Dysbacteriosis of the vagina

Dysbacteriosis of the vagina is an equilibrium disorder of the microflora of the vaginal environment. With the dysbacteriosis of the vagina, the ratio of useful and conditionally pathogenic bacteria is disrupted, and the conditionally pathogenic flora begins to predominate significantly.

The change in the composition of the vaginal environment occurs in both a quantitative and qualitative ratio, which is manifested by considerable discomfort in the genital area and can provoke the development of inflammatory processes in the reproductive field with the addition of various infectious complications. However, for a certain number of women, the imbalance of the vaginal microflora may be asymptomatic for a while.

This material will allow you to understand what is the dysbacteriosis of the vagina, how to deal with it and how to prevent the appearance of this unpleasant pathology in the future.

[1], [2]

Causes of vaginal dysbiosis

The number of useful microflora in the vaginal environment may decrease for several reasons:

• the appearance of favorable factors for the development of fungal infection in the vagina;
• frequent colds and infectious diseases, hypothermia;
• imbalance of the hormonal background associated with puberty, lack of sexual activity, pregnancy, menstruation disorders, abortion, menopause, etc .;
• frequent climate change;
• frequent psychoemotional stresses and mental overload;
• violation of sanitary and hygienic standards (non-compliance with personal hygiene rules, untimely change of linen, replacement of tampons and gaskets, as well as promiscuous sexual intercourse without the use of a condom;
• inflammatory processes (especially chronic) of the uterus and appendages;
• abnormal or prolonged use of antibiotics;
• violation of the normal balance of the intestinal environment, frequent stool disorders;
• presence of infectious diseases of the genital area (ureaplasma, chlamydia, trichomonas).

Especially it is necessary to distinguish several factors that create favorable conditions for the growth and development of fungal and other pathogenic flora in the environment of the vagina. These are the following reasons:

• disorders of metabolic processes (diabetes, obesity, dysproteinemia);
• thyrotoxicosis, avitaminosis, diseases of the blood system;
• abnormal or prolonged treatment with antibiotics, contraceptives, corticosteroid hormones, cytostatic agents that provoke a failure of the hormonal balance and reduce immune defense.

[3], [4]

Symptoms of vaginal dysbiosis

At first, dysbiosis can be asymptomatic. However, after some time, the first signs of a pathological condition appear:

• vaginal discharge, which had not previously been observed;
• sensation of itching and discomfort in the vagina;
• unpleasant sensations in sexual contact;
• and dryness in the vaginal cavity.

Allocations for dysbacteriosis of the vagina have a muddy pastel yellowish or even greenish tinge, as well as an unpleasant putrefactive odor. Sometimes women do not pay much attention to the vaginal discharge, as it normally also happens. However, normal discharge is transparent, and does not differ with an unpleasant odor.

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

Dysbacteriosis of the vagina in women

Very often, the causes of dysbiosis are promiscuous sexual intercourse, neglect of condom use, periodic infection with infections that are sexually transmitted. If the vaginal flora is within the normal range, then the risk of developing an infectious disease of the reproductive organs is minimized. The development of sexual infection suggests that the balance of the microflora has disrupted, and the body ceases to cope with the invasion of foreign agents.

If in the genital organs there is a causative agent that is transmitted sexually, simultaneously with it the process of inflammation starts in the genital sphere, and the imbalance of the vaginal environment is only aggravated. It is important to understand that the infection does not cause the disease itself, but only in conjunction with conditionally pathogenic microorganisms that are present in the vagina. Therefore, the treatment of genital tract infection, along with the destruction of the pathogen (Trichomonas, Chlamydia, etc.) should be accompanied by measures to restore normal microflora in the vagina. If this is not done, the treatment of bacterial vaginosis may be unsuccessful.

The question of simultaneous treatment of a sexual partner in diseases that are sexually transmitted, should be decided on admission from a specialist, since not in all cases, such treatment is appropriate and necessary.

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

[5], [6]

Dysbacteriosis of the vagina during pregnancy

Very often during pregnancy there is an exacerbation of hormone-dependent diseases in the body of a woman. Such diseases include dysbacteriosis of the vagina (bacterial vaginosis). It's not a secret that in pregnant women the hormonal level changes almost daily. Along with this, the immune defense decreases, the nature of nutrition and sexual life change. For these reasons, the development of vaginal dysbiosis during this period is a very very common phenomenon.

Due to the fact that pregnant women are not recommended to take any treatment before the birth of a child, it is unlikely to cure dysbiosis completely in this period. Experts do not admit the use of antibiotics and immunostimulants in pregnant women.

Treatment is reduced to symptomatic therapy, correction of nutrition and compliance with personal hygiene. Sometimes a local treatment (ointment, syringing) is prescribed at the doctor's discretion.

[7], [8], [9]

Dysbacteriosis of the vagina in the child

Dysbacteriosis of the vagina is often found not only in adults, but also in childhood and adolescence. Infectious and non-infectious factors can become the causes of the disease.

