Key Cells in the Smear in Women and Men: Reasons for Detection

Many human diseases are hidden from the eyes and have no pronounced external manifestations. But they can easily become the cause of the development of other diseases that have obvious symptoms and unpleasant consequences. Thus, a bacterial infection caused by the reproduction of a conditionally pathogenic microflora can manifest itself. But only a laboratory study of the biomaterial can detect and recognize such an infection. When it comes to female diseases, the doctor necessarily takes a swab in the vagina or uterus where infection is suspected. Sometimes the doctor discovers the key cells in the smear, and this interpretation of the analysis can alarm a woman. In fact, it usually refers to such a widespread violation of the vaginal microflora, as a dysbacteriosis, although it is not necessary to exclude more dangerous pathologies.

What are the key cells in the smear?

This is the question posed by women, most often suspecting that it is a matter of oncological pathology, sexually transmitted diseases, sexually transmitted diseases, dangerous viruses, etc. These suspicions in most cases are groundless, because the key cells in the smear doctors call a flat epithelium with bacteria concentrated on its surface from the discharge of a pathogenic or conditionally pathogenic microflora. The presence of key cells in the smear from the vagina in most cases indicates the development of bacterial vaginosis (gardenerellosis) caused by opportunistic bacteria with a strange name gardnerella. If in the biomaterial, epithelial cells with an adherent microflora other than the gardnerella attached to it have been identified, they speak of false-key cells in the smear.

Identify the causative agents of vaginosis by bacterioscopy. First, the patient on the armchair is examined by a gynecologist and immediately takes a smear on the microflora. Further in the laboratory, the biomaterial was examined under a microscope. This is a traditional method for diagnosing most diseases of the genitourinary system, which has become widespread in gynecology.

Gardnerelli under the microscope look like small sticks, dotting the surface of the flat epithelium, taken during the stroke. Ideally, a negligible amount of such bacteria is found on the vaginal mucosa, and they do not pose a threat to either the woman or her sexual partner. The main inhabitants of the inner environment of the vagina are lactobacilli (95%) and some other types of beneficial bacteria that are used to living in an acidic environment. But the pH of the vagina is supported by lactic acid bacteria. It is with their help that the woman's body cares about the health of the sexual sphere.

For pathogenic and conditionally pathogenic bacteria, the acidic environment of the vagina is not particularly suitable for life, as it reduces their activity and prevents reproduction. They can only wait for the acidity of the internal environment to move toward alkalization. And this can happen only if the amount of lactobacilli decreases in comparison with the norm.

Changing the microflora in the direction of reducing the beneficial bacteria is called a dysbacteriosis. The place of lactobacilli in this case is occupied by actively multiplying cocci and rod-shaped bacteria, which are present in the minimum amount in the vagina, but in the smears of a healthy woman are not found. The presence of key cells in the smear testifies to bacterial gynecological pathology.

Such elements most often testify to bacterial vaginosis (dysbacteriosis of the vagina), but in some cases can be found in erosion of the uterus, as well as in dysplasia (precancerous state). Even less often they can be found at an early stage of oncological pathology, with polyposis of the uterus and other neoplasms of the inflammatory plan.

Depending on the revealed microflora, one can speak of pathology that has struck a woman: gardnerelli (gardnerellez), fungi (candidosis), gonorrhea (gonorrhea), chlamydia (chlamydia), mycoplasma (mycoplasmosis), trichomonas (trichomoniasis). But most often a mixed microflora is found, and the diagnosis sounds blurry - the dysbacteriosis of the vagina.

If you look closely, you can see that all the above bacterial pathologies can be transmitted sexually, and this speaks in favor of the fact that dysbiosis can be diagnosed not only in women but also in men. Although here it is worth mentioning, because the conditionally pathogenic microflora is the "aboriginals" of any human organism, therefore the decisive role in the development of the disease is played not by the transmission of bacteria from person to person, as we just mentioned, but by the immune status of the organism. With strong immunity, infection does not actually occur, because the causative agents from the sexual partner will be absorbed by the phagocytes or will again go into an inactive state.

