Violation of the microflora of the vagina at least once in a lifetime worried any woman. Girls who have never had a sexual life also face this disease. The disease is asymptomatic, but can cause the most severe consequences, accompanied by an inflammatory process. Gynecologists call pathology dysbiosis or dysbacteriosis.

What is dysbiosis?

Dysbiosis is defined as a violation of the microflora of the vaginal environment. If it is not treated, the disease will progress, causing a number of the most negative consequences.

Violation of the microflora of the vagina at the first stage does not manifest itself. They change only to a slight extent. In a normal state, a woman does not have them, and if they do, then in small quantities. With a healthy microflora, there is no pain, pain, smell, burning sensation, dryness during intercourse and discomfort.

An unpleasant smell, an increase in the number indicate the presence of such a pathology as a violation of the microflora of the vagina. Why is this happening? This will be discussed further.

The normal microflora consists of 90% lactobacilli and 9% bifidobacteria. The remaining 1% falls on which rarely provoke any disease. A woman's body easily tolerates minor changes, especially with good immunity. With serious violations, where the number decreases, and the percentage of opportunistic microorganisms grows, the reproductive system may fail. As a result, such harmful bacteria as fungus, gardnerella, streptococcus, Proteus, E. coli, chlamydia, etc. multiply. Vaginal dysbacteriosis occurs and, as a result, an inflammatory process. The immune system continues to fight pathogenic bacteria, but in the absence of treatment, the protective functions of the body no longer give the desired effect.

The most common types of diseases include:

• bacterial vaginosis;
• candidiasis;
• thrush.

If dysbacteriosis occurs in a latent form, then severe symptoms are rarely observed. Without tests and examination by a doctor, it can be difficult to recognize a disease in this form. Therefore, women are advised to visit a gynecologist twice a year.

Causes of violation of the microflora of the vagina

There are many factors that influence the appearance of dysbiosis:

• Single and constant hypothermia, which reduces immunity and contributes to the development of dysbacteriosis.
• Change in hormonal background. Unsystematic sex life, menopause, pregnancy, childbirth, abortion, menstrual irregularities, etc.
• Change of climatic zones.
• stressful situations.
• Chaotic sex life. Frequent change of sexual partners. Ignoring methods of contraception.
• Inflammatory and pelvic.
• Infections acquired after sexual intercourse.
• Prolonged antibiotic treatment.
• Intestinal diseases.
• Incorrect insertion and use of menstrual tampons.

All these and other reasons cause a violation of the microflora of the vagina.

Symptoms of the disease

They will help in time to recognize the violation of the microflora of the vagina, the symptoms of the disease. Although in many cases, especially at the initial stage of the disease, they are simply absent. If the bacteriosis began to progress, there may be:

• highlighting white and yellow;
• bad smell;
• discomfort in the genital area;
• dryness during sex;
• burning, itching and pain in the genital area.

These are the main signs of a violation of the microflora of the vagina. If dysbiosis is not treated, endometritis, inflammation of the appendages, cervix, or vaginal walls may occur. If the infectious process has affected the genitourinary organs and the urethra, then, as a rule, cystitis or urethritis develops.

Violation of the microflora of the vagina during pregnancy and after childbirth

Pregnancy, hormonal changes can provoke an acute stage of vaginal dysbiosis. During the period of bearing a child, the symptoms of the disease worsen. There is an abundance of discharge, an unpleasant odor, itching and burning in the genital area, and pain during sex.

Many drugs are contraindicated for women during pregnancy, so it is not possible to conduct a full-fledged treatment here. All actions are directed only to the temporary elimination of symptoms, and the necessary treatment with antibiotics is carried out after delivery.

There may be a violation of the microflora. How to treat the patient in this situation? This question is decided only by the doctor. Often, young mothers are diagnosed with thrush, which is caused by a yeast-like infection. This process is influenced by hormonal changes in the body, as well as a number of medications that the woman giving birth was forced to take.

In this case, therapy is carried out with antifungal agents in combination with probiotics, which have a positive effect on the vaginal microflora and prevent the secondary appearance of the disease.

Vaginal dysbacteriosis and sexual partner

Often, the imbalance of the microflora of the vagina does not affect the sexual life of a woman and does not cause any special problems for the sexual partner. An exception is the advanced stage of dysbiosis. In this case, a man may develop signs of balanoposthitis or nonspecific urethritis, and then only if the stronger sex has a predisposition to the disease.

As a rule, diseases of the sexual partner do not affect the woman's vaginal environment, of course, we are not talking about sexually transmitted diseases.

Treatment of vaginal dysbiosis is carried out only in women, without involving a partner, unless the pathology is caused by a sexual infection.

If STDs occur, they are accompanied by severe dysbacteriosis. Cause imbalance in the vaginal environment. They provoke the appearance of an inflammatory process and disrupt the microflora of the vagina. However, there are no situations where the causative agent is only a sexually transmitted infection. Always the disease is accompanied by negative changes in this should be taken into account in the fight against the disease. Here, taking antibiotics alone is unlikely to help, since it will not restore the normal level of microflora.

The course of treatment should always end with probiotics that restore the vaginal environment. Serious problems caused by chlamydia and Trichomonas are solved by antibiotic therapy, after which the restoration of microflora is necessary. These courses should be separated and run one after the other.

In situations where the disease has a mild form, it is necessary to carry out urogenital diagnostics. And you can restore the necessary background simultaneously with the elimination of sexual infection.

Dysbacteriosis in girls

Violation of the microflora of the vagina occurs even in girls who have never had sexual intercourse. A variety of factors come into play here. This is hormonal changes in the body during puberty, and features of the structure of the hymen, and non-compliance with the rules of hygiene (including improper washing of the genitals), and taking antibiotics and other drugs. The reasons in this case are similar to the factors contributing to the development of dysbacteriosis in women who have an active sex life. But there are also nuances.

Unlike women, girls rarely experience heavy discharge, since the hymen does not allow them to leave the vagina in full. A certain part of them accumulates in the small pelvis, which causes an inflammatory process. Also, at the beginning of the development of sexual life in girls, a lot of bacteria enters the urethra from the vagina, which can cause “honeymoon cystitis”.

Therapy of dysbacteriosis in virgins is quite complicated, since the hymen does not allow for a thorough treatment of the vagina. In some cases, even hymenectomy is indicated, in which there is a violation of the hymen.