At birth, the girl's vagina, which was supported by her mother's estrogen hormones at the intrauterine stage of development, is hypertrophied by a layered flat-epithelial tissue containing glycogen. The indices of the vaginal environment during this period may be 5.5-7.0. Such a natural physiological state can lead to the appearance of milky white discharge of a dense consistency during the first twenty days of life, the amount of which gradually decreases as the active action of the mother estrogens decreases.

Approximately from the third week of life and up to the beginning of the climacteric period, the vaginal mucous can become atrophic, will not contain glycogen, and the vaginal environment will maintain a neutral or alkaline pH (from 6.5 to 7.4). This development of pathology favors the development of pathogenic microorganisms.

Dysbacteriosis of the vagina in girls can manifest themselves in different ways. Little babies can scratch and rub the genital area, be capricious during urination or defecation. Older girls describe the sensation of itching and soreness. Separated from the sexual gap is unstable and may not be considered the first symptom of dysbiosis.

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

An important role in the etiology of dysbiosis in childhood is played by antibiotic therapy, the presence of a genetic predisposition to diabetes mellitus, helminthic invasion, skin diseases (psoriasis, eczema, dermatitis). These factors can accelerate or contribute to the development of dysbiosis.

[10], [11], [12],

Diagnosis of vaginal dysbacteriosis

Standard diagnosis of vaginal dysbiosis, in addition to the basic gynecological examination, should include such analyzes:

• taking a smear on the microflora;
• PCR analysis;
• carrying out the sowing of the vaginal discharge.

The analysis for the dysbacteriosis of the vagina is taken with a disposable spatula in three places: in the cervical canal, in the opening of the urinary canal and from the vaginal wall. Before passing such an analysis, a woman should follow certain recommendations:

• not have sex Yes 1-2 days before delivery of smear;
• Do not use intimate creams, vaginal suppositories;
• Do not douche and do not take a bath, do not swim in the reservoirs and pool before the procedure.

Taking a smear on the microflora is done whenever possible several times in the same laboratory in order to avoid a difference in the norms. It is compulsory to take the analysis before and after treatment.

PCR analysis allows identifying the causative agent of infection. For analysis, samples of vaginal discharge are usually used, which are combined with specific enzymes and placed in a specialized reactor. Such a study not only determines the type of infectious agent, but also allows you to detect how much infection is present in the body. This method determines the presence of chlamydia, ureaplasma, mycoplasma, fungal infection, gardnerella, trichomonas, herpes, etc.

Sowing on the flora (culture research) allows to obtain a pure culture of microbes, to carry out their identification and to determine the properties of the pathogen.

With the help of sowing, you can find klebsiella, E. Coli, protozoa, cocci flora, enterobacteria, Pseudomonas aeruginosa, corynebacteria, etc. Simultaneously with sowing, sensitivity to antimicrobials is determined, if necessary.

[13], [14]

Dysbacteriosis of the vagina after antibiotics

The change in the composition of the vaginal flora is one of the most common consequences after treatment with antibiotic drugs.

Antibiotics - one of the most effective drugs in the fight against various infectious diseases. These medicines can shortly stop the reproduction and destroy pathogens, but at the same time they can kill useful microbes, without which the normal work of the body becomes impossible. At this point, and develops dysbacteriosis of the vagina after antibiotics.

To prevent the development of dysbiosis, you must adhere to several rules:

• if the doctor has prescribed therapy with antibiotics, it is necessary to follow the scheme of treatment precisely, not to miss taking pills or injections, to not independently cancel and prolong the course of antibiotic therapy;
• simultaneously with antibiotics should be taken drugs that help restore microflora in the body, and containing a complex of living beneficial bacteria.

During antibiotic therapy it is important to adhere to a special diet that will protect the body from a violation of the balance of the intestinal and vaginal flora. This diet provides for the use of fresh sour-milk products, vegetables and fruits, as well as the rejection of sweets and alcohol.

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

Treatment of vaginal dysbiosis

How to treat the dysbacteriosis of the vagina? For successful treatment it will be necessary to solve several questions:

• stop the growth and reproduction of pathogenic microorganisms that were found in the vaginal environment;
• promote the growth of the number of beneficial microorganisms in the vaginal cavity;
• to adjust the immune resistance of the mucous membranes of the vaginal wall.

If the phenomenon of dysbacteriosis is associated with the detection of an infectious agent, the main treatment regimen for vaginal dysbiosis should be directed towards the complete destruction of foreign microorganisms. In such a situation, antibiotics are prescribed depending on the sensitivity of the detected bacteria. If there were no sexual infections, douching or topical application of antimicrobial and antiseptic agents can be used. This method can be used to suppress the growth of pathogenic bacteria, restore normal environmental parameters and local immunity. To suppress the growth of pathogenic microorganisms, antibiotics are often prescribed (amoxiclav, sumamed, trichopole, doxacycline), the use of local antiseptic agents (chlorhexidine, miramistine), and the use of antimicrobial suppositories (ginopevaril, terzhinana).

Preparations for dysbacteriosis of the vagina:

• Trichopolum (metronidazole) by 0.5 g orally twice a day for a week. The drug effectively fights infection, prevents the development of complications, but can sometimes cause diarrheal disorders;
• metronidazole-gel (synonyms Metrogil, Flagil) - is introduced into the vaginal cavity by means of a special device (included) daily before bedtime for five days. This treatment has fewer side effects and is safely tolerated by patients;
• clindamycin ointment (synonymous with Dalacin) - is injected into the vagina cavity before going to bed for five days;
• the drug clindamycin (dalacin, klimitsin) - 0.3 grams orally twice a day for a week. This remedy is often prescribed if there is an allergy to metronidazole;
• lactobacterin - a probiotic preparation that normalizes the microflora of the vaginal medium, which increases the immunity and inhibits the growth of pathogenic and conditionally pathogenic flora. Lactobacterin before application is diluted with boiled water and injected into the vagina from 2.5 to 5 doses for 10-12 days;
• bifidumbacterin - restores the balance of the flora of the vaginal cavity, inhibits the growth of staphylococci, protea, E. Coli, shigella, fungal infection. Powder is consumed inside half an hour before a meal according to the doctor's prescription, usually 5 doses three times a day.

Suppositories from the dysbacteriosis of the vagina:

• Neo-pentotrans are antimicrobial vaginal suppositories that are prescribed for bacterial and trichomonas vaginitis, fungal infections, and mixed flora. Usually, one suppository is used at bedtime, the duration of treatment is 2 weeks. Sometimes it is possible to prescribe suppositories with application twice a day: in the morning and at night for a week. The drug can not be used in the first trimester of pregnancy and in childhood;
• flagyl suppositories - appoint concomitantly with oral therapy metronidazole, injected at night with 1 suppository for 7-10 days. The drug is not recommended to take long, and also to conduct more than 3 courses of therapy for the year;
• terzhinan - vaginal tablets, which are introduced into the vagina for 1 pc / day, the duration of use is from 10 to 20 days. If necessary, treatment with terzhinan can be carried out even during menstruation;
• ginolact - contains lactic acid bacteria that inhibit the growth of pathogenic microorganisms and activate the natural mechanism of immunity. One capsule is inserted into the vagina, the duration of treatment is from 3 to 6 days. If necessary, the treatment can be repeated after a one-week break;
• Acylact - a probiotic agent containing active acidophilic lactobacilli. Suppositories are used intravaginally, 1 unit each. One or 2 times a day. The average duration of treatment is from 5 to 10 days.

To successfully treat vaginal dysbacteriosis and prevent relapses, vitamin complexes are prescribed, and it is also recommended to adhere to a diet with the predominant use of vegetables, fruits, herbs, and sour-milk products. Limit sweets, smoked and spicy food, alcoholic beverages.

With frequent signs of vaginal dysbiosis, discard the following products:

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

During the course of therapy it is advisable to refrain from sexual contacts or to use condoms, as often after the act of sexual intercourse the symptoms of dysbiosis can become worse.

Alternative remedies for vaginal dysbiosis

As an alternative treatment, it is possible to use infusions from juniper berries, yarrow, sage, eucalyptus, camomile, calendula. To prepare the infusion, 1½ -2 full tablespoons of dry ground grass should be poured 200 ml of boiling water and insist 40-50 minutes. The drug can be taken three times a day for 1/3 cup after meals, or used for syringing.

These herbs have a strong antimicrobial effect, they can be used alone or as a mixture in arbitrary proportions.

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

To combat fungal infection successfully used soda tubs. For their preparation mix in warm water a teaspoon of baking soda and 50 drops of iodine. The bath should be taken before bedtime, the duration of treatment - from 1 to 2 weeks.

Well, the following remedy helps: take 10 cloves of garlic, 100 g of home-made sour cream, 400 ml of apple juice, 200 g of prunes and 200 g of fresh berries (strawberries, raspberries, blueberries). Chive garlic, prunes and berries chop, mix with liquid ingredients and take 1 tbsp. Spoon three times a day for 14 days.

A few more recipes for restoring the normal vaginal microflora:

• Aloe juice is mixed with vegetable oil in equal proportions, we moisten in a mixture of a tampon and inject it into the vagina cavity for the night;
• bark of oak (1 tablespoon) is poured in a thermos 300 ml of boiling water. We insist for 3 hours, filter out and apply for syringing at night;
• we moisten the tampon in the sea-buckthorn oil and inject it into the vagina cavity for the night;
• take 5 tbsp. Spoons of crushed currant leaf, throw into boiling water, add 5 cloves of garlic, passed through the press, remove from heat and pour in juice of half a lemon. Filter out the mixture and drink 1/2 cup to 4 times a day.

It is useful to drink daily 1 cup of fresh kefir or curdled milk at night. Especially good is fresh yogurt from goat's milk. It is important that the product is fresh: old kefir or sour milk does not contain active beneficial bacteria that will benefit the body.

Never spend syringing with kefir or yoghurts, this will only exacerbate the situation. Sour-milk products have a beneficial effect only when ingested.

Sometimes it makes sense to conduct preventive treatment courses 1-2 times a year. At first, after therapy, it is advisable to be examined every three months for one year. Adhere to the recommendations of the doctor, because the dysbacteriosis of the vagina - a very common and unpleasant problem that can be addressed: especially effective treatment in the early stages of the disease.

[19], [20]