Found key cells in a smear in women. How does vaginosis develop? Symptoms of an infection

Before we start talking about key cells in a smear, it is necessary to clarify in which laboratory studies they are found. So, bacterioscopy involves the study of bacteria under a microscope, better known in modern gynecology as a smear on the flora. This is where highly undesirable key cells can show up. What does it mean?

The key cells in the smear are squamous epithelial cells, indicating the presence. At the same time, a gardnerella stick is attached to their walls, giving them a specific granular appearance. Such a pathology is fraught with consequences, since it can significantly undermine immunity and provoke a disease due to the large number of opportunistic microflora.

In order to understand the seriousness of the appearance of key cells in a smear, it is necessary to familiarize yourself with the consequences of their occurrence in the body. If the balance of microflora in the vagina is disturbed, a disease such as gardnerellosis begins to progress rapidly. Diagnosis of these diseases is carried out with the explicit detection of key cells containing many pathogenic microorganisms. The productive elimination of such abnormal cells is aimed at suppressing the growth, reproduction of bacteria and the restoration of the normal microflora of the vagina.

So, the key cells in the smear are a characteristic sign of bacterial vaginosis, which can bring its owner a lot of discomfort, become a cause for concern. However, here it is necessary to take into account the correctness and accuracy of the study of this medical analysis. First of all, it is necessary to pay special attention to the number of leukocytes, since their high rate may indicate the presence of an inflammatory process in the body. In addition, various pathogenic cells - rods or cocci - can dominate in the analysis, in particular, key cells in the smear can also be visually observed. And this already suggests that it would not hurt to sign up for a consultation with a specialist. It is important to note that pregnant women are especially prone to such a pathological phenomenon, since during this period their immune system productivity is significantly weakened, and pathogenic microbes overcome the weakened body.

If the results of a correctly performed smear on the microflora revealed key cells, treatment should be prescribed immediately. First of all, it is necessary to clarify that the goal of productive treatment is the elimination of bacterial vaginosis as a characteristic symptom. Recovery requires a comprehensive medical approach, and only a woman as a carrier of the source of infection should undergo a course of intensive therapy recommended by a specialist. Such treatment should be prescribed by the attending gynecologist, based on the form of the disease and the specifics of the diseased organism in each clinical case.

At the beginning of the course, it is necessary to use medicines such as Clindamycin and Metronidazole, which are available in the form of tablets or in the form of suppositories. After these medications are completely cleared of pathogens, regular intake of medications containing beneficial lactobacilli is necessary to restore the familiar environment. Such drugs are Acilact or Narine. If key cells are found in the smear, treatment should take place under the strict supervision of a doctor.

At the end of the course, the patient (patient) retakes a smear for a detailed laboratory study, which will show whether there are key cells in the smear or not.

When looking at key cells in a woman's smear, a doctor will first suspect vaginal dysbiosis or bacterial vaginosis.

What are the key cells and what treatment is needed to prevent the development of diseases - these and other questions are answered in the article.

Any woman should undergo a routine examination by a gynecologist at least once a year. At the appointment, the doctor makes a smear, which determines the condition of the genital organs.

The presence of particles and pathogenic bacteria in a smear in women may indicate the development of inflammation and pathologies.

A smear usually reveals a small number of squamous epithelial cells (Dederlein sticks), which line the inner surface of the female genital organs.

The absence of epithelial cells probably indicates an insufficient production of female hormones or an excess production of male hormones.

Lactobacilli perform a specific function: they create an alkaline environment in the vagina, due to which the development of pathogenic microorganisms becomes impossible.

With a decrease in the number of squamous epithelial cells, pathogenic bacteria begin to actively multiply, and the acidic environment of the vagina changes to alkaline.

Such changes also affect the structure of the Dederlein sticks themselves: Gardnerella Vaginalis bacteria attach to them, and the cells become granular. It is these cells that can be seen with bacterioscopy of a smear of a woman.

Key cells are called altered squamous epithelial cells. If the test result showed their presence, then this signals a change in the bacterial balance in the vagina or the development of bacterial vaginosis.

Symptoms of a change in the balance of the microflora of the vagina include copious discharge with a pungent odor, discomfort and itching in the genital area, and a burning sensation during sexual contact.

If you have such complaints, you should immediately visit a doctor and take tests.

At the appointment, the doctor will establish the correct diagnosis and prescribe a specific treatment. After a course of therapy, the analysis is given three times with a short interval in order to exclude a false negative result and to verify the effectiveness of the prescribed treatment.

In men, the presence of key cells in a smear most often indicates chronic urethritis or even urethral leukoplakia.

Treatment for such diseases must be carried out under the supervision of a physician. Timely, well-chosen therapy will exclude the development of concomitant pathologies.

Causes of the appearance of pathology

Key cells are altered squamous epithelial cells with attached pathogenic bacteria (most often gardnerella).

There is a change in epithelial cells due to a shift in the balance of the vaginal microflora and a decrease in the acidity of the environment.

An alkaline environment that is comfortable for the reproduction of bacteria leads to an active growth in the number of pathogenic microorganisms and the displacement of healthy cells.

Changes in the flora of the vagina occur against the background of hormonal disorders (for example, a decrease in estrogen levels) and the use of antibiotics.

Frequent douching and the use of local antiseptics lead to a violation of the microflora of the vagina.

Frequent colds and a decrease in general immunity adversely affect the balance of the environment in the vagina.

External factors often cause bacterial vaginosis. Thus, excessive physical and emotional stress leads to a change in the microflora of the vagina and a decrease in its acidity.

Hormonal failure caused by pregnancy and lactation often provokes alkalization of the environment and a decrease in the number of healthy epithelial cells.

A rare, but still possible case of the formation of key cells is considered to be a change in the mucous membrane of the cervix and vagina of oncological origin.

Erosive lesions of the mucosa and other pathologies of the genital organs of a woman often lead to the destruction of the structure of the Dederlein sticks and the attachment of harmful bacteria to them.

In men, the presence of key cells in a smear is no less dangerous. The fact is that attachment to epithelial cells of bacteria may indicate the presence of urethritis of gardnerella origin or local inflammation.

Such diseases are sometimes asymptomatic and are detected only during a routine examination. The reason for an emergency visit to the doctor in men is discomfort during urination.

Chronic diseases caused by the presence of key cells often lead to infertility or fertility problems in both men and women. That is why timely treatment is so important and should be carried out only under the supervision of a doctor.

Diagnosis and treatment regimen

The success of therapy and the speed of recovery depend on whether the key cells in the smear are detected in a timely manner.