Development of dysbiosis and the intestinal environment

Often, some diseases of the stomach and intestines lead to a violation of the microflora both in the intestinal walls and in the vagina.

The rectum is in close contact with the vaginal cavity, as a result, bacteria freely pass through the walls of the organs. When intestinal dysbacteriosis develops and progresses, the bacteria (E. coli, enterococci, etc.) that cause this disease easily penetrate the walls of the vagina, where they also disturb the background. What to do in such a situation? Of course, contact a specialist, in no case resorting to "amateur" and the help of folk remedies.

Treatment of a violation of the microflora of the vagina in this case is a complex process, since the likelihood of a new infection is quite high. Here, simultaneous therapy of both the vagina and the intestines should be carried out. This is the most severe form of dysbiosis.

Diagnosis of dysbacteriosis

In order for the treatment to give a result, it is necessary to correctly diagnose the disease. First of all, a gynecological examination of the patient is performed. Then tests are ordered. As a rule, this is:

• PCR diagnostics, which allows you to verify the absence or presence of genital infections;
• a smear on the flora, indicating the state of the vaginal microflora;
• sowing vaginal discharge;
• the sensitivity of the patient to antibiotics is determined.

The obtained data of laboratory studies allow us to establish the cause of the disease and the degree of its complexity.

Treatment of dysbiosis

Therapeutic measures to restore the vaginal microflora are divided into several stages:

• Destruction of pathogenic bacteria that caused this disease.
• Restoration of the vaginal microflora.
• Immunity boost.

If dysbacteriosis has arisen due to genital infections, then the causative agent of the disease is first eliminated by prescribing a course of antibiotics. If the violation of the microflora of the vagina is caused by another reason, then antibiotics may not be used. And if such therapy is prescribed, then for a period of no more than five days.

It is very important for dysbiosis to carry out external procedures. These are various baths and tampons. Such activities inhibit the development of pathogenic microorganisms and restore immunity. Treatment of violations of the microflora of the vagina with antiseptics - in this case they are used topically - is much more effective than antibiotics, and their area of ​​​​effect is much wider. Almost all bacteria are susceptible to their influence. Antiseptics also help develop the immunity of the walls of the vagina and normalize its microflora. They inhibit the growth of pathogenic bacteria.

The neglected form of dysbacteriosis is difficult to cure only with immunomodulatory therapy; here, in addition, antibiotics are almost always prescribed.

Drugs for the treatment of dysbiosis

Violation of the microflora of the vagina (drugs are usually prescribed in the form of ointments, suppositories, vaginal tablets and creams) is a rather complex disease, which often requires an integrated approach.

Often, Dalacin cream, which is an antibiotic with a wide spectrum of action, is used to treat dysbacteriosis. The active ingredient is clindamycin phosphate 2%. It intensively affects the vaginal microflora. Also effectively restore the background with such a pathology as a violation of the microflora of the vagina, suppositories "Dalacin". They contain up to 100 mg of antibiotic.

A good result in vaginal dysbiosis is given by Flagil candles. The drug is used once a day, at night. Also, for the treatment of the disease, doctors recommend using "Hexicon" - these are suppositories with chlorhexidine. They are inserted into the vaginal cavity once a day. The course is 10 days.

For the treatment of vaginal dysbiosis, many today choose Betadine and Terzhinan suppositories. Metronidazole gel also gives a good effect.

If the disease is advanced, and only topical preparations cannot be dispensed with, then tablets are prescribed for oral administration. This is:

• "Ornidazole".
• "Naxojin".
• Meratin.
• "Tiberal".
• "Tinidazole".
• "Trichopol" or "Metronidazole".
• "Clindamycin".

Medicines are taken throughout the week. It should be remembered that when using oral medications, alcohol is prohibited. This is especially true for Trichopolum.

In combination with other drugs for the normalization of microflora, it is prescribed: "Linex", "Probifor", "Bifidumbacterin", "Bifiform", "Bifidin" or "Bifiliz". To increase the number of lactobacilli in the vaginal environment, "Acilact", "Lactobacterin", "Acepol", etc. are prescribed. It is recommended to drink the medicine in a course, starting from the second day of taking antibacterial agents. They also prescribe means to maintain immunity - "Immunal", "Cycloferon", etc.

If the cause of the violation of the microflora was sexual intercourse, then the sexual partner should also be examined and treated.

About preventive measures

Treatment for dysbiosis can take up to four weeks. In some cases, it is difficult to prevent this disease, since it is difficult to establish the real cause that caused the disease. The only thing a woman can do is to strengthen the immune system and follow the necessary rules of hygiene.

After the restoration of the microflora of the vagina, you should visit the gynecologist every three months for a year. This is necessary in order to detect a relapse in time and take appropriate measures. In the future, under normal circumstances, you can see a doctor once a year.

09.02.2013 VAGINAL MICROFLORA DISTURBANCE: CAUSES, SYMPTOMS, TREATMENT

What is a violation of the microflora of the vagina? Violation of the microflora of the vagina (vaginal dysbacteriosis, vaginal dysbiosis) is a phenomenon associated with the functioning of the female reproductive system. Violation of the microflora of the vagina: symptoms, treatment depend on many factors. These factors include the general condition of the patient, the course of concomitant diseases, diet, quality of sexual life, etc. Violation of the vaginal microflora is manifested by whitish discharge from the vagina. Such secretions can have a different consistency, smell and abundance. Such discharge may be a normal part of the process of cleansing the vagina of a healthy woman. But also vaginal discharge may indicate a pathological process, including vaginal dysbacteriosis.

According to statistics, a violation of the microflora of the vagina occurs in every second woman. Such a violation can occur in mature women after the onset of menopause, in middle-aged women with an established sexual life, in girls before the onset of sexual activity, in girls before the onset of the menstrual cycle. Often, vaginal dysbacteriosis goes unnoticed. A woman may not suspect a violation of the vaginal microflora for a long time. Asymptomatic course is dangerous for its complications. It is the complications in the asymptomatic course that make the patient go to a specialized clinic.