The result of long-term studies in this field has become the theory that the gardnerelles themselves are not the causative agents of any serious disease. Moreover, in most cases of diagnosed gardnerelleza, active trichomonads and chlamydia are found in smears. And the cause of adhesion of the activated pathogenic microflora to the rejected epithelial cell becomes a slow-moving infection called chlamydia, which a person could not even suspect.

Analyzes of a patient with acute chlamydial infection do not show a significant increase in leukocytes, the presence of trichomonads and other activated bacteria, only the beneficial microflora of the body and epithelial cells that are affected by chlamydia suffer. If the infection subsides and the chlamydia die or decrease its activity, for example, when changing to a chronic form, its place is occupied by other bacteria: gardnerelles, trichomonads, cocci, etc. (a holy place is never empty, because the decrease in the amount of useful microflora leads to a decrease in immunity and the active development of opportunistic and pathogenic organisms that penetrated inside).

With chlamydial and some other infections that affect the cells of the epithelium, their destruction and detachment are observed. It is to these cells that the activators of dysbacteriosis and other pathologies become active. During the taking of the smear the doctor removes the mucus from the inner sheath of the vagina, in this mucus just find the gardnerella and other unpleasant microflora. Detecting under such a microscope such mutated epithelial cells the doctor speaks about the presence of "key cells in the smear".

To date, both theories exist in parallel. Some scientists believe that gardnerellez is not really a disease and does not require conventional treatment, focusing on the therapy of the causes of activation of opportunistic and pathogenic microflora. In other words, it is necessary to increase immunity and treat chlamydia, and, as necessary, to fight with another activated microflora.

But most doctors consider gardnerellez (remember that such a disease does not actually exist in the international classification of diseases) as an independent disease, in the treatment of which antibiotics come to the fore. That is, first we destroy all the microflora found in the vagina, and then we start to restore the useful one in order to prevent relapses of the disease.

The admirers of which theory are right, but who goes along the line of least resistance and the greatest income, time will tell. But in any case, it is necessary to treat the infection, not hoping that it will subside on its own. If immunity does not cope with excessively multiplying bacterial microflora, antibiotics are needed.

The causes of the appearance of key cells in the smear

As we have already figured out, the key cells in the smear appear not accidentally. This is facilitated by a decrease in the acidity of the vagina, which makes it possible to successfully multiply the pathogenic bacteria that enter the woman's body. But for what reason can the balance of the internal microflora of the organism be disturbed? When can I expect the appearance of key cells in the smear?

First of all, they talk about reduced immunity. Lactobacilli, living in the small intestine and vagina actively participate in the synthesis of immunoglobulins, which in turn form the immune system. The weakened immune system is not able to protect the body from the dominance of pathogenic bacteria and can not slow down the growth of the opportunistic microflora, which, while multiplying excessively, does no less harm.

Low immunity is not the only reason for the appearance of key cells in the smear, but the effect of any of the underlying causes will be tied to a weakening of the defenses of the organism, i.e. On the reduction of immunity. So, key cells can appear against the background of hormonal failures that occur during pregnancy, during puberty, when menopause occurs. About hormonal failures outside these periods may indicate problems with the conception of a child, the growth of hair on the body of a woman, various violations of the menstrual cycle.

An important role in the violation of the microflora of the body is played by inflammatory processes, especially those that have a chronic course. Chronic inflammations always lead to a weakening of immunity, regardless of the location of their localization. And if it is also inflammation of the internal genital organs or pelvic organs to maintain the bacterial balance will be extremely difficult.

