Smear for flora in women - leukocytes 15. What are the reasons for increased leukocytes in a smear in women

At every visit to the gynecologist during the examination, samples must be taken from the urogenital tract, regardless of whether the woman has complaints or not. The flora smear shows not only beneficial, opportunistic and pathogenic bacteria, but also leukocytes.

Often, elevated white blood cells in a smear in women indicate some kind of problem in the body, which requires finding out the cause of this condition, and, of course, treatment. It is important to remember that no amount of self-medication will help cope with the problem, and sometimes can lead to negative consequences.

Briefly about leukocytes

Leukocytes are white blood cells that protect the body from all types of harmful agents (bacteria, viruses, etc.). That is, the main function of leukocytes is to protect the body, as specific, for example, from certain type microorganisms, both nonspecific and general.

The concentration of leukocytes increases in areas of inflammation, where they capture and digest foreign agents. In case large cluster pathogenic agents, white blood cells increase significantly in size and begin to break down. The process of destruction of leukocytes is accompanied by local inflammatory reaction: swelling and hyperemia of the damaged area, increased local temperature.

Flora smear

A smear on the flora, as already indicated, is taken from the woman at each visit antenatal clinic, that is, every six months, if the patient has complaints, as well as after a long course of antibiotics, when planning pregnancy, during gestation and after childbirth. During pregnancy, a smear for microflora (in the absence of complaints) is examined three times: during registration, before maternity leave(30 weeks) and at 36 weeks.

Preparing for the test

In order for the results of a smear on the flora to be reliable, it is necessary to prepare in advance for the test:

exclude sexual intercourse for 1 – 2 days;
Douching is not allowed 2 days before a visit to the doctor;
the use of suppositories, tablets and creams is prohibited for at least 24 hours;
a smear is not taken during menstruation, since menstruation changes the composition of the smear;
2 – 3 hours before visiting the gynecologist, refrain from urinating;
You should wash yourself the day before your appointment, warm water no soap.

If a woman is preparing for preventive examination, then it is advisable to schedule a visit to the gynecologist in the first days after your period or before it starts.

Procedure for collecting and examining material

In a gynecological smear, the composition of the microflora of the contents is determined urethra, vagina and cervix.

The material is collected using sterile disposable instruments. A smear is taken from the urethra with a bacteriological loop or a Volkmann spoon, from the vagina (posterior fornix) with a sterile gauze swab, and from the cervix with an Eyre spatula.

The following symbols are indicated on the slides:

U – smear taken from the urethra;
C – cervical smear;
V – vaginal smear.

After the glasses are dry, they are sent to the laboratory for testing. Laboratory assistants stain smears with special dyes (Gram stains), then examine them under a microscope. During the analysis, leukocytes and various opportunistic and pathogenic bacteria are counted, which are painted in different colors.

Explanation of smear analysis

Data indicated in the smear analysis:

Leukocytes

The leukocyte rate depends on the location from which the smear was taken. Their content is normally small. In the urethra, the number of leukocytes is 0 – 5 – 10, in the vagina their concentration corresponds to 0 – 10 – 15, and in the cervical canal from 0 to 30.

During pregnancy, the content of leukocytes increases slightly and can range from 15 to 20 (in the vagina) in the field of view.

Flat epithelium

Flat epithelium lines the vagina, urethra and cervical canal. IN normal smears the number of epithelial cells ranges from 5 to 10. When the epithelium disappears (0 cells in the field of view), they speak of atrophy of the mucous membrane, and in the case of an increase in epithelial cells, they speak of inflammation.

Mucus

Lactobacilli or Doderlein bacilli

It is typical for normal smears great content they are in the vagina, while they are absent in the cervix and urethra. When the number of lactic acid bacteria decreases, they speak of.

Yeast

Fungi of the genus Candida are normally absent at all three points of smear collection, but their occasional presence in the vagina is allowed. An increase in yeast-like fungi indicates thrush.

"Key" cells

They are conglomerates of cells squamous epithelium and bacteria - gardnerella. Normally absent, the presence of such cells is a sign of gardnerellosis or bacterial vaginosis.

