexually transmitted diseases. If they appear, it is necessary to consult a gynecologist with an examination and tests for determining infections, including sexually transmitted ones.

    Uterine bleeding in the middle of the cycle, increased and prolonged bleeding during menstruation. Consultation with a gynecologist with examination and Ultrasound in this case, they are necessary to determine the source of bleeding. Bleeding that occurs during pregnancy requires immediate hospitalization.

    Abdominal pain. In female gynecological diseases, it is most often observed in the lower abdomen. A consultation with a gynecologist with an examination, tests and other examinations are necessary to identify the cause of the pain.

    Problems with conception. Conceiving a child requires preparation. Gynecological diseases can negatively affect pregnancy and the unborn baby. Therefore, it is very important to come for a consultation and examination with a gynecologist to identify and treat them before conception.

    At planning pregnancy a woman needs to come for an examination and consultation with an obstetrician-gynecologist, be examined and take a test in advance tests to identify infections, including - ureaplasmosis. Planning your pregnancy and performing a gynecological examination during pregnancy allows you to avoid complications and unpleasant surprises during pregnancy.

    Diagnosis of pregnancy. The first signs of pregnancy before a missed period are inaccurate and often mislead women. During pregnancy, menstrual-like discharge is possible. In order to diagnose pregnancy in a timely manner, at the slightest suspicion, you need to consult a gynecologist, do an ultrasound and a blood test for hCG.

    Termination of pregnancy (medical abortion). In the event of an unwanted pregnancy, you will receive qualified advice from an obstetrician-gynecologist on how to terminate it. Medical abortion is the least traumatic for a woman.

    Contraception. Every woman should, with the help of a gynecologist, choose the most suitable means of protection against unwanted pregnancy for her. This requires a consultation with a gynecologist with an examination, ultrasound, and, if necessary, hormonal studies and other tests.

    Hormonal disbalance. Often the main cause of diseases of the female reproductive system is hormonal changes (hormonal imbalance). During your consultation, your gynecologist will prescribe the necessary examinations to diagnose hormonal disorders.

    Menstrual irregularities. Ovarian dysfunction is most often a symptom of serious gynecological diseases. A consultation with a gynecologist and an examination is necessary to identify these diseases.

    From symptoms of premenstrual syndrome ninety percent of all women are affected. Before your period a woman may experience many unpleasant and painful sensations that should not normally exist. A woman should not put up with these sensations and suffer in silence; she must come for a consultation with a gynecologist.

    Tides and painful sexual intercourse are the most common symptoms of menopause. During the consultation, the gynecologist will tell the woman how to alleviate the pathological menopause. A very dangerous symptom is the appearance of bloody discharge from the genitals after menopause. When they appear, a woman should consult a gynecologist for an examination immediately.

    Cervical erosion. One of the most common diseases, which may not manifest itself in any way and can only be detected during a preventive gynecological examination.

    Uterine fibroids. It may also not manifest itself in any way and be detected only during a preventive gynecological examination. Asymptomatic progression can lead to severe growth of the node, bleeding and surgical intervention.

    Endometrial hyperplasia often asymptomatic, but more often manifests itself as dysfunctional uterine bleeding. Often the diagnosis of endometrial hyperplasia is made when a woman comes to see a gynecologist about infertility.

    Polyps of the uterus (endometrium) and cervix(cervical canal). In recent years, polyps of the uterus and cervix have been found even in teenage girls. They do not manifest themselves in any way for a long time and over time can become malignant. For their timely detection, every woman needs a consultation with a gynecologist and a preventive examination twice a year.

    Ovarian cyst. During a routine ultrasound examination, a gynecologist may detect an ovarian cyst in a woman. Some cysts may disappear on their own, but in many cases a course of hormonal treatment is required, and in some cases surgery is required to get rid of the source of the danger.

    Spikes are formed when an acute inflammatory process in the female genital organs becomes chronic and the healing process extends over time. Adhesive disease is practically untreatable. Therefore, to avoid the formation of adhesions, if symptoms occur inflammation Immediately come for an appointment with a gynecologist.