What else can lead to an imbalance of vaginal microflora in women? Excessive passion for hygiene of intimate places, which is no less dangerous than its non-compliance. If hygiene standards are not observed, there is a danger of entering into the body pathogens and fungi, but with strong immunity, lactobacilli can cope with them on their own. But here the frequent reference to such medical-and-hygienic procedure, as syringing, promotes washing away of useful microflora along with pathogenic.

The restoration of the norm of lactobacilli takes time during which the acidity of the vagina will be disturbed and the omnipresent opportunistic microflora will have the opportunity to reproduce with impunity, causing various pathologies accompanied by itching, abundant discharges from the vagina, and sometimes an unpleasant odor.

Some treatment procedures can be considered risk factors for dysbiosis. Therapy with antiseptics and antibiotics can adversely affect the microflora of the body. But if antiseptics act more or less selectively and do not completely destroy the main composition of the bacterial vaginal microflora (if it's not about syringing), then antibiotic therapy can ruin it completely. Antibiotics do not care who is in front of them: the causative agent of the disease or the defender of the body, for them it is important that this is a foreign substance related to bacteria.

Antibiotic therapy should be accompanied by the intake of drugs replenishing the reserve in the body of useful lacto- and bifidobacteria, otherwise it is very difficult to avoid dysbacteriosis, especially with prolonged antibiotic treatment.

Taking antibiotics without prescribing a doctor is even more dangerous, because it promotes the emergence of resistant strains of bacteria. When the need for antibiotic therapy does appear, it may be that the prescribed antibiotic can no longer cope with the pathogen, and additionally a course of treatment with another drug (and sometimes not one) will be prescribed. Lactobacilli are not able to develop protective components against antibiotics, and it turns out that the first drug will be destructive only for beneficial microflora, giving even more freedom to pathogens. Antibacterial agents, appointed later, will definitively ruin a useful microflora and destroy the causative agent of the disease. But on the fertile (not acidic) soil, other dangerous bacteria, fungi and other harmful microorganisms can enter, leading to new problems associated with dysbacteriosis.

Weakening of the body's defenses causes not only antibiotics and chronic inflammatory processes. Here, regular excessive physical exertion, acute inflammation of the urogenital system, stress and depression, infectious systemic diseases, especially of a viral nature, malnutrition (for example, restriction or refusal to accept dairy products), etc. Can make their "hand".

If you adhere to the second theory of dysbacteriosis of the vagina, its cause should be considered healed chlamydial infection, which as a result of incorrect treatment passed into a slow form without significant symptoms. The conclusion is one - chlamydia should be treated, even if the inflammation does not bother you, and take it seriously, so that the bacteria are completely destroyed.

But back to the violation of the hormonal background. But it can be caused not only by internal, but also by external causes. For example, oral contraceptive administration contributes to a change in the balance of hormones, which is why their contraceptive effect is connected. And barrier contraception quite often becomes the cause of infection of the vagina or the development of the inflammatory process. If, moreover, additionally every day to resort to the help of spermicides, which have some bactericidal action, there is a danger of destroying the beneficial microflora in the vagina.

You can talk about underwear separately. Enthusiasm for synthetics, which is easily erased and well worn, does not contribute to the improvement of internal microflora. Restricting air access to the tissues of the body and creating a so-called greenhouse effect, they provide all conditions for the multiplication of pathogenic bacteria and fungi, which are very much pleasant warmth and moisture. It is not surprising that women who prefer linen from synthetic tissues more often than others turn to a doctor with complaints of itching and discharge from the genitals.

As for the modes of transmission of infections, the situation here is as follows. Violation of microflora in one of the partners entails the multiplication of pathogens, which during sexual intercourse are easily transmitted to another partner. If, at the same time, his immunity is reduced (and a rare person can boast of a strong immunity), newly arrived bacteria will quickly fix the situation by pulling the lot to their side. Now, the second partner has a dysbacteriosis or other infectious and inflammatory pathology of the reproductive system (chlamydia, candidiasis, gonorrhea, etc.). It must be said that promiscuous sexual relations only increase the risk of the appearance of key cells in the smear, which is not surprising when you do not know what "sore" may lurk in the depths of an unfamiliar partner.