Normally, a normal, non-pathogenic microflora lives in the woman's vagina. This microflora ensures the functioning of the genital organs. The microflora of the vagina consists of approximately 90% lactobacilli, 9% bifidobacteria and less than 1% consists of other opportunistic microorganisms. Conditionally pathogenic microorganisms normally do not provoke the development of the disease, but under the influence of predisposing factors can cause the disease. Opportunistic pathogens cover the walls of the vagina. These include fungi of the genus Candida, gardnerella and some other microorganisms. The body of a healthy woman controls the ratio of microorganisms in the vagina and prevents the appearance of uncharacteristic microflora. At the same time, immunity does not react in any way to representatives of the characteristic microflora of the vagina. If there have been minor changes in the microflora of the vagina, then the microflora will renew itself. Such a process is not reflected in any way on the health of a woman. The impact of predisposing factors and violation of the vaginal microflora reduces the number of lactobacilli and bifidobacteria. At the same time, an increase in the number of conditionally pathogenic microflora is observed, and pathogenic microorganisms also appear. Such a microorganism can be gardnerella, a fungus of the genus Candida, a sexual infection (trichomoniasis, chlamydia, gonorrhea, etc.), as well as another pathogen from the environment (staphylococcus aureus, streptococcus, proteus, E. coli, etc.). Such microorganisms during reproduction and vital activity are the cause of inflammation of the vagina. Inflammation depends on the level of immunity of a woman, the general condition of her body, on the number of pathogenic microorganisms, etc. In the absence of treatment for inflammation and in the absence of therapy against pathogenic microorganisms, the disease will progress.

Symptoms of a violation of the microflora of the vagina

Violation of the microflora of the vagina, as mentioned above, will often be asymptomatic. A woman for a long time may not even suspect a violation of the microflora of the vagina. But still, a violation of the microflora of the vagina provokes a number of symptoms. So, vaginal discharge of various types can be observed. Often women ignore this symptom, or do not notice it at all. Allocations are not accompanied by dryness of the vagina and external tissues of the genital organs, discomfort during intercourse. Over time, the amount of secretions increases and such secretions acquire a characteristic odor. If other symptoms are observed, they are related to symptoms of concomitant diseases. After all, dysbacteriosis is often the cause and predisposing factor for the development of sexually transmitted diseases, erosion processes, inflammatory processes, tumor growth, etc.

Complications of microflora disorders include: inflammation of the walls of the vagina (vaginitis), inflammation of the cervix (cervicitis). These complications are the most common. The symptoms of inflammation include an increase in vaginal discharge, the appearance of discomfort during urination, the appearance of discomfort in the perineum (itching, burning, pain, pain, etc.), pain during intercourse or after intercourse, and other symptoms. Pain during intercourse occurs due to vaginal dryness and insufficient secretion. Long-term infection can spread to all internal genital organs. So inflammation of the uterus (endometriosis), inflammation of the uterine appendages (adnexitis) can occur. Infection and pathogenic bacteria can enter the urethra. The penetration of pathogenic bacteria into the urethra provokes the development of cystitis and urethritis.

There are many reasons for the development of a violation of the microflora of the vagina. Violation of the microflora of the vagina: symptoms, causes, treatment - every woman needs to avoid predisposing factors. It is better to prevent the development of the disease than to treat its consequences.

Violation of the microflora of the vagina - causes:

Local or general hypothermia. Hypothermia is the cause of a decrease in immunity and is displayed on the ratio of microorganisms in the vagina.

Hormonal disorders. Hormonal disorders occur with irregular sexual activity, menstrual irregularities, puberty, pregnancy, after childbirth, abortion, menopause, etc. A sharp change in hormonal levels is reflected in the state of the genital organs.

Change of climate zone. A change in the climatic zone or a sharp change in climate provokes an exacerbation of dysbacteriosis.

Sexual infections. Sexual infections can be both a cause and a consequence of a violation of the microflora of the vagina.

Inflammatory process of the pelvic organs. The inflammatory process of the pelvic organs provokes the occurrence of specific symptoms, and the cause of inflammation can be an imbalance of microorganisms in the vagina.

Taking antibiotics. Long-term use of antibiotics disrupts the microflora of the vagina and destroys not only harmful microorganisms, but also beneficial microorganisms. Therefore, with prolonged use of antibiotics, it is necessary to colonize beneficial microorganisms in the vagina (which an experienced gynecologist should do).

Failure to comply with the rules of personal hygiene or hygiene of sexual life. Improper hygiene can cause pathogenic microflora to enter the vagina.

Intestinal disease (intestinal dysbiosis). The intestinal microflora is associated with the microflora of the vagina. Therefore, the presence of one of them causes a violation of the other.

Poor hygiene during menstruation. Poor menstrual hygiene involves the improper use of tampons and pads during menstruation. It is recommended to replace hygiene products during menstruation every two hours. If you ignore the recommendations, then favorable conditions are created for the reproduction of conditionally pathogenic microflora of the vagina, as well as for the development of inflammation.

The above factors do not always lead to a violation of the microflora of the vagina. After all, the woman's immune system is able to control and regulate the microflora of the vagina in case of its change. But still, it is better to avoid predisposing factors.

Violation of the microflora of the vagina - treatment

Treatment of violations of the microflora of the vagina is based on the results of the preliminary diagnosis. For the purpose of diagnosis, the following tests are carried out: a smear for the flora, a PCR test, crops of vaginal discharge with the determination of sensitivity to antibiotics. A smear on the flora allows you to determine the state of the microflora of the vagina and identify inflammation. The PCR test allows you to determine the type of microorganism that caused the violation of the microflora. Culture of bacteria also allows you to calculate the pathogen and determine its sensitivity to antibiotics. In parallel with laboratory tests, an ultrasound examination of the small pelvis and calposcopy are performed. Ultrasound examination of the small pelvis allows you to assess the condition of the genital organs, their shape, the presence of tumors, etc. Cytoscopy allows you to assess the condition of the walls of the vagina and identify uncharacteristic changes in the epithelial cover of the vagina. Quality diagnostics is essential. After all, 90% of the treatment depends on the results of the diagnosis.