Leptothrix

Refers to anaerobic (living without air) gram-negative bacteria, often found when mixed infections, for example, thrush and bacterial vaginosis or trichomoniasis and chlamydia. If these bacteria are detected in a smear, an advanced analysis for sexually transmitted infections is indicated.

Others

Mobiluncus - also applies anaerobic microorganisms and is present in candidiasis or bacterial vaginosis.
Trichomonas is a protozoan; normally they are absent from the smear.
Gonococci - cause a sexually transmitted disease - gonorrhea, respectively, are normally absent.
Escherichia coli— normally observed in single numbers in a vaginal smear. As the concentration of bacteria increases, bacterial vaginosis and neglect of personal hygiene are possible.
Cocci - in gynecological smears are divided into gram-positive - colored blue and gram-negative - do not stain and remain pink. Gram-positive cocci include opportunistic bacteria: streptococci, staphylococci and enterococci, which are normally found in smears in single quantities. When their concentration increases, they speak of nonspecific vaginitis (colpitis).

Degrees of vaginal smear purity

When we talk about gynecological smears, we mean not only smears taken from the cervical canal, urethra and vagina, but also separate species a smear that determines the degree of cleanliness of the vagina. The material is collected from the walls of the vagina and dried on a separate glass. There are 4 degrees of purity, but only degrees 1 and 2 are considered normal:

1st degree - leukocytes 0 - 5

Counts ideal option. The number of leukocytes is small, the microflora is mainly (up to 95%) represented by lactic acid bacteria, and there are only a few epithelial cells.

2nd degree - leukocytes 5 - 10

Also refers to the norm, but in a smear it is not determined large quantities conditionally pathogenic microorganisms(cocci or single yeast fungi). Lactobacilli predominate, leukocytes and mucus are moderate, epithelial cells are normal.

3rd degree - more than 10 (up to 50)

The content of leukocytes increases, a lot of mucus and epithelium are detected. The concentration of Doderlein bacilli decreases due to an increase in opportunistic flora.

4th degree - leukocytes completely (cannot be counted)

Against the background of a huge number of leukocytes (the term “entirely” is indicated in the description of the smear), pathogenic microorganisms (gonococci, trichomonas) are determined. Doderlein's rods are not detectable, there is a lot of mucus and epithelial cells (a consequence of the inflammatory process).

If grade 3 and 4 purity of the vaginal smear is detected, it is necessary to establish the cause of inflammation and carry out treatment.

Reasons for an increase in the content of leukocytes in a smear

If leukocytes in a smear in women are elevated, then the causes may be either diseases of the reproductive sphere or malfunctions of other internal organs and systems. Inflammation comes first among the causes of an increase in leukocytes in urogenital smears:

inflammatory process in the cervical canal or;
development of inflammation in the appendages (tubes and ovaries) or salpingoophoritis;
inflammation of the uterine mucosa – endometritis;
inflammatory process in the vagina - colpitis or vaginitis;
development of inflammation in the urethra – urethritis;
malignant tumors of the genital organs (destruction of healthy tissue is accompanied by inflammation);
intestinal and/or vaginal dysbiosis;
infections that are sexually transmitted (both sexually transmitted diseases and hidden sexually transmitted infections).

Pathogenic microorganisms are the culprits of inflammation

Why do leukocytes increase in a smear? The development of the inflammatory process involves pathogenic microorganisms that are difficult to detect in the usual way - by examining a urogenital smear, or activated representatives of opportunistic flora. To detect pathogens of hidden sexually transmitted infections, they resort to a more complex examination - PCR method(examination of blood, urine, genital discharge).

A detailed study may reveal the following in smears or blood:

mycoplasma and ureaplasma;
gonococci (see);
Koch's bacillus (the causative agent of tuberculosis);
Treponema pallidum (causative agent);
Donovan bodies (causative agents of granuloma inguinale);
Trichomonas (see);
amoeba;
human papillomavirus (cause);
immunodeficiency virus;
viruses;
mushrooms of the genus Candida ();
actinomycetes fungi.

Other causes of increased white blood cell counts

Bacterial vaginosis or vaginal dysbiosis

Under certain conditions, opportunistic flora is activated and the growth of lactic acid bacteria is suppressed:

disruptions in hormonal status ( puberty or decline in reproductive function - pre- and menopause, pregnancy and spontaneous abortion, endocrine diseases);
weakening of local and general immunity (hypothermia, antibiotic therapy);
severe stress and overwork;
microtrauma of the vagina due to intense sex;
radiation treatment, chemotherapy;
use of spermicides in the form of ointments and suppositories;
oral sex;
a large number of sexual partners;
excessive adherence to rules intimate hygiene, passion for douching;
entrance to the vagina deformed by scars ( anatomical features, pathological birth, surgical interventions);
imbalance of intestinal microflora (dysbacteriosis);
foreign bodies in the vagina (tampons).

Allergy

allergies to medications and herbs;
intolerance to lubricants (gels, ointments);
intolerance to partner's sperm.

Irritation of the vulva and vagina

neglect of intimate hygiene;
temperature changes (hypothermia and overheating);
mechanical injury (tight, synthetic underwear, thongs, rough sex, etc.);
chemical burns (douching with acids and other drugs);
general diseases (diabetes mellitus, pathology urinary system and others).

In addition, elevated white blood cells in urogenital smears can be observed within 24 hours after coitus or for 7 to 10 days after installation intrauterine device. If the reason for the increase in the content of leukocytes in smears cannot be established, a more thorough and detailed examination, including for the purpose of identifying malignant tumors reproductive system.

Causes of increased leukocytes in pregnant women

A slight increase in the level of leukocytes in a smear during pregnancy is considered normal. The normal content of white blood cells in vaginal smears corresponds to 15 - 20 per field of view.

Elevated leukocytes in pregnant women in a smear are explained by physiological factors:

Firstly, during the period of gestation, restructuring occurs hormonal balance, progesterone and estrogens are produced in large quantities. Under the influence of estrogens, Doderlein's bacilli begin to actively multiply, which create an acidic environment in the vagina and prevent the proliferation of opportunistic and pathogenic flora, but contribute to the accumulation of leukocytes.
Secondly, expectant mothers have a decreased immune system, which prevents the embryo from being rejected as a foreign body. Due to weakened immunity, pathogenic bacteria easily penetrate into the vagina or become activated hidden infection, which explains the increase in leukocytes in gynecological smears ( defensive reaction during inflammation).

It is often revealed that very high concentration white blood cells in smears (50 - 100 or leukocytes completely in the field of view), which is usually noted with thrush (urogenital candidiasis). In such cases, in addition to a large number of leukocytes, fungi of the genus Candida and mycelium in the form of white threads are found in the smear.

An excess of leukocytes in expectant mothers requires thorough examination and appropriate treatment. Infectious process from the vagina can pass to the cervix and cervical canal, penetrate into the uterine cavity, which will lead to infection of the amniotic fluid and fetus and result in miscarriage or premature birth.

Clinical manifestations

An increased level of leukocytes in secretions from the cervical, urethral and vaginal canals often accompanies diseases of the female urinary and reproductive system:

rapid and painful urination– sign or ;
false urge to defecate indicates intestinal dysbiosis;
discharge from unpleasant smell accompanied by itching and burning may indicate vaginitis, cervicitis or inflammation of the uterus and;
purulent, foamy discharge or curdled discharge observed with vaginitis of a specific etiology (thrush, gonorrhea, trichomoniasis);
possible with pathology of the cervix, uterus or appendages;
in combination with an increase in leukocytes makes one think about inflammation of the appendages.

Diagnostics that determine the direction of treatment

Before you start fighting increased level white blood cells in smears, it is necessary to establish the cause of this phenomenon. It often happens that the content of leukocytes in a gynecological smear is high, although there is no activation and growth of opportunistic flora and, especially, specific pathogens. What to do in such a case?

The gynecologist will recommend taking smears again, choosing the most successful day menstrual cycle and recommending that you properly prepare for testing (exclude sexual intercourse, taking medications, douching). If, when taking smears again, the leukocytes again have high rate, an extensive examination is carried out:

A smear from the cervical canal and vagina onto the tank. sowing

When vaginal and cervical secretions are sown on nutrient media, colonies of pathogenic and opportunistic microorganisms often grow. The pathogen is identified and its sensitivity to certain antibiotics is determined, which is necessary for further treatment.