Symptoms of pathologies with key cells in the smear

It is believed that in smears from the genitals of a healthy person, key cells should not be at all. As soon as they appear, there is reason to suspect a violation of the microflora of the vagina, when the balance shifts towards pathogenic and opportunistic microflora. Single key cells in the smear can say that the disease is grabbed at the very beginning and will be easily defeated, sometimes only by normalizing the vaginal microflora. If there are a lot of key cells in smears, this indicates a neglected form of the disease indicating the active multiplication of harmful bacteria, and there is no need to take antibiotics.

But as we already know, the key cells in the biomaterial are not detected by chance. This is not a blood test, which we take several times a year and not only for diagnostic purposes, but even for preventive purposes. Taking a smear is justified when a person has come to see a specialist doctor with certain complaints.

However, gynecologists prefer to be reinsured, and take smears on the microflora, even during preventive examinations. This is due to the fact that in our life there are a lot of negative factors that can affect the health of the internal environment of the body. Unfavorable environmental conditions, stress, fatigue significantly undermine women's health and all too often cause the dysbacteriosis of the vagina. The sooner such a violation is detected and the treatment of the problem is started, the less negative consequences it will have.

Key cells in the smear in women - this is by no means a rarity in the practice of a female doctor, so diagnosis usually does not cause special difficulties when women handle common complaints. It is clear that, depending on the type of bacterial microflora, the clinical picture of the disease may vary slightly, but there are similarities in similar diseases.

The first signs of most diseases of the genitourinary sphere, in which there is a shift in the balance of the vaginal microflora, are itching and burning in the genital area, discomfort during or after sexual intercourse due to irritation of the mucous membrane, the appearance of abundant secretions with an unusual odor (normally odor in discharge from the vagina sourish). The change in the color of the discharge to yellowish and greenish indicates an active reproduction of the pathogenic bacterial infection. Such secretions are called purulent, and they speak more of a neglected process.

Key cells in the smear during pregnancy are usually associated with gardnerellez. Future mothers are usually selective in sexual relations, preferring one man, usually the father of the child. And if he, in turn, was equally accurate in sexual terms and remained faithful to his wife, the probability of catching a serious bacterial infection remains extremely low. Another thing is that during pregnancy in the body of a woman there is a hormonal reorganization, which can adversely affect the state of the microflora of the vagina.

And since permanent residents of the mucous membrane of the genital organs are not only lactobacilli and certain types of beneficial microorganisms, but also gardnerella (in a limited number and inactive state), imbalance of hormones can cause activation of the latter, which will lead to dysbacteriosis of the vagina with the appearance of pruritus and suspicious secretions. It is with these problems that the future mothers who are jealous of their health and the future of their baby rush to the doctor.

As for future fathers and other men, they can catch an infection when they have sex with a woman who has bacterial vaginosis. And the more sex with different women, the higher the risk of infection.

The readers may have a fair question: where can the key cells appear in men, because they do not have a vagina with a microflora peculiar to it? There is no vagina, but there is a penis with known wrinkles. And although it does not have its own epithelial cells, getting inside the vagina during copulation, it is quite possible to take with them the key cells from there.

On the head of the penis and under the foreskin, covering it, there is a microflora. Affected cells from the vagina are mixed with it, the bacteria actively multiply and cause inflammation in the tissues of the head, which doctors call a bacterial balanoposthitis. The sampling of the biomaterial in this case will show single key cells in the smear, as its penis on the surface does not have its epithelial cells.

Characteristic signs of the disease are: redness of the glans penis, appearance of pimples and whitish plaque on it, the appearance of an unpleasant odor even after hygiene procedures. All this indicates the development of pathogenic microflora and the need for urgent medical measures.

