Menopausal thrush

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

Causes menopausal thrush

Thrush develops very often 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 reasons is a disorder of the digestive system. The intestinal microflora and vaginal microflora have a similar composition in one woman, so if there is a pathology in the form of constipation or functional dyspepsia, then intestinal microflora disorders develop. This entails similar disorders in the vagina with subsequent proliferation of fungal flora, which contributes to the development of thrush.

Another reason for the development of thrush may be long-term antibiotic therapy. In this case, the pathogenesis of thrush development is that under the influence of antibacterial drugs, not only pathogenic flora dies, but also beneficial bacteria of the vagina. This happens with long-term antibiotic treatment or with an inadequately selected dose, or with an incorrect choice of antibiotic without concomitant use of probiotics in people at risk. All this can cause the development of thrush in a woman, so this should also be taken into account.

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Risk factors

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

Thus, the main reason for the development of thrush during 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 during menopause. Therefore, the peculiarity of the treatment of this pathology during menopause is its comprehensive approach.

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Pathogenesis

As for the menopause period, the pathogenesis of thrush development may be slightly different. The cause may also be long-term antibiotic treatment and concomitant pathologies of the digestive system. But all these changes develop against the background of a deficiency of hormones that should regulate local immunity in the internal genital organs. At the same time, a state of decreased immune status of a woman develops, which develops against the background of a decrease in the level of estrogens during menopause and this contributes to the development and reproduction of opportunistic flora, which entails many unpleasant moments. The vagina is a place that has its own biocenosis and functions normally due to opportunistic microflora, which normally inhibits the reproduction of pathogenic microorganisms. When a woman's overall immunity decreases, local defenses also decrease, which contributes to a decrease in the activity of beneficial bacteria. Thus, one of the common diseases that bothers women in menopause develops - fungal vaginitis, or thrush. This is a pathology characterized by the proliferation of vaginal fungal flora with the development of corresponding clinical manifestations. This occurs against the background of a decrease in the number of vaginal lactobacilli and Doderlein bacilli, which normally form lactic acid in the vagina when breaking down glucose and thus help maintain a slightly acidic vaginal environment. This is one of the main local mechanisms of vaginal protection, which is disrupted in women during menopause and candidiasis or fungal vaginitis develops.

Also, in the pathogenesis of thrush development during menopause, disorders from local changes in the vagina play a significant role. As is known, progesterone and estrogens ensure the normal state of trophism of the skin and mucous membranes. In case of a decrease in the level of these hormones during menopause, trophic changes in the urethra occur, which contribute to a burning sensation and frequent urination. Dryness of the skin of the genitals, itching, and discomfort during sexual intercourse also occur. This contributes to the frequent development of urogenital infections, since the barrier function of the vaginal mucus is disrupted. This is another predisposing factor for the development of thrush during menopause, even if the woman did not have such disorders before.

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Symptoms menopausal thrush

Thrush during menopause only disrupts the normal menopause period, so it requires a solution to this problem and timely diagnosis. Menstrual irregularities during menopause and accompanying thrush affect the condition of the genitals and disrupt the barrier function, which in the future threatens complications.

First of all, symptoms of the disease appear in the form of unpleasant sensations in the vagina. The woman begins to be bothered by discharges that are white, cheesy in nature, and have an unpleasant odor. Such discharges can be quite abundant or, on the contrary, scanty. But often the first signs of the disease are subjective sensations, and only then do discharges appear. In this case, the woman feels a burning sensation, itching, and an unpleasant tingling in the area of the external genitalia. This contributes to the fact that there is a violation of sexual desire and an increase in the level of general nervousness, which is already quite significant during menopause. Therefore, the primary local symptoms of thrush during menopause contribute to a violation of the general condition of the woman, which is also important for the treatment of this pathology.

Often, thrush is combined with other clinical manifestations of menopause, which is a mutually aggravating 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 can often be attacks of sweating, fever, headache and palpitations. All these clinical signs disrupt the general condition, nervous activity, and at the same time, the symptoms of thrush can only become more complicated. General symptoms of thrush are not limited to vegetative manifestations, so it is worth paying attention to the symptoms of other organs and systems.