You can identify the presence of pathology by means of a smear on the flora, which is a mandatory test when making an appointment at the antenatal clinic.

The analysis is carried out immediately after menstruation or immediately before it begins. So that the results of the study are not distorted, it is not recommended to carry out hygienic washing on the day of the smear.

Do not use antibacterial intimate hygiene products or vaginal suppositories/tampons. 1-2 days before the appointment with the doctor, it is recommended to refuse any sexual contact.

At the appointment, the doctor will take material from the walls of the vagina, from the cervical canal and urethra. In men, discharge from the urethra is examined.

Complex treatment with a positive result of the analysis of microflora is carried out in two phases. First, you should suppress the reproduction of harmful bacteria in order to stop the development of diseases. Next, you need to restore the damaged microflora of the vagina.

In the presence of key cells in the smear, the doctor prescribes antibacterial drugs.

Most often, agents with the active substance clindamycin (for example, Dalacin) or metronidazole (for example, Trichopolum) are used.

Medications are available in the form of injections and in the form of a vaginal cream or gel. Treatment on average is carried out for 5 to 7 days, after which a second analysis is given.

At the end of antibiotic therapy, treatment proceeds to the next stage. To restore the flora of the vagina, probiotics are used - preparations in the form of suppositories or tablets (for example, Lactonorm).

Often, to maintain the intestinal microflora, probiotics are prescribed in the form of tablets or powder for oral administration (for example, Bifidumbacterin).

Taking such drugs is justified, among other things, because of antibiotic therapy. Treatment with antibacterial drugs adversely affects the state of the intestinal microflora and can lead to malfunctions of the gastrointestinal tract.

In the presence of itching and burning in the genital area, it is recommended to wash with herbal decoctions (for example, chamomile or calendula).

Key cells in a smear are not a dangerous disease, but they can talk about concomitant pathologies and do not show themselves for a long time.

Correct identification of the cause of their occurrence and timely treatment will stop the development of the disease and exclude the possibility of its transition to a chronic form.

Correctly not filling a smear on the flora: Bacterioscopy. The smear is taken by the gynecologist after inserting the vaginal speculum, under the control of the eye, using a disposable spatula (a plastic stick with an expanded end).

The material taken with a spatula is evenly distributed over a clean glass slide with a wide stroke. It is wrong to apply the material in a thick layer, a drop, a small smear - so it will be much more difficult for a laboratory doctor to do his job.

The material from different areas is placed on the glass separately, on the reverse side of the glass the place of taking the smear is marked: "U" - the urethra, "C" - the cervix, "V" - the vagina.

After that, the glass is dried in air and sent to the laboratory. In the laboratory, the smear is stained and examined under a microscope.

DNA diagnostics (PCR). DNA diagnostics includes several methods, but the most common is the polymerase chain reaction (PCR).

This is the detection of pathogen DNA in the material. DNA is the molecule that contains all the information about a cell.

In the cells of organisms of the same species (for example, genital mycoplasma), certain sections of DNA are the same. Therefore, knowing the structure of these areas in the main pathogens, you can create mirror copies that will find and contact them.

Finding even one such site is enough for PCR to be positive. This indicates the extremely high sensitivity of the method.

A smear for flora is a basic diagnostic procedure that is used in venereological, urological and gynecological practice. It serves as a kind of indicator of violations in the urogenital area, and, despite the fact that many experts consider it outdated and uninformative, it firmly holds its position in the list of standard medical manipulations.

Indications for the procedure

A study of the microflora contained in a smear from the urethra is carried out in all cases of contacting a urologist or venereologist, whether it is a preventive medical examination or a visit to the doctor in connection with the following complaints:

unusual discharge (too plentiful, discolored or with an unpleasant odor) from the external opening of the urethra;
a feeling of discomfort or pain in the urethra, often aggravated after and during urination;
infertility (ineffective attempts to conceive a child for a year or more).

In addition, a smear on the flora is taken without fail if a sexually transmitted disease has been detected in a sexual partner. Without this, the partner will not be prescribed a course of treatment.

What is analysis

During an objective examination of the patient, the doctor inserts a special sterile instrument into the urethra. Having made a light scraping from the walls of the urethra, the resulting contents are applied to glass slides.

The depth of insertion of the instrument is about 3 cm. It is at this distance from the entrance to the urethra that microorganisms live, deeper than 5 cm the cavity and the walls of the canal are practically sterile. Sometimes the doctor does not use instruments, but a sterile cotton or dactron swab.

Subsequently, slides are dried in the open air and stained with special preparations. After the coloring dries, the laboratory assistant examines them under a light or electron microscope.

Different cells and their parts react to color in their own way: some are sensitive to it, others are not. This simplifies the work of the laboratory assistant, who differentiates the identified microscopic particles from each other.

As a rule, the laboratory assistant analyzes the smear according to the following criteria:

The presence and number of leukocytes in the field of view.
Presence and number of erythrocytes.
Determination of the number of cells of desquamated squamous epithelium.
The presence of mucus and pus.
Presence, type and number of microorganisms.

If infection with Trichomonas is suspected, the smear is examined immediately after being applied to a glass slide, this makes it possible to identify mobile causative agents of trichomoniasis.

There can be several reasons for the appearance of key elements in a flora smear. But the main reason why pathology develops is a violation of the immune defense of the human body.

This usually happens against the background of a shift in opportunistic microflora as a result of the uncontrolled use of antibacterial drugs, which is why key cells appear.

In the future, it triggers a chain reaction mechanism in which pathogenic microflora begins to actively multiply, simultaneously destroying beneficial bacteria that provide a deterrent.

With long-term dysbacteriosis, the general immune status is disturbed, which can lead to the development of oncological forms of neoplasms on the cervix and its body.

With such test results, an experienced gynecologist makes a diagnosis of bacterial vaginosis of established etiology and prescribes a specific treatment. A second smear is done to monitor the effectiveness of therapy. The impact ends after receiving three times negative results.

Key cells in the smear appear as a result of the vital activity of special bacteria that live on the surface of the squamous epithelium - gardnerella. They turn the acidic environment of the vagina into an alkaline one.

These small sticks indicate the presence of vaginal dysbacteriosis or gardnerellosis. In some cases, key cells may indicate cancer or various erosions, and the presence of pathology.

With the proper functioning of the genitourinary system, Dederlein sticks live in the vagina. They ensure the proper functioning of the squamous epithelium, creating the so-called sour-milk environment. It is believed that these sticks in the smear should be present most of all. According to some data, this is about 95% of the entire flora of the vagina.

