Vaginal dysbiosis

Vaginal dysbacteriosis is a disorder of the balance of the vaginal microflora. With vaginal dysbacteriosis, the ratio of beneficial and opportunistic bacteria is disrupted, and opportunistic flora begins to significantly predominate.

The composition of the vaginal environment changes both quantitatively and qualitatively, which manifests itself as significant discomfort in the genital area and can provoke the development of inflammatory processes in the reproductive sphere with the addition of various infectious complications. However, in a certain number of women, the imbalance of vaginal microflora can be asymptomatic for some time.

This material will help you understand what vaginal dysbacteriosis is, how to deal with it and how to prevent this unpleasant pathology from appearing in the future.

[ 1 ], [ 2 ]

Causes of vaginal dysbacteriosis

The number of beneficial microflora in the vaginal environment can decrease for several reasons:

• the emergence of favorable factors for the development of fungal infection in the vagina;
• frequent colds and infectious diseases, hypothermia;
• hormonal imbalance associated with puberty, lack of sexual activity, pregnancy, menstrual disorders, artificial termination of pregnancy, menopause, etc.;
• frequent climate change;
• frequent psycho-emotional stress and mental overload;
• violation of sanitary and hygienic standards (failure to observe personal hygiene rules, untimely change of underwear, replacement of tampons and pads, as well as promiscuous sexual relations without the use of a condom;
• inflammatory processes (especially chronic) of the uterus and appendages;
• incorrect or prolonged use of antibiotics;
• disruption of the normal balance of the intestinal environment, frequent bowel disorders;
• the presence of infectious diseases of the genital tract (ureaplasma, chlamydia, trichomonas).

It is especially important to highlight several factors that create favorable conditions for the growth and development of fungal and other pathogenic flora in the vaginal environment. These are the following reasons:

• metabolic disorders (diabetes mellitus, obesity, dysproteinemia);
• thyrotoxicosis, vitamin deficiency, blood system diseases;
• incorrect or prolonged treatment with antibiotics, contraceptives, corticosteroid hormones, cytostatic agents, which provoke a hormonal imbalance and reduce immune protection.

[ 3 ], [ 4 ]

Symptoms of vaginal dysbacteriosis

At first, dysbacteriosis may proceed asymptomatically. However, after some time, the first signs of a pathological condition appear:

• vaginal discharge that was not previously observed;
• itching and discomfort in the vaginal area;
• discomfort during sexual intercourse;
• burning and dryness in the vaginal cavity.

Discharges from vaginal dysbacteriosis have a cloudy pastel yellowish or even greenish tint, as well as an unpleasant putrid odor. Sometimes women do not pay much attention to vaginal discharge, since it is also normal. However, normal discharge is transparent and does not have an unpleasant odor.

Disruption of the microflora in the vagina can be accompanied by inflammation of the bladder (cystitis), adnexitis (an inflammatory process in the appendages) or colpitis (inflammation of the vaginal mucosa), as well as other inflammatory and infectious diseases of the reproductive system.

Vaginal dysbacteriosis in women

Very often, the causes of dysbacteriosis are promiscuous sexual intercourse, neglect of condom use, periodic infection with sexually transmitted infections. If the vaginal flora is within normal limits, the risk of developing an infectious disease of the genitals is reduced to a minimum. The development of a sexually transmitted infection indicates that the balance of microflora has been disrupted, and the body can no longer cope with the invasion of foreign agents.

If a sexually transmitted pathogen appears in the genitals, then at the same time an inflammation process begins in the genital area, and the imbalance of the vaginal environment only worsens. It is important to understand that the infection does not cause the disease by itself, but only together with opportunistic microorganisms that are present in the vagina. Therefore, the treatment of genital tract infection, along with the destruction of the pathogen (Trichomonas, chlamydia, etc.), should be accompanied by measures to restore normal microflora in the vagina. If this is not done, the treatment of bacterial vaginosis may be unsuccessful.

The question of simultaneous treatment of a sexual partner for sexually transmitted diseases should be decided at a specialist appointment, since such treatment is not appropriate and necessary in all cases.