But again, as in the case of the female type of disease, inflammation can have internal causes. These include chronic inflammatory pathologies of the genitourinary system (cystitis, urethritis, prostatitis, etc.). For men, this is especially true if you take into account the features of the urethra, which at the same time is also a penis. Internal bacterial infection reduces immunity and promotes the reproduction of opportunistic microflora (more often gardnerell, less often streptococci, staphylococcus, etc.) not only in the urethra, but also outside it.

If, moreover, the man neglects intimate hygiene, the bacteria multiply particularly actively, hiding behind the foreskin and causing a strong inflammation of the glans penis. Hygiene for men is no less important than for a woman. If after a sexual intercourse with a woman who had bacterial vaginosis, the man thoroughly washed his penis and all his folds, the probability of finding later his key cells from the vagina, which led to the development of balanoposthitis, would have come to naught.

It is necessary to understand that dysbacteriosis is not an infectious disease that transmits sexually, although there is a possibility of such infection during sexual intercourse. But this probability is not as great as it seems. In order for the disease to develop, internal and external factors that negatively affect human immunity are needed. In other words, the disease affects only people with reduced immunity.

What cells can be found in the smear?

As we have already said, gynecologists knowingly try to take a smear every time a woman comes to the reception, even if this is a preventive checkup. After all, by results of a smear it is possible to reveal pathologies about which the woman at all does not suspect. After all, the key cells in the smear, which are associated primarily with the gardnerella, are considered only one of the indicators of the disturbance of microflora. In fact, the pathogenic microflora of the vagina can be much richer, just at the beginning of the disease, there are no symptoms of pathology.

Yes, 95% of the microflora of the vagina are our helpers of the lactobacillus, and the remaining 5% should be accounted for by another microflora, which can be affected by various types of bacteria and viruses: round (cocci, with Staphylococcus aureus in the forefront) and rod-shaped (bacilli, including gardnerelles), corynebacteria, aerobic and anaerobic microorganisms. A total of about 40 species, which normally should take from 2 to 5%, not more. If this percentage is higher, it is already a violation of the balance, i.e. Lactobacillus can no longer restrain the growth of pathogenic microflora, and with each passing day pests will become more and more.

The key cells of the gardnerella in the smear are a modified flat epithelium that has a granular structure. In principle, a small amount of flat epithelium is found in the inner flora of a healthy woman. This is normal, because his absence can talk about violations of the development of sex hormones. But cocci, having a rounded shape, and rod-shaped gardnerella change the surface of the epithelium, and the doctor diagnoses the key cells in the smear. Detection in the smear of cocci is already an alarm signal, which indicates the proliferation of harmful bacteria and a decrease in the number of lactobacilli.

Biomicroscopy and cytological analysis are based on the detection of pathogenic microorganisms. They are recognized by the peculiarities of the structure of cells when examining the biomaterial under a microscope. If suspected of a microflora that should normally not be present in the vagina at all (for example, chlamydia, gonococci, etc.), other methods of laboratory research (for example, PRC analysis, seeding on microflora, etc.) may be prescribed, allowing to identify the causative agent of the disease and assess the degree of development of the infectious process.

Any bacteria, even opportunistic, excessively multiplying, cause irritation and inflammation of the vaginal tissues. The indicator of the inflammatory process has always been considered to be leukocytes - the main advocates, acutely responsive to infectious processes. If the key cells are found in the smear and the white blood cells are enlarged, this indicates the development of the inflammatory process caused by the gardnerella or other bacteria detected in large quantities during laboratory tests.

Normally, the decoding of the smear from the vagina of leukocytes should be no more than 10, in the biomaterial from the cervical canal - no more than 20. In inflammatory processes, this figure increases to 30 or more, which indicates the activation of the immune system to fight infection. But reducing the number of lactobacilli weakens the immune system, which means that help from the infection will be required from the side.

