Why are leukocytes in the smear increased in women and men?
Last reviewed: 23.04.2024
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One of the standard procedures performed during a gynecological examination is taking a smear from the vagina. Analysis of its composition is quite informative. Although not all pathological processes, he can tell, but it allows you to suspect that something is wrong, when white blood cells are raised in the smear, and determine the direction of further diagnostic measures.
The contents of the vaginal smear, which is taken most often, are almost always determined by white blood cells, in the field of view of the laboratory assistant their number should be about 10-15. This is the norm, small deviations are allowed depending on where the scraping was done (vagina - 0-15, urinary canal - 0-5, cervix - 0-30). Perhaps the impact on the result of the study of the human factor, both the patient and the laboratory assistant.
What does "elevated white blood cells in the smear" mean?
In most cases - this conclusion indicates the presence of an inflammatory process. White blood cells or leukocytes are direct participants in the body's immune response. They recognize external and internal foreign substances, try to destroy them, and also - to preserve information about the invasion of pathogens. All kinds of white cells are able to quickly move, penetrate through the shell of vessels into the intercellular space, accumulate and destroy there foreign agents.
When massive invasion of pathogens is active phagocytosis, leukocytes die, not coping with the digestion of enemies - there are purulent discharge (dead leukocytes - neutrophils). The symptoms of acute inflammation increase - swelling, redness, soreness, itching, and the influx of new white blood cells.
If a woman feels symptoms of distress and goes to a gynecologist with certain complaints, then elevated white blood cells are unlikely to surprise her. And when such a conclusion falls "like snow on the head" after a preventive examination, then women begin to flip through the medical directories and turn to the network, asking the sacramental question: "What does" elevated white blood cells in the smear "mean?
Let us dwell first of all on the human factor. Since we can not influence the laboratory, we will outline the rules for putting the brushstroke, which must be performed, so that the result is as informative as possible.
To give a smear is best right after the end of menstruation. In addition, it is necessary to refrain from sexual intercourse, taking analgesics and barbiturates at least two days before the test. If the patient is taking immunosuppressants, cytotoxic drugs or hormones, the doctor should be informed about this. On the eve of a visit to the gynecologist to reduce physical activity (especially on the muscles of the abdominal and buttocks), do not use any vaginal products, medicinal and intimate hygiene, do not douche, just wash yourself with warm clean water. Do not take the test within a decade after the end of antibiotic therapy, or at least warn the doctor about it. It is undesirable to empty the bladder for two hours before a visit to the gynecology room, since it is possible to wash off the diagnostic components from the vaginal mucosa.
Agree, such rules before visiting a gynecologist, we do not always do. And their failure can lead to a distortion of the result.
Causes of the elevated leukocytes in the smear
The most likely cause of an increase in the content of cells of the immune system in the contents of the scraping is an inflammatory process located in the urogenital ways: vaginal (colpitis or vaginitis), the mucous membrane of the cervical canal or the uterus itself (exo and endocervicitis, endometritis), the urethritis (urethritis); fallopian tubes and ovaries ( salpingoophoritis ). Sometimes, in the same smear, there are also found the culprits of inflammation - gonococci, trichomonads, often for their detection, more modern and deeper methods of diagnosis are needed to identify chlamydia, ureaplasma, viruses and other infectious agents (PCR, ELISA, Mutual Diagnostics, culture and cytological analysis of the smear, biopsy, ultrasound), as well as a general health examination of the patient (consultation of other specialists).
If the leukocytes in the smear are increased in the erosion of the cervix, then the cause of this is not the mucosal structure defect itself, but the presence of the inflammatory process, which apparently led to the appearance of erosion.
Depending on the type of infectious agent, the inflammation of the urogenital organs is divided into specific ones caused by Trichomonas, chlamydia, gonococci, myco-and ureaplasma, tubercle bacillus, yeast fungi, viruses, and nonspecific, caused by various cocci, gardnerella, proteus, intestinal and Pseudomonas aeruginosa . The conditionally pathogenic flora becomes the causative agent of the inflammatory process, when favorable conditions are created in the body for it - a decrease in immunity. Nevertheless, the division of infections into completely and conditionally pathogenic microorganisms is relatively relative, since inflammation is mainly caused by microbial associations.
Infectious agents (specific) are transmitted mainly during sexual intercourse, sometimes by contact-household methods when using general hygiene items. The second way is usually infected in childhood.