Complications and consequences

The consequence of the appearance of symptoms of thrush may be not only the aggravation of the pathology, but also an infectious inflammation, which has an ascending nature. In case of untimely appeal to the doctor, inflammation of the uterine appendages - adnexitis, as well as inflammation of the renal pelvis and bladder with the development of pyelonephritis and cystitis may develop. This may also have complications in the form of the addition of other urogenital flora with bacterial colpitis, vaginitis.

A complication of thrush can be a protracted process in the uterus with a slow regression of symptoms, so it is necessary to closely monitor such phenomena. The prognosis for recovery is positive in case of timely diagnosis and treatment of this pathology in combination with the treatment of climacteric changes. The prognosis for life is also favorable, since there are many methods of treating the pathology and all that is needed is timely treatment.

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Diagnostics menopausal thrush

Diagnostic signs of thrush during menopause mainly include complaints about the appearance of pathological discharge. It is necessary to clarify the anamnestic data regarding the nature of the discharge, its quantity, color, as well as the method of treatment that the woman could use at home. It is also very important to clarify the nature of the menstrual function. It is necessary to find out when such symptoms first appeared and whether this is associated with a delay in menstruation. It is necessary to find out what the nature of the symptoms is now, how the symptoms changed depending on the situation, and also to detail the patient's complaints. A feature of thrush during menopause can be the multiple nature of complaints, that is, there can be symptoms from the heart, increased pressure with simultaneous changes in the nervous system, as well as other urination disorders, so a thorough anamnesis is important. If this is a routine examination by a gynecologist, then it is necessary to examine the woman on the chair, which allows identifying disorders in the form of dryness of the vaginal mucosa, pathological discharge, which can confirm the diagnosis. You can also see the discharge, determine its color and nature, which will allow you to make a preliminary diagnosis.

The tests that are necessary to clarify the diagnosis are general clinical and special. General tests are blood tests, biochemical blood tests with lipidogram and kidney function indicators, and urine tests. 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 further treatment of menopause, but also for analyzing the level of hormonal changes and the duration of the pathology. A microbiological examination of a smear from the posterior vaginal fornix is mandatory. This smear makes it possible to determine the possible pathogen and the degree of purity of the vagina. It is also necessary to conduct a histological examination of the smear of the cervical canal.

For more accurate diagnostics, special instrumental methods of examination are carried out. Colposcopy is a diagnostic of the cervix with a special device that has a magnifying power of 2 to 32 times, depending on the power. Such magnification allows you to see any changes in the epithelial cover that are not determined during a normal examination in mirrors. In addition to simple colposcopy, extended colposcopy is also carried out. In this case, the area of the examined epithelium of the cervix is stained with trichloroacetic acid, iodine or Lugol's solution, and the degree of staining is looked at. Areas of altered epithelium will be pale against the background of normally stained epithelium. Such diagnostics allows you to confirm the presence of other concomitant conditions, such as metaplasia, polyp, endometriosis, cyst. They, in turn, can be the basis for the development of thrush and its subsequent relapses.

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

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Differential diagnosis

Differential diagnostics of thrush during menopause should be carried out by the nature and color of the discharge, which can provide a basis for assuming a particular pathology. It is necessary to differentiate the possible pathogen by the nature of the symptoms, which will allow for the correct treatment. Discharge during an infectious process is yellow or green, has 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 intoxication syndrome.

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

Bloody discharge occurs in the presence of concomitant pathology - a polyp, cyst or endometriosis. Brown discharge may indicate specific urogenital flora, so special attention should be paid to such discharge. In any case, for a thorough differential diagnosis, it is necessary to conduct a microscopic examination of the smear and determine the type of flora, which will help in the treatment of thrush.

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Treatment menopausal thrush

Treatment of thrush during menopause should take into account not only the principle of the etiological approach, but also the fact that during menopause it is necessary to correct the hormonal background. As for the issue of treating thrush, in order to carry out etiological treatment it is necessary to determine the type of pathogen and its sensitivity to various antibiotics. For this purpose, a vaginal smear is examined for pathological flora with simultaneous determination of the sensitivity of the pathogen to antibacterial agents.