PCR for latent sexually transmitted infections

The method is highly accurate and almost 100% detects hidden sexually transmitted infections, which may not manifest themselves clinically, but lead to irreversible consequences (infertility).

Ultrasound of the pelvic organs

In this case, preference is given to ultrasound performed with a transvaginal sensor. Possible reason elevated white blood cells In the tests, in addition to inflammation of the uterus and appendages, there may be various tumor-like formations (ovarian cysts, uterine fibroids or sarcoma, uterine polyps, etc.).

Colposcopy

Examination of the cervix under multiple magnification helps to diagnose diseases that are not visible to the naked eye, but are the cause of elevated white blood cells in tests (leukoplakia, cervical dysplasia or early stage cancer).

Consultations of related specialists

Appointed after the above examination. For example, consulting an endocrinologist and prescribing appropriate therapy will help normalize the level of leukocytes when diabetes mellitus, pathology thyroid gland or when overweight. A nephrologist will identify a disease of the urinary system (pyelonephritis, cystitis) and prescribe anti-inflammatory therapy (antibiotics, nitrofurans). The allergist will advise you to exclude irritating factors (synthetic underwear, the use of intimate sprays, deodorants and various lubricants). Neurologist appoint sedative fees and drugs to eliminate neurosis, which can also cause an increase in leukocytes.

Anti-inflammatory treatment

Anti-inflammatory treatment is prescribed only if an infection is detected. The doctor decides what to treat, depending on the test results. Anti-inflammatory therapy includes:

local treatment;
general treatment;
restoration of normal vaginal microflora.

Local treatment consists of douching:

the course is short and lasts no more than 4 – 5 days
medications (solutions of potassium permanganate, chlorhexidine, miramistin)
herbs (chamomile, sage, coltsfoot, calendula, St. John's wort). Cm. .

Candles:

at the same time, suppositories with an anti-inflammatory effect are prescribed locally (hexicon, polygynax, betadine and others, see).
if a diagnosis of urogenital candidiasis is made, it is recommended to use suppositories with an antifungal effect (clotrimazole, pimafucin, livarol, see). Suppositories are administered once or twice a day for 10 to 14 days.
when the inflammatory process is not started, treatment is limited to this.

Treatment of hidden sexually transmitted infections

If a viral infection is detected, venereal diseases or latent genital infections, systemic antibiotic therapy or antiviral drugs are prescribed. Choice medicine depends on the etiology of colpitis and/or cervicitis.

Restoration of the world flora

The final stage of therapy is the restoration of normal vaginal microflora (increasing the content of lactic acid bacteria). For this purpose the following are appointed:

vaginal suppositories or tampons with probiotics (lactobacterin, bifidobacterin, acylact, colibacterin and others).
A high content of white blood cells in smears during pregnancy is dangerous for premature termination of pregnancy (miscarriage or premature birth), intrauterine infection fetus, development of chorioamnionitis (inflammation of the waters and placenta), ruptures birth canal during childbirth and development purulent-septic diseases V postpartum period. Therefore, expectant mothers should follow the doctor’s recommendations with special care and carry out the prescribed or treatment if the leukocyte count in the tests increases.

Question:
Is it possible to have sexual activity with elevated leukocytes in smear tests?

If not identified specific infection(gonorrhea, chlamydia, genital herpes and other diseases), then having sex is not contraindicated.

Question:
Can I get pregnant if my smears show elevated white blood cells?

Yes, it is quite possible to become pregnant, but it is advisable to undergo preliminary treatment, since often a high level of leukocytes in tests indicates an inflammatory process in the genital organs.

Question:
Is it possible to reduce the content of leukocytes in tests using only traditional methods treatment?

You should not self-medicate, including treatment only with traditional medicine, if you have a “bad” smear test result. Only a doctor can identify the cause of “bad smears” and prescribe appropriate treatment. Reduce white blood cells in tests only with the help of traditional medicine is not possible, since treatment with antibiotics or antiviral drugs or therapy for concomitant diseases.

Before collecting material for reliable results Some requirements must be met:

abstain from sexual intercourse in 1-2 days;
a few days before, stop taking medications that have not been approved by the doctor, douching;
Before visiting a doctor, perform genital hygiene only with the help of warm water;
last urination at least 2 to 3 hours before taking a smear.