Treatment of violations of the microflora of the vagina includes:

Suppression of pathogenic and conditionally pathogenic microorganisms. If a violation of the microflora of the vagina is associated with a sexual infection, then the treatment is aimed at the complete destruction of such an infection. In this case, treatment includes a course of antibiotics. But if genital infections are not caused by a violation of the vaginal microflora, antibiotics are not prescribed. Sometimes a short course of antibiotics is prescribed. Local procedures are considered very effective in the treatment of violations of the microflora of the vagina. This is how special tampons, candles, creams, ointments, special baths, etc. are prescribed. Such drugs combine all the tasks of treatment: suppression of pathogenic microflora, restoration of normal vaginal microflora, correction of immunity. It should be noted that in the treatment of vaginal microflora, the use of antiseptics is much more effective than the use of antibiotics. The effectiveness of antiseptics is explained by the broad action, the resistance of bacteria to antiseptics.

Restoration of normal microflora. In order to restore the microflora of the vagina, special vaginal preparations are used. Such drugs allow you to populate the vagina with useful and necessary microorganisms, as well as restore the walls of the vagina.

Restoring the immune system looms the vagina. Restoring the immunity of the vaginal wall will help maintain the normal composition of the vaginal microflora. For this, various systemic and local preparations are used. It is not recommended to engage in the restoration of immunity on your own. Immunity-correcting drugs have contraindications for use and specifics of use. Advanced forms of the disease require a serious approach to treatment. Often, immunostimulants are combined with antibiotics. This treatment takes on average several weeks (2-4 weeks). It is worth noting that in the treatment of violations of the microflora of the vagina, it is recommended to conduct a study of the state of health and the sexual partner of a sick woman. After the end of treatment, control studies are carried out. Control studies allow confirming the quality of treatment and confirming the elimination of predisposing factors for the recurrence of vaginal dysbacteriosis.

You can prevent the violation of the microflora of the vagina by adhering to the rules of prevention. For the purpose of prevention, all women are recommended to visit the office of a gynecologist-endocrinologist at least 1-2 times a year. So, when visiting a specialist, you should report changes in the body, past diseases, bad habits, etc. This information allows you to timely assess changes in the state of the vaginal microflora. If the gynecologist detects the influence of predisposing factors, then he prescribes a number of necessary studies. Also, measures to prevent violations of the vaginal microflora include: timely treatment of genital infections; timely treatment of acute diseases; proper nutrition; rejection of bad habits; use of mechanical contraceptives; having one sexual partner, etc.

Experienced doctors, including a gynecologist-endocrinologist, conduct their practice at the Hippocrates clinic. With us you can undergo the necessary examinations, as well as undergo the treatment of gynecological diseases with modern methods. Our specialists accept by appointment. Appointments can be made at any time by phone. Take care of your health.

Vaginal dysbacteriosis is a violation of the normal ratio of beneficial and pathogenic microorganisms that inhabit the vaginal microflora. Pathology is often accompanied by a violation of the acidity of the vaginal environment, which contributes to the appearance of uncomfortable sensations during intimacy and creates favorable conditions for the reproduction of microbes, bacteria and fungi.

Bacterial dysbiosis has characteristic symptoms that every woman should know in order to take the necessary measures in time and prevent complications. Some infections that can develop in the female body when the vaginal microflora is disturbed can adversely affect health and cause a number of dangerous gynecological diseases. Sexual infections during pregnancy are especially dangerous, as they can cause infection of the baby during childbirth, as well as birth defects and malformations during fetal development.

The imbalance of microorganisms in the microflora of the vagina always has certain signs and symptoms. An asymptomatic course of dysbiosis is possible, but only in rare cases when a woman has no problems with the activity of the immune system.

One of the main clinical manifestations of dysbacteriosis in women, doctors consider an increase in the volume of vaginal discharge between menstruation. This situation may be a variant of the norm in the middle of the cycle, when a woman ovulates. The amount of mucus during this period increases, the consistency of the secretions also changes: they become thicker and more viscous. On the 4-5th day after the release of a mature egg from the ovary, the discharge usually returns to normal, but there are a number of symptoms that should alert the woman and become a reason for contacting the observing gynecologist.

1. Colour. Normal discharge is colorless and looks like clear white mucus. If pathogenic flora actively develops in the vaginal environment, their color will change to yellow, green, brown or white.
2. Consistency. Normal secretions can be compared with egg white - they have the same consistency and viscosity (sometimes the discharge can be more liquid, but if there are no pathological signs of infectious diseases, this is also considered a normal variant). With bacterial infections, the discharge becomes thick and resembles yellow or marsh-colored fatty sour cream. With thrush, plaque on the walls of the vagina and external genitalia looks like curdled cottage cheese.
3. Smell. If the discharge has a strong smell of fish or decay products, you should immediately consult a doctor.

The symptomatology of dysbiosis depends on which type of microorganisms began to grow in the vaginal environment. Pathogenic flora can be bacterial or fungal in nature - in each case there will be certain clinical symptoms and signs.

Type of dysbacteriosis	What microorganisms predominate?	Symptoms
Fungal	Predominantly microscopic organisms - yeast-like fungi Candida	White discharge with a consistency of thick cream or curd mass. There may be small inclusions. An unpleasant odor may be present, but it is usually mild and resembles sour milk. The main complaints of women are burning and itching in the perineum and anal canal. There may be discomfort during urination (if the infection has spread to the urogenital tract). The skin of the genitals is reddened and inflamed
Bacterial	Trichomonas, Gardnerella, Chlamydia	The discharge becomes very thick and profuse, accompanied by severe itching and inflammation of the skin of the labia and mucous membranes of the vulva. The color of the discharge is brown, green or yellow. A distinctive feature of bacterial infections is a sharp, unpleasant odor (also called a "fishy" odor)

Note! Previously, vaginal dysbacteriosis was not considered a disease, and therapy consisted mainly in the use of alternative medicine methods. Dysbiosis is now listed in the International Classification of Diseases (ICD-10) as “inflammatory diseases of the vulva and vagina (including unspecified inflammatory processes).

Vaginal itching

Itching and burning are observed in 100% of cases of vaginal dysbacteriosis. Skin manifestations can have different localization and intensity. Sometimes severe itching in a woman appears only in the perineal area and affects the external genitalia. The opposite clinical picture is when burning occurs in the vaginal tract and intensifies after urination, intimacy and other provoking factors. In half of the cases, the pathology takes a combined form, when pathological manifestations occur both in the perineum and in the vagina. If the number of pathogenic microorganisms is growing rapidly, itching may also appear in the anorectal region: around the anus and in the rectum.

