Bacterial vaginosis

Bacterial vaginosis – a gynecologic infectious not inflammatory disease. Developing of an illness owing to sexual contacts is characteristic. According to the statistics 20% of women of reproductive age have a vaginosis. The disease of changes of the vulval environment and flora is characterized, production of lactic acid goes down and decreases rn the vulval environment. Thus, the arisen neutral environment does not interfere with development of various microbes, including trichomonads.

The microflora of a vagina can be presented in the form of a mobile ecosystem. The microflora of a vagina contains lactobacilli which play protective function in a normality. Lactobacilli processing a glycogen (at women of reproductive age epithelial cells of a vagina contain a glycogen in a large number) into lactic acid, thereby, lowering acidity of a vagina. Besides, lactobacilli are capable to form hydrogen peroxide. Peroxide of hydrogen and acidic environment of a vagina suppress reproduction of opportunistic pathogenic bacteriums (streptococci, stafilokokk, anaerobic bacteria, colibacillus, Mobiluncus spp, Gardnerella vaginalis.). Which in small amounts come to light in microflora of a vagina of the vast majority of women.

If in an organism the share of lactobacilli that instead of them in an ecosystem decreases occupy opportunistic pathogenic bacteriums (Gardnerella vaginalis first of all). The last promote allocation flying amine which on a smell are comparable with a smell of rotten fish.

The bacterial vaginosis is not transmitted sexually as is not a venereal disease. Bacteria causative agents of a bacterial vaginosis (first of all Gardnerella vaginalis) can be transferred at sexual contacts. But their broadcast from the woman to the woman cannot serve as a basic reason of a disease. As in small amounts these microbes are a part of microflora of a vagina of the vast majority of women.

The unprotected sexual contacts, nevertheless, can play a part in emergence of a bacterial vaginosis. Here all it is not infectious infection, and that a seed of the sexual partner or several sexual partners are the reason of change of microflora of a vagina.

Serve as a basic reason of a disease not just presence of bacteria activators of a bacterial vaginosis (they are present almost at each woman in small quantity), and change of proportions of opportunistic microbes (which cause a bacterial vaginosis) and lactobacilli. The share of lactobacilli at a bacterial vaginosis decreases, and the share of disease-producing factors increases. Therefore the bacterial vaginosis in medicine carries the name vagina dysbacteriosis.

Can lead to developing of a bacterial vaginosis both internal influences of an organism, and external influences, so-called exogenous and internal causes. It can be changes of a hormonal background, decrease in a host defense, disturbance in work of intestines, in particular a microbiocenosis. Can cause a disease also such reasons as use of antibiotics, hormonal drugs, immunodepressants, and also the postponed earlier inflammatory diseases of urinogenital system.

Bacteria activators of a bacterial vaginosis are not dangerous to men. Men in whom the Gardnerella vaginalis activator was found as well as sexual partners of patients with a bacterial vaginosis of women, do not need treatment.

Symptoms of a bacterial vaginosis

Бактериальный вагинозThe bacterial vaginosis has no specific characters. Some clinical manifestations are characteristic of a disease, these are plentiful creamy allocations from a vagina. They homogeneous have grayish-white color, often stick to vagina walls. Because of disintegration of amines which develop bacteria vulval allocations often have an unpleasant, so-called "fish" smell. Allocations cause such symptoms of a bacterial vaginosis as burning and an itch in a vagina. It becomes frequent the reason of inflammatory diseases of the female generative organs unpleasant sometimes of painful feelings during sexual intercourse.

There are several types of a vaginitis, for each of them there is the symptomatology:

  • The aerobic vaginitis – appears as a result of hit on mucous aerobic microflora, during one-time decrease in normal lactoflora of a vagina.
  • The mecotic vaginitis – is one of the most widespread types of a vaginitis.
  • Mycotic vulvovaginitis – an inflammatory fungus as which main activators serve drozhzhepodobny fungi of Candida.
  • The allergic vaginitis – is one of types of a genital allergy which is caused by use of drugs for prevention of undesirable pregnancy or treatment of a disease of generative organs.
  • Desquamative inflammatory vaginitis — one of types of a nonspecific vaginitis.

Diagnosis of a bacterial vaginosis

Diagnosing of a disease is carried out in several steps. First of all laboratory research of smears on existence of key cells is conducted. When coloring a smear methylene blue it is possible to find flat epithelial cells to which gardnerella because of what cells take as if a priperchenny form are attached. In addition the laboratory analysis of smears includes the amine test. At research vulval allocations are diluted from 5-10% with potassium hydroxide solution. Arising at the same time began to smell, fishes or more precisely the amine smell speaks about existence of a disease.

Diagnosis of a bacterial vaginosis also includes determination of level rn microflorae of a vagina. For this purpose directly during survey on a gynecologic chair the doctor enters by means of tweezers rn paper into a secret of the vulval arch. Existence of a disease is defined at rn 4,5.

Existence of all these signs, and also symptoms of a bacterial vaginosis precisely confirm the diagnosis. It is possible to diagnose a disease also by method of allocation of pure culture of bacteria, but such diagnosis is ineffective. It is connected with the fact that more than 58% of healthy women have the high level of microbes Gardnerella vaginalis in a vulval secret.

Treatment of a bacterial vaginosis

Бактериальный вагинозThe disease demands conservative treatment. Reception of antibiotics, such as metronidazole, clindamycin, Tinidazolum is appointed. They are made in drugs for peroral and vaginal use. It is Flagyl, metrogel, kleotsin, tindamaks. Vlagalishny drugs are more effective, to their thicket include in treatment of a bacterial vaginosis. They cause less side effects, but there is a risk of emergence of the milkwoman.

As optimum way as treatment of a bacterial vaginosis serves metronidazole (for example, Trichopolum) to accept within 7 days 2 times a day 500 mg inside. Sometimes drug is hard transferred (can make sick). It is not compatible to alcohol at all. But system treatment can reduce probability of the complications caused by a bacterial vaginosis.

Reserve drugs:

Clindamycin (dalatsin, klimitsin) within 7 days 2 times a day on 300 mg inside. Clindamycin promotes suppression of growth not only bacteria of Gardnerella vaginalis, but also and laktobatsill (Lactobacillus spp.). Clindamycin is appointed in case of intolerance by patients of metronidazole.

Cream Clindamycin, with concentration in 2% (dalatsin) is entered by means of the enclosed applicator into a vagina within 5 days once a day (for the night). Of course, topical treatment is transferred much better, however less effectively system treatment reduces risk of complication of a bacterial vaginosis.

Gel Metronidazole, 0,75% (Metrogil, flagyl) enter into a vagina by means of the enclosed applicator within 5 days 2 times a day. As well as with the previous drug, topical treatment is transferred much better, however less effectively system treatment reduces risk of emergence of complications of a bacterial vaginosis.

There is other treatment of a bacterial vaginosis, its system consists of two stages. First, it is necessary to suppress reproduction of pathogens. For these purposes it is used an irrigation by solutions of boric and milk acids, but there are also more modern medical supplies. Namely, drug fluomizin — antiseptic medicine of a wide range of influence — is applied intravaginalno one time (on one tablet) within 6 days.

It should be noted that this drug can be used in the course of pregnancy for sanitation of parturient canals. It is carried out according to the same scheme, the beginning of therapeutic treatment — in 6-7 days prior to PDR.

At the second stage recovery of a biocenosis of a vagina is carried out. For these purposes the eubiotik, medicinal sedstvo containing strains lakto-and bifidobacteria are used locally.

Complications of a bacterial vaginosis: unpleasant smell of allocations, discomfort, itch; development of an endometritis (after Cesarean section, postabortive, puerperal); risks of premature births and an abortion on late durations of gestation.

Section: Gynecology