Dysbacteriosis vagina - this change in the normal vaginal flora quantitative composition of non-inflammatory origin.Dysbacteriosis vagina is the most common gynecological diseases, which may be accompanied by pronounced symptoms.This pathology diagnosed every third pregnant patient and often discovered by chance.
healthy vaginal mucosa is composed of squamous cells, arranged in rows, and has an important barrier function: prevents the reproduction of adverse microflora, thus protecting the overlying sex structure of inflammation and infection.In turn, the normal vaginal flora protects the vaginal mucosa against the negative influence of harmful bacteria.
Normally, in healthy women vaginal microflora has a constant composition.It is based on Dederlyayna sticks - lactobacilli (98%) and a small amount of acidophilus microorganisms (40 species), helping to "protect" the vagina.
remains insignificant 2% are opportunistic pathogens, so named because it is equally likely o
vaginal mucosa is constantly updated by the surface layer - the "old cells" are rejected, yielding place to new.The surface cells of the stratified squamous epithelium of the vagina contains glycogen.Lactobacilli cleave it to lactic acid, with the participation of hydrogen peroxide, thereby creating an acidic medium (pH 3.8 - 4.5).In this environment, comfortable feel and reproduce only lactobacilli, they create a kind of surface mucous layer that protects the vagina from infection and inflammation.For representatives of conditionally pathogenic flora acidic environment is devastating.
Stratified squamous epithelium lining the vagina is gormonalnozavisimyh cloth.In maintaining the constancy of the vaginal environment plays an important role hormonal ovarian function and normal biphasic ovulatory cycle as estrogen ensure proper deposition of glycogen in the surface layer of the vaginal epithelium and progestins are involved in the process of timely rejection of mucosal cells.
Pregnant along with the usual mechanisms of the vaginal bacteria overgrowth can develop in a special scheme - through the increase in the number of lactobacilli.We can say that the vaginal bacteria overgrowth during pregnancy developed for physiological reasons.During pregnancy, under the influence of hormonal changes occurring physiological process of preparing for the upcoming vaginal childbirth: it becomes more elastic and loose.Such changes are due to thickening of the vaginal epithelium.Along with the increase in the number of epithelial cells grow glycogen stores, and that it is required to recycle more of lactobacilli.Increasing the number of lactobacilli causes that the medium in the vagina becomes too acidic and does not allow them to reproduce.As a result, conditions are created for the growth of pathogenic organisms such as fungi Candida, ureaplasma, and so on, so the vaginal bacteria overgrowth during pregnancy often provokes the development of fungal infection (candidiasis).
Thus, any deviation of the pH values from normal vaginal environment, whether it is increasing or decreasing, predisposes to the development of dysbiosis vagina.
not uncommon vaginal bacteria overgrowth in children and elderly patients.
have dysbiosis vagina is not any single cause.If at any stage of the "work" of the normal microflora fails, run the local pathological processes.It will be correct to say that dysbacteriosis vagina - it is not a disease but a pathological condition that can lead to disease.If the number of lactobacilli in the vagina decreases, change the acidity of the medium, and conditionally pathogenic microflora begins to multiply, occupying the vacant place.This mechanism triggers a chain of events adverse to the body.
symptoms of vaginal dysbiosis pronounced in patients differently, depending on what kind of opportunistic microbes occupy a dominant position in the vaginal environment.
in the development of dysbiosis vagina take the joint participation of the representatives of a variety of bacterial flora.The disease is not caused by a single pathogen, and the whole association of various opportunistic germs.
often expressed clinical signs of dysbiosis vagina and may not be detected by chance.The long existing in the vagina without treatment, goiter can take a chronic form.
dysbiosis vaginal therapy aimed at restoring normal composition of the local flora and the inhibition of growth of opportunistic microorganisms.
Dysbacteriosis vagina itself does not cause significant harm to women's health, but his background is much more likely to have inflammatory and infectious processes.
Causes of dysbiosis vagina
only the immediate cause of dysbiosis vagina is a quantitative change in composition of the normal vaginal flora and the vaginal environment.
You can not point to a specific "culprit" of vaginal dysbiosis, as they may be representative of any opportunistic flora that inhabits the vagina.It has been established that the signs of dysbiosis vagina revealed amid increasing breeding gardnerellas every second patient.Besides these bacteria overgrowth vaginal accompany mycoplasma and anaerobic bacteria.
composition of the vaginal microflora depends on the condition of the vaginal mucosa, local immunity and hormonal status of the organism.Dysbacteriosis vagina can be triggered as the most simple and more complicated circumstances.These include:
- Incorrect intimate hygiene.Frequent douching not only "wash away" from the surface of the normal microflora of the vagina, they can injure the mucosa, promoting the development of inflammation.Use in hygienic procedures antibacterial agents detrimental effect on lactoflora and the use for cleaning the soap (it contains alkali) alters the normal acidity of the vaginal environment.
- Severe dysbiosis vagina after antibiotics related to their detrimental effects on vaginal lactoflora and reduction of local immunity.
- Changes in hormonal status.When hormonal dysfunction increases the number of anovulatory menstrual cycles, leading to structural changes in the vaginal mucosa.During pregnancy, for quantitative variations in the composition of the normal vaginal flora is responsible hormone of the corpus luteum.Patients menopausal vaginal bacteria overgrowth develops on the basis of the extinction of the hormonal function.
External hormonal causes of dysbiosis vagina is long-term use of hormonal preparations.
- Foreign body in the vagina - IUD, vaginal swab, or intrauterine ring.Foreign bodies are usually non-medical origin provoke vaginal bacteria overgrowth in infants.
- Neginekologicheskie diseases that lead to the disruption of the hormonal and immune systems.The most common symptoms of vaginal dysbiosis in patients diagnosed with diabetes, and thyroid disease.We prove a close relationship with intestinal dysbiosis dysbiotic disorder in the vagina.
- Inflammatory diseases of the external genitalia lead to the development of dysbiosis vagina, since the local inflammation in the mucous layer of disturbed metabolism and decreased immunity.
- Dysbacteriosis vagina in girls, usually develops during the period of up to 10 years of age and because the mucous membrane is too thin, and the reaction of vaginal contents close to alkaline.
absolutely untrue assertion that the goiter is sexually transmitted, so it is not a specific infectious disease.
symptoms of vaginal dysbiosis
dysbiosis vagina have no specific symptoms.In the vagina of any woman in the lifelong occur qualitative and quantitative fluctuations microflora under the influence of a variety of reasons.Normally, in healthy women such deviations are temporary and are compensated by the body at the expense of internal resources.If the body is not able to develop signs of dysbiosis vagina.
Bright clinical triggers only "fresh" vaginal bacteria overgrowth and chronic process proceeds with scant symptoms.Asymptomatic vaginal dysbiosis occurs in 18-37% of patients.
abnormal discharge is the leading symptom of vaginal dysbiosis.Their number is not always the same, but most patients complain of heavy, uniform grayish-white discharge, sometimes resembling the consistency of cream.Selections almost always have a characteristic stale "fishy" odor, formed as a result of vital activity of anaerobic bacteria.
The consistency and appearance of cables depends on the duration of the disease: in the long course of dysbiosis (over two years), the discharge becomes thick and become more saturated yellow - green color.Thick discharge cheesy kind escorted dysbiosis vagina after antibiotics against excessive multiplication of fungal flora.
Often patients tell of unsuccessful long-term treatment "inflammation" in the vagina antibacterial agents or methods of traditional medicine and how to use standard antibacterial drugs led to an increase in emissions.Thus, persistent vaginal discharge, not amenable to the methods of standard therapy, is an important diagnostic sign of vaginal dysbiosis.
Another important symptom of vaginal dysbiosis is the absence of external signs of inflammation - swelling and redness.When viewed from the mucosa it looks normal, and thick discharge evenly distributed along the walls of the vagina.
During a pelvic exam, you can estimate the rate of change vaginal pH using special test systems.Commonly used test strips with a scale division.When dysbiosis vaginal pH is in the range of 5.0 - 7.5.
In addition to measuring the pH of the amine is carried out the test: an alkaline solution is added to the vaginal discharge.When dysbacteriosis vagina there is a characteristic smell of rotten fish.
valuable information about the disease provides a simple laboratory examination of smears from the vagina.During microscopy evaluate the quantitative composition of microflora in the vagina.A typical laboratory signs of dysbiosis vagina is a large number of cells desquamated vaginal epithelium with "stuck" to the surface of microbes, these cells are referred to as "key".
Thus, the diagnosis of dysbiosis implies a discharge characteristic of the type, pH of the vagina more than 5.0, positive amine test and the key cells in the smear.Diagnosis vaginal dysbacteriosis is placed in the patient the presence of at least three of these symptoms.
Sometimes patients with dysbiosis complain of discomfort, itching or burning sensation in the vagina, bladder disorder.These symptoms are not typical for dysbiosis, they are due to irritation of the mucous membranes or copious appear after joining a secondary infection as a complication.
itching of the vagina dysbacteriosis significantly pronounced in fungal infections of the mucous.
A small number of patients dysbiosis vagina accompanied by local inflammation in the form of redness and swelling of the mucous, the appearance of discomfort, burning, and pain during sexual intercourse.
Treatment of dysbiosis vagina
Dysbacteriosis vagina without proper care can last for years and eventually lead to serious complications of infectious and inflammatory nature.All patients, regardless of the severity of the symptoms of vaginal dysbiosis appointed by adequate therapy.Treatment of vaginal dysbiosis is conducted in two stages with a small interval of 2 - 3 months.
The first step is to eliminate pathogenic microflora and lead to normal vaginal pH.In parallel, the correction of existing immune and hormonal disorders.
Antibiotic therapy is prescribed based on the data from vaginal smear microscopy, depending on what the representatives of conditionally pathogenic microflora are involved in the pathological process.Commonly used drugs for topical use in the form of suppositories, lotions or gels.But sometimes, depending on the clinical situation, and can be assigned to the tablet.
Before starting therapy the patient is asked during treatment follow simple rules: respect the sexual rest, do not drink alcohol, avoid taking antibiotics or hormonal agents.
treatment to be correct, it is necessary to take into account the state of the immune and hormonal functions.As required in the list of medicinal drugs include hormones, immunomodulators, and anti-allergic agents.
If the patient complains of itching, burning or pain in the vagina, for their elimination apply local anesthetics.
To reduce the acidity of the vaginal environment to normal along with antibacterial drugs is always a solution or candles containing lactic acid.
If dysbiosis triggered by fungal vaginal flora, to eliminate it using special anti-fungal drugs.
therapy dysbiosis vagina in pregnant women is carried out taking into account the potential risks to the health of the fetus.The decision about when to treat vaginal dysbacteriosis during pregnancy and what drugs to use, receives the physician, according to the situation.In some cases, when the symptoms of dysbiosis are minimal, and no matter what the patient does not complain, therapy begins in the second half of pregnancy.Systemic therapy anitibakterialnymi means in the first half of pregnancy contraindicated, so in this period is assigned only to topical treatment.
During antibiotic therapy dysbiosis vagina in 6-18% of patients developed vaginal candidiasis.In some cases, when the probability of such a scenario is very high, it can be assigned to prophylactic treatment of anti-fungal drugs.
Antibiotic therapy eliminates the excessively multiplied conditionally pathogenic flora, but can not help to restore the proper vaginal environment.For these purposes, it requires a second treatment step, which proceed through two or three days.
second phase of the treatment of vaginal dysbiosis takes no more than 10 days and is designed to restore the normal flora in the vagina with the help of biological products, which are introduced directly into the vagina.
criteria for cure of dysbiosis vagina exists.In 90% of the complex therapy leads to complete restoration of the normal vaginal flora and eliminates the adverse effects of dysbiosis.However, full recovery does not guarantee the absence of recurrence of the disease.
Self dysbiosis vagina does not bring proper results.Rare cases of the positive effects of self may mean that the patient accidentally guessed desired therapeutic drug or indicate that inadequate antibiotic treatment eliminated not the process itself, and its active symptoms.