How does intimate life change with dysbacteriosis?

If there is a decrease in the number of bifidus and lactobacilli in the vaginal environment, one of the symptoms may be dryness of the walls of the vagina. Women who have irregular sex life may not notice this symptom, the only manifestation of which at the initial stage of the pathology will be moderate discomfort and itching. But if sexual relations occur periodically, a woman may notice that sexual contact has become more painful, and the sensations of intimacy have changed their physical and emotional coloring.

Pain and discomfort during intercourse appear in three stages:

• the introduction of the penis into the vagina (the most painful process in severe dysbacteriosis);
• increased partner activity (stronger and rougher movements);
• the period after the end of intimacy (the first 1-2 hours).

In some cases, the pain syndrome can be localized not only in the vagina. Pulling pain can be felt in the lower abdomen, on the left or right side of the small pelvis. Bacterial dysbiosis can occur against the background of inflammatory diseases of the uterus, ovaries or bladder, therefore, when a pain syndrome of any localization and intensity appears, it is necessary to check the functioning of the organs of the genitourinary system and pass a urine and blood test.

Note! Discomfort and pain during sex are caused by insufficient production of vaginal lubrication or its complete absence. In most cases, women with disturbed microflora do not experience the pleasure of intimacy and cannot achieve orgasm. Such violations should also be the reason for contacting a specialist, especially if such symptoms have not appeared before.

Who is at risk?

Vaginal dysbacteriosis can develop at any age. Often, pathology is diagnosed in adolescent girls during puberty. There may be several reasons for this:

• increased synthesis of sex hormones and associated hormonal imbalance;
• weak immunity, the causes of which may be frequent respiratory infections, malnutrition, adherence to rest and mental and physical labor;
• poor personal hygiene of the intimate area;
• hypothermia.

Parents of girls should be aware that up to 17-18 years of age, vaginal dysbacteriosis in this age group of patients can manifest itself only with intense itching in the inguinal and anorectal region. Pathological secretions and other signs of disturbed microflora may be absent, so you need to carefully monitor the child's condition and notice signs of discomfort. It is very important to establish a warm and trusting relationship with the child, so that if such problems arise, the girl does not hesitate to inform her mother about them.

In adult women, there are a lot of reasons for bacterial dysbacteriosis. Most provoking factors are associated with a negative effect on the immune system, which weakens and cannot restrain the growth of pathogenic flora.

These factors include:

• bad habits;
• unbalanced nutrition with insufficient intake of proteins, carbohydrates, fiber and lipids (or a violation of their balance among themselves);
• work in conditions of constant pollution (in industrial warehouses, factories, industries);
• a state of chronic stress;
• taking hormonal drugs (for example, oral contraceptives);
• frequent change of sexual partners (subject to intimate contacts without a condom).

The condition of the microflora of the vagina and intestines is negatively affected by long-term use of antibacterial drugs. The likelihood of pathology increases if a woman has undergone prolonged treatment with agents from the group of macrolides and cephalosporins. It is these groups of antibiotics that have the maximum list of side effects (compared to penicillin drugs) and have the most aggressive effect on the microflora of the female body.

Specialists distinguish several categories of women who are at risk for the development of bacterial dysbacteriosis. These include women:

• over 50 years old;
• in a state of menopause;
• pregnant women;
• suffering from diseases of the endocrine system (diabetes mellitus, disorders of the thyroid gland, pituitary gland, adrenal cortex);
• with overweight.

All of the listed categories of patients are recommended to pay special attention to the prevention of dysbacteriosis: eat a balanced diet, include a lot of seasonal berries and fruits, greens in the menu, increase the level of physical activity, give up bad habits, walk more often, and carry out hardening activities. If necessary, you can use medical preventive methods (1-2 times a year after consultation with a gynecologist).

How to treat?

Treatment of bacterial dysbacteriosis includes following a special diet with a complete rejection of products containing chemical additives, as well as sugar, spices, smoked and pickled foods. Coffee and carbonated drinks are also recommended to be excluded before stopping the acute process.

Particular attention should be paid to intimate hygiene. Bed and underwear should be made of natural cotton or linen fabrics. It is necessary to change underwear every day after hygienic washing. Bedding should be changed every 3-4 days. If the fabric from which the duvet covers and pillowcases are sewn allows (for example, bleached calico with a density of 140 g / m), it is better to wash bed linen at high temperatures - from 90 ° to 100 °.

You can wash yourself for the period of treatment with decoctions of medicinal herbs that have anti-inflammatory, antiseptic and bactericidal properties. These are calendula, sage, St. John's wort, chamomile. With severe inflammation of the skin of the genital organs, you can prepare a decoction of oak bark - this is a powerful antibacterial agent that is not inferior in effectiveness to some drugs. To prepare a decoction, pour 2 tablespoons of the bark into 500 ml of boiling water and simmer for 15 minutes.

Medical treatment

To eliminate the symptoms of bacterial dysbiosis and destroy the pathogenic flora, doctors may prescribe medications containing beneficial microorganisms or topical antibiotics (depending on the indications). Most often, women who are sexually active, doctors prescribe drugs in the form of vaginal suppositories, for example:

• "Acilact";
• "Terzhinan";
• "Pimafucin";
• "Bifidumbacterin";
• "Ginolact";
• "Flagil".

Vaginal suppositories should be used 1-2 times a day for 5-10 days (exact information is contained in the instructions for a specific drug). Before the introduction of a suppository or vaginal tablet, it is necessary to wash and dry the skin of the perineum. After that, you need to lie on your back and bend your knees. With a finger (or a special applicator, if it is included), insert the suppository to the maximum depth. After the introduction, the candle will begin to melt, so you need to roll over on your stomach and lie down for 15-20 minutes to prevent the medicine from leaking out.

With a complicated course of pathology, a woman can be prescribed systemic drugs in the form of capsules and tablets for internal use. The most commonly used drugs in combination therapy are:

• "Trichopol";
• "Metronidazole";
• "Metrogil";
• "Flagil";
• "Clindamycin";
• "Dalatsin".

Additionally, you can take oral preparations containing bifidobacteria, probiotics, prebiotics and lactic bacteria: Normobact, Bifidumbacterin, Yogulact, Lineks, Bifiform.