The cause of the inflammatory process may be a violation of the vaginal microflora. With a decrease in the concentration of lacto- and bifidobacteria, active development of opportunistic microorganisms begins, in particular, Candida yeast fungi or gram-varietal flora. That is why there are detected leukocytes in the smear with thrush, which can be caused by the use of antibiotics, and ureaplasmosis, mycoplasmosis, chlamydia. Therefore, additional diagnostics are required.
Inflammation of the external genital organs can be caused by an allergic reaction to medications and phytopreparations, intimate hygiene products, local contraceptives and even partner sperm.
Malignant neoplasms can cause a high concentration of leukocytes in the smear, since the destructive process is also accompanied by inflammation.
The level of leukocytes varies under the influence of sex hormones, even during the menstrual cycle, and also - with fluctuations in the hormonal background in puberty and in menopause, in pregnant women, immediately after abortion and childbirth, in endocrinologist patients, in ovarian dysfunction. Therefore, do not panic, noticing the elevated white blood cells in the smear before the menstruation. A few days before the proposed menstruation, the number of white blood cells (without signs of destruction) in the scrapie from the vaginal mucosa can be 35-40 units in the field of vision. Similarly, the slightly elevated white blood cells in the smear should not be intimidated by menopause, during pregnancy. However, high levels of immune system cells even during periods of hormonal background fluctuations indicate the presence of an inflammatory process, especially if the leukocytes have morphological transformations associated with their protective activity.
[Risk factors
The risk factors for leukocytosis in the contents of scrapings from the urogenital tract mucosa may be related to:
- with a decrease in immunity due to stress, overwork, hypothermia, antibiotics, chemotherapeutic and other drugs;
- with mechanical irritation as a result of intense sex, uncomfortable synthetic underwear or trousers;
- with a frequent change of sexual partners, an unhealthy lifestyle;
- with spermicide contraception;
- with the installation of the Navy within the next ten days;
- with insufficient or, on the contrary, too conscientious execution of hygienic procedures (for example, infatuation with syringing using drugs);
- with frequent use of hygienic vaginal tampons;
- with intestinal dysbiosis;
- with systemic diseases;
- with a recent (within 24 hours) sex before the delivery of the smear;
- with another deviation from the rules of the analysis.
Symptoms of the elevated leukocytes in the smear
A smear for vaginal microbiocenosis is taken from the patient when she visits the gynecological office every time, both with complaints and with a preventive examination.
The first signs of trouble that should prompt a woman to come to the doctor for examination are a change in the appearance of the vaginal discharge, uncomfortable sensations in the process of bladder emptying, itching and burning in the area of the external and internal genitalia, pain in the lower abdomen, discomfort with coitus.
Highly elevated leukocytes in the smear and secretions make you think about the inflammatory process. In inflammation, a sufficient number of neutrophils, killed in the fight against foreign substances of leukocytes, and a considerable amount of mucus are found. In addition, bacteria are smeared in the smear (sticks and cocci), fungi, and lacto- and bifidobacteria are usually already inadequate.
Vaginal discharge causing discomfort in the form of severe itching, with an unpleasant odor can indicate vulvovaginitis, colpitis, cervicitis, endometritis.
Allocations: purulent, foamy gray-green color, whitish curdled are a sign of a specific inflammation.
Soreness during intercourse accompanies, as a rule, inflammatory diseases of the uterus, its cervix, fallopian tubes or ovaries.
Elevated white blood cells in a smear in women who have noticed an unstable menstrual cycle may indicate an inflammation of the ovaries or other pathology.
Leukocytosis in combination with frequent and painful emptying of the bladder indicates the presence of urethritis or cystitis, and with false and frequent urge to empty the intestine - about its possible dysbiosis.
Unconditional inflammatory process corresponds to the record: leukocytes in the smear of 50 or more. Sometimes their number can not be counted, and then the conclusion of the laboratory assistant may look like "leukocytes are completely in sight." This formulation speaks of acute inflammation and the need for immediate treatment. This smear usually contains not only leukocytes, but a lot of mucus and other pathogenic and conditionally pathogenic microorganisms, for example, epithelial cells, colonized by gardnerella, the so-called key cells. This is a symptom of bacterial vaginosis.