In the future, with successful implementation of measures to restore the vaginal environment, the incidence of infectious diseases of the genital tract can be reduced to a minimum.

[ 5 ], [ 6 ]

Vaginal dysbacteriosis during pregnancy

Very often during pregnancy, hormone-dependent diseases in a woman's body become aggravated. Such diseases include vaginal dysbacteriosis (bacterial vaginosis). It is no secret that pregnant women experience changes in hormonal levels almost daily. Along with this, immune protection decreases, the nature of nutrition and sexual life changes. For these reasons, the development of vaginal dysbacteriosis during this period is a very, very common phenomenon.

Since pregnant women are not recommended to take any treatment before the birth of the child, it is unlikely that dysbacteriosis will be fully cured during this period. Specialists do not allow the use of antibiotics and immunostimulants in pregnant women.

Treatment is limited to symptomatic therapy, dietary correction and personal hygiene. Sometimes local treatment (ointments, douches) is prescribed at the discretion of the doctor.

[ 7 ], [ 8 ], [ 9 ]

Vaginal dysbacteriosis in a child

Vaginal dysbacteriosis is common not only in adults, but also in childhood and adolescence. The causes of the disease can be infectious and non-infectious factors.

At birth, the vagina of a girl who received support from her mother's hormones-estrogens during the intrauterine stage of development, hypertrophies due to the layered squamous epithelial tissue containing glycogen. The vaginal environment indicators during this period can be 5.5-7.0. Such a natural physiological state can lead to the appearance of milky-white discharge of a thick consistency during the first twenty days of life, the amount of which gradually decreases as the active effect of maternal estrogens decreases.

From about the third week of life and up until the onset of the climacteric period, the vaginal mucosa may become atrophic, will not contain glycogen, and the vaginal environment will maintain a neutral or alkaline pH (from 6.5 to 7.4). Such development of pathology favors the development of pathogenic microorganisms.

Vaginal dysbacteriosis in girls can manifest itself in different ways. Small children can scratch and rub the genital area, be capricious during urination or defecation. Older girls describe a feeling of itching and pain. Discharge from the genital slit is unstable and may not be considered the first symptom of dysbacteriosis.

It is necessary to pay attention to the possible entry of foreign bodies into the vagina. In older girls, these may be tampons, napkins. Sometimes irritants are detergents (soap, shower gel or intimate hygiene), deodorants and clothing items. Underwear with a predominance of synthetic fabrics, as well as narrow and tight underwear will only aggravate the problem.

Antibiotic therapy, hereditary predisposition to diabetes, helminthic invasions, skin diseases (psoriasis, eczema, dermatitis) play an important role in the etiology of dysbacteriosis in childhood. These factors can accelerate or contribute to the development of dysbacteriosis.

[ 10 ], [ 11 ], [ 12 ]

Diagnosis of vaginal dysbacteriosis

Standard diagnostics of vaginal dysbacteriosis, in addition to a basic gynecological examination, should include the following tests:

• taking a smear for microflora;
• PCR analysis;
• conducting a culture of vaginal discharge.

The analysis for vaginal dysbacteriosis is taken using a disposable spatula in three places: in the cervical canal, in the opening of the urethra and from the vaginal wall. Before taking such an analysis, a woman should follow some recommendations:

• do not have sex for 1-2 days before taking the smear;
• do not use intimate creams or vaginal suppositories;
• Do not douche or take a bath, do not swim in bodies of water or in a pool the day before the procedure.

Taking a smear for microflora is done, if possible, several times in the same laboratory to avoid differences in norms. It is necessary to take the test before and after treatment.

PCR analysis allows identifying the infectious agent. As a rule, samples of vaginal discharge are used for analysis, which are combined with certain enzymes and placed in a specialized reactor. Such a study not only determines the type of infectious agent, but also allows detecting the amount of infection present in the body. This method determines the presence of chlamydia, ureaplasma, mycoplasma, fungal infection, gardnerella, trichomonas, herpes, etc.

Culture testing (flora culture) allows one to obtain a pure culture of microbes, identify them, and determine the properties of the pathogen.