Among the reasons for the appearance of key cells, the most common are:

Prolonged use of antibiotics.
Hormonal disruptions.
Improper nutrition with a lack of sour-milk products.
Chronic bowel disease.
Abuse of personal hygiene products - panty liners or tampons.
Clothing and underwear that interferes with the penetration of oxygen.
Local antiseptics.
Transferred operations.
Immunodeficiency.
A special period in a woman's life is pregnancy, menopause, puberty.

Often, the presence of key cells in the body is accompanied by copious discharge, burning and itching. All this is enhanced by an unpleasant odor, discomfort during intercourse.

Preparation and methodology for passing the analysis

Detection of key cells in a smear occurs when several tests are taken. The most common way to detect these cells is to choose a smear for cytology. With it, it is easy to detect a granular texture, but some doctors may prescribe an additional endometrial biopsy - the removal of a small amount of tissue from the uterus. But it is prescribed for suspected pathology.

Analyzes for the presence of key cells are taken from the cervical canal in the period immediately before or immediately after menstruation. As with any analysis, to accurately detect key cells in a smear, you need to prepare. The preparatory measures are as follows:

On the eve of the test, avoid any sexual contact.
Three days before the visit to the doctor, completely stop using intimate hygiene products - panty liners, special gels, creams, vaginal and spermicidal lubricants.
At least two hours before the test, you can not go to the toilet for small needs.
If possible, stop taking hormonal drugs.
The last shower before the tests should be the night before and only warm water.

The test itself is painless. For this, the doctor uses only special mirror devices and a cotton swab. A woman is required to relax her muscles for just a few moments.

Therapeutic activities

If, after passing the tests, key cells were found in the smear, you should not panic. But it is also impossible to postpone treatment, because over time the inflammatory process will only progress. Self-treatment is strictly prohibited, as it can lead to irreversible consequences.

The doctor will prescribe a phased treatment of key cells in the smear. First you need to suppress opportunistic bacteria with antibacterial drugs:

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Some specialists prescribe topical preparations - gels, ointments and douches. Everything is selected individually.

When the key cells found in the smear begin to lose ground, everything must be done to restore the normal microflora of the vagina. For this, doctors prescribe various vaginal suppositories, tampons and creams that serve as probiotics.

When treating key cells in a smear, you should start following a diet that your doctor will prescribe. It focuses on replenishing the missing micronutrients in a natural way. During this period, it is important to give up alcohol and heavy physical exertion.

Those who visit a gynecologist at least twice a year can be sure that the diagnosis will be made on time and the treatment will be as quick and painless as possible. Those who are not so responsible for their health should not lose sight of such serious symptoms. The realization that early diagnosis brings more fruitful and faster treatment will allow you to pass the necessary smear as soon as possible.

At the appointment with the gynecologist during the examination, a smear is taken, which is mandatory for diagnosing the microflora of the woman's vagina.

When the result comes, and the doctor says that they have found key cells, the question arises: "What is it, how dangerous and what to do?"

Key cells - what is it?

Normally, the vagina contains a minimum number of various microorganisms (Candida fungi, gardnerella, ureaplasma, mycoplasma). Their number is controlled by lactobacilli and the environment they create. If number of microorganisms increases, this is evidence that the balance between beneficial lactobacilli and anaerobic bacteria is disturbed.

The mucous membrane of the female genital organs is lined with squamous epithelium, its cells provide an acidic environment to the vagina. It is detrimental to pathogenic microflora.

Expert opinion

Kovaleva Elena Anatolievna

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If an acidic environment for some reason turns into an alkaline one, then the epithelial cells also change. They are overgrown with bacteria and thus appear key cells. In many cases, this is a symptom of vaginal dysbacteriosis - bacterial vaginosis.

But the presence of these same cells does not always indicate a violation of the bacterial balance. They can appear in the presence of erosive changes in the mucous membrane and cancer. For this, it is necessary to constantly monitor their content in the smear.

key cells during pregnancy

The incidence of bacterial vaginosis varies from 4% in females who do not complain, to 86% in patients who have applied to various clinics. And in pregnant women, this pathology is detected in 15-37% of cases, and in the first three months 2 times more often than in the next.

Pregnant women with bacterial vaginosis is a very serious circumstance for the development of infectious complications. During pregnancy, chronic diseases are often exacerbated and, as a result, immunity is weakened. The disease can cause a lot of trouble in pregnant women: intrauterine infection of the fetus, interruption in the later stages or premature birth.

Symptoms of an infection

Not all women with bacterial vaginosis develop any clinical symptoms of the disease, and not all women with established symptoms of the disease experience infectious complications. It has not yet been determined why vaginosis does not lead to adverse consequences in some, while in others it is a potentially dangerous health problem.

The main manifestations of infection are the following symptoms: itching in the vagina, creamy discharge with an unpleasant smell of "fish shop", discomfort during intercourse. It is noted that in more than 50% of cases of already diagnosed bacterial vaginosis, there are no complaints and discharge from the genital tract. Therefore, it is very important to be examined by a specialist at least once a year.

Diagnostic methods

Expert opinion

Kovaleva Elena Anatolievna

Doctor-Laboratory. 14 years of experience in the clinical diagnostic service.

Ask an expert

To diagnose a disease such as bacterial vaginosis, it is necessary to rely not only on the symptoms of the disease itself, but also on the results of laboratory tests.

Nowadays, it is widely used

method of bacteriological examination of microflora vagina.

To get the most realistic result, preparation is needed:

7 days before the examination, do not use topical medications;
2-3 days before admission, do not resort to intimate hygiene products;
one day before the procedure, it is necessary to refuse contact with a sexual partner;
in the evening it is necessary to wash only with warm water, and do not do this in the morning;
2 hours before coming to the doctor, do not urinate.

98.8% of women with detected key cells have bacterial vaginosis. In most cases, anamnesis that is correctly collected, as well as research and the use of laboratory tests, allows you to make an accurate diagnosis and start treatment on time.

Causes of bacterial vaginosis

It has been proven that the microflora of the vagina is strictly individual for each woman and even in the normal state is subject to changes depending on age, phase of the menstrual cycle, physiological processes and other factors.

Cause key cells can be:

pregnancy: due to the restructuring of the hormonal background, a violation of the microflora in the vagina occurs;
prolonged infection leading to a weakened immune system;
taking a large number of antibiotics: they kill "good" bacteria;
the presence of intestinal dysbacteriosis;
constant use of panty liners: when there is no free access of oxygen;
wearing tight synthetic underwear.