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

Moronal is a drug that has an antifungal effect, which is especially pronounced against yeast-like fungi. The drug is from the group of polyene drugs, which has a pronounced effect on fungi and does not affect 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 different forms - in tablets, ointments, suppositories, and is also part of combination drugs. Suppositories, that is, candles, are distinguished as vaginal and rectal, which are used respectively to treat vaginal and intestinal candidiasis. Tablets, ointments and candles have a similar trade name - "Nystatin", and the drug is also part of combination candles for the treatment of candidiasis with the name of the drug "Polygynax". The dosage of the drug for the treatment of thrush during menopause is the starting one and in the case of using candles - it is 250,000-500,000 per day. Suppositories must be placed twice a day, in the morning and in the evening after hygienic procedures. The course of treatment is 7-10 days, depending on the regression of manifestations. The drug is contraindicated for use, especially during pregnancy, in the presence of allergic reactions in the anamnesis or in case of allergy to additional components of the drug. Side effects are very rare precisely because of the peculiarities of pharmacodynamics, since the drug is not absorbed and does not affect systemic organs. If the dose is exceeded, dyspeptic disorders may be observed in the form of abdominal pain, nausea, malaise, vomiting. There may be local manifestations when using suppositories with nystatin in the form of itching, discomfort in the vagina, burning.

Precautions - during pregnancy and lactation, you must consult a doctor.

Canesten is an antifungal drug that has a local effect and is effective in the treatment of fungal infections. This drug is one of the oldest drugs and is effective against all possible fungi. It is effective against yeast-like, mold fungi, dermatophytes, actinomycetes, blastomycosis, which contributes to its widespread use not only for the treatment of thrush, but also for fungal infections of other localizations - fungal lesions of the skin, mucous membranes, scalp. The drug is also effective against some gram-negative staphylococci and streptococci, trichomonads and amoebas, which increases the chances of recovery from thrush, which is caused by a fungal-bacterial association. The main mechanism of action of the drug is to disrupt the structure of the cell membrane of fungi and their function. This occurs due to the fact that the active substance clotrimazole disrupts the normal synthesis of the main cell component of the fungal wall - ergosterol. As a result, the work of potassium-sodium pumps is disrupted and sodium can freely enter the cell, pulling water with it - this disrupts the work of all elements of the cell and lysis of its contents occurs. Clotrimazole also contributes to the disruption of the mitochondrial complex and peroxide is released with premature hydrogen peroxide oxidation. This is an additional mechanism for disrupting the cell of fungi and some microorganisms. Therefore, the indications for the use of clotrimazole are very wide - these are fungal skin lesions caused by these pathogens, secondary infectious mycoses, oral candidiasis and urogenital fungal lesions. Due to the local action and different forms of release, clotrimazole can be used locally for lesions of various localizations.

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

The drug is contraindicated for use, especially during pregnancy in the first trimester, in the presence of allergic reactions in the anamnesis or allergy to additional components of the drug. Side effects occur very rarely precisely because of the peculiarities of pharmacodynamics, since the drug is not absorbed and does not affect systemic organs. Overdose of clotrimazole can cause dyspeptic disorders 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. It is produced in the form of suppositories for local therapy of 15 milligrams. Suppositories are inserted rectally twice a day after toilet of the genitals. The course of treatment is no more than five to seven days.

Contraindications to the use of the drug are a history of allergic reactions, bronchial asthma, as well as gastrointestinal tract pathology in the form of gastric ulcer or duodenal ulcer, intestinal bleeding, hyperacid gastritis.

Side effects are possible from the gastrointestinal tract in the form of glossitis, damage to the esophagus, stomach, intestines with dyspepsia, and disturbances in the evacuation function of the intestines. Also possible are allergic manifestations of varying severity. When the drug affects the hematopoietic system, anemia, a decrease in the number of platelets and granulocytic neutrophils may occur.

When acting on the heart and vascular system, rapid heartbeat, pain in the heart area, irregular heartbeat, and lability of blood pressure may occur.

It is necessary to conduct hormone replacement therapy in parallel with local therapy for thrush during menopause, if necessary, as well as general strengthening and immunomodulatory treatment in the form of vitamin therapy. Vitamins of group A and E are recommended, and better yet, multivitamin complexes.

Surgical treatment of thrush during menopause is not used, since there are no special indications for such intervention.

Traditional treatment of thrush during menopause

Traditional treatment of thrush during menopause is of priority importance, since complex treatment of fungal vaginitis and menopause itself is often necessary. For this, medicinal herbs and traditional remedies are used.