Important! Simultaneous use of vaginal suppositories containing beneficial bacteria and oral preparations based on prebiotics and probiotics is not allowed.

Vaginal dysbacteriosis cannot be called a dangerous disease. Nevertheless, this pathology is extremely unpleasant. Painful symptoms and discomfort impair the quality of a woman's daily and intimate life. Violation of the ratio of beneficial and pathogenic microorganisms increases the risk of developing infectious diseases of the vulva, vagina, bladder, appendages, uterus. For this reason, it is important to seek medical help in the early stages of pathology. Women at risk are advised to pay special attention to hygiene and nutrition and annually undergo medical prophylaxis of bacterial dysbiosis, selected by the district gynecologist.

Video - Vaginal dysbacteriosis

The microflora of the vagina is a balance of certain groups of microorganisms that perform a protective function and themselves exist at the expense of the resources of the carrier's body. But sometimes there is a shift in the ratio of different groups, which is not accompanied by an inflammatory reaction. This condition is called dysbacteriosis. Signs of vaginal dysbacteriosis are diverse and depend on the predominance of a certain microflora.

What is a norm?

The vagina is an environment conducive to the life of several types of microorganisms. Regulate the processes of sex hormones - and.

The epithelium is in a state of constant renewal. Depleted cells break down, and the glycogen they contain serves as a breeding ground for bacteria. The result of metabolism is lactic acid. It defines an acidic environment, which ranges from 3.5 to 5.5 pH.

The basis of the microflora is made up of three types of bacteria:

1. Lactobacilli, or Dederlein sticks.
2. Bifidobacteria.
3. Peptostreptococci.

The coccal flora, Candida cells and mycelium of the fungus are opportunistic microflora, which, with a small amount, does not give clinical manifestations and does not require treatment.

Normally, there should be no pathological microorganisms:

• gonococci;
• Trichomonas;
• spirochetes.

A large number of leukocytes, mucus, in combination with coccal flora indicate an inflammatory process that requires treatment. It is also important to detect key cells - desquamated epithelium with bacteria adhering to it.

What is considered dysbiosis?

It is believed that the state of vaginal dysbacteriosis experienced at least once every third woman. It cannot be called a disease: dysbacteriosis is not sexually transmitted. This is a violation of the ratio of normal and conditionally pathogenic microflora without signs of inflammation.

Its private manifestations can be considered thrush and. In both cases, there is a decrease in the number of lactobacilli and an increase in other microorganisms. With thrush, these are fungi of the genus Candida, and with bacterial vaginosis, gardnerella. These pathologies have similar causes of appearance, but differ in manifestations.

Who is prone to imbalances?

The reasons for the development of vaginal dysbacteriosis can be external and internal. Most of them can be influenced, and some cannot be corrected.

Hygiene features

It matters both its non-compliance and excessive cleanliness. Neglect of hygiene procedures violates the normal ratio of microorganisms, an inflammatory reaction may occur, which will lead to vaginosis. A rare change of underwear, the use of synthetics instead of natural cotton also disrupts the normal state of the genitals.

Excessive hygiene is also harmful. The passion to wash more than 2 times a day, especially with the use of antibacterial soap, can lead to dysbiosis.

Some women have a false idea that the vagina is dirty, especially after intercourse. In an effort to clean up, they resort to douching. But it washes out the normal microflora.

Tampons are a good hygiene product when used correctly. If they are not changed every 2 hours, they become a breeding ground for microbes.

sexual relations

Frequent change of partners without use will "enrich" the microflora with new microorganisms. Men do not suffer from dysbiosis, but may be carriers of pathogens.

Spermicidal agents have some danger for disrupting normal biocinosis. Their frequent use can bring imbalance.

Taking antibiotics

Antibacterial agents act indiscriminately. Regardless of the reason for their appointment, they are distributed in tissues and body fluids and cause the death of most microorganisms, including normal microflora. The vacated niches become a breeding ground for conditionally pathogenic flora. Therefore, after a course of antibiotics, vaginal dysbacteriosis is not uncommon.

Cytostatics, strong antifungal agents, the passage of radiation therapy lead to a local decrease in immunity. Therefore, bacterial vaginosis is a natural result of such therapy.

Hormonal changes

The woman is in a state of constant hormonal storm. Over the course of a month, one predominant hormone changes with another. Before menstruation, this becomes especially noticeable, so thrush, gardnerellosis often become aggravated during this period.

Pregnancy, the time of onset are special periods in a woman's life. During pregnancy, vaginal dysbacteriosis often manifests itself for the first time. Timely treatment of this condition is necessary so that complications do not affect the course of gestation and the development of the child.

During menopause, a natural decrease in estrogen levels leads to atrophic phenomena. Against this background, the development of gardnerellosis may be natural with a combination of additional factors.

A hormonal shake-up can be called a state after an abortion or spontaneous miscarriage. This does not pass without a trace for the microflora, it will take a long period of its recovery.

Pathologies of the reproductive organs

Inflammatory processes can become a background for a violation of the ratio of microorganisms. Sometimes, as a result of the transferred inflammation or against the background of chronic inflammation, there is vaginal dysbiosis. This is due to a violation of local immunity.

Chronic vaginal dysbacteriosis can develop in the presence of congenital anomalies of the reproductive organs, as well as after surgical interventions that have led to deformation of the neck, vagina, or pelvic floor muscles.

Intestinal dysbacteriosis

It has been proven that the state of the intestinal microflora can affect the vaginal. Changes in the intestines cause a similar picture in the vagina. Therefore, it is often impossible to treat one area without the other.

When should you suspect dysbiosis?

Symptoms of vaginal dysbacteriosis may not appear clearly for a long time. Sometimes some women report discomfort on the eve of menstruation, which disappears after menstruation. But they do not associate it with pathology. Only the prolonged existence of symptoms can force examination.

The signs of change are as follows:

1. Abundant discharge. Normally, the amount of whites is small, they do not stain linen and are almost invisible. Increased discharge in vivo occurs before, sometimes before menstruation. Allocations with vaginal dysbacteriosis are white, sometimes a grayish tint. They may resemble those at.
2. Itching and burning are a variable symptom, some women may be absent.
3. Discomfort during intercourse. Often this symptom appears with the progression of pathology. A change in the nature of the discharge can lead to vaginal dryness, which will be accompanied by pain during intercourse.
4. Burning during urination may be present, but is also not a permanent symptom.

