Thrush with menopause

Thrush in menopause is a very common pathology due to the fact that the hormonal background of a woman changes and a violation of the local immune status occurs. This pathology can be the cause of the development of various complications during menopause, and therefore requires timely diagnosis and proper treatment. It is important to know the main clinical signs of the disease in order to seek help in time and to be effective.

Causes of the thrush with menopause

Thrush develops very often both in women of reproductive age, and in older women. This is due to the fact that there can be many reasons for the development of this pathology. One of these causes is a violation of the digestive system. The microflora of the intestine and the microflora of the vagina have a similar composition in one woman, so if there is a pathology in the form of constipation or functional dyspepsia, then violations of the intestinal microflora develop. This entails and similar violations in the vagina with the subsequent reproduction of fungal flora, which contributes to the development of thrush.

Another reason for the development of thrush may be prolonged therapy with antibiotics. In this pathogenesis of thrush development is that under the influence of antibacterial drugs, not only pathogenic flora perishes, but also beneficial bacteria of the vagina. This happens when the antibiotic is treated for a long time, or if its dose is not adequately selected, or if the antibiotic is not properly selected without the concomitant use of probiotics in people at risk. All this can cause the development of thrush in women, so you need to take this into account.

[1], [2], [3]

Risk factors

It is necessary to identify women from risk factors that need to be told about possible violations and their symptoms. This group includes women who have a pathology of the digestive system in the form of ulcerative colitis, functional dyspepsia, as well as women who receive cytostatic therapy and long-term antibiotic therapy.

Thus, the main cause of thrush development in menopause can be considered a sudden decrease in the level of opportunistic beneficial microorganisms, which entails the development of fungal flora. These changes are only facilitated by the state of hormonal imbalance that develops with menopause. Therefore, the peculiarity of treating this pathology with menopause is its complex approach.

[4], [5], [6], [7]

Pathogenesis

As for the period of menopause, the pathogenesis of thrush development may be slightly different. The reason can also be long-term antibiotic treatment and concomitant pathologies of the digestive system. But all these changes develop against a background of insufficiency of hormones that should regulate local immunity in the internal genital organs. At the same time, the state of decreasing the immune status of a woman develops, which develops against the background of a decrease in the level of estrogens in menopause and this contributes to the development and reproduction of the opportunistic flora, which entails many unpleasant moments. The vagina is a place that has its own biocenosis and functions normally due to a conditionally pathogenic microflora that normally inhibits the multiplication of pathogenic microorganisms. When a woman's general immunity decreases, local defenses also decrease, which reduces the activity of beneficial bacteria. Thus, one of the frequent diseases that worries women in menopause is developing - fungal vaginitis or else it is called thrush. This pathology, which is characterized by the multiplication of fungal flora of the vagina with the development of appropriate clinical manifestations. This occurs against the background of the fact that the number of lactobacilli of the vagina and Dodderlein sticks decreases, which normally in the vagina during the splitting of glucose form lactic acid and thus contribute to the maintenance of a weakly acidic environment of the vagina. This is one of the main local mechanisms for protecting the vagina, which is disrupted in women with menopause and develops candidiasis or fungal vaginitis.

Also in the pathogenesis of thrush development in menopause, a minor role is played by violations from local changes in the vagina. As is known, progesterone and estrogens provide a normal state of trophism of the skin and mucous membranes. In case of a decrease in the level of these hormones, climacteric trophic changes of the urethra occur, which promotes burning sensation and frequent urination. Also, there is dry skin of the genitals, itching, unpleasant sensation during sexual intercourse. This contributes to the frequent development of urogenital infections, as the barrier function of the vaginal mucus is impaired. This is another predisposing factor in the development of thrush during the menopause, even if earlier the woman had no such violations.

[8], [9], [10], [11], [12], [13], [14], [15]

Symptoms of the thrush with menopause

Thrush during menopause only disrupts the normal period of menopause, so it requires the solution of this problem and timely diagnosis. Violations of menstruation with menopause and concomitant thrush affect the condition of the genital organs and violate the barrier function, which subsequently threatens complications.