There was no statistically significant sexual transmission of bacterial vaginosis.

Methods of treatment

There is a certain group of drugs that are included in the standards all over the world. treatment for bacterial vaginosis. They can be applied topically in the form of suppositories or creams. These drugs are recommended by the World Health Organization and all national organizations for the management of patients with bacterial vaginosis. They can be used in short three-day courses and have fewer side effects.

At the same time, the treatment should be comprehensive, therefore, to restore the microflora, it is necessary recommended to take probiotics(Bifiform). Great importance is attached to increasing the immunity of a woman, for which immunomodulatory drugs (Viferon) are prescribed.

Expert opinion

Kovaleva Elena Anatolievna

Doctor-Laboratory. 14 years of experience in the clinical diagnostic service.

Ask an expert

Pregnant only a specialist should prescribe treatment and subject to constant monitoring, because taking medications can harm the development of the fetus, and when breastfeeding, a certain amount of medication is excreted along with breast milk and passed on to the baby.

Treatment with folk remedies

The concept of "bacterial vaginosis" in folk medicine did not exist before, so all treatment was aimed at eliminating secretions and unpleasant odors. For this they did douching with decoctions or infusions medicinal herbs.

Collection of leaves plantain and chamomile flowers, one tablespoon, pour boiling water in the amount of one liter and insist for half an hour. The mixture is filtered and douching with warm infusion twice a day.
a tablespoon of fruit bird cherry pour 400 ml of water and boil. Reduce heat and cook for another 15 minutes. Strain, cool and use for douching the entire resulting volume once a week.

With the same success, they used gauze swabs, which were soaked with herbal remedies. Currently, you can buy tampons for hygiene at the pharmacy. They are soaked in aloe juice diluted 1:1 with sea buckthorn or olive oil and left in the vagina for 7-8 hours.

Do sedentary daily baths with decoctions plants. Dilute half a liter of hot water with two tablespoons of honey, preferably flower. Pour the mixture into a bath of warm water. Another option: take 250 grams of oak bark, soak it in cold water for 3-4 hours. Boil the mixture, strain through gauze or strainer and pour into the prepared bath. These baths should be taken for 20 minutes.

Disease recurrence

Despite this variety of treatments, recurrence of dysbacteriosis disease are the main problem of this pathology. At the moment, there is no treatment regimen using any one medicinal substance for long-term therapy and maintaining the necessary balance of microflora.

Studies have shown that the treatment of sexual partners does not affect the number of relapses and the success of therapy in women. In this case, you can resort to vaccination. Due to this, local immunity is created in the vagina against the development of pathological microflora.

Thus, the key cells in a woman's body are a danger to her health. Timely treatment helps prevent the development of more serious infectious and oncological diseases.

What does it mean if key cells are found in a smear?

anaerobic coca;
corynebacteria.

We find out the cause of the pathology

Read also:

Coccal flora in a smear in women
Deciphering the cytological examination of smears

Treatment Methods

"Metronidazole";
"Trichopol";
"Clindamycin";
"Klindacin";
"Dalatsin".

"Vagisan";
"Laktonorm";
"Vagilak";
"Acilact".

Read also:

What does a cytology smear show: decoding
Leukocytes in a smear: the norm in men and women
What can squamous epithelium tell in a smear?

Key cells in a smear in women: causes and treatment

In a completely healthy woman, key cells in a smear should not be found. Their presence indicates a violation of the microflora of the vagina and the development of a favorable environment for the reproduction of bacteria. For a woman, this may mean that it's time to seriously think about your health.

The microflora of the vagina is a very fine structure, which consists of various cells and microorganisms. It is generally accepted that most of the flora, about 95%, is colonized by lactobacilli of anaerobic and aerobic origin. They are united by a common name - Doderlein sticks or lactic acid bacteria. The remaining 5% of the microflora is occupied by about 40 microorganisms. Of these, the analysis most often determines:

non-motile Gram-positive cocci;
gram-negative rod-shaped bacteria;
anaerobic coca;
corynebacteria.

In physically healthy women, lactic acid bacteria dominate over other microorganisms, taking part in the formation of a bactericidal barrier and guaranteeing the immunity of the vagina to infectious diseases. But under the influence of various factors on the body, the vaginal microflora can change, and the percentage of pathogenic microbes can increase, replacing healthy epithelial cells. This process is called vaginal dysbiosis or bacterial vaginosis.

We find out the cause of the pathology

Pregnancy, puberty, the onset of menopause, various phases of the menstrual cycle and its irregularities can lead to the fact that key cells will be found in the smear. An important role in changing the microflora is also played by the degree of sexual activity, the presence of sexual contacts without a condom, the course of hormone therapy, and various surgical interventions in the pelvic area.

What tests detect the presence of pathogenic microflora?

The presence of key cells in the cervical mucus is determined using the usual test for the purity of the vagina - in medicine it is called a smear on the flora. Such tests are taken on a regular basis in women undergoing a gynecological examination and who are aged 16 to 65 years. Biological material is taken from the cervical canal of the cervix, from the walls of the vagina and urethra.

The analysis shows the most accurate results when taking mucus in the first days after the menstrual cycle or before it begins. Before taking the test, doctors recommend adhering to the following rules:

at least 2 hours before the visit to the gynecologist, do not go to the toilet for small needs;
in the evening, you need to wash the external genitalia only with warm water without the use of soap and other means for intimate hygiene;
it is necessary to suspend the use of local medical hormonal drugs, if possible;
sexual intercourse with a partner is prohibited a day before visiting a doctor;
3-4 days before visiting the gynecologist, vaginal and spermicidal lubricants should not be used during intercourse.

On the gynecological chair, be prepared for the doctor to examine the internal state of the vagina with the help of special mirror devices and take a smear of the epithelium with a cotton swab. The whole procedure is absolutely painless and can bring the patient only slight discomfort.

Treatment Methods

The detection of key cells in a smear does not yet mean that a pathogenic infection has settled in the vagina, but it can contribute to the emergence and development of one. Therefore, timely medical intervention and properly selected therapy are of great importance. It is strictly forbidden to try to restore the balance of microflora on your own, all actions and appointments should be carried out only by a qualified doctor.

Often, in the presence of key cells in a smear in women, treatment takes place in two stages:

The vital activity of opportunistic bacteria is suppressed.
The normal balance of lactobacilli is being restored.

At the first stage of therapy, the following antibacterial drugs are prescribed:

"Metronidazole";
"Trichopol";
"Clindamycin";
"Klindacin";
"Dalatsin".