The material is collected with a special spatula using a gynecological speculum. For microscopic examination Swabs are taken from the vagina and cervix. These samples are applied to glass slides.

Normally, a smear on the flora determines:

squamous epithelium;
leukocytes;
rods (lactobacillus).

If there are infectious diseases in the genitourinary system inflammatory processes, then the smear may reveal:

Candida fungus;
cocci;
Trichomonas;
Staphylococcus aureus, etc.

One of the most important indicators smear analysis - leukocytes. These are cells immune system, which have protective functions against infection. Normally healthy woman detected in smear analysis single leukocytes– up to 15 in the field of view (depending on the phase of the menstrual cycle). An increased content (up to several tens or hundreds) of these cells indicates an infection genitourinary system and the inflammatory process.

Along with an increase in the number of leukocytes, a smear analysis usually reveals an increased number of pathogenic bacteria or fungi.

Reasons

The reason for the increase in the number of leukocytes may be:

sexually transmitted diseases (syphilis, gonorrhea, ureaplasmosis, genital herpes, etc.);
cervicitis;
colpitis;
urethritis;
endometritis;
malignant formations and some others.

Exceeding the norm of leukocytes indicates the presence of an inflammatory process, but to prescribe treatment it is necessary to identify the causative agent of the disease. Therefore, additional laboratory research. The doctor may prescribe bacterial culture, PCR diagnostics, and immunological tests.

If after treatment the norm for the number of leukocytes in the smear is still exceeded, or additional tests do not show the presence of pathogenic flora, then this may indicate vaginal dysbiosis. That is, the relationship between microflora microorganisms is disrupted, possibly due to the use of antibiotics.

Another reason why the leukocyte content in a smear is exceeded is a violation of the rules for taking a smear or a mistake by the laboratory assistant.

Analysis of smears for flora in pregnant women - normal leukocytes

During pregnancy, smear tests are performed regularly, as infection is most dangerous during this period. The number of leukocytes in a smear in pregnant women is slightly higher - up to 15-20 units.

Enough common reason detection of the number of leukocytes in a smear above the norm during pregnancy - vaginal candidiasis (thrush). This disease occurs more often due to changes in hormonal levels, against the background of a decrease in general immunity.

Leukocytes in the smear are normal

A smear is also taken to determine the microflora of the urethra (urethra). This bacteriological analysis allows you to identify diseases such as urethritis, cystitis, pyelonephritis, and sexually transmitted diseases.

Preparation for analysis and requirements before conducting it are similar. Material for research is collected with a special probe, which is inserted into the urethra. This procedure may be slightly painful.

The norm of leukocytes in a smear analysis is from 0 to 5 visible units. An increase in the number of these cells also indicates inflammation.

A smear that determines the number of leukocytes is necessary to examine a woman’s reproductive system. Using a smear, you can determine the gynecological disease and its severity. What should be the norm of leukocytes in a smear in women? Let's look at the question in the article.

What are leukocytes? These are colorless blood cells responsible for the elimination of pathological agents in the human body. When pathogenic bacteria or viruses multiply, the number of leukocytes immediately increases. Therefore, an analysis for the presence of an increased number of leukocytes determines the presence/absence of diseases in the body.

A smear on the flora is taken in for preventive purposes and for making a diagnosis of diseases. A gynecologist can issue a referral for testing in the following cases:

pathological nature of vaginal discharge;
painful sensations lower abdomen;
painful sensation when urinating;
pathology of the menstrual cycle;
first trimester of pregnancy;
long course of hormonal therapy;
long-term treatment with antibiotics.

A gynecological smear is always taken after recovery from gynecological diseases and when planning pregnancy. If you have undergone an active course of antibiotic treatment, you should definitely take a smear - medications wide range exposure greatly weakens the immune defense.

Also, an indication for testing is a woman’s complaint of pain during intimate contact. However, gynecologists recommend getting tested regardless of the manifestation of the pathology, since many gynecological diseases can develop without any symptoms or signs.