In a healthy person, the immune system should work "perfectly". For this, phagocytes are responsible - a special kind of leukocytes, capable of absorbing foreign cells. Such properties are possessed by neutrophils, macrophages, monocytes and some other cells. In principle, they must absorb any active pathogenic bacterium that enters the body, searching for it with the help of special receptors. If the phagocytes are normal, and the key cells in the smear are found in large numbers, this indicates a violation of phagocytosis, i.e. Malfunctions in the immune system.

The degree of prevalence of the pathological process can be judged by the number of key cells, pathogenic microorganisms, leukocytes. With bacterial vaginosis, although they speak of the presence of active gardnerella, in fact, speech is most often a mixed microflora, the amount of which exceeds the prescribed 5%.

But to accurately assess the population of the vagina by bacteria, viruses and fungi, a smear should be taken and examined in accordance with certain requirements. First, these are the requirements for patients to prepare for an examination of the gynecologist, which the doctor should remind of too cleanly patients regularly. Secondly, the requirements for the analysis.

Proper preparation for a gynecological examination followed by taking a smear on the microflora implies:

• refusal to use local hormonal drugs, vaginal lubricants, spermicidal ointments for a few days before the examination (at least 3 days), since they can all distort the real picture of the vaginal microflora,
• 1-2 days before visiting a gynecologist you need to refrain from sexual activity,
• in the evening before a gynecological examination a woman should conduct an intimate hygiene procedure, but neither douche, nor use a variety of detergents can not, on the day of reception, hygienic procedures are undesirable,
• many women queue for a gynecologist trying to empty the bladder to reduce discomfort when viewed. In fact, you need to go for a small need no later than 2 hours before admission.

A smear on the microflora is taken from the walls of the vagina, the cervical canal of the uterus, the urethra. Most informative it will be in the first days after menstruation. And it will be better if the analysis is carried out within the first 3 hours after taking the smear.

Consequences and complications

The single epithelial cells found in the smear, a small number of leukocytes, mucus and even yeast fungi are not considered an alarming symptom. All this can be present in the microflora of the vagina in a moderate amount. A small number of cocci, restrained by an acidic environment created by lactobacilli, is also not a cause for concern.

However, the doctor may schedule a follow-up examination later to ensure that the pathogenic bacteria do not begin to multiply. Why is it so important? Because it depends on women's health. Bacteria, fungi, viruses and other parasites lead to the development of an inflammatory process on the mucosa of the female's internal genitalia.

Not only does the patient begin to experience constant itching in the genital area, there are irritations and wounds on the mucous, so on this background there are also problems in sexual life. A woman begins to avoid sexual contact, because during coition she experiences pain and discomfort. This provokes quarrels and scandals in the family, caused by the dissatisfaction of both partners with a sexual life.

Again, the inflammatory processes do not pass by themselves. Gradually they spread to an ever larger area, capturing nearby internal organs. If nothing is done, the inflammation will pass into a chronic form. Against the background of inflammation on the mucous membrane of the vagina polyps can form, erosion occurs. Over time, on the site of severe inflammation begin to uncontrollably grow their own tissue of the uterus (dysplasia) and there is a risk that under the influence of predisposing factors, cells will begin to mutate and turn into malignant. It would seem that simple inflammation, but without treatment, it can eventually turn into a terrible disease - cancer.

The problem of infringement of the vaginal microflora can cause another trouble for young women - these are problems with conceiving a child, and key cells in a smear during pregnancy are at risk of premature birth and miscarriage, infection of the child with a bacterial infection during the passage of birth canal, various postpartum complications.

What is dangerous gardnerellez for women? If the disease is not treated, then there is a chance to get an inflammation of the ovaries and urethra, accompanied by pains in the lower abdomen, and in the latter case also in the genital area. In addition, often women are often tormented by frequent desires for a small need.

Gardnerellez in men is usually limited to inflammatory processes in the glans penis and rarely causes other complications. And yet, in the presence of certain factors, there are risks of development against pathogens such as urethritis, prostatitis, cystitis, vesiculitis, pyelonephritis, etc., if the propagated bacteria continue to travel through the body against the background of activation of the opportunistic microflora.

If only key cells and a small number of cocci are found in the smear, and the doctor diagnoses the dysbacteriosis of the vagina, this is not an excuse to give up sexual life. Bacterial vaginosis, no matter how scary it may sound, is not a contagious disease. The only requirement is strict adherence to penis hygiene after having sex.

But the shift in the balance of the microflora of the vagina and the alkalization of its internal environment attracts not only a conditionally pathogenic microflora. As a part of the mixed flora, pathogenic microorganisms transmitted sexually can also be detected over time (especially if the sexual partner is not one). For them, an insufficiently acidic environment is also a fertile soil for reproduction. It will take a very short time and chlamydia, mycoplasmosis, gonorrhea, etc., will join the vaginal dysbiosis, as the immune system of a woman weakened with a decrease in the number of lactobacilli can no longer resist the growth and multiplication of pathogens.

Now the patient will be dangerous for her sexual partners. But STDs are already a separate topic for conversation.

Can a man with an infectious-inflammatory non-venereal disease of the penis infect his partner? Such a risk exists, because any, even conditionally pathogenic microorganisms that live on our skin and mucous membranes, can be dangerous if they start multiplying. But they will start to multiply, if the immune system of a woman is visibly weakened by already existing diseases. Thus, the likelihood that balanoposthitis or other infectious-inflammatory disease of the penis in a man can cause the development of bacterial vaginosis in women is relatively low (no more than 8%). True, this is not a reason for men not to treat their male diseases, because the risk still remains.

[1], [2], [3], [4], [5], [6], [7]

Prevention

The fact that the disease does not belong to the category of heavy does not mean that one should carelessly take into account the possibility of acquiring it. Almost any disease is easier to prevent than cure. Moreover, preventive measures usually do not require a person to do something impossible or superheavy. In most cases, it all boils down to respecting body hygiene and a healthy lifestyle.

But what preventive measures will help to avoid such an unpleasant disease as bacterial vaginosis:

• Since we are talking about genitals that come into contact with physiological discharges containing bacterial cells, the hygiene requirement remains very relevant. Daily intimate hygiene with the use of specialized means, if it does not become a guarantee of good health, will help to prevent dangerous infectious diseases. It is believed that the usual bath or baby soap, gels and shower creams are not suitable for cleaning procedures in intimate places because of an unsuitable pH. But also special means for intimate hygiene with the necessary indicator of acidity can do harm if they are simply not suitable for a woman. So the choice of means for caring for the reproductive organs should be treated responsibly.
• Intimate hygiene is important not only for women, but for men, which is the main preventive factor for them. Daily water treatments with natural cleansers plus genital hygiene after sexual intercourse will help the strong sex avoid unpleasant surprises. An additional protection against STIs will be a known latex product under the sonorous name "condom".
• Bacteria, viruses, fungi are microorganisms, which are very attracted by the warm and moist inner environment of the vagina. Do not make it even more attractive with the help of underwear made of synthetic materials, creating a "greenhouse effect". The same goes for too tight panties. The laundry should be sufficiently loose and made from natural fabrics.
• Negative opinion among gynecologists has developed and concerning stringov. This model of underwear for women is considered a provoking factor for irritation of the genital tissues and entry into the vagina of the infection hiding in the anus.
• In all women of childbearing age, who most often find key cells in the smear, there is such an unpleasant, but very important phenomenon, like menstruation. During this period, modern women use hygiene pads, which are purchased in pharmacies and stores. But not all gaskets affect well the state of female microflora. Synthetic surface and base of airtight material is not the best choice for a woman who cares about her sexual health. It is necessary that the material of the gaskets should be as natural as possible, "breathable" and soft. If the pads cause irritation of the genital tissues, itching and other unpleasant sensations, it is better to refuse them. The same goes for hygienic tampons.
• Ambiguous attitude of doctors and the so-called "dailies." Daily gynecologists recommend wearing only in the first and last days of menstruation, as long as there are scant dark discharge. They will be useful for those women who, due to pathological reasons, have abundant light discharge, strongly soiling underwear and creating a feeling of dampness. But even in this case to use gaskets is not always recommended. It is better to change panties more often. The fact is that "everyday" have a dense basis, poorly air-permeable, which prevents the body from "breathing", but promotes the reproduction of anaerobic bacteria.
• Now, as far as sexuality is concerned. For a woman, the source of the bacterial infection can serve as a carrier of this infection. Frequent replacement of partners is fraught not only with the risk of developing vaginal dysbiosis, but also with the infection of sexually transmitted diseases. So it's better to look for different ways to get sexual satisfaction with one partner than on the side with unverified men. By the way, this moment is relevant for the representatives of the stronger sex.
• If a couple practices anal sex and alternates with vaginal sex, the woman should be ready for the fact that at some point in her vagina the gynecologist will discover "outsiders". The anal opening and rectum contain such a rich composition of different microflora, not suitable for the woman's vagina, that dysbacteriosis will not be something unexpected.