These can be special solutions for douching, injections or topical application of drugs in the form of a gel and ointment.

After the first stage of therapy, it is time to help the beneficial lactobacilli recover. For this, special tablets are prescribed to restore microflora - probiotics. Such drugs are available in the form of vaginal tampons, suppositories, creams, or as tablets. From a wide range, the following medicines have proven themselves well:

"Vagisan";
"Laktonorm";
"Vagilak";
"Acilact".

In addition, the doctor may prescribe a special diet for a while and provide a list of recommended foods. At the end of both courses of treatment, the woman is assigned to retake the analysis, the results of which will make it possible to judge the success of the measures taken.

Why do key cells appear in a smear in women and what is it in general?

Everyone who has been to the gynecologist knows that the first step is to take a smear on the flora, as a result of which the state of the internal epithelium of the vagina is determined. With the help of bacterioscopy (examination of a smear under a powerful microscope), the composition of the mucous secretion is studied in the laboratory and key cells are often found.

What are key cells?

Key cells is a figurative name used by doctors. The fact is that it is by them that they determine that the balance of microflora is disturbed.

The walls of the vagina are composed of squamous epithelium, which normally contains microorganisms that provide benefits and create an optimal environment for protection.

If the smear is in order, then only leukocytes, rod flora and Staphylococcus aureus are found there. With a disturbed imbalance, various pathogenic microorganisms can be found on the epithelium.

The most common are small gardnerellosis sticks and spherical cocci, due to which the walls of the epithelium acquire a spherical granular shape. This is noticed by a laboratory assistant, studying a smear under a microscope, and makes a conclusion about the presence of key cells on the epithelium.

What causes cells to form?

Once the clue cells are found, doctors begin to identify specific pathogens. The most common microorganism found is gardnerella vaginalis, which is the cause of bacterial vaginosis.

This is a very unpleasant disease that requires treatment and has symptoms that cause inconvenience - severe itching, unpleasant burning, pulling pains in the lower abdomen, copious discharge, and an unpleasant odor.

If this microorganism was not found in the laboratory, then the patient is sent for a second examination.

There are a number of other reasons for the presence of key cells in a smear:

the presence of cancer in the body;
the presence of erosive changes;
gonorrhea;
chlamydia;
the occurrence of polyps;
trichomoniasis.

Violation of the microflora, which means the appearance of key cells, does not happen just like that.

long course of antibiotics;
violation of the rhythm of the day - insufficient sleep and lack of rest;
change of sexual partner;
the presence of frequent stressful situations;
insufficient or incorrect intimate hygiene;
the presence of an infection in the intestine;
improper use of tampons;
use of a contraceptive spiral;
wearing uncomfortable synthetic underwear.

Thus, the balance of microflora can be disturbed quickly, and its consequences will have to be treated thoroughly. The presence of key cells can be judged if a woman has frequent attacks of thrush.

To prevent the disease from progressing, it is imperative that every woman be examined at least once a year, and even better every 3-6 months.

Methods for getting rid of cells

Since the reason for the presence of key cells is in most cases bacterial vaginosis, it is worth considering ways to treat it. The main objectives of the treatment of dysbacteriosis are the elimination of microorganisms - the causative agents of the disease, the restoration of the balance of microflora and the restoration of the immune system.

Treatment with Dalacin, Flagyl and Clindamycin

This drug effectively copes with dysbacteriosis. It can be purchased as a vaginal cream or as a vaginal suppository.

This medicine brings relief in 90% of cases. Both preparations are designed for 3 doses - the cream is administered using an applicator for 3 consecutive days at night, as well as candles (3 candles with an applicator).

It is available in the form of vaginal suppositories in the amount of 10 pieces. Do not use more than 1 suppository per day. The effectiveness of this drug is not inferior to the previous one.

It is used orally in the form of tablets for a week, no more than 2 times a day. Its lack of side effects - diarrhea may occur. This can be avoided by using a topical cream.

Restoration of microflora

After the key cells have been destroyed by one of the above drugs, it is necessary to restore the own microflora of the vagina.

To do this, 2-3 days after the first stage, zubiotics and probiotics such as Acylactobacterin, Bifidumbacterin, Acylact are prescribed.

After 10 days, you need to check the result. If it is not satisfactory, then a repeat course of treatment is necessary. Also, do not forget about prevention. The partner does not need treatment, since dysbacteriosis is not sexually transmitted. Treatment must take into account the individuality of each patient.

In the event that key cells are found in a smear for any other reason than bacterial vaginosis, then only a doctor can prescribe treatment.

Important: During treatment, the patient must give up spicy, sweet and sour, as well as avoid sexual contact. Do not delay treatment, as the disease can become chronic.

Key Cells During Pregnancy

Immediately after the conception of a child, hormonal changes occur in the body of a woman. The microflora of the vagina is also changing - there is an active growth of epithelial cells, leading to the formation of glycogen, due to which lactobacilli develop. A large number of them maintains the balance of microflora and protects the baby from bacteria during childbirth.

The presence of key cells in pregnant women is undesirable, as this can harm the child and provoke a miscarriage, so treatment should not be delayed. The use of antibiotics during pregnancy is not recommended.

But thanks to the existence of topical creams and suppositories, it is possible to restore the microflora. For this purpose, in most cases, clindamycin is prescribed in the form of a cream. Other drugs can only be prescribed by a doctor.

The main thing is to take the necessary tests on time, do not forget about prevention, plan pregnancy correctly (be examined before conception) and remember the reasons that lead to the emergence of key cells.

What does the detection of key cells in a smear mean in women?

You can detect key cells using a smear analysis (cytology test), which is taken by a gynecologist. Not every woman knows what key cells are, and is very worried when she hears from a doctor about their presence in a smear.

As a result of bacterioscopy, during which the laboratory assistant examines the smear under a microscope, it is possible to determine the state of the internal epithelium of the vagina, mucous and internal microflora. When the vaginal microflora is normal, only elements of the squamous epithelium, leukocytes, rods of normal vaginal microflora and Staphylococcus aureus can be detected in the smear, which together create a favorable environment for the vaginal microflora. What is it, key cells in a smear in women?

If, however, during the analysis, key cells are found in the smear, then this indicates that the vaginal microflora is disturbed and any pathogenic microorganisms are present on the epithelium (the most common are pathogens of gardnerellosis, spherical coccus, fungus).

As a rule, when the vaginal microflora deviates from the norm and in the presence of key cells, a woman is often worried about candidiasis (thrush) or bacterial vaginitis. Therefore, with symptoms of thrush, it is important to immediately consult a doctor. It is fair to say that pathogenic cells can also be found in a healthy woman, but in this case they are harbingers of a disease (infection, hormonal failure, vaginal dysbacteriosis), so it would be useful to undergo a complete examination of the body in order to identify a predisposition to a particular disease .

1. Causes of the phenomenon
2. Methods of therapy
3. Preventive measures

Before proceeding with treatment, it is necessary to identify the causes of the presence of key cells. Some of the most common reasons for the appearance of key cells in a smear include the following reasons:

Bacterial vaginosis. With this disease, a woman is concerned about severe pain in the lower abdomen, which is accompanied by severe itching and burning in the vagina, as well as copious discharge with a sharp unpleasant odor. The woman's immunity drops sharply, and if treatment is not taken in time, then negative consequences are possible, up to the development of a malignant tumor in the cervical region.
Taking antibiotics. In this case, we are talking about long-term antibiotic treatment, which was not controlled by doctors. This leads to a sharp decrease in immunity and contributes to the disruption of the natural microflora of the vagina: the environment becomes not acidic, but alkaline, and pathogenic bacteria begin to actively multiply, destroying those beneficial microorganisms that are responsible for maintaining the vaginal microflora at the proper level.
Overwork. The female body reacts sharply to fatigue, therefore, excessive physical exertion, chronic lack of sleep, stress, a sharp change in the daily regimen is a fairly common cause of a violation of the vaginal microflora.
Non-observance of personal hygiene. In this case, we are talking not only about non-observance of intimate hygiene at the proper level, but also about the use of various flavored hygiene products, which can lead to allergic reactions and irritation of the mucous membrane. Failure to comply with the rules for using tampons and pads during menstruation can be the main reason for the presence of key cells in the smear. Frequent douching also contributes to the violation of the vaginal microflora.
various infections. As a rule, in the presence of an infection, a woman has abundant vaginal discharge, which has a sharp unpleasant odor, the smell of rotten fish. Often, emptying the bladder causes pain, a burning sensation, and a smear analysis will reveal the presence of key cells of coccal forms.

Also, among the reasons that provoked the appearance of key cells, there may be such reasons as: change of sexual partner, hormonal failure (due to the use of hormonal drugs, during pregnancy, in the first months of lactation), the presence of an IUD (intrauterine contraceptive - spirals). Often, the normal vaginal environment is disturbed during various diseases (cervical erosion, trichomoniasis, chlamydia, gonorrhea, cancer), and even due to the fact that a woman wears uncomfortable or low-quality underwear.

All of the above factors can affect the change in the vaginal environment in a woman: the acidic environment becomes alkaline, which leads to a decrease in healthy epithelial cells. But only a gynecologist can accurately determine the factors that influenced the development of key cells, so you can’t self-medicate. Treatment should be prescribed by a doctor after a thorough examination and accurate diagnosis.

Therapy Methods

In the presence of key cells due to bacterial vaginosis, it is important not only to eliminate the key cells, but also to get rid of the root cause - bacterial vaginosis. Medicines should be prescribed by a doctor, and the entire treatment process should be under the supervision of a doctor. After all, it is important not only to eliminate microorganisms that cause the disease, but also to restore the immune system and the natural balance of the vaginal microflora. Therefore, the entire treatment process takes place in two stages: the suppression of the vital activity of pathogenic microorganisms and the restoration of the normal microflora of the vagina.

Among the most effective medicinal antibacterial drugs are clindamycin (Dalacin, Clindamycin), metronidazole (Trichopolum). These drugs are prescribed in the form of systemic injections, tablets, vaginal suppositories, and even creams and gels. The use of the above drugs will have a therapeutic effect and will clear the vaginal microflora from pathogens, preventing them from multiplying further. Usually the course of treatment is from 5 to 7 days. During treatment, the patient will need to periodically take a smear for analysis. Bacterial vaginosis must be treated until a smear test is negative three times in a row.

After the key cells have been eliminated, it is necessary to restore the damaged vaginal microflora. For this, the gynecologist usually prescribes drugs such as Atsilakt, Narine, Bifidumbacterin, Vagilak and Laktonorm.

These drugs are available in the form of oral capsules, vaginal suppositories containing lactic acid bacteria, and an intimate hygiene gel. Probiotics will not only restore the acidic vaginal environment, but also prevent intestinal dysbacteriosis, the risk of which is very high due to antibiotic treatment. Contrary to popular belief, only a woman needs to be treated - prevention is not at all necessary for her healthy partner. But it is advisable to refrain from sexual intercourse until complete recovery.

Preventive actions

Having cured the disease that caused the appearance of key cells in the smear, do not forget about prevention in order to prevent their recurrence. To maintain a normal vaginal environment, the following recommendations should be followed:

Take the necessary time to rest. It is important that a woman's rest is complete, so you should strictly adhere to the daily routine, not forgetting to set aside the allotted time for sleep and rest.
Observe personal hygiene. It is necessary to pay due attention to intimate hygiene every day, in addition, one should responsibly approach the choice of means for maintaining personal hygiene and give preference to soaps and shower gels, which contain extracts of medicinal herbs, and the amount of artificial dyes is minimal. It is important to adhere to the rules for using tampons and sanitary pads, change them in time and select products suitable for delicate skin.
Wear only high-quality underwear made from natural fabrics that do not irritate the skin. Synthetic underwear that does not allow the skin to breathe is best put aside for now.
Monitor your nutrition. If possible, exclude spicy, sweet and fatty foods from the diet. Eat plenty of fruits and vegetables rich in vitamins. You can buy a complex of vitamins at the pharmacy. The adoption of such measures will significantly strengthen the immune system.
Treat any developing infectious disease in a timely manner. If you need to take antibiotics, you must definitely agree on the duration of the course of treatment and the dosage of medications with your doctor.

If you do not take up treatment in time, then the key cells in the smear can lead to the fact that the disease that provoked them can become chronic. In the alkaline environment of the vagina, pathogenic bacteria will actively multiply, continuing to displace healthy epithelial cells. Therefore, every woman should be attentive to her health, and with the frequent appearance of uncharacteristic discharge from the vagina, immediately undergo an examination by a gynecologist.

In addition, it is necessary to make it a rule: you need to undergo an examination by a gynecologist and take a smear for analysis at least 2 times a year (ideally 1 time in 3 months).

This approach will not only prevent the occurrence of various diseases, but also detect cancer at an early stage. This means that the likelihood of developing a serious illness, and as a result, the emergence of key cells, will be minimized!

Key cells in the smear - a sign of vaginal dysbacteriosis

Key cells in a smear from the genitourinary organs of a woman should not be detected in the norm for microflora. Their presence indicates that the ratio between normal and conditionally pathogenic microflora is disturbed in the vagina, that is, conditions have been created for the development of the disease - an inflammatory process in the vagina, cervical canal or urethra.

Reasons for the appearance of key cells in the smear

Key cells are cells of the superficial squamous epithelium of the genitourinary organs of a woman, covered with bacteria adhered to them. Bacteria most often have the form of small sticks - gardnerella, which belong to the conditionally pathogenic microflora. The presence of key cells in the smear on the flora indicates dysbacteriosis - a violation of the ratio between normal and conditionally pathogenic microflora.

Normally, the main volume of the microflora of the woman's vagina should be lactobacilli or Dederlein's sticks. They are able to create an acidic environment in the vagina, which inhibits the development of opportunistic and pathogenic microflora. If there are enough lactobacilli, even the presence of some types of pathogenic cocci (for example, Staphylococcus aureus) is not dangerous.

But sometimes the volume of normal microflora in the vagina is reduced. This happens with hormonal disorders (for example, with a lack of female sex hormones estrogen, which support the development of lactobacilli), after prolonged use of antibiotics, against the background of the systematic use of local antiseptics (constant douching, the use of local contraceptives), as well as after infections and inflammatory processes in decrease in general and local immunity.

As soon as the volume of normal microflora decreases, opportunistic microflora begins to multiply rapidly. For the time being, it may not cause an inflammatory process, but if not treated, sooner or later this will happen, since the acidity of the vagina changes, it becomes alkaline. And the alkaline environment is a comfortable environment for the reproduction of pathogenic microflora.

Vaginal dysbacteriosis (bacterial vaginosis) is most often caused by gardnerella, which, sticking to the walls of the cells of the squamous epithelium of the vagina, form key cells.

Which test detects key cells

Key cells are found in a smear for flora (smear for purity), which is taken from each woman when visiting a gynecologist. Biological material is taken from three places: from the walls of the vagina, from the cervical canal (cervical canal) and the urethra (urethra).

It is best to carry out this analysis after or before menstruation. In order to get a reliable result of the study, a woman needs to prepare:

do not use topical drugs for a week before the examination;
do not use intimate hygiene products 2-3 days before the examination;
refrain from sexual intercourse the day before the examination;
the night before, before taking a smear, wash only with warm water, do not wash yourself in the morning;
it is advisable not to urinate in the morning, and if the visit to the doctor is to take place in the afternoon, do not urinate two hours before the appointment with the doctor.

Key cells in a smear - treatment

The appearance of key cells in smears on the flora is most often not a disease, but there is a high risk of its development. Key cells can also appear during inflammatory processes in the vagina, cervical canal and urethra. Of great importance is the timely identification and elimination of the cause of the development of vaginal dysbacteriosis (for example, hormonal imbalance). Therefore, bacterial vaginosis is treated in two stages. At the first stage, the vital activity of the opportunistic microflora that caused bacterial vaginosis is suppressed, and at the second stage, the normal microflora of the vagina is restored.

The drugs of choice at the first stage of treatment are clindamycin (trade names - Dalacin, Clindamycin) and metronidazole (trade name - Trichopolum). They are prescribed, both in the form of systemic (by mouth, in the form of injections), and local (in the form of a vaginal cream or gel) therapy.

After a course of antibiotic therapy, the second stage of treatment is carried out - the restoration of the normal microflora of the vagina. To do this, prescribe courses of probiotics locally in the form of vaginal suppositories and in the form of oral administration (for the prevention and treatment of intestinal dysbacteriosis). Well-established drugs such as:

Acylact - contains lactic acid bacteria, is available in the form of capsules for oral administration and vaginal suppositories:

Vagilak is a source of probiotic strains of lactobacilli; available in the form of a moisturizing gel for intimate hygiene and capsules for oral administration;
Lactonorm - vaginal capsules with lactobacilli.
Key cells in a smear are not a tragedy, but it is necessary to be treated.

Galina Romanenko

Article tags:

gynecological examination

www.womenhealthnet.ru

Key cells are squamous cells that line the vagina. They indicate the presence of an imbalance in the vaginal microflora - bacterial vaginosis, which is caused by specific pathogens. This disease of the vagina is one of the most frequent, it is detected in women of reproductive age, regardless of pregnancy. Bacterial vaginosis is quite easy to treat, so prompt diagnosis and early treatment of the disease is very important.

1 What is bacterial vaginosis?

Bacterial vaginosis (BV) is an infectious non-inflammatory disease with a polymicrobial etiology. It is characterized by qualitative and quantitative suppression of the vaginal microflora (normally these are peroxide-producing lactobacilli) with its replacement by obligate and facultative anaerobic conditionally pathogenic microorganisms. In a healthy body, the microflora of the vagina supports local immunity, protecting the reproductive organs of a woman from the development of infection. When it is violated, the body's resistance decreases, and the woman is at greater risk of various gynecological diseases. In men, this disease does not occur.

In tests for the vaginal flora with dysbiosis, the following representatives of the bacterial world are found:

Bacteroides spp.;
Prevotella spp.;
Gardnerella vaginalis;
Mobiluncus spp.;
Veillonella spp.;
Megasphera spp.;
Leptotrichia spp.;
Atopobium vaginae and others.

Gardnerella is the most common cause of vaginosis in women, and it is she who contributes to the formation of key cells that are detected in the smear. According to statistics, Gardnerella is detected in a smear in more than 87% of cases of bacterial vaginosis.

This disease is not life-threatening, but is a risk factor for many pathological conditions. With the appearance of vaginosis during pregnancy, the risk of spontaneous abortions, premature births, and the birth of children with a lack of body weight increases significantly. After childbirth, the development of endometritis and other diseases of the pelvic organs with an inflammatory reaction, up to sepsis, is possible. When the fetus passes through the birth canal of the mother, the development of infectious complications in the child is not excluded. If invasive procedures are performed (abortions, the establishment of an intrauterine device) with active bacterial vaginosis, then the infection may ascend into the small pelvis and develop an abscess or peritonitis.

If the disease is not treated for a long time, the risk of developing malignant neoplasms of the cervix increases.

Why does vaginal dysbiosis develop and how does it manifest itself?