The smear is taken using a disposable medical spatula. In the laboratory, the material is examined under a microscope and the following characteristics are determined:

norm of leukocytes in the vagina;
norm of leukocytes in the cervical canal;
the norm of leukocytes in the cervical mucosa.

Pain during scraping can only be present in cases of inflammatory foci in these organs. If the patient’s mucous membranes are in order, the procedure is absolutely painless.

Causes of pathology

Why can the leukocyte count exceed the norm, and what should be the norm of leukocytes in a smear for flora? Main reasons increased rate are considered:

hormonal disorders in the body;
decreased protective functions of the body;
bacterial infections of the genitals;
inflammation of the urinary tract;
intestinal or vaginal dysbiosis;
foci of inflammatory processes of the internal genital organs;
cysts and neoplasms of the reproductive organs;
systemic diseases.

Pay attention! The appearance of vaginal discharge always indicates a violation of the microflora of the vaginal environment and requires treatment.

Any discomfort in the lower abdomen, burning and itching of the external genital organs indicates a leak. pathological processes which can contribute to the development of serious illnesses.

However, sometimes an increase in leukocytes occurs due to natural cause- active sexual life. In some patients, elevated readings may appear on the eve of menstruation, especially if premenstrual syndrome characterized by pain.

Pay attention! Frequent use tampons during critical days can lead to the development of pathological processes in the vagina.

Ideally, the number of white blood cells should not increase either before or after menstruation. But in some women, inflated data after menstruation indicate that the uterus has not completely cleared itself of the effects of egg destruction. Also, an overestimated result occurs when using tampons on menstrual days.

Interpretation of test values

Since the smear is taken from different areas female reproductive system, they have their own name:

C - cervical area;
V - vaginal mucosa;
U - cervical canal.

Table of leukocyte indicators in the cervix, vagina and cervical canal:

An increase in leukocytes indicates the development of a pathological process in reproductive system women. During pregnancy, the number of leukocytes may be slightly elevated due to a decrease in the body's protective functions. However, the indicator should not exceed more than three units ideally. The indicator can also increase in women after 50 years of age due to hormonal changes.

Important! Many doctors consider an increase of 5 units to be natural and acceptable. However, an increase in the number of leukocytes by 20 units indicates the development of a pathological process.

The epithelium may deviate in its value, and its absence indicates a deficiency - hormonal pathology. An overestimated indicator indicates an inflammatory process.

Candida, Trichomonas, Gonococcus and key cells should not be present in the material - this indicates the development of viral/infectious processes.

Mucus is produced in the cervix and vaginal environment. Excessive mucus secretion is a sign of pathological abnormalities.

Other flora include lactobacilli and gram-positive bacilli, a moderate amount of which should be present in healthy flora. A decrease in indicators indicates the risk of developing pathology due to the inactivity of local immunity.

If the material contains E. coli, then there is a risk of bacterial vaginosis. The stick can get in due to poor personal hygiene and when wearing thongs.

Many people believe that only sexually active women can have a large number of white blood cells in the material. However pathological changes may also occur in virgins, for example, due to visiting a sauna or hypothermia. The reasons may be different, so all the nuances can only be clarified after laboratory examination biomaterial.

Degree of vaginal cleanliness

The result of a flora study characterizes the degree of purity of the vagina, which is expressed in four states.

The first degree is a moderate rate of leukocytes in the smear, moderate levels of epithelium and mucus secretion. This degree characterized by the absence of pathogenic and conditionally pathogenic bioenvironment, the presence of a sufficient number of lactobacilli. In practice, this condition of the vaginal environment is very rare.

The second degree is characterized by the presence of yeasts and cocci. This indicates a decrease in local immunity and the risk of developing inflammatory processes. This state of the vaginal environment is most common among subjects.

The third degree is characterized by an increase in the number of leukocytes, which indicates the occurrence of pathological processes. The composition of the microflora in this case is represented by yeast fungi, cocci and a small amount of lactobacilli. The woman needs active treatment.

The fourth degree is characterized a large number leukocytes together with a pathological bioenvironment and the absence of lactobacilli. This is extremely dangerous condition which requires immediate treatment.

Preparation for the procedure

The analysis is taken in the first days after the end of menstruation or before its onset, however, in emergency cases, scraping is done at any time. What rules must be followed when preparing? A woman should:

refuse intimate contacts three days before taking a sample;
stop taking any medications a week before the tests - including diuretics;
refuse to use hygiene products to wash the genitals two days in advance - you should wash only with warm water;
refrain from urinating for three hours before taking the sample.

You should also not douche a couple of days before taking a smear. When visiting a doctor, you need to wear fresh, pure cotton underwear; your genitals should be washed with warm water without hygiene products. In case of morning bowel movements, you should wipe the perineum with an antibacterial wipe.

The tests are ready in about 2-3 days. IN paid clinics the result can be obtained in a few hours. If tests reveal an increased number of white blood cells, a diagnosis for a hidden disease is prescribed.

Bottom line

A gynecological smear for flora and the norm of leukocytes in it determines the degree of purity of the vaginal environment and the presence/absence of pathology. Ideally, the vaginal environment should contain lactobacilli, healthy bacilli, and a moderate percentage of white blood cells. With hormonal and other abnormalities, the balance changes towards pathogenic microflora. To avoid the development of gynecological diseases, regularly take a smear for preventive purposes.

Every woman has had to undergo a smear test more than once when visiting a gynecologist. What does the number of leukocytes mean when deciphering this analysis and what does a deviation from the norm indicate?

smear of a healthy woman

The norm for leukocytes in a smear in women lies within strict limits. But if they are significantly increased or, conversely, less than prescribed, then this indicates the presence of a disease and the doctor prescribes additional examination. What does this indicator mean for women's health?

Leukocytes is a collection of types of blood cells whose function is to resist any infection. If their number on the mucous membrane of the vagina, cervix and urethra does not exceed certain limits (the norm for leukocytes in a smear in women is clearly defined), then this indicates that there are no inflammatory processes in the body.

Therefore, with the help of a gynecological (urogenital) smear, it is possible to determine the presence of genitourinary diseases in women of any age. In particular, such an assessment of the level of leukocytes (increased or decreased) is necessary to ascertain the infectious-inflammatory process and assess its intensity.

Reasons for prescribing such an analysis may include:

pathological discharge;
disturbance of the stability of the menstrual cycle;
pain in the lower abdomen;
itching, burning and pain when urinating;
discomfort during intimacy.

In addition, a smear test is taken in the first trimester pregnancy and after long-term use antibiotics or hormonal drugs, and also, prophylactically, once every three months.

A woman needs to properly prepare for this procedure, otherwise the result of this analysis will not be reliable.

For smear readings to be accurate, you must:

give up intimate relationships no later than three days before the analysis;
do not accept medicines during the week preceding the analysis;
within two days before taking a smear, avoid the use of soap and gels for intimate hygiene, and limit yourself to using warm boiled water.

A laboratory assistant examines a smear under a microscope and calculates the content of white blood cells in the laboratory material.

The table shows the readings for this parameter corresponding to the normal content of these cells.

What does an excess of the normal level of leukocytes in a smear indicate?

If a smear test reveals that a woman has increased concentration leukocytes than in the table above, this indicates the likelihood of the development of inflammatory processes in organs associated with reproductive function, namely:

colpitis;
andexite;
enderometritis;
urethritis.

as well as the development of other types of inflammation.

In addition, an elevated white blood cell count may indicate that a woman has:

sexually transmitted diseases;
tumors.

The number of leukocytes can be increased as a result of taking various medications (for example, antibiotics or hormones), as a result of stress, overwork. Therefore, when the concentration of leukocytes increases, the specialist will definitely pay attention to what indicators characterize the microflora present in the biomaterial.

During pregnancy, white blood cell counts in a smear also differ slightly from the usual norm and range from 15 to 20. Sharp increase leukocyte count may indicate how hidden pathology, and for the presence of inflammation in the body, which requires immediate treatment.

For example, thrush develops against the background of a fungal infection, and with the disease bacterial vaginosis and gonorrhea infection is detected Staphylococcus aureus. But the presence of lactobacilli, which are responsible for the acidity of the environment, may in this case be below normal.

Therefore, an increased content of leukocytes in a smear is a reason for prescribing other tests and a more detailed examination.

In what case can the number of leukocytes be lower than normal?

