Gynecology and Mammology >>>> Bacterial vaginosis

Bacterial vaginosis.

Normally, the vaginal microflora is represented by the overwhelming majority of Doderlein sticks (a type of lactobacillus). These bacteria maintain an acidic environment in the vagina, and this ensures the suppression of opportunistic microorganisms that do not survive in such conditions. When the quantitative composition of lactobacilli changes towards their decrease, the acidity of the internal environment of the vagina decreases, which makes it possible for opportunistic and pathogenic microbes to colonize the vaginal lumen. This is how vaginal dysbiosis develops , which is the precursor of bacterial vaginosis. When we talk about bacterial vaginosis , they mean an infectious, but not inflammatory, lesion of the vaginal mucosa. Note, bacterial vaginosis - a name that does not quite accurately reflect the state of the vaginal microflora, since representatives of pathogenic microorganisms can be not only bacteria, but also fungi or protozoa. There is another variant of the name - gardnerellosis, a special case of bacterial vaginosis, indicating a specific bacterium that has colonized the vaginal mucosa.

Causes of bacterial vaginosis:

Decreased activity of the immune system,
Long-term antibiotic therapy reduces the number of lactobacilli colonies,
Hormonal disruptions lead to changes in the cellular structures of the vagina.

Against the background of reduced immunity and an altered quantitative composition of normal microflora, infectious agents have many opportunities to be in the lumen of the vagina:

poor hygiene,
improper use of hygiene tampons and other personal hygiene products,
various sexual relations,
a partner with multiple third-party contacts,
a partner who does not follow the rules of personal hygiene.

Bacterial vaginosis signs:

Vaginal discharge (may be white) with an unpleasant odor like fish
Itching, burning sensation from the walls of the vagina,
Occasionally accompanied by painful urination, which indicates the exit of the infectious process beyond the vaginal mucosa and spread to the urethra ( urethritis ),
Painful sensations during intercourse,
Sticking of the labia with the participation of drying up purulent discharge.

It is possible to diagnose bacterial vaginosis or vaginal dysbiosis as a whole by performing a gynecological examination with confirmation of the data by laboratory tests that will clarify the current composition of the vaginal microflora, the acidity of the environment in the vagina.

Treatment of bacterial vaginosis is carried out in stages:

Clarifies the strain of bacteria (or several bacteria) using laboratory tests.
They check the resistance of bacteria to certain antibiotics, which will allow you to choose the most effective antibacterial agent.
Prescribe a course of selected antibiotics and, if necessary, a course of antifungal and / or antiprotozoal drugs.
When identifying suitable for therapy bacteriophage strains of pathogenic bacteria are carried out simultaneously treated bacteriophages. To achieve successful results of phage therapy, the bacteriophage is selected using phage-typing .
After successful antimicrobial therapy, treatment of vaginal dysbiosis follows, that is, the stage of restoration of the vaginal microflora, which includes long-term intake of lactobacilli (oral and vaginal). It must be remembered that lactobacilli can be used during and after antibiotic therapy.

To monitor the effectiveness of treatment, laboratory tests of a smear on the vaginal microflora should be carried out.

In the future, for the prevention of bacterial vaginosis, one should take into account the fact that when treating other diseases of the body with antibacterial agents, it is necessary to select antibiotics that have the least detrimental effect on the microflora of the body, in particular on lactobacilli.