Women often look for answers on the Internet, getting their hands on analysis and, apparently, not satisfied with the explanations of the doctor. But only one indicator of white blood cells in the field of vision is impossible to diagnose, it is necessary to analyze other indicators. Even if only leucocytes are increased, this does not exclude the presence, for example, of chlamydia, which is diagnosed by other methods.
If the elevated white blood cells in the smear are 40-50 and there is another symptomatology (discharge, discomfort and others), then the presence of trouble is undoubted. In the absence of other symptoms, you can retake the smear, observing all the rules of the analysis, their violation can provoke a false result and more impressive.
Leukocytes in smear 35-40 may be a sign of both a chronic sluggish inflammatory process, and inappropriate time for delivery of the analysis (for example, routine preventive examination of a gynecologist organized in the workplace).
The same can be said about the figure "white blood cells in the smear 20-25", which is even less different from the norm. Even if you are not worried about anything, and you are sure of your health, it is worthwhile to insure yourself and retake the smear, while respecting all the rules. The human factor also can not be ignored, but it is unlikely that the lab technician makes a mistake twice.
When cocci and elevated white blood cells are detected in the smear, at least in the presence there is bacterial vaginitis - the development of pathogenic flora in violation of the microbiocenosis of the vagina. This condition can be caused by different reasons from self-infection with improper washing up to hormonal, anatomical and immune disorders. In addition, the presence of cocci does not exclude the possibility of detecting other inflammatory provokers, hence, additional diagnostics - PCR, ELISA and others.
If the leukocytes are stubbornly raised, but nothing is found, do not hide the "head in the sand", but check well on oncopathology. A timely diagnosis will save your life, because the reproductive organs are not relevant to life.
Leukocytes in the smear during pregnancy are often increased, especially in the second half. In the first - with a physiological decrease in immunity, inflammatory processes in the genito-urinary organs are possible. A slight increase in leukocytes in the absence of other symptoms should not cause concern, and the inflammatory process must be eliminated.
When the leukocytes are elevated after the birth in a smear, it is most likely a symptom of the inflammatory process, which is associated with a violation of the vaginal microflora, with an infection that has been dozing for a while, or a new infection. The same goes for abortion. Recommendations in this case are common to all. In the absence of other symptoms, the analysis can be retested, examined more thoroughly. They treat not elevated white blood cells, but the cause that caused their increase, which needs to be established.
Elevated white blood cells in the smear in a child are usually found when the child is disturbed by other symptoms, because with a prophylactic purpose a smear in children is usually not taken. Infect the child can any infection by contact and household way from the parents, respectively, it must be carefully examined and treated by a competent specialist.
Complications and consequences
The result of analyzes with deviations from the norm in the quantitative indices of the content of immune cells must at least be rechecked.
What are the dangerous leukocytes in the smear? The possibility of an inflammatory process, ignoring which can lead to violations of reproductive function, ectopic pregnancy, proliferation of connective tissue strands in the small pelvis, pathologies of the uterus and neglected oncological process.
An increased level of leukocytes in a future mother is dangerous for spontaneous abortion, infection of the child in utero or in the process of childbirth, premature or complicated birth, complications of the postpartum period.
Treatment of the elevated leukocytes in the smear
The Internet is full of questions: What if the white blood cells in the smear are increased? How to get rid of leukocytes in a smear?
One gets the impression that the trust in doctors is minimal, because no adequate medical doctor will treat leukocytes and explain to the patient that this is just a laboratory indicator, a symptom and it is necessary to find out the reason for such an increase.
Nevertheless, we strongly advise not to engage in self-medication, to find a trustworthy doctor who will help get rid of leukocytes in the smear.
Prevention
Prevent the increase in the level of white blood cells in the smear can, first of all, avoiding infection of the urogenital tract, that is - promiscuous sexual relations, neglect to sanitary and hygienic standards.
Secondly, you need to take care of your immunity, hormonal background and general health, eating well and varied, fully resting and leading an active lifestyle.
When there are deviations in the parameters of the composition of the smear, it is necessary to find out the cause and remove it in time.
Forecast
Inflammatory diseases of the urogenital tract, which are mainly responsible for the increase in the number of white blood cells in the smear, are successfully treated. Modern medicine has a large arsenal of funds for this.
Other causes are also eliminable and are not deadly diseases, especially if medical care is requested on time.
The prognosis of the resolution of the situation when the leukocytes in the smear is increased depends entirely on the cause of the increase and responsible attitude of the woman to her health.