With prolonged existence of vaginosis and the absence of treatment, the condition worsens. These signs become more pronounced.

With vaginosis and candidiasis, the discharge may be similar, but how to distinguish thrush from vaginal dysbacteriosis? The main feature that you can notice on your own is the smell. It is compared to rotten fish. Getting rid of it is almost impossible. Washing with soap will only increase the odor. Some try to increase the frequency of hygiene procedures throughout the day, but this does not bring relief.

The use of sanitary pads with strong fragrances can further aggravate the situation: an allergic reaction develops to artificial additives in a state of suppression of local immunity. Swelling of the labia, strong, unbearable itching of the vulva is added to the unpleasant symptoms.

When the condition is neglected, the process of urination may be disturbed. There are frequent urges, sometimes false, burning in the process of emptying. These symptoms are signs of joined cystitis.

It is not an inflammatory disease. Therefore, the appearance of swelling, redness and other signs of inflammation is a consequence of the development of complications.

Why is dysbiosis dangerous?

Changing the balance of microflora is not dangerous in itself, but it is accompanied by unpleasant symptoms. But those changes that occur against the background of dysbacteriosis can create conditions for the reproduction of pathogenic flora. Therefore, it is not uncommon that after treated dysbiosis, it turns out that it is necessary to treat sexually transmitted infections.

How to diagnose pathology?

After conducting a survey, the doctor determines the time of onset of the first pronounced symptoms, their relationship with menstruation, sexual intercourse, lifestyle, or taking antibiotics.

During the examination, the doctor may smell an unpleasant odor. To confirm its origin, a special amine test is carried out. To do this, vaginal discharge is applied to a glass slide, 10% potassium hydroxide is added to it. This is an alkali, which, when combined with the waste products of gardnerella, will give a pronounced smell of rotten fish.

Such a test is carried out daily by women on their own, without knowing it. Ordinary soap contains an alkali based on potassium or sodium. A fishy smell that intensifies when washed indicates the presence of violations.

An analysis for vaginal dysbiosis includes a microscopic examination of a Gram-stained smear.

To determine the acidity of the medium, special litmus strips are used. They change color depending on the reaction of the environment. Some clinics use more modern pH meters instead of paper strips. In this case, a pH of more than 4.5 is considered pathological.

The diagnosis of vaginosis can only be made if there are changes in the results of three studies.

Sometimes a cultural and bacteriological research method is required, which reveals all pathogens that determine the state of the microflora. On the other hand, the detection of gardnerella using the microbiological method without clinical signs of the disease cannot indicate the presence of dysbacteriosis, because. these microorganisms are present in smears in 60%.

Symptoms of the disease in women manifest themselves in different ways. In general, this condition is characterized by a violation of the ratio of the normal microflora of the body and conditionally pathogenic.

In adult women, most often with dysbiosis, there is a decrease in lactobacilli in the body and an increase in Escherichia coli and staphylococci.

It is important to know! For successful treatment, it is important to identify this pathology at an early stage of development and prevent its progression. To do this, you should first understand the causes of dysbiosis, and then apply a comprehensive treatment of the disease.

Causes of vaginal dysbacteriosis in gynecology

• Large number of sexual partners and lack of contraception or use of hormonal contraceptives.
• hormonal disorders, associated with abortion, menstrual disorders, prolonged absence of sexual intercourse, thyroid dysfunction, as well as any ovarian dysfunction.

Dysbacteriosis in gynecology is quite a common phenomenon, it affects about 75% of women

• Improper personal hygiene - frequent douching, untimely tampon change, abuse of antimicrobial agents.
• Stress, nervous breakdowns, excessive overwork.
• Long-term use of antibiotics.
• Climate change, hypothermia.
• Chronic infections of the vagina.
• General decrease in the body's immunity.
• Intestinal diseases.
• Diabetes.
• Smoking, drug use, excessive alcohol consumption.

Note! This is not a complete list of reasons that characterize dysbacteriosis. Symptoms of the disease in women manifest themselves in different ways, depending on the individual characteristics of the body. Therefore, the causes of the disease according to gynecological reference books may be different.

Causes of vaginosis

Gardnerella

In addition to the main causes of dysbacteriosis, it is important to determine the provoking factors of the disease. These include bacteria, the type of which will help determine the identified symptoms of the disease in women.
The main types of bacteria that provoke vaginosis:

• Streptococci and staphylococci;
• Gardnerella;
• Mycoplasma and ureaplasma;
• The causative agent of thrush is Candida fungus;
• Clostridium, Klebsiella, Corynebacterium;
• Escherichia coli.

When bacteria are present in small numbers, they are harmful to health, but when they multiply and spread, they cause disease.

The main symptoms of vaginal dysbacteriosis in women

For a long time, vaginosis can occur without any visible symptoms, however As the disease progresses, there is:

• Vaginal dryness- this condition is very clearly noticeable during intercourse and can give a woman very unpleasant sensations. This condition means the transition of dysbiosis to the pelvic organs. These symptoms can lead to irritability and loss of interest in sex.
• Allocations. Dysbacteriosis in gynecology is also characterized by symptoms in women such as an increase in clear discharge in the initial stage. With the development of the disease, namely an increase in the number of staphylococci and E. coli, they acquire a pungent odor and become greenish.

Symptoms of bacterial vaginosis in women may not appear for a long time. Therefore, it is important to regularly undergo a gynecological examination.

• Itching and burning. If vaginosis is aggravated by thrush, a white coating appears on the walls of the vagina, itching and burning are possible.
• Pain in the lower abdomen. With a long course of dysbacteriosis, pain in the lower back and lower abdomen may appear, in an aggravated form, frequent painful urination is possible.

Should know! With vaginosis of the initial stage, there are no visible signs of the inflammatory process.

Ignoring vaginal dysbacteriosis for a long time can lead to more serious diseases and a significant deterioration in overall health.

Symptoms of vaginal dysbacteriosis in girls

According to the accepted data of modern gynecology, the symptoms of vaginal dysbacteriosis in girls can appear at any age.

The main causes of the development of the disease in adolescents:

• hypothermia;
• mistakes in personal hygiene, most often the incorrect use of tampons and gels for intimate hygiene;
• weak immunity;
• malnutrition, lack of rest and fresh air, stress;
• hormonal imbalance during puberty.