However, in some cases, analysis of a urogenital smear reveals a decrease in the number of leukocytes in women. Such indicators occur in older women during menopause, usually in the absence of intimate relationships. A decrease in the number of leukocytes is alarming symptom, since this fact indicates the suppression of the body’s protective functions. In this case, the woman needs to be regularly examined by a doctor to prevent the development of a dangerous disease.

Thus, any woman, regardless of age, presence or absence of intimate relationships, reproductive period or during menopause, do not neglect regular visits to the gynecologist.

Uncomplicated, painless procedure taking a smear, performed using sterile disposable instruments and taking a few minutes, will be able to detect development in time dangerous diseases, many of which are on initial stages may be asymptomatic. Timely diagnosis and appropriate treatment will help a woman of any age in this case avoid dangerous complications.

A woman’s health is the health of future children and generations. When visiting a gynecologist, it is important to conduct a full examination, which will determine the degree of purity of the patient or identify the presence of diseases. A number of tests, including a flora smear, will help answer your questions. It determines the value based on several indicators, one of which is the balance of leukocytes of the vaginal microflora in relation to mucus and other bacteria. The availability and ease of determining values in a gynecological smear reflects important information about the woman's health status.

What are leukocytes in a flora smear?

When the lymphocyte count decreases or increases, it signals that the body is weakened or has a disease. These cells carry protective function. An increased content means that inflammatory processes are occurring. The gynecologist, based on the number of cells in the cervical fluid, determines:

viral infection;
venereal diseases;
inflammation of the urinary system;
inflammation of the appendages and uterus;
violation of hygiene;
dysbacteriosis;
oncological diseases.

By increasing white blood cells, the body begins to fight. A decrease in cells or their absence indicates a decrease in the local immunity of the flora of the cervix, vagina, and urinary canal. Calls this process aging, vaginal tissue atrophy, passive sex life. If there are serious suspicions and there is no result of treatment, the doctor prescribes additional research. Which balanced norm leukocytes in a woman’s smear, an experienced gynecologist will definitely answer, but there are accepted values.

Leukocyte norm

How many leukocytes should there be in a smear? In gynecology, an indicator from 0 to 15 units is considered normal. But this information is not always decisive; it also depends on the age and place of collection of the analysis on the mucous membrane. Norm for normal flora:

vagina – 0-10 units;
cervix – 0-30 units;
urethra – 0-5 units.

These cell count limits are generally accepted for women reproductive age, with the exception of girls under 14 years of age and women over 45 years of age (after the onset of menopause). The result is affected hormonal background, period of the menstrual cycle, specific reasons, concomitant diseases (hormonal and endocrine, for example).

Causes of elevated leukocytes in women during bacterioscopy

A woman’s body responds to inflammatory processes in the reproductive system by increasing cells. The causes of elevated white blood cells are the presence of pathogens:

fungus;
Trichomonas;
gonococci;
staphylococci.

Symptoms may not appear, but often they include itching, redness, burning in the lower abdomen, discomfort, discharge, and even decreased vision. Pathogenic bacteria may lead to serious illnesses, sometimes irreversible, therefore timely detection of ailments and treatment is important factor. Bacterioscopy must be performed at least once a year.

Why is leukocytosis in a smear dangerous?

Ignoring high content microphages is unacceptable; delaying treatment leads to the development of diseases. Here is a partial list of them:

colpitis
urethritis;
cervitis;
vaginitis;
adnexitis
oncology of the genital organs;

Monitoring the norm of leukocytes in a smear in women is important for the woman herself in order to normal image life, experience sexual satisfaction. Observation regularly is everyone’s task! Having identified the causative agent of leukocytosis using additional analysis for culture, by selecting the necessary drug, you can avoid the danger of disease progression, which often increases many times.

When leukocytes are elevated in a smear during pregnancy

When a woman is expecting a child, the content of leukocyte cells increases, and deviations from the norm appear. The norm for this period is considered to be from 15 to 20 units. Over the course of 9 months, a pregnant woman takes a smear several times, and the dynamics are constantly monitored. High level may indicate the presence of a disease. Infections, worsening, manifest themselves actively due to weakened immunity. The difficulty in treating pregnant patients lies in limiting the use of antibiotics.