    Cervicitis- inflammation of the mucous membrane of the cervix. May manifest as pathological discharge, burning, itching. If the flow is hidden, it may not manifest itself in any way. Therefore, every woman needs a preventive consultation with a gynecologist with an examination at least twice a year. The causative agents of infection are often gonococci and Trichomonas.

    Thrush (or vaginal candidiasis) Caused by yeast-like fungi of the genus Candida. It often becomes chronic due to improper self-medication. To select the correct treatment and identify infections that often accompany exacerbation of thrush, which a woman may not even suspect (including sexually transmitted infections), it is necessary to consult a gynecologist for an examination.

    Vaginal dysbiosis- this is a violation of the normal microflora of the vagina. This disease affects most women; it is often the result of improper self-medication. Dysbacteriosis can lead to the development of inflammatory gynecological diseases. Before prescribing medications to normalize the vaginal microflora, a consultation with a gynecologist, examination and tests is necessary.

    For examination on syphilis a woman can also come for a consultation and examination with a gynecologist . Syphilis is a chronic venereal disease that affects the skin, mucous membranes, many internal organs, bones and the nervous system. Recently, it has often been completely asymptomatic. The RW (Wassermann reaction) used to diagnose syphilis is often false-positive and false-negative and is very outdated.

Advantages of the Demetra Gynecological Clinic

  • The consultation is conducted by highly qualified gynecologists with extensive experience.
  • Considering the frequent imitation of gynecological diseases in the pathology of other organs, close cooperation is carried out between gynecologists and the therapist for the benefit of patients
  • Modern methods of diagnosis and treatment of diseases, incl. laboratory tests, pelvic ultrasound and pregnancy ultrasound, colposcopy
  • Treatment of diseases without hospitalization (outpatient)
  • Convenient location of the clinic in Kyiv: Darnitsky district, near Poznyaki metro station
  • Convenient working hours by appointment only
  • If you have any questions, call us, our employees will provide all the necessary information

Symptoms of the disease manifest themselves differently in women. In general, this condition is characterized by a violation of the ratio of normal microflora of the body and opportunistic microflora.

In adult women, most often with dysbiosis, there is a decrease in lactobacilli in the body and an increase in E. coli and staphylococci.

It is important to know! For successful treatment, it is important to identify this pathology at an early stage of development and prevent its progression. To do this, you should first understand the causes of dysbiosis, and then apply comprehensive treatment of the disease.

Causes of vaginal dysbiosis in gynecology

  • Large number of sexual partners and lack of contraception or use of hormonal contraceptives.
  • Hormonal disorders associated with abortion, menstrual disorders, long absence of sexual intercourse, thyroid dysfunction, as well as any disruption of the ovaries.
Dysbacteriosis in gynecology is quite a common phenomenon, it affects about 75% of women
  • Improper personal hygiene - frequent douching, untimely changing of the tampon, abuse of antimicrobial agents.
  • Stress, nervous breakdowns, excessive fatigue.
  • Long-term use of antibiotics.
  • Climate change, hypothermia.
  • Chronic vaginal infections.
  • General decrease in the body's immunity.
  • Intestinal diseases.
  • Diabetes.
  • Smoking, taking drugs, drinking too much alcohol.

Note! This is not a complete list of reasons characterizing dysbiosis. Symptoms of the disease in women manifest themselves differently, depending on the individual characteristics of the body. Therefore, the causes of the disease, according to information from gynecological reference books, may be different.

Provoking factors for the occurrence of vaginosis

Gardnerellas

In addition to the main causes of dysbiosis, it is important to determine the provoking factors of the disease. These include bacteria, the type of which will help determine the identified symptoms of the disease in women.
The main types of bacteria that cause vaginosis:

  • Streptococci and staphylococci;
  • Gardnerellas;
  • Mycoplasma and ureaplasma;
  • The causative agent of thrush is Candida fungus;
  • Clostridia, Klebsiella, Corynebacterium;
  • Escherichia coli.

When bacteria are present in small quantities, they are harmful to health, but when they multiply and spread, they cause illness.

The main symptoms of vaginal dysbiosis in women

Vaginosis can occur for a long time without any visible symptoms, however as the disease worsens, the following is observed:

  • Vaginal dryness– this condition is very clearly noticeable during sexual intercourse and can give a woman very unpleasant sensations. This condition means the transition of dysbiosis to the pelvic organs. These symptoms can lead to irritability and loss of interest in sex.
  • Discharge. Dysbacteriosis in gynecology is also characterized by symptoms in women such as an increase in clear discharge in the initial stage. As the disease develops, namely an increase in the number of staphylococci and E. coli, they acquire a pungent odor and become greenish.

Symptoms of bacterial vaginosis in women may not appear for a long time. Therefore, it is important to undergo regular gynecological examinations
  • Itching and burning. If vaginosis is aggravated by thrush, a white coating appears on the walls of the vagina, and itching and burning are possible.
  • Pain in the lower abdomen. With a long course of dysbacteriosis, pain in the lower back and lower abdomen may appear; in an aggravated form, frequent painful urination is possible.

You should know! With vaginosis at the initial stage, there are no visible signs of the inflammatory process.

Ignoring vaginal dysbiosis for a long time can lead to more serious illnesses and a significant deterioration in overall health.

Symptoms of vaginal dysbiosis in girls

According to the accepted data of modern gynecology, symptoms of vaginal dysbiosis in girls can appear at any age.

The main reasons for the development of the disease in adolescents:

  • hypothermia;
  • errors in personal hygiene, most often incorrect use of tampons and gels for intimate hygiene;
  • weak immunity;
  • poor nutrition, lack of rest and fresh air, stress;
  • hormonal imbalance during puberty.

In most cases, until adulthood, the main symptoms of the disease are itching and burning in the groin area. Discharge and a specific odor appear in older girls.

If you suspect the development of this disease in a child, you should consult a doctor to determine the causes and treatment program.

Diagnosis of vaginal dysbiosis

Standard diagnosis of dysbiosis includes:

  • gynecological examination;
  • microflora smear;
  • polymerase chain reaction analysis;
  • vaginal seeding.

Before taking a smear, it is important to abstain from sexual intercourse, use of vaginal suppositories and douching for several days.

A smear is taken before the start of treatment and at the end of it.

A PRC analysis must be taken to determine the causative agent of the infection and the number of bacteria in the body. In turn, taking a culture helps determine the properties inherent in the pathogen. It is also necessary to determine the body's sensitivity to antimicrobial agents.

Vaginal dysbiosis during pregnancy

Quite often, dysbiosis in gynecology is characterized by the presence of similar symptoms in pregnant women:

  • discomfort and itching in the vagina;
  • an abundance of discharge that has an unpleasant, sometimes pungent odor.

Stress caused by worry about the child, excessive fatigue, and poor nutrition can lead to dysbacteriosis. The most common cause is hormonal imbalances, which lead to decreased immunity.


Self-medication is prohibited during pregnancy, all procedures must be agreed with the attending physician so as not to harm the baby.

Comprehensive treatment of vaginal dysbiosis

To achieve a positive result, it is necessary to stop the proliferation of pathogenic microorganisms, after which the presence of beneficial microorganisms in the vagina should be increased.

To consolidate the result, you need to strengthen the body's immunity. Treatment of vaginal dysbiosis consists of taking prescribed medications and therapy to restore normal microflora. Let's look at each stage in more detail.

Drug treatment

Let's highlight Some drugs that help treat vaginal dysbiosis and restore microflora:

Drug, price Method of administration Cause
Tiberal (price about 700 rubles)A week twice a day, 500 mlDestruction of pathogenic microorganisms
Tinidazole (pack about 45 rubles)3-4 tablets per day, 6 days
Clindamycin (approximate price 600 rubles)Per day from 600 to 1800 mg three times a day, for a weekAgainst staphylococci and E. coli
Terzhinan (price from 350 rubles)1 tablet in the evening in the vagina, 10 days
Essentiale forte (price from 700 rubles)2 capsules, three times a dayRecovery process

Doctors warn that taking medications that were not prescribed by a specialist can negatively affect the functioning of the body and worsen overall well-being.