First of all, the symptoms of the disease appear in the form of discomfort in the vagina. Women start to worry about the discharge, which is white, curdled, unpleasant. Such discharges can be very abundant or vice versa. But often the first signs of the disease are subjective sensations, and only then there are secretions. At the same time, a woman feels burning, itching, unpleasant tingling in the area of external genitalia. This contributes to the fact that there is a violation of sexual desire and increases the level of general nervousness, which with climacteric and so very significant. Therefore, the primary local symptoms of thrush with menopause contribute to the violation of the general condition of women, which is also important for the treatment of this pathology.

Thrush is often combined with other clinical manifestations of menopause, which is a mutually exaggerating circumstance. This is manifested by vasomotor and emotional-psychological changes. The woman is concerned about irritability, mood swings, depression, decreased sexual desire, insomnia, fatigue. Also, vegetative manifestations often can be attacks of sweating, heat, headache and palpitations. All these clinical signs disrupt the general condition, nervous activity and thus symptoms of a thrush can only become complicated. The common symptoms of thrush are not limited only to vegetative manifestations, so it is worth paying attention to the symptomatology of other organs and systems.

Complications and consequences

The consequence of the emergence of symptoms of thrush may be not only aggravation of pathology, but also infectious inflammation, which has an ascending nature. In case of untimely contact with a doctor, inflammation of the appendages of the uterus - adnexitis, as well as inflammation of the renal pelvis and bladder can develop with the development of pyelonephritis and cystitis. It can also have complications in the form of joining another urogenital flora with bacterial colpitis, vaginitis.

Complication of thrush can be a protracted process in the uterus with a slow regression of symptoms, so you need to carefully monitor these phenomena. The prognosis for recovery is positive in the case of timely diagnosis and treatment of this pathology in conjunction with the treatment of climacteric changes. For life, the prognosis is also favorable, since there are many methods of treating pathology and only need timely treatment.

[16], [17], [18], [19]

Diagnostics of the thrush with menopause

Diagnostic signs of thrush in menopause include mainly complaints about the appearance of pathological discharge. In this case, it is necessary to clarify the anamnestic data on the nature of the secretions, their number, color, and also the method of treatment that a woman could use at home. It is also important to clarify the nature of menstrual function. It is necessary to find out when these symptoms first appeared and whether it is associated with a delay in menstruation. It is necessary to find out what kind of symptomatology now, how the symptoms varied depending on the situation, and also to detail the patient's complaints. The peculiarity of thrush in menopause may be the multiple nature of complaints, that is, there may be symptoms from the heart, increased pressure with simultaneous changes in the nervous system, as well as other disorders of urination, so careful collection of anamnesis is important. If this is a routine examination by a gynecologist, then you need to examine the woman on the armchair, which allows you to identify violations in the form of dryness of the mucous membrane of the vagina, pathological discharge, than can be confirmed by the diagnosis. You can also see the selection, determine their color and nature, which will make a preliminary diagnosis.

Analyzes that are necessary to clarify the diagnosis are general clinical and special. General - a blood test, a biochemical blood test with a lipidogram and indicators of kidney function, urine analysis. As for special tests, it is necessary to determine the level of the main female hormones in the blood. This is necessary not only for the further treatment of menopause, but also for analyzing the level of hormonal changes and the duration of pathology. Obligatory is the microbiological examination of the smear from the posterior vaginal vault. This smear makes it possible to determine the possible causative agent and the degree of purity of the vagina. It is also necessary to conduct a histological examination of the cervical canal smear.

For more accurate diagnosis, special instrumental methods of investigation are carried out. Colposcopy is the diagnosis of the cervix by a special device that has a magnifying power of 2 to 32 times, depending on the power. This increase allows you to see any changes in the epithelial cover that are not detected during a routine examination in the mirrors. In addition to simple colposcopy, an expanded colposcopy is also performed. In this case, the site of the examined epithelium of the cervix is colored with trichloroacetic acid, iodine or Lugol solution, and look at the degree of coloration. Sites of altered epithelium will be pale against a normally colored epithelium. Such a diagnosis can confirm the presence of other concomitant conditions, such as metaplasia, polyp, endometriosis, cyst. They, in turn, can be the main one for the development of thrush and its subsequent relapse.

These are, perhaps, the main methods of diagnosing thrush, which help to establish a diagnosis and confirm it.

[20], [21], [22], [23], [24]

Differential diagnosis

Differential diagnosis of thrush in menopause should be carried out according to the nature and color of the secretions, which can provide the basis for the assumptions of a particular pathology. It is necessary to differentiate the possible causative agent by the nature of the symptoms, which will allow to correctly assign the treatment. Allocations in the infectious process have a yellow or green color, an unpleasant odor and can cause unpleasant sensations in the form of itching, burning and tingling. Unlike simple thrush, infectious inflammatory diseases are accompanied by an intoxication syndrome.

The different nature of the discharge indicates different types of pathology, which helps in the differential diagnosis of pathology.

Bloody discharge occurs if there is a concomitant pathology - polyp, cyst or foci of endometriosis. Brown discharge can indicate a specific urogenital flora, so special attention should be given to such allocation. In any case, for careful differential diagnosis it is necessary to conduct a microscopic examination of the smear and determine the type of flora that will help in the treatment of thrush.

[25], [26], [27], [28]

Treatment of the thrush with menopause

Treatment of thrush in menopause should take into account not only the principle of the etiological approach, but also that with climax it is necessary to correct the hormonal background. With regard to the treatment of thrush, for the conduct of etiological treatment it is necessary to determine the type of pathogen and its sensitivity to different antibiotics. To do this, the smear from the vagina to the pathological flora is investigated with simultaneous detection of the sensitivity of the pathogen to antibacterial agents.

Drugs that are used in the case of thrush with menopause, are mainly aimed at reducing the inflammatory process and eliminating the focus of infection by eliminating the pathogen. Therefore, use anti-inflammatory drugs, antifungal and antibiotics. The best route of administration is local therapy, which provides a good effect along with general treatment. To treat thrush with menopause, as the most common among diseases of female genital organs, candles are widely used. The names of suppositories for the treatment of this pathology can be completely different, but the active ingredient of all these suppositories are antifungal drugs - ketoconazole, fluconazole, nystatin, itroconazole, fungicide. They can also use combination drugs, which in one suppository have not only antifungal, but antibiotics, then their action is more complex.

Moronal is a drug that has an antifungal effect, which is especially pronounced with respect to yeast-like fungi. The drug from the group of polyene preparations, which has a pronounced effect on fungi and does not affect the bacterial and viral flora. In moderate therapeutic doses, the effect of the drug is to temporarily block the reproduction of fungi, that is, it has a fungistatic effect.

Nystatin, as a pharmacological drug is available in various forms - in tablets, in ointments, in suppositories, and also is a part of combined preparations. Suppositories, that is, suppositories, distinguish between vaginal and rectal, which are used respectively for the treatment of candidiasis of the vagina and intestine. Tablets, ointment and suppository have a similar trade name - "Nystatin", as well as the drug is a part of combined suppositories for treatment of candidiasis with the name of the drug "Polizhinaks". Dosage of the drug for treatment of thrush with menopause is the starting point and in case of using suppositories it is 250,000-500,000 per day. Candles should be placed twice a day, in the morning and in the evening after hygiene procedures. The course of treatment is 7-10 days, depending on the regression manifestations. The drug is contraindicated for use, especially during pregnancy, in the presence of allergic reactions in the history or in case of allergies to additional composite components of the drug. Adverse events occur very rarely precisely because of the peculiarities of pharmacodynamics, since the drug is not absorbed and does not affect the system organs. If the dose is exceeded, dyspepsia can occur in the form of abdominal pain, nausea, malaise, vomiting. There may be local manifestations when applying suppositories with nystatin in the form of itching, discomfort in the vagina, burning sensation.

Precautions - during pregnancy and lactation you should consult a doctor.

Kanesten is an antifungal drug that has local action and is effective in the treatment of fungal lesions. This drug is one of the oldest drugs and has efficacy against all possible fungi. It is effective against yeast-like, mold fungi, dermatophytes, actinomycetes, blastomycoses, which contributes to its wide use not only for treatment of thrush, but also for fungal infections of other localization - fungal lesions of the skin, mucous membranes, hair of the head. Also, the drug is effective against some gram-negative staphylococci and streptococci, trichomonads and amoebas, which increases the chances of recovery with thrush, which is caused by a fungal-bacterial association. The main mechanism of action of the drug is a violation of the structure of the cell membrane of fungi and their function. This is due to the fact that the active substance of clotrimazole disrupts the normal synthesis of the main cellular component of the fungal wall - ergosterol. As a result, the work of potassium-sodium pumps is disrupted and sodium can freely enter the cell, attracting water - this disrupts the work of all cell elements and loses its contents. Clotrimazole also contributes to the disruption of the mitochondrial complex and the peroxide yields premature peroxide oxidation of hydrogen. This is an additional mechanism for disrupting the work of cells of fungi and some microorganisms. Therefore, indications for the use of clotrimazole are very broad - these are fungal skin lesions caused by these pathogens, secondary infectious mycoses, candidomycosis of the oral cavity and urogenital fungal lesions. Due to local action and different forms of release, clotrimazole can be used topically in lesions of various locations.

The form of the drug is vaginal tablets of 100, 200 milligrams in the amount of six or three tablets in a package, respectively, or one with a dosage of 500 milligrams. For the course of treatment, as well as cream and ointment 1% in a tube in the amount of 20 grams. To treat thrush with menopause, vaginal suppositories are used. Candles should be put once a day after hygiene procedures. The course of treatment is 6 days.

The drug is contraindicated for admission, especially during pregnancy in the first trimester, in the presence of allergic reactions in the anamnesis or in case of allergies to additional constituent components of the drug. Adverse events occur very rarely precisely because of the peculiarities of pharmacodynamics, since the drug is not absorbed and does not affect the system organs. An overdose of clotrimazole can cause dyspeptic abnormalities in the form of abdominal pain, nausea, malaise, vomiting, dizziness.

Movalis is a drug that has an anti-inflammatory, anti-edematous, antimicrobial effect. It also relieves, pain, signs of irritation and inflammation, which contributes to a better effect along with the use of an antibiotic. Produced in the form of suppositories for topical therapy at 15 milligrams. Candles are injected rectally twice a day after the toilet of the genitals. The course of treatment is not more than five to seven days.

Contraindications to the use of the drug are allergic reactions in the anamnesis, bronchial asthma, as well as pathology of the gastrointestinal tract in the form of peptic ulcer of the stomach or duodenum, intestinal bleeding, hyperacid gastritis.

Adverse events are possible on the part of the gastrointestinal tract in the form of glossitis, lesions of the esophagus, stomach, intestines with dyspepsia, violation of evacuation function of the intestine. Also possible allergic manifestations of varying severity. When the drug acts on the hematopoietic system, anemia, a decrease in the number of platelets and granulocyte neutrophils may occur.

When acting on the heart and the vascular system, there may be an increased heart rate, pain in the heart, heart rhythm disturbance, lability of blood pressure.

It is necessary in parallel with the local therapy of thrush at the climax to carry out hormone replacement therapy if necessary, as well as general restorative and immunomodulating treatment in the form of vitamin therapy. Recommended vitamins A and E, and preferably multivitamin complexes.

Operative treatment of thrush in menopause is not used, because there is no special indication for such an intervention.

Alternative treatment of thrush with menopause

Alternative treatment of thrush in menopause is a priority, as often complex treatment of fungal vaginitis and climax itself is often necessary. For this, medicinal herbs and alternative agents are used.

The main methods of alternative treatment are:

1. Very useful in this case, sessile baths. To do this, many means are used. The most common is the use of a bath, for which you need to take a liter of boiled water in a warm form, there you need to add two teaspoons of baking soda, as well as a couple drops of iodine. This solution should be stirred, poured into a basin and sit in this water for 20 minutes. The principle of the action of such a bath is an immediate local effect, in which soda is capable of destroying the membrane of a fungal cell and the fungi die, and the thrush passes.
2. Garlic has a pronounced antimicrobial and anti-inflammatory effect, which allows it to be used to treat pathological discharge. To do this, squeeze out the juice from the clove of garlic and mix it with boiled water in a ratio of one to one, and then make a tampon and insert it into the vagina once a day. This can be done for 10 days not more than 10 minutes.
3. Douching is very useful, as is the local treatment of thrush. In this case, the effect is most pronounced, since the active substance enters the vagina with a prolonged action of the drug. For syringing the most suitable solution is potassium permanganate, which has a good antiseptic effect and affects not only the fungi, but also the pathogenic bacteria. To do this, boil water, cool it to a warm state, add half a teaspoon of potassium permanganate to a glass of warm water and stir. This solution needs to be typed in a pear and spend douching, preferably twice a day.
4. Kalanchoe leaves, which have a pronounced anti-inflammatory and regenerating effect, are squeezed into a glass and dipped in a tampon, inserted into the vagina, repeating the procedure once a day for two weeks. In this case, the discharge should stop after 3-4 days.
5. A very common double method of treatment, in which syringing with magnesium sulfate solution is used. To do this, you need to take one ampule of this substance, which is 5 milliliters, and dissolve in a glass of boiled, but warm water. This solution must be typed into a small pear and douched for the night. After this, it is necessary to make a gauze swab and soak it in fat kefir, preferably home-made, after which it is introduced into the vagina for several hours. This will help normalize the biocenosis of the vagina due to the content of lactic acid bacteria.

Herbal treatment also has its advantages, as phytotherapy in addition to local action has a general soothing effect.

1. Chamomile shows a good effect in the treatment of discharge with thrush . To make the tincture, you need to collect the leaves of chamomile, dry them, pour alcohol and insist in a dark place for at least a day, and after that, diluting with boiled water take one tablespoon three times a day. The course of treatment lasts one month.
2. Leaves of elecampane in the amount of 2 tablespoons are brewed in boiled water and insisted, after which they take half a glass 2-3 times a day.
3. Infusion of calendula flowers, which is prepared from three tablespoons of marigold that are brewed in a liter of boiled water, promotes bactericidal effect and prevents the development of bacterial pathology as a complication of thrush. Before taking this infusion, add a spoonful of honey and take half a cup 3 times a day.
4. The leaves of the yarrow also contribute to the restoration of biocenosis and the normalization of milk bacteria with a decrease in the number of pathological discharges. To prepare a tea-broth from herbs, which has a hysterotropic effect. The leaves of yarrow and sage are insisted in boiled water and boiled for five to ten minutes, after which they drink tea instead of tea up to four times a day.

Homeopathic remedies for treatment of thrush in menopause are also widely used, since they are aimed at eliminating the local process, and are also able to regulate the hormonal background, which is important in menopause. The basic preparations:

1. Traumeel C is an analgesic, anti-edematous, anti-inflammatory agent. It is highly effective in the discharge due to thrush and inflammatory changes. It is available in ampoules for parenteral administration and in tablets. Dosage of the drug - one tablet 3 times a day. Precautions - not recommended for hypersensitivity. Side effects are possible in the form of redness and itching at the injection site.
2. Galium-Heel is a drug that has a pronounced immunomodulatory effect, and also improves the excretion of pathological secrets and speeds up recovery. The drug is available in the form of drops and applied 10 drops three times a day. Side effects are noted rarely in the form of allergic phenomena. Contraindication to use is pregnancy and allergic hypersensitivity to the components of the drug.
3. Lachezis-plus - a combined homeopathic remedy, which affects all violations of regulatory processes in the body under any regulatory pathologies and pathologies of the endocrine system. The drug also affects hormonal disorders during the menopause, as well as on the activities of other organs and systems, primarily on the immune system. This allows the drug to be used as an additional therapy for thrush, which regulates the violation of the hormonal status of women. Lachezis-Plus is available in the pharmacological form of homeopathic granules and is dosed on eight granules five times a day half an hour before meals or an hour after. It is necessary to dissolve the granules until completely dissolved and not washed down with water. Side effects are not common, but there may be stool disorders, dyspepsia and allergic reactions. There may be an exacerbation of symptoms, but this is considered a normative value and does not require withdrawal of the drug, so you need to monitor the condition of a woman and after three days the severity of the symptoms should go down.

These are the main alternative and homeopathic remedies that can be used in complex treatment, not only to influence thrush, but also to correct the hormonal background in menopause.

[29], [30], [31], [32]

Prevention

Prevention of the emergence of thrush in menopause is primarily in the control of health and mandatory screening for the doctor. It is necessary to exclude long-term use of antibiotics or to use probiotics from the first day of treatment in a complex in women with an increased risk group. When detecting thrush for the best result of treatment, it is necessary at the time of treatment to exclude sexual activity, as well as use barrier methods that contribute to the retention of bacteria. In case of any symptoms during treatment, you should immediately contact a doctor to avoid complications.

Thrush in menopause is a common pathology that develops due to local immunosuppressive status during menopause. This disease is accompanied by unpleasant symptoms and requires treatment. At the heart of the treatment is the use of antifungal vaginal suppositories against the background of the use of funds for the correction of the hormonal background. But the best way to avoid this pathology is to prevent it with regular examination by a doctor.

[33], [34], [35]