• the most common diseases,
• treatment of hidden infections in women - drugs that are advisable to take,
• what general medications involve the treatment of genital infections and urinary tract infections,
• is there a disease that is resistant to certain types of drugs, and how can it be cured,
• the most effective treatment – ​​sexually transmitted infections and the most effective medicine.

Bacterial infectious diseases

Bacterial vaginosis

Bacterial vaginosis (BV) is a common vaginal infection that increases the risk of contracting other sexually transmitted infections and may occur along with them. First mentioned in 1955 as “nonspecific vaginitis” (Gardner and Dukes). The term "bacterial vaginosis" has been coined since 1984.

Etiology

Gardnerella vaginalis is a multiplied, facultative anaerobic bacterium with a high concentration of Mobiluncus SPP, Prevotella SPP, Peptostreptococci, Fusobacterium SPP, Bacteroides SPP, aerobic bacteria, alpha-hemolytic streptococci, etc. C The most common is the “combination” with Trichomonas.

Clinical picture

• The infection is asymptomatic in 50%.
• The disease is usually characterized by copious sticky discharge with a fishy odor.
• Involvement of the cervix leads to acute purulent cervicitis, which is manifested by grayish-white discharge of a denser consistency.
• Irritation of the skin and mucous membranes of the genital organs, swelling, erosions, ulcers
• Nonspecific urethritis.
• Possible complications: inflammation of the pelvic area, complications after abortion and hysterectomy, premature birth.

Diagnostics

• White-gray, homogeneous, sticky discharge.
• Microscopic examination - native drug and Gram method (clue cells - epithelial cells with granular cytoplasm - presence of bacteria).
• Vaginal pH is greater than 4.5.
• positive amine test - characteristic fishy odor upon alkalization of fluorine with 10% KOH.

How to treat?

Metronidazole (nitroimidazole chemotherapy drugs - bactericidal effect on anaerobic bacteria and protozoa, for example, Trichomonas):

• orally: 500 mg 2 times a day for 5-7 days, possibly 2 g once,
• intravaginally: Klion D 1-2 vaginal tablets/day for 10 days (combined product with fungistatic imidazole and fungicidal antifungal miconazole 150 mg + Metronidazole 100 mg),
• Clindamycin (lincosamide bacteriostatic antibiotic with an antibacterial spectrum),
• orally: 300 mg 2 times a day, for 7 days,
• intravaginally: 2% cream 5 g/day for 7 days.

Chlamydial infection of the reproductive system

Genital chlamydia is the most common sexually transmitted infection. It accounts for a total of 50-60% of all cases of nonspecific urethritis. The highest incidence is in women aged 16-19 years, and men aged 20 to 24 years. Factors associated with an increase in the prevalence of chlamydial infection increase during periods of increased sexual activity and when alternating sexual partners, especially in the case of unprotected sex.

Etiology

Chlamydia has an affinity for columnar epithelium (serotype D-K causes urogenital infections). The incubation period is 7-21 days.

Diagnosis of chlamydial infection is based on the direct detection of chlamydial antigens, isolation of chlamydia in cell cultures, the presence of chlