Dysbacteriosis of the vagina: symptoms and treatment

Dysbacteriosis of the vagina is a clinical situation in which the qualitative and quantitative composition of the vaginal microflora is disturbed.

Most often this leads to the development of a disease such as bacterial vaginosis.

It is characterized by secretions from the genital tract, which have an unpleasant smell, persist for a long time, while with microscopy of the vaginal smear it is not possible to detect any pathogenic microbes.

Causes of vaginal dysbiosis

The main cause of bacterial vaginosis development is dysbacteriosis of the vagina, in which there is an increase in the number of anaerobic microorganisms.

Most often in the vaginal discharge it is possible to detect bacteroides, peptococci, peptostreptococci and others. In addition, it is sometimes possible to identify mycoplasmas and gardnerella. It should be noted that the development of vaginal dysbiosis leads to the development of microbial associations, which normally should not be found in the genital tract.


For the dysbacteriosis of the vagina is characterized by a significant decrease in the number of lactobacilli, which perform a protective function, protecting against the entry of pathogenic microorganisms into the genital tract of a woman.

The protective function is realized through the following mechanisms:

• formation of lactic acid acidifying the vaginal medium
  
• formation of hydrogen peroxide
  
• competitive antagonism with pathogens.

Dysbacteriosis in the vagina is a condition that is not transmitted sexually. This is a reflection of the general state of the organism with a violation of local biocenosis. However, there is a causal relationship between sexual activity and bacterial vaginosis.

These factors are:

• early sexual life
  
• a large number of sexual partners
  
• unconventional sex life.

In addition to this condition predispose:

• diabetes
  
• consumption of a large number of sweet products
  
• violation of personal hygiene
  
• use of corticosteroid drugs, etc.

Symptoms of vaginal dysbacteriosis

The main clinical manifestations of bacterial vaginosis( vaginal dysbacteriosis) are the following symptoms:

• increased amount of whites from the genital tract
  
• , whites have an unpleasant smell of
  
• , whites persist for a long time.

It is important to note that bacterial vaginosis is a non-inflammatory disease, therefore it is not characterized by such symptoms as( they can be noted only in a small percentage of cases):

• itching
  
• pain
  
• burning sensation.

Inspection of the genital tract in the mirrors can also provide important diagnostic information. It can detect symptoms such as:

1. 1) The vaginal mucosa remains unchanged, that is, its color is normal, no hyperaemia is detected.
   
2. 2) A large amount of leucorrhea that adheres closely to the walls of the vagina
   
3. 3) The discharge is white,and when the disease lasts for a long time, they become thick with a greenish shade of
   
4. . 4) Beli can be in a mild or abundant amount of
   
5. . 5) In perimenopausal women, point spots can be seen on the vaginal mucosahemorrhages.

Diagnosis

To determine the dysbacteriosis of the vagina, additional methods of investigation are needed, since on the basis of clinical manifestations one can only suspect this disease.

The main diagnostic tests are the following:

1. 1) Measurement of the acidity of the vagina( medium in the vagina becomes alkaline)
   
2. 2) Amniotest with potassium hydroxide. The test is considered positive when the smell of "rotted fish" appears
   
3. 3) The microscopic examination of the vaginal discharge can detect the so-called key cells. They are epithelial cells that are covered with Gram-negative bacilli-shaped bacteria)
   
4. 4) Lactic acid bacteria in the vagina are not detected by
   
5. 5) The level of leukocytes remains within normal limits, since bacterial vaginosis is not an inflammatory disease.

Treatment of vaginal dysbacteriosis

Treatment is performed in all clinically relevant cases, that is, if there are any symptoms of bacterial vaginosis, it is indicated.

Treatment of vaginal dysbiosis in women has such goals as:

• relief of unpleasant symptoms
  
• prevention of infectious and inflammatory diseases of the genital tract.

Therapy of vaginal dysbacteriosis is carried out in two stages:

1. 1) Within the first stage, the antibacterial therapy is shown to be effective against anaerobic microorganisms that became dominant in the vaginal biotope
   
2. . 2) The second stage is the normalization of the microflora in the vagina with the colonization of useful milk-acid bacteria, which perform a protective role.

The first stage involves the following activities:

• administration of either clindamycin, or metronidazole, or chlorhexidine as systemic dosage forms
  
• use of lactate in order to reduce acidity in the vagina
  
• laser therapy
  
• may in some cases require immunocorrecting agents, estrogen preparations andnonsteroidal anti-inflammatory.

The second stage should always follow the first, because otherwise it is not possible to achieve success. This is due to the fact that between organisms in the vagina there is fierce competition.

In the case where the treatment was effective and all the symptoms disappeared, further monitoring of the patients is not carried out. If the convalescence does not come or the relapse of the disease is observed, the doctor prescribes alternative treatment regimens.

Given that the disease is not sexually transmitted, the sexual partner should not be treated. This is not advisable.

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