2 When does the disease occur?

Lack of sexual hygiene and uncontrolled sex life is the main factor provoking the development of bacterial vaginosis. However, BV is not a sexually transmitted disease.

Other risk factors for bacterial vaginosis include:

age-related changes in the body of a woman (the formation of menarche, the onset of sexual activity, pregnancy, menopause);
drug therapy with antibiotics, cytostatics and antifungal drugs, in which the normal microflora throughout the body is suppressed;
infection with STIs;
untreated sexually transmitted diseases;
anatomical changes in the pelvic organs, for example, developmental anomalies;
the presence of a foreign body in the uterus - the uterine spiral;
non-compliance with intimate hygiene, the use of spermicides.

Vaginal dysbacteriosis: causes, symptoms and treatments

3 Clinical manifestations

The first thing that begins to bother a woman is discomfort in the area of the external genital organs and the appearance of secretions. The discharge is homogeneous, whitish-gray, with a specific unpleasant fishy odor, which intensifies during and after sexual intercourse, after menstruation and hygiene procedures.

Sexual contact is accompanied by dyspareunia - discomfort, sometimes pain in the vaginal area. Burning and itching are rare in BV, but if present, vaginosis cannot be ruled out. Possible phenomena of dysuria - painful urination with itching and burning.

If any vaginal symptoms appear, a woman should be carefully examined, since other infections can be hidden under the mask of bacterial vaginosis: gonorrhea, trichomoniasis, chlamydia, mycoplasmosis, candidiasis, ureaplasmosis, etc.

On examination, the gynecologist will find thick white-gray discharge, which is evenly distributed over the mucosa of the vulva and vagina. Symptoms of inflammation - edema, hyperemia - the doctor will not see, since the disease belongs to the group of non-inflammatory.

Mucous, like snot, discharge from the vagina in women

4 Diagnosis and key cells

Researchers have developed 4 Amsel criteria, 3 of which indicate the presence of bacterial vaginosis. These include:

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the presence of vaginal discharge - thick, homogeneous, whitish-gray, with an unpleasant odor;
an increase in the pH value of the vaginal discharge to > 4.5;
obtaining a positive result of the amino test (the appearance of a “fishy” smell when the vaginal discharge is mixed in equal proportions with a 10% KOH solution on a glass slide);
detection of key cells by microscopy of the vaginal discharge.

The most informative, simple and affordable diagnostic method is a microscopic examination of vaginal discharge. In the presence of vaginosis, the normal flora - gram-positive rods of different lengths and thicknesses - decreases in number or disappears altogether, other types of bacteria, spherical or other forms, dominate. Leukocyte, that is, inflammatory, reaction to foreign microflora is not observed.

The presence of key cells is the main criterion for the development of BV. These are cells of the superficial vaginal epithelium, to which bacteria have "adhered". Such adhesion of bacteria, mainly Gardnerella, leads to the characteristic appearance of these cells - granularity. Their edges are uneven, with protrusions and notches, outwardly resembling keys. It is usually impossible to distinguish bacteria adhering to cells, so any microorganisms can be suspected.

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Molecular genetic research methods are a new and modern niche in the diagnosis of vaginosis. DNA and RNA studies allow you to accurately determine the type of microorganism that violates the biocenosis of the vagina. This is achieved with the help of special test systems developed in accordance with pathogens.

Culture methods are not used to diagnose BV: inoculation of vaginal secretions on a nutrient medium takes time to detect colony growth. In addition, the vaginal flora is very diverse, so many different nutrient media are needed for research. Exceptions are cases of suspicion of specific diseases with sexual transmission, when sowing is done with the expectation of isolating a specific pathogen.

5 Treatment regimens for bacterial vaginosis

Before starting treatment, the gynecologist sets the following goals:

complete recovery with no clinical manifestations of BV;
return to normal indicators of additional studies: laboratory, microscopic;
exclusion of the possibility of developing infectious complications during pregnancy or childbirth, in the postoperative period.

Bacterial vaginosis is treated on an outpatient basis, such conditions are not subject to hospitalization. The main means of treating this disease according to modern recommendations are drugs of the 5-nitroimidazole group (Metronidazole) and Clindamycin. The use of the latter is preferable, since it has practically no side effects. During treatment, it is necessary to refrain from taking alcohol during the entire course of therapy and for a day after - the combination of these drugs with alcohol causes severe adverse reactions. Medicines are usually prescribed intravaginally, in the form of a cream or vaginal suppositories. Various treatment regimens are recommended:

cream Clindamycin 2% is injected into the vagina 5 g at night for one week;
Metronidazole 0.75% gel is used 5 g intravaginally at bedtime for 5 days;
Metronidazole tablets are taken at 500 mg with water, twice a day - in the morning and in the evening, the course of treatment is a week;
Tinidazole tablets are taken 2 grams with water, 1 time per day for 3 days.

1. Ovuli with clindamycin 100 mg inside the vagina at night for 3 days.
2. Clindamycin capsules 300 mg orally twice a day for 7 days.
3. Metronidazole in tablets of 2 grams once (high loading dose).
4. Tablets Tinidazole course of 5 days, once a day, 1 gram.

Treatment of pregnant women is carried out only with tablet forms of Metronidazole and Clindamycin. The appointment of Metronidazole is possible only after the end of the first trimester of pregnancy, and Clindamycin is not contraindicated in the early stages. The drugs are prescribed for one week.

If bacterial vaginosis was diagnosed in a girl who is not sexually active, then Metronidazole tablets are used in therapy at the rate of 10 mg / kg of body weight 3 times a day with a course duration of not more than 5 days.

The complex therapy of BV must necessarily include preparations of ascorbic and lactic acid to restore the acidity of the internal environment of the vagina (normal pH = 4.5). These are drugs such as Vagilak and Vaginorm S. Their appointment is carried out after antibiotic therapy, when foreign microorganisms are removed and it is necessary to restore the normal flora from scratch.

6 Outcome of treatment and prevention

As a result of treatment, clinical remission and convalescence, a return to normal indicators of laboratory and instrumental studies should be achieved. Fixation of cure is carried out no earlier than 2 weeks after the end of therapy. In cases where BV often recurs, a woman needs to be examined by a gynecologist-endocrinologist and gastroenterologist. They will help to exclude or identify other diseases that contribute to the violation of the microflora of the body as a whole and the vagina.

Preventive measures are very simple: personal hygiene is necessary, regular sex life with one and a permanent partner, as well as a preventive visit to the obstetrician-gynecologist annually.

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Itching, burning and strange discharge
Impaired urination
Refusal of intimacy, problems in sex.

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