But all of the above does not help a woman protect herself from infection in the way that the coordinated work of the immune system does. And that it was necessary:

• To reconsider the attitude or relation to a delivery. It should be regular and full. Products should be taken natural and, if possible, without harmful additives. Preference should be given to vegetables and fruits containing a rich complex of vitamins and minerals that will help to strengthen immunity. Useful for the immune system are lemon, honey, ginger, chicory, apples, garlic, almonds and other natural products.

Strengthening the immune system and maintaining the normal microflora of the body, and the vagina in particular, is promoted by milk and dairy products, which must necessarily be present in the diet of a woman.

• Hardening is a well-known healing procedure, which helps to strengthen immunity. The main thing is to carry it out correctly, because the female's sexual system is very sensitive to hypothermia, so the decrease in water temperature and the increase in the duration of walking in cold air should be gradual.
• It is clear that such bad habits, like drinking and smoking, do not have the best effect on the protective functions of the body. But the rejection of such unnecessary habits in favor of a healthy and active lifestyle only contributes to the strengthening of immunity.
• Stress and fatigue - that's the worst way to affect a person's health. We need to learn to cope with stressful situations, use relaxation practices, normalize physical and mental loads. This will help the body not to waste its resources in vain, but to attract them to fight against uninvited guests.
• What else will help preserve the microflora and strong immunity?

• Timely treatment of infectious diseases of different etiology and localization.
• Regular preventive examinations at the therapist and gynecologist. Women of reproductive age to visit the "beloved" doctor is recommended every six months.
• A sensible approach to antibiotic treatment. They need to be taken only if the doctor sees this as a necessity. Assign yourself to strong drugs alone - this is a risk to worsen the situation and additionally supplement the list of already existing diseases with a couple of new ones. The intake of antibiotics should always be combined with the recovery of microflora with the help of probiotics.

It would seem that there is nothing complicated in preventing the disturbance of microflora in your body. Nevertheless, the key cells in the smear are found daily in women of different ages and positions. And the reason for this carefree attitude of women towards a popular disease that is not considered dangerous, but still can bring quite a lot of trouble. Probably, to monitor your women's health and appreciate it you need to teach girls from an early age. And then you can hope that the situation with time will change for the better.

Forecast

Dysbacteriosis of the vagina is a fairly common disease, which, nevertheless, is not considered life threatening. If the process is not started, treatment of the disease is not particularly difficult. The prognosis of the disease with a serious approach to its treatment is always favorable. Complications can be expected if you do not take any medical measures, as well as in the case of antibiotic treatment without restoring the destroyed useful microflora with the help of special probiotics.

[8], [9]