In most cases, until the age of majority, the main symptoms of the disease are itching and burning in the groin. Discharge and a specific smell appear in older girls.

If you suspect the development of this disease in a child, you should consult a doctor to determine the causes and treatment program.

Diagnosis of vaginal dysbacteriosis

The standard diagnosis of dysbacteriosis includes:

• gynecological examination;
• smear on microflora;
• polymerase chain reaction analysis;
• vaginal culture.

Before taking a smear, it is important to refrain from sexual intercourse, the use of vaginal suppositories and douching for several days.

The smear is given before the start of treatment and at the end of it.

PRC analysis must be taken to determine the causative agent of the infection and the number of bacteria in the body. In turn, taking a crop helps to determine the properties inherent in the pathogen. It is also necessary to determine the sensitivity of the body to antimicrobial agents.

Dysbacteriosis of the vagina during pregnancy

Quite often, dysbacteriosis in gynecology is characterized by the presence of similar symptoms in pregnant women:

• discomfort and itching in the vagina;
• profusion of secretions that have an unpleasant, sometimes pungent odor.

Dysbacteriosis can lead to stress caused by anxiety for the child, excessive fatigue, poor nutrition. The most common cause is hormonal disorders that lead to a decrease in immunity.


During pregnancy, self-medication is prohibited, all procedures must be agreed with the attending physician so as not to harm the baby.

Complex treatment of vaginal dysbacteriosis

To achieve a positive result, it is necessary to stop the reproduction of pathogenic microorganisms, after which it is necessary to contribute to an increase in the presence of beneficial microorganisms in the vagina.

To consolidate the result, you need to strengthen the body's immunity. Treatment of vaginal dysbacteriosis consists of taking prescribed drugs and therapy for restoring normal microflora. Let's consider each stage in more detail.

Medical treatment

Let's single out some drugs that help treat vaginal dysbacteriosis and restore microflora:

Drug, price	Method of administration	Cause
Tiberal (price about 700 rubles)	500 ml twice a day for a week	Destruction of pathogenic microorganisms
Tinidazole (packing about 45 rubles)	3-4 tablets per day, 6 days
Clindamycin (approximate price 600 rubles)	Per day from 600 to 1800 mg three times a day, for a week	Against staphylococci and E. coli
Terzhinan (price from 350 rubles)	1 tablet in the evening in the vagina, 10 days
Essentiale forte (price from 700 rubles)	2 capsules, three times a day	Recovery process

Doctors warn that taking medications that have not been prescribed by a specialist can adversely affect the functioning of the body and worsen overall well-being.

Therapy for the restoration of microflora

Violation of the vaginal microflora is directly related to the woman's immunity, therefore, during treatment, it is necessary to pay enough attention to strengthening the immune system.

Most often, the restoration of microflora takes no more than 1 month. After the end of the course, a re-examination by a specialist is required. If the disease is in an undeveloped state, the use of immunomodulators is sufficient for treatment.


In more complex cases, for example, to restore the microflora after thrush, it is necessary to take products containing lactobacilli and a component that restores the epithelium.

Drugs that help restore the normal environment of the vagina:

A drug	Mode of application
Gynoflor	For a week, one tablet in the vagina at bedtime
Lactogin	For women over 18, one capsule, 10 days
Ecofemin	1 capsule twice a day. Take from two weeks to a month
Lactobacterin	Ten days, one vaginal suppository before bed

The recovery course of medication should be discussed with the doctor.

Possible complications of vaginal dysbacteriosis

If the disease is not treated for a long time, complications are possible, which include:

• endometritis- inflammation of the uterine cavity;
• vaginitis- inflammation of the walls of the vagina;
• cervicitis- the development of the inflammatory process of the uterus;

• development of cystitis as a result of infection of the bladder;
• adnexitis- inflammation of the appendages.

Most often, the first signs of the onset of the development of such diseases are due to the appearance of burning and itching, as well as an increase in the amount of discharge.

Folk recipes for the treatment of vaginal dysbacteriosis

Dysbacteriosis in gynecology. The use of folk recipes for the treatment of identified symptoms in women
Name	Ingredients	Recipe	Reception
Douching - no more than 15 minutes. Normalization of the state of the body	1. Chamomile and plantain	1 st. spoons of herbs, pour a liter of boiling water, leave for half an hour, strain	In the morning and before bed
	2. Oak bark	1 st. spoon, pour 200 ml of boiling water, leave for three hours, strain, cool	During the week at night
	3. Bird cherry	1 st. spoon for 400 ml of water, boil, cook for 20 minutes over low heat, strain and cool	For a week once a day
Therapeutic sitz baths (dip to the waist) - have a calming effect and relieve inflammation	1. Oak bark	250 gr. collection insist in cold water for four hours, boil, add to the bath	Daily for 20 minutes
	2. Flower honey	2 tbsp. spoons of honey diluted with 500 ml of hot water and add the mixture to the bath	20 minutes every two days
Tinctures to strengthen immunity	1. Quince, cherry, garlic, lemon and apples	Mash the cherries, grate the quince and apples, finely chop the lemon, squeeze out the garlic. Mix all the ingredients, pour 1.5 liters of water, close and let it brew for 30 minutes, then strain	Four times a day, 100 ml
	2. Dried rowan, honey, onion	2 tablespoons of berries pour 400 ml of water, cook for 25 minutes, add 2 tablespoons of honey and grated onion	One spoon 4 times a day
	3. Leaves of garden purslane, egg white	Grind leaves, mix with protein	Drink three times a day, course 15 days

We should not neglect the fact that in order to improve the effect of treatment, in addition to the above methods, fresh fruits, vegetables and dairy products should be introduced into the daily diet.


You should take vitamins E and C, which have a positive effect on the balance of microflora.

Using alternative methods of treatment, one should not neglect the advice of a qualified specialist. This will help you get better treatment.

According to the data of modern gynecology, dysbacteriosis, regardless of the identified symptoms in women, is not transmitted during intercourse and does not apply to sexually transmitted diseases. However, it must be treated immediately when the first symptoms are detected.

Useful videos about vaginal dysbacteriosis from doctors

Dysbacteriosis in gynecology. Symptoms in women:

Bacterial vaginosis, its consequences and treatment: