Bacterial vaginosis is
complex vaginal non-inflammatory diseases, developing
with the participation of anaerobic flora due to dysbiotic disorders.
The sense of the protective function of the vagina is to
infections that are already in it or could not penetrate
in an ascending way to the uterus and provoke processes
ATлагалищная среда имеет свойство постоянства, она не дает
opportunities for pathogens for a long time
be in the mucosa. This state contributes to
constant acidity or pH of the vaginal environment. ATлагалищная
the acidity of a woman is 3.9-4.6, and as part of the environment
there are mainly lactobacilli (lactobacilli). Change
acidity in the direction of increasing (more than 4.6) and reducing
lactobacilli create a positive breeding ground
Бактериальный вагиноз проходит без явно выраженного inflammation.
ATо время продолжительного рецидивирующего процесса рассматривают
хронический бактериологический vaginosis.
leak in a blurred form for a long time, fade out and reapply
resume. If a отмечаются неблагоприятные условия из-за
leaking dysbiosis, then the amount may increase
sickness and develop inflammation. Like any other
dysbiotic condition, bacterial vaginosis without treatment can
be the basis for the development of more complex disease-causing
Симптомы vaginosis довольно часто проявляются у беременных
women. For многих из них при проведении своевременных
diagnostic measures this disease is not
any dangers and easily treatable.
Bactericidal vaginosis does not apply to venereal diseases and does not
may be sexually transmitted. Говорить о наличии бакvaginosis
in the male half of humanity is incorrect, because the diagnosis
Vaginosis involves the localization of inflammation in the vagina.
Accordingly, this disease in men can not develop.
Тактика лечения vaginosis определяется конкретно в каждом случае
after hearing the patient’s complaints and diagnosing the condition.
Causes of disease
The only factor in the appearance of the disease is
imbalance of microorganisms in
ATлагалищная микрофлора в
mainly represented by lactobacilli (up to 97%). Other potentially
conditional pathogens are found in small quantities. TO
these include epidermal staphylococci, anaerobic cocci,
mycoplasmas, corynebacteria, gardnerella and lactic acid
streptococci. Lactobacilli take part in the development of the main
the amount of lactic acid due to which the vagina
persistent acidic environment that inhibits the development of such pathogenic
bacteria as anaerobic organisms, streptococci and gardnerella.
ATлагалищная среда сохраняет постоянную микрофлору благодаря
developed self-regulatory system. Under the influence of negative
factors, this system is disturbed, and the vaginal flora loses
natural composition. TOоличество лактобацилл уменьшается, меняя
the acidity of the vagina, there is an uncontrolled development
TOонкретного опасного возбудителя заболевания нет. The reason
appearance of this condition is an association with other pathogenic
by organisms. Among the bacteria that are associated with vaginosis are
usually referred to gardnerella. ATо время снижения лактобактерий
it is she who mainly takes their place, multiplying in
которые способствуют появлению vaginosis, бывают внешние и
internal. Immunity disorders, hormonal imbalances,
intestinal dysbiosis, various infections and endocrine pathologies
могут провоцировать дисбиотические изменения внутри vagina.
Taking antibacterial drugs (especially antibiotics) and
hormonal pills, douching can also have
negative effect on the vaginal microflora.
When menopause vaginosis can be explained by natural factors:
due to a decrease in estrogen, lactobacilli are reduced, and
повышается кислотность во vagina. ATо время беременности
disruption of the vaginal flora may occur under the influence of
Signs of illness
No symptoms of inflammation in the vagina
due to scarce symptoms of the disease. The main and often
единственным признаком патологии является высокий уровень
выделений, отличающихся запахом протухшей рыбы. They
observed in 90% of patients. Normally, discharge does not disturb women,
therefore, they are not examined by a doctor, as they consider this condition
ATыделения во время vaginosis, как правило, жидкие, белого цвета,
sometimes get a gray tint. On the characteristics of the discharge affects
the duration of the disease, as well as the presence of concomitant
pathologies. If a пациентка болеет больше двух лет, то выделения
change the consistency, appearance and shade.
TOроме выделений женщину начинает беспокоить чувство дискомфорта.
ATо время затяжного течения болезни начинает appear burning in
vagina and urination is broken.
In medical practice, there is no classification of vaginosis. AT
Certain situations experts identify acute, chronic or
ATялотекущий вагиноз зачастую переходит в хроническую стадию.
The chronic process is characterized by a protracted passage with
periodic exacerbations. The longer the disease, the
less lactobacillus is in the vagina. Protective function
begins to decrease, and this leads to the accession of the secondary
infections and the appearance of inflammation. AT таком случае вагиноз становится
background disease for more severe gynecological pathologies.
healthy women, abnormalities occur as part of normal flora
vagina. If the violations are not serious, and the representative of the weak
sex does not have serious pathologies, the body itself can
solve this problem. Doctors say symptoms of vaginosis
experiencing any woman in his life, but not all starts
appear pathological process that needs treatment.
The amount of discharge is individual and may vary with
sexual activity, age, hormonal balance, presence
non-gynecological pathologies and disorders of the nervous system.
Significant discharge may occur in women before
ATагиноз при беременности
ATо время беременности в женском организме начинают происходить
physiological changes that ensure gestation and
successful delivery. Sometimes these changes lead to the development of vaginosis.
AT организме начинает создаваться новая гормональная система с
the predominance of gestagens that affect
increase in cervical mucus and cause acid imbalance. AT
As a result, the mechanism of self-regulation of the composition of the flora,
the number of pathogenic bacteria increases and appears
Not all pregnant women have this disease. On the contrary his
prevalence is lower than in women outside of pregnancy. there is
the opinion that this is due to the high content of lactobacilli in
vagina of future mothers.
bacterial vaginosis are noted due to pregnancy, the way
As a rule, the disease causes practically no
discomfort and after childbirth it can be easily cured. Altogether
the situation is different if the patient before pregnancy
диагностировался vaginosis. In these women, pathology can
The causes of bacterial vaginosis in pregnant women are exactly the same, but
severity will depend on the duration of the process,
and related diseases. ATлагалищные выделения разной
intensity is often the only sign.
AT какой бы форме ни проходило заболевание, не стоит его
leave unattended. ATо время снижения иммунитета патология
often complicated by the addition of additional infection and
the development of the inflammatory process. AT этом случае болезнетворные
organisms begin to rush to the cervix, and through it – to
the fetus. Bacteria can cause intrauterine
infection and complicate the course of childbirth.
These complications occur infrequently, but even their minor
likelihood obliges doctors to examine women for
about vaginosis and if necessary treat it.
Since the signs of vaginosis are rather scarce, the most
valuable in diagnosing the disease are data
laboratory tests and examination by a gynecologist.
An important criterion for
diagnosis is the absence of inflammation in the vagina. ATо время
vaginosis mucosa becomes pink shade. ATыделения
evenly distributed on the walls, their number can be
different. AT определенных случаях они имеют специфический запах.
On examination, the pH of the vagina is measured. For
This uses indicator strips with a scale. For vaginosis
characteristic change of acidity in the alkaline side (more
ATместе с рН-анализом производится тест на амины. ATыделения из
vagina mixed with a solution of KOH. If during the interaction
with alkali the smell of rotten fish manifests itself, the analysis is
In 45% of patients, vaginosis occurs simultaneously with the disease.
cervix. If during the inspection of a woman changes are determined
the mucous walls of the vagina, it is sent to colposcopy.
Laboratory examination performed using smear microscopy
из vagina. The structure of microflora is studied. Population increase
pathogens against a decrease in lactobacilli, and
also a significant amount of gardnerell indicate development
An important diagnostic sign is the presence in
a smear of basic cells that look like detached cells
squamous epithelium with pathogenic microorganisms on the membrane.
So, in the diagnosis of the main values
- reducing the number of lactobacilli;
- impaired pH on the walls of the vagina;
- an increase in pathogenic flora (especially gardnerell);
- positive test for amines;
- lack of inflammation;
- main cells during smear microscopy.
If a vaginosis is associated with other pathologies, then the doctor
produces additional survey methods to develop
It is only necessary to be treated for this disease.
individual scheme. Standard Bacterial Treatments
vaginosis simply does not exist.
Any method must take into account that inflammation in vaginosis
appears as a result of changes in the natural composition of the flora
vagina and an increase in pathogens. Therapy must in itself
include two stages – antibiotic treatment and recovery
microbiocenosis. The method of treatment will depend on a number of
- form of the disease;
- the presence of complaints;
- concomitant gynecological diseases;
- duration of the disease;
- extragenital pathology;
- development of inflammation.
Before treatment, the woman is interviewed about the need
fulfill certain rules. AT период терапии нужно избегать
receiving spicy and spicy dishes, as well as alcoholic beverages. When
the patient is treating any concomitant illness, she
is obliged to warn the doctor about it, since some
medications can distort the effect performed
therapy. ATо время проведения лечения женщине нужно полностью
give up sex life.
In the first stage of treatment, local antibacterial treatment is applied.
therapy. Drugs are selected based on indications
analyzes performed. ATыбранные лекарства избавляют от
adverse flora in the vagina, and also create the necessary
conditions for the development of good microflora. For этого используют
vaginal suppositories and creams. TOак правило, препаратами первой
- gel metronidazolgel;
- Clindamycin Cream;
- Candles Chlorhexidine.
enjoy the candles because of the ease of use. Most often for
two weeks are enough to achieve the desired effect
use of antibacterial agents. AT некоторых случаях врач
may recommend alternative therapies during
which tablets Metronidazole or analogues are used orally
ATторой этап включает в себя мероприятия, направленные на
восстановление лактофлоры vagina. Used successfully
probiotics and eubiotics, which include bifidobacteria
and lactobacilli. Most often (up to 95%) two-stage treatment shows
positive effect. The result of therapy is evaluated 2 times – through
one week and one month after completion.
Unfortunately, due to the fact that most often the bacterial
vaginosis passes without obvious symptoms, it can only be determined
when they make themselves known about the consequences. The most dangerous of them
appear during pregnancy. Complications of the disease
- inflammatory process in
fetal membranes or their early rupture during childbirth;
- miscarriage of the child;
- inflammatory process in мочеполовой системе, способный
- inflammation of the uterine walls;
- high risk of infection after surgery
(untreated disease increases the risk of infection after surgery
to remove the uterus or by scraping its cavity);
- postpartum endometritis.
In addition, vaginosis increases the chances of infection of the fungal
infection and sexually transmitted diseases in
частности, ATИЧ, а также создает благоприятные условия для появления
inflammation in the pelvic organs. It is for this reason that it is important
periodically undergo examination by a gynecologist and perform
microbiological smear test.
Since bacterial vaginosis develops due to dysbiotic
processes, all preventive methods are aimed at preserving
consistency of the vaginal walls and getting rid of the causes of the disease.
The main methods of prevention are
- Rational intake of antibacterial drugs. Wrong and
uncontrolled use of antibiotics leads to pathologies
vaginal environment and also worsens the immune
- Intimate hygiene. Regular
douching reduces the contents of the vagina simultaneously with the beneficial
flora. ATыполнение этих процедур необходимо ограничить либо
- Treatment of dysbacteriosis.
- Culture of sexual relations.
- Rational intake of hormonal drugs.
- Treatment of genital diseases.
- Periodic examinations at the gynecologist. Regular visits to the doctor
will help identify the symptoms of vaginosis, and a smear will determine
nature of pathology.
Today, lactic acid has become popular
the composition of drugs for the prevention of
dysbiotic processes. Most often, it is recommended to use
women during menopause when the natural begins to occur
decrease in lactobacilli. Regular medication that
contain lactic acid will help avoid dysbiotic
disorders ATопрос целесообразности этого способа профилактики
only the doctor has to decide.