Bacterial vaginitis - a pathological condition of the mucous membranes of the vagina noninflammatory nature, arising from a change in the composition of its normal microflora, namely the excessive concentration of anaerobic opportunistic pathogens, and a significant reductionthe number of lactic acid bacteria.To emphasize the participation of non-specific flora in the occurrence of this condition, the doctors before it was defined as nonspecific bacterial vaginitis.
vaginal flora of women of reproductive age is a dynamic system whose state depends on the condition of the female body: hormonal, immunological status, the pH of the vaginal environment and other physiological processes.Bacterial vaginosis is the result of a violation of this system.
changes in bacterial vaginitis occur with pathogenic microflora on the background of the change in pH (acidity indicator) of the vaginal environment.Can proceed in acute and sub-acute form and is divided into an asymptomatic ba
Despite the fact that the non-specific bacterial vaginosis is not always bright clinical manifestations, left untreated it can not be.Long existing dysbiosis vaginal mucosa may cause the appearance of a much more serious disease.
It is believed that bacterial vaginosis in pregnant women deserves attention because of possible complications to pregnancy occurring.
bacterial vaginosis in men does not occur, since this pathology refers to the vagina.However, in rare cases strongly expressed long bacterial vaginosis in women can cause inflammation of the urethra in its sexual partner.In such cases, it can be said that the bacterial vaginitis occurs indirectly in men and should treat both sexual partners.
cause of bacterial vaginitis
underlying cause of bacterial vaginosis is considered a violation of a part of the normal vaginal microflora by reducing lactic acid bacteria in it.The mucosa of the vagina has the function of the immune defense against pathogenic bacteria, lactobacilli and created an acidic environment inhibits their growth.Excessive proliferation of opportunistic bacteria associated with the violation of these mechanisms.
notion of normal microflora of the vagina can more accurately understand how changes occur in his micro system in response to the adverse effects.
usually considered normal vaginal microflora of healthy women as a kind of collection of certain types of microorganisms.Their relationship is constant and the interaction with the immune system allows the body to resist the penetration and proliferation of pathogenic (foreign) microorganisms.In women of reproductive age in the microbial community of the vagina is dominated by Lactobacillus (up to 95-98% of the composition).They cleave glycogen to lactic acid production in large quantities.Due to this in the vagina is supported by an acidic environment, and its pH from 3.8 to 4.5.It is important to note that at low pH values occur curbing the growth of unfavorable bacteria such as Gardnerella, streptococci and obligate anaerobes.In the vagina there epidermal stafilokkok, lactic acid streptococci, Corynebacterium, mycoplasma.Other potentially pathogenic microorganisms present in minor amounts.Normally, the vagina anaerobic flora prevails.
As the number of lactobacilli in the microflora of the vagina change the pH, which entails an increase in the number of opportunistic pathogens.An examination of women with bacterial vaginosis, along with most other bacteria and Mycoplasma Gardnerella detected.
Thus, deviations in the normal functioning of the immune and hormonal systems of the female body, and the state, leading to changes in the vaginal flora, can serve as a trigger in causing bacterial vaginosis.
bacterial vaginosis can occur in the background of diabetes and hormonal disorders (including pregnancy and menopause), with intestinal dysbiosis, and the presence of an intrauterine device.Causes of bacterial vaginosis can also serve as promiscuity, hormonal treatment, antifungal and antibacterial agents, serious violations of personal care and gynecological incorrect manipulation.
Symptoms of bacterial vaginosis
severe symptoms bacterial vaginosis depends on the stage and form of the disease, the condition of the immune system and the hormonal status of the woman.Sometimes the process is asymptomatic, and signs of bacterial vaginosis can only be detected at a reception at the gynecologist or checkups.
leading symptom of bacterial vaginitis are different in intensity from the genital tract, occasionally accompanied by a feeling of discomfort, itching and unpleasant odor.Color selections may vary from white to yellow or green, and their consistency - from a viscous liquid to.Before menstruation or after intercourse, vaginal discharge volume can be increased.When viewed from the vaginal mucosa may have slight signs of inflammation.In half of those cases are not detected.For women with severe symptoms of bacterial vaginosis is characterized by its combination with cervical pathology - pseudo, leukoplakia, endotservitstitom, endometriosis.
Symptoms of bacterial vaginosis are not unique and can be similar to symptoms of other diseases in which women are concerned isolation, discomfort, itching and so on. In this connection it is necessary to differentiate this pathology with vulvovaginal candidiasis and trichomonas, gonococcal and chlamydial cervicitis.
Regardless of the form and severity of clinical manifestations, the last point in the diagnosis puts laboratory diagnostics.The diagnosis of bacterial vaginosis is confirmed by studies of vaginal contents, conducted smear microscopy, sowing the contents of the vagina is determined by the pH of the vaginal environment.Number of analyzes and studies the method chosen by the attending physician after examining the complaints and gynecological examination.
bacterial vaginosis in pregnancy
during pregnancy can often occur and additional causes of bacterial vaginosis.They are associated with hormonal processes, when the influence of corpus luteum hormone changes the proportion of microorganisms in the vagina, creating conditions for the emergence of bacterial vaginosis.
pregnant patients complain of heavy greyish-white, liquid discharge.The most unfavorable situation is such that the process is asymptomatic.Approximately 35-50% of patients have asymptomatic bacterial vaginosis course, but in-depth examination have revealed all the signs of the disease.
bacterial vaginosis on a background of pregnancy can not be considered safe diseases.In pregnant women with a diagnosis of bacterial vaginosis has an increased risk of complications during childbirth.Multiply uncontrollably opportunistic flora may provoke rising infection, intrauterine fetal infection, inflammation of the chorionic membranes and preterm delivery.For such patients is offered an individual plan including preventive measures and the appointment of adequate treatment.
embarked on the record on the presence of pregnancy, women undergo mandatory testing for the presence of a pathological process in the vagina three times - in the statement on the clinical account of pregnancy, for a period of 27-30 and 36-40 weeks of pregnancy.
in maternity wards a similar survey carried out among pregnant women without prenatal held, and all have complicated childbirth.
Treatment of bacterial vaginosis
variety of manifestations of bacterial vaginosis explains the lack of standard treatment regimens.The decision to prescribing takes a gynecologist.
Since the basis of the disease is based on two basic trigger mechanism - a violation of the biocenosis of the vagina and as a result, the reproduction of unwanted flora - any treatment regimen should be aimed at their elimination.When choosing a method of treatment takes into account the presence of comorbidities hormonal, neuroendocrine and inflammatory nature.If necessary, the treatment plan included measures to correct these conditions.
Treatment of bacterial vaginosis involves two main steps, depending on how pronounced the clinical picture:
1. Elimination of conditionally pathogenic flora using antibiotic therapy
2. Restore vaginal biocenosis
Antibacterial agents are selected by the attending physician.They are used in the form of suppositories, gels, ointments, tablets, and solutions.In the presence of chronic inflammation or bright clinics may be used antibiotics.Antibacterial agents are appointed after a study of sensitivity to them microflora of the vagina.Avoid antibiotics during pregnancy.
most popular drugs in the treatment of bacterial vaginosis is Metronidazole and its derivatives, Ofori, Fluomizin.Vaginal suppositories and gels (metronidazole, neomycin, clindamycin, Hexicon and so on.) Are used both as monotherapy and in combination with other drugs.For the irrigation of the mucous and breast used solutions of boric acid, chlorhexidine, and so on.
The next stage of therapy are the necessary conditions for the restoration of the normal amount of lactic acid bacteria in the vaginal environment using eubiotics, probiotics bifidobacteria and lactobacilli.Candles Femileks containing lactic acid, helps to restore the vaginal pH.
The effectiveness of the treatment is assessed after 6-10 days.The criteria for cure is considered to be the restoration of normal relations microbial vaginal environment, confirmed by laboratory tests.
therapy of bacterial vaginosis in pregnant women has its own peculiarities.In the first trimester of antibiotic therapy is contraindicated.Exclusively local media.
System drugs are prescribed in the second trimester of pregnancy along with local therapy.The choice of drug is only gynecologist.The second stage of therapy is similar to that in non-pregnant patients.
large number of antimicrobials with a different spectrum of activity may cause an incorrect choice of self-treatment, what is the danger of self-bacterial vaginitis.
methods of specific prevention of bacterial vaginosis does not exist.Currently, those deemed competent personal hygiene, lack of promiscuity, the normalization of the gastrointestinal tract, the elimination of hormonal and immune changes in the body.
Restoring normal biocenosis vaginal environment is the key to women's health and a favorable outcome of pregnancy.
annual visit to the gynecologist will preserve women's health.
Bacterial vaginosis is not a venereal disease and sexually transmitted.