The main methods of folk treatment are:

1. Sitz baths are very useful in this case. Many means are used for this. The most common is to use a bath, for which you need to take a liter of boiled water in a warm form, add two teaspoons of baking soda, as well as a couple of drops of iodine. This solution needs to be stirred, poured into a basin and sit in this water for 20 minutes. The principle of action of such a bath is a direct local effect, in which soda is able to destroy the membrane of the fungal cell and the fungi die, and the thrush goes away.
2. Garlic has a pronounced antimicrobial and anti-inflammatory effect, which allows it to be used to treat pathological discharge. To do this, squeeze the juice out of a clove of garlic and mix it with boiled water in a one-to-one ratio, then make a tampon and insert it into the vagina once a day. This can be done for 10 days for no more than 10 minutes.
3. Douching is very useful as a local treatment for thrush. The effect is most pronounced, since the active substance gets into the vagina with a long-term effect of the drug. A solution of potassium permanganate is best suited for douching, which has a good antiseptic effect and affects not only fungi, but also pathogenic bacteria. To do this, you need to 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 should be collected in a pear and douching should be done, preferably twice a day.
4. Kalanchoe leaves, which have a pronounced anti-inflammatory and regenerating effect, are squeezed into a glass and, after wetting 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, which uses douching with a solution of magnesium sulfate. To do this, you need to take one ampoule of this substance, which is 5 milliliters, and dissolve it in a glass of boiled but warm water. This solution should be collected in a small pear and douched at night. After this, you need to make a gauze swab and soak it in fatty kefir, preferably homemade, and then insert it 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, since herbal medicine, in addition to its local action, has a general calming effect.

1. Chamomile shows a good effect in the treatment of discharge during thrush. To prepare the tincture, it is necessary to collect chamomile leaves, dry them, pour alcohol and insist in a dark place for at least a day, and then dilute with boiled water and take one tablespoon three times a day. The course of treatment lasts one month.
2. Two tablespoons of elecampane leaves are brewed in boiled water and infused, after which half a glass is taken 2-3 times a day.
3. An infusion of calendula flowers, which is prepared from three tablespoons of calendula, which are brewed in a liter of boiled water, promotes a 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 glass 3 times a day.
4. Yarrow leaves also help restore the biocenosis and normalize lactic bacteria with a decrease in the amount of pathological discharge. For treatment, a herbal tea is prepared, which has a hysterotropic effect. Yarrow and sage leaves are infused in boiled water and boiled for another five to ten minutes, after which they drink instead of tea up to four times a day.

Homeopathic remedies for the treatment of thrush during menopause are also widely used, since they are aimed at eliminating the local process, and are also able to regulate hormonal levels, which is important during menopause. The main drugs are:

1. Traumeel S is an analgesic, decongestant, anti-inflammatory agent. It is highly effective in cases of discharge due to thrush and inflammatory changes. It is available in ampoules for parenteral administration and in tablets. The dosage of the drug is 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 removal of pathological secretions and accelerates recovery. The drug is available in the form of drops and is used 10 drops three times a day. Side effects are rare in the form of allergic reactions. Contraindications for use are pregnancy and allergic hypersensitivity to the components of the drug.
3. Lachesis Plus is a combined homeopathic remedy that affects all disorders of regulatory processes in the body in any regulatory pathologies and pathologies of the endocrine system. The drug also affects hormonal disorders during menopause, as well as the activity of other organs and systems, primarily 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 a woman. Lachesis Plus is available in the pharmacological form of homeopathic granules and is dosed 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 drink water. Side effects are not common, but stool disorders, dyspeptic phenomena and allergic reactions may occur. An exacerbation of symptoms is possible, but this is considered a normative value and does not require discontinuation of the drug, so it is necessary to monitor the woman's condition and after three days the severity of the symptoms should decrease.

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

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Prevention

Prevention of thrush during menopause consists primarily of monitoring the state of health and mandatory screening examination by a doctor. It is necessary to exclude long-term use of antibiotics or use probiotics from the first day of treatment in combination with women with a high risk group. If thrush is detected, for the best treatment result, it is necessary to exclude sexual activity at the time of treatment, as well as use barrier methods that help to delay bacteria. If any symptoms appear during treatment, you must immediately contact a doctor to avoid complications.

Thrush during menopause is a common pathology that develops due to a local immunosuppressive state during menopause. This disease is accompanied by unpleasant symptoms and requires treatment. The basis of treatment is the use of antifungal vaginal suppositories against the background of the use of means for the correction of hormonal background. But the best way to avoid this pathology is its prevention with regular examination by a doctor.

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