dysbiosis vagina - is a violation of the quantitative composition of microflora of normal vaginal environment.Specific pathogens dysbiosis vagina exists.The pathological process of forming entirely internal resources vaginal microflora and redistribution due to the quantitative composition of microorganisms in it.The greatest role in the formation of vaginal dysbiosis play not single organisms and associations of various bacteria.
vaginal environment is protective because of the constancy of its composition and acidity, a leading role in this process is given lactobacilli.At the core of all the changes microecology vagina is a violation of the ratio of lactobacilli and all other microorganisms.
Clinical manifestations of dysbiosis vagina overwhelmingly scarce or absent.Pronounced symptoms appear due to lower local immunity and inflammation secondary attachment.
vaginal dysbiosis may appear and disappear without medical intervention like any physiological changes in the b
dysbiosis vagina can be found in representatives of all ages, it occurs in adolescence (puberty), and in menopausal women, is depending on the hormonal and immune systems.
signs of dysbiosis vagina in pregnant women - not uncommon.Since the disruption of the normal composition of the vaginal microflora in pregnant patients may lead to undesirable consequences, dysbiosis vagina in expectant mothers subject to medical correction.
dysbiosis may be present in the vagina as an independent pathological process, be a cause or a consequence of other diseases.Correct to regard it as a condition or symptom.
Causes of dysbiosis vagina
normal vaginal microflora by 98% consists mainly of lactic acid bacteria (lactobacilli, sticks Dederlyayna).Along with lactobacilli in the vagina are anaerobic cocci, Staphylococcus epidermidis, Corynebacterium, mushrooms and other.In very small quantities of opportunistic pathogens - Mycoplasma, Ureaplasma, gardnerelly and mushrooms.The presence of bacteria in the vaginal environment is not indicative of disease, pathology can say, if the number of "harmful" higher than normal microflora.To avoid this, the vaginal flora should be a constant quantitative composition and acidity (pH).Lactobacilli not only quantitatively suppress reproduction of unwanted microbes, they maintain the pH of the constancy of the vaginal contents, participating in the synthesis of lactic acid.Healthy woman normal vaginal pH values of 3.8 - 4.5, and in the composition of the microflora is dominated by lactobacilli.Persistence of vaginal environment supports the immune and hormonal systems.There is a correlation between the amount of estrogen in the body and the normal microflora of the vagina - with estrogen deficiency decreases the amount of lactic acid bacteria.For this reason, in postmenopausal women develop symptoms of dysbiosis vagina.
dysbiosis vagina is not caused by any - any one microorganism.The leading role in its development belongs to the association of bacteria that competitively displace vaginal lactobacilli.
only cause of vaginal dysbiosis is a significant reduction in the number of lactobacilli in the composition of its flora.As a result, the pH changes (rises above 4.5), creating favorable conditions for the reproduction of the bacteria that were present in the vagina in the minority, including the conditionally pathogenic flora.Further developments will depend on many factors and may occur in two scenarios - the body can compensate for this condition, and the phenomenon dysbiosis will do or the process will start to progress up to the complete disappearance of the "good" flora in the vagina.In marked dysbiosis vaginal lactobacilli in the composition of its flora may be absent altogether.
final episode dysbiosis may be ambiguous and depends on many factors: age of the patient, her hormonal state and local immunity, presence of concomitant extragenital and gynecological pathology.An important role in the development of vaginal dysbiosis play stress, infectious diseases.Frequent douching and incorrect use of vaginal swabs eliminate normal flora mechanically and can provoke dysbiosis.More than 54% of women with vaginal dysbiosis, intestinal dysbiosis is detected.Often dysbiosis vagina develops in patients receiving antibiotics or antifungal drugs.Symptoms of this condition are present in half of the women with intrauterine devices.
dysbiosis vagina is no inflammation.Inflammation in the vagina can only appear as a complication.
symptoms of vaginal dysbiosis
When dysbiosis vagina there are no specific symptoms.Seek medical attention unusual for a woman forced her discharge from the genital tract, which is the only symptom of the disease.If the discharge appeared recently, they are liquid, white or grayish.The longer the separation, the thicker they grow and acquire a yellowish tint.Number of selections may vary and depends on the individual assessment of a woman.
Sometimes patients may indicate abnormal discharge unpleasant odor, resembling the smell of fish.
Severe dysbiosis vagina is sometimes accompanied by a feeling of discomfort, itching and burning.
long existing dysbiosis may become the basis for the development of inflammatory processes in the vagina and on the cervix.In this case, the nature of the discharge will depend on what this inflammation caused by microorganisms.
Classification dysbiosis exists.Conditionally can distinguish acute, flaccid (asymptomatic) and chronic dysbiosis.
The more pronounced the symptoms of vaginal dysbiosis, the faster she goes to the antenatal clinic.Asymptomatic process can proceed for a long time and become chronic.Chronic dysbiosis is characterized by periods of relapse and remission.The composition of the vaginal microflora of lactobacilli are gradually disappearing, and begins to develop opportunistic microflora.Unwanted bacteria ascending path can enter the uterus and appendages.
Difficulties diagnosing vaginal dysbiosis explains the wide range of microorganisms that form the normal microflora.The concept of rules varies depending on many factors.For example, a "normal" microflora young women differs from that in premenopausal women, hence the nature of the violations they will be uneven.
dysbiosis vagina Diagnosis begins with a study of complaints and gynecological examination.Vaginal mucosa when dysbiosis no signs of inflammation, vaginal secretions abundant, uniform, can have an unpleasant "fishy" odor.
vaginal pH measurement content is of great diagnostic value.For this purpose, use special test strips with a scale division.When dysbiosis vaginal pH is in the range 5.0 - 7.5.
With pH - meters in an analysis on dysbiosis vagina recommended amine test: vaginal discharge mixed with a solution of alkali.In the case of a positive response to a specific "fishy" odor.
laboratory methods for diagnosis of vaginal dysbiosis include vaginal smear microscopy and bacteriological examination of vaginal contents if there are signs of infection (is rare).
analysis on dysbiosis vagina as such does not exist.Each study provides indirect evidence of the disease, the totality of which indicates its presence.At microscopy evaluate the qualitative and quantitative composition of the microflora of the vagina.A typical feature is the presence of dysbiosis vaginal smear exfoliated epithelial cells covered with small Gram-negative rods, such cells are called "key".
Thus, the diagnosis of vaginal dysbiosis is based on four (or three) signs:
- heavy vaginal discharge (sometimes with a specific smell);
- raising the pH;
- positive amine test;
- the presence of clue cells.
Variety of causes of vaginal dysbiosis, the presence of asymptomatic cases, and self-healing indicate that disbiotic disorder can occur in any woman, but a doctor treated only those whose bodies he could not cope with the disorders.Careful study and timely elimination of background diseases and related genital disease are the key to successful treatment dysbiotic processes in the vagina.
dysbiosis vagina during pregnancy
The changes during pregnancy complete the list of causes of vaginal dysbiosis.Reducing estrogen effect on the background of increasing the dominant role of progestogens leads to an increase in cervical mucus and increasing pH.It begins to actively proliferate unfavorable flora, which displaces lactobacilli.At equivalent process in the vagina in pregnancy dysbiosis develops not everyone.
If you are pregnant characteristic laboratory changes, but there are no complaints, it may be decided on the dynamic observation without treatment.Often microecosystem vagina using hormones on their own eliminates dysbiosis.
Pregnancy does not cause dysbiosis vagina, but it can create favorable conditions for its occurrence.
If the number of unfavorable flora is too high, it may migrate upward through through the cervical canal to the fetal membranes, causing intrauterine infection.Despite the small probability of such complications, dysbiosis vagina in expectant mothers should not be ignored.
Treatment of vaginal dysbiosis
main stages of the treatment of dysbiosis vagina are the elimination of opportunistic pathogenic microorganisms or using antibacterial therapy and recovery microbiocenosis vagina.
treatment program drawn for each patient taking into account the nature of the complaint, data inspection and laboratory diagnosis.It is important to take into account the presence of background processes and extragenital pathology.
During therapy, the patient must comply with several conditions: avoid alcohol, to observe sexual rest, do not take any foreign drugs.
Antibiotic therapy includes local agents and drugs for systemic effects (pills).Local therapy dysbiosis vagina is the method of choice in most cases and has several advantages: the possibility of introducing the drug directly to the disease site, the fewest side effects, ease of use.
parallel with antibacterial agents appointed by the topical application of lactic acid (in the form of irrigation or in candles) to restore the acidity of the vaginal environment and stop the growth of bacteria.
Symptomatic therapy is applied depending on the clinical situation.Can be used local anesthetics, antiallergic agents, immunomodulators.
Sometimes antibacterial therapy in the vagina can be activated by fungal microflora.For the prevention of candidiasis appointed antifungal agents.
The objective of the second phase of the treatment of vaginal dysbiosis is to create conditions for the quantitative growth of normal microflora and restore local immunity.To this end, the group successfully cope eubiotics drugs and probiotics, having in its composition and laktobakterin bifidobakterin.
Pregnant local therapy is the dominant method.For the topical treatment of vaginal dysbiosis often used candles, ointments, creams and gels.The drugs of choice are Hexicon candles, vaginal cream or suppositories Clindamycin, Metronidazolgel.
Systemic antibiotics are used less frequently.
Pregnant permissible use of local treatment, and the second half of pregnancy on the testimony can be used oral drugs.To avoid the negative impact of drugs on the fetus, reduced doses of prescribed drugs.
course of treatment of vaginal dysbiosis usually does not exceed 10 days.To evaluate the effectiveness of the therapy rather twice - at the end of treatment and one month.
Relapses dysbiosis vagina does not depend on the effectiveness of therapy in acute.To eliminate dysbiotic changes in some cases, will require a comprehensive treatment of the causes and background processes of disease.