By means of sowing, it is possible to detect Klebsiella, Escherichia coli, protozoa, coccal flora, enterobacteria, Pseudomonas aeruginosa, Corynebacteria, etc. Simultaneously with sowing, if necessary, sensitivity to antimicrobial drugs is determined.

[ 13 ], [ 14 ]

Vaginal dysbacteriosis after antibiotics

Changes in the composition of vaginal flora are one of the most common consequences after treatment with antibiotics.

Antibiotics are one of the most effective drugs in the fight against various infectious diseases. These medications are able to stop the reproduction and destroy pathogenic microorganisms in a short time, but at the same time they can kill useful microbes, without which the normal functioning of the body becomes impossible. At this point, vaginal dysbacteriosis develops after antibiotics.

To prevent the development of dysbacteriosis, it is necessary to adhere to several rules:

• If the doctor has prescribed antibiotic therapy, it is necessary to strictly follow the treatment regimen, not miss taking pills or injections, and not cancel or extend the course of antibiotic therapy on your own;
• Along with antibiotics, you should take medications that help restore the microflora in the body and contain a complex of live beneficial bacteria.

During antibiotic therapy, it is important to follow a special diet that will protect the body from disruption of the balance of intestinal and vaginal flora. Such a diet involves the consumption of fresh dairy products, vegetables and fruits, as well as the rejection of sweets and alcohol.

[ 15 ], [ 16 ], [ 17 ], [ 18 ]

Treatment of vaginal dysbacteriosis

How to treat vaginal dysbacteriosis? For successful treatment, you will need to resolve several issues:

• stop the growth and reproduction of pathogenic microorganisms that have been detected in the vaginal environment;
• promote the growth of beneficial microorganisms in the vaginal cavity;
• to establish immune resistance of the vaginal wall mucosa.

If the dysbacteriosis phenomena are associated with the detection of an infectious agent, then the main treatment regimen for vaginal dysbacteriosis should be aimed at the complete destruction of foreign microorganisms. In such a situation, antibiotics are prescribed depending on the sensitivity of the detected bacteria. If no sexually transmitted infections have been detected, douching or local application of antimicrobial and antiseptic agents can be used. This method can suppress the growth of pathogenic bacteria, restore normal environmental parameters and local immunity. To suppress the growth of pathogenic microorganisms, antibiotic therapy (taking amoxiclav, sumamed, trichopolum, doxacillin), the use of local antiseptic agents (chlorhexidine, miramistin), and the use of antimicrobial suppositories (ginopevaril, terzhinan) are often prescribed.

Medicines for vaginal dysbacteriosis:

• Trichopolum (metronidazole) 0.5 g orally twice a day for a week. The drug effectively fights infection, prevents the development of complications, but can sometimes cause dyspeptic disorders;
• metronidazole gel (synonyms Metrogyl, Flagyl) - is inserted into the vaginal cavity using a special device (included in the kit) daily before bedtime for five days. This treatment has fewer side effects and is well tolerated by patients;
• clindamycin ointment (synonym Dalacin) - is inserted into the vagina before bedtime for five days;
• the drug clindamycin (dalacin, climicin) - 0.3 g orally twice a day for a week. This drug is often prescribed in the presence of an allergy to metronidazole;
• lactobacterin is a probiotic drug that normalizes the microflora of the vaginal environment, increases immunity and inhibits the growth of pathogenic and opportunistic flora. Before use, lactobacterin is diluted with boiled water and inserted into the vagina in 2.5 to 5 doses over 10-12 days;
• Bifidumbacterin - restores the balance of vaginal flora, inhibits the growth of staphylococci, Proteus, E. coli, Shigella, fungal infections. The powder is taken orally half an hour before meals as prescribed by a doctor, usually 5 doses three times a day.

Suppositories for vaginal dysbacteriosis:

• neo-penotran - antimicrobial vaginal suppositories, which are prescribed for bacterial and trichomonas vaginitis, fungal infections, as well as mixed flora. As a rule, 1 suppository is used before bedtime, the duration of treatment is 2 weeks. Sometimes it is possible to prescribe suppositories for use twice a day: in the morning and at night for a week. The drug cannot be used in the first trimester of pregnancy and in childhood;
• Flagyl suppositories - prescribed simultaneously with oral therapy with metronidazole, administered before bedtime, 1 suppository for 7-10 days. The drug is not recommended for long-term use, as well as for more than 3 courses of therapy per year;
• terzhinan - vaginal tablets that are inserted into the vagina 1 pc./day, duration of use from 10 to 20 days. If necessary, treatment with terzhinan can be carried out even during menstruation;
• ginolact - contains lactic acid bacteria that inhibit the growth of pathogenic microorganisms and activate the natural immune mechanism. One capsule is inserted into the vagina, the duration of treatment is from 3 to 6 days. If necessary, the treatment can be repeated after a week's break;
• acylact is a probiotic containing active acidophilic lactobacilli. Suppositories are used intravaginally, 1 piece once or twice a day. The average duration of the course of treatment is from 5 to 10 days.

For successful treatment of vaginal dysbacteriosis and prevention of relapses, vitamin complexes are prescribed, and it is also recommended to adhere to a diet with predominant consumption of vegetables, fruits, greens, and fermented milk products. Sweets, smoked and spicy foods, and alcoholic beverages are limited.

If you frequently experience signs of vaginal dysbacteriosis, avoid the following products:

• sugar and sugar-containing products, baked goods, sweets, cakes, chocolate;
• yeast baked goods;
• coffee, alcohol;
• chili pepper.

During the course of therapy, it is advisable to abstain from sexual intercourse or use condoms, since often after sexual intercourse the symptoms of dysbacteriosis can intensify.

Folk remedies for vaginal dysbacteriosis

As a folk remedy, it is possible to use infusions of juniper berries, yarrow, sage, eucalyptus, chamomile flowers, and calendula. To prepare an infusion, 1 ½ -2 full tablespoons of dry crushed grass should be poured with 200 ml of boiling water and infused for 40-50 minutes. The remedy can be taken three times a day, 1/3 cup after meals, or used for douching.

These herbs have a strong antimicrobial effect and can be used either on their own or as a mixture in any proportions.

A good remedy for fighting pathogenic microbes is St. John's wort. It can also be used for douching and taking sitz baths. To do this, take 2 full spoons of raw material and pour 200 ml of boiling water, leave for 50-60 minutes.

Soda baths are successfully used to combat fungal infections. To prepare them, mix a teaspoon of baking soda and 50 drops of iodine in warm water. The bath should be taken before bedtime, the duration of treatment is from 1 to 2 weeks.

The following remedy helps well: take 10 cloves of garlic, 100 g of homemade sour cream, 400 ml of apple juice, 200 g of prunes and 200 g of fresh berries (strawberries, raspberries, blueberries). Grind the cloves of garlic, prunes and berries, mix with liquid ingredients and take 1 tablespoon three times a day for 14 days.

Here are a few more recipes for restoring normal vaginal microflora:

• mix aloe juice with vegetable oil in equal proportions, soak a tampon in the mixture and insert it into the vagina overnight;
• oak bark (1 tbsp) is poured into a thermos with 300 ml of boiling water. Infuse for 3 hours, filter and use for douching at night;
• we soak a tampon in sea buckthorn oil and insert it into the vaginal cavity overnight;
• take 5 tablespoons of crushed currant leaves, throw them into boiling water, add 5 cloves of garlic, passed through a press, remove from heat and pour in the juice of half a lemon. Filter the mixture and drink ½ glass up to 4 times a day.

It is useful to drink 1 glass of fresh kefir or sour milk every night. Fresh sour milk from goat's milk is especially helpful. It is important that the product is fresh: old kefir or sour milk does not contain active beneficial bacteria that will benefit the body.

Never douche with kefir or yogurt, this will only make the situation worse. Fermented milk products have a beneficial effect only when taken internally.

Sometimes it makes sense to conduct preventive treatment courses 1-2 times a year. In the first period after therapy, it is advisable to undergo examination every three months for one year. Follow the doctor's recommendations, because vaginal dysbacteriosis is a very common and unpleasant problem that can be fought: treatment is especially effective in the early stages of the disease.

[ 19 ], [ 20 ]