Microflora restoration therapy

Violation of the vaginal microflora is directly related to a woman’s immunity, so during treatment it is necessary to pay enough attention to strengthening the immune system.

Most often, restoration of microflora takes no more than 1 month. After completing the course, a re-examination by a specialist is required. If the disease is not in an advanced state, the use of immunomodulators is sufficient for treatment.


In more complex cases, for example, to restore microflora after thrush, it is necessary to take products containing lactobacilli and a component that restores epithelium.

Drugs that help restore the normal vaginal environment:

A drug Mode of application
GynoflorFor a week, one tablet into the vagina before bedtime
LaktoginFor women over 18 years old, one capsule, 10 days
Ecofemin1 capsule twice a day. Take from two weeks to a month
LactobacterinTen days, one vaginal suppository before bed

A rehabilitation course of medication should be discussed with your doctor.

Possible complications of vaginal dysbiosis

If the disease is not treated for a long time, complications are possible, which include:

  • endometritis– inflammation of the uterine cavity;
  • vaginitis– inflammation of the vaginal walls;
  • cervicitis- development of the inflammatory process of the uterus;

  • development of cystitis as a result of bladder infection;
  • adnexitis- inflammation of the appendages.

Most often, the first signs of the onset of the development of such diseases are caused by the appearance of burning and itching, as well as an increase in the amount of discharge.

Traditional recipes for the treatment of vaginal dysbiosis

Dysbacteriosis in gynecology. The use of traditional recipes to treat identified symptoms in women
Name Ingredients Recipe Reception
Douching - no more than 15 minutes. Normalization of the body's condition1. Chamomile and plantain1 tbsp. spoons of herbs, pour a liter of boiling water, leave for half an hour, strainIn the morning and before bed
2.Oak bark1 tbsp. spoon, pour 200 ml of boiling water, leave for three hours, strain, coolDuring the week at night
3. Bird cherry1 tbsp. spoon per 400 ml of water, boil, cook for 20 minutes over low heat, strain and coolOnce a day for a week
Therapeutic sitz baths (waist-deep) – have a calming effect and relieve inflammation1.Oak bark250 gr. leave the collection in cold water for four hours, boil, add to the bathDaily for 20 minutes
2.Flower honey2 tbsp. dilute spoons of honey with 500 ml of hot water and add the mixture to the bath20 minutes every two days
Tinctures to strengthen the immune system1.Quince, cherry, garlic, lemon and applesMash the cherries, grate the quinces and apples, finely chop the lemon, squeeze out the garlic. Mix all the ingredients, pour in 1.5 liters of water, close and let it brew for 30 minutes, then strainFour times a day, 100 ml
2. Dried rowan, honey, onionPour 2 tablespoons of berries into 400 ml of water, cook for 25 minutes, add 2 tablespoons of honey and grated onionOne spoon 4 times a day
3. Purslane leaves, egg whiteGrind leaves and mix with egg whiteDrink three times a day, course 15 days

One should not neglect the fact that to improve the effect of treatment, in addition to the above methods, fresh fruits, vegetables and dairy products should be introduced into the daily diet.


You should take vitamins E and C, which have a positive effect on the balance of microflora.

When using traditional methods of treatment, one should not neglect the consultation of a qualified specialist. This will help you get better treatment.

According to modern gynecology, dysbacteriosis, regardless of the identified symptoms in women, is not transmitted during sexual intercourse and is not classified as a venereal disease. However, it must be treated immediately when the first symptoms are detected.

Useful videos about vaginal dysbiosis from doctors

Dysbacteriosis in gynecology. Symptoms in women:

Bacterial vaginosis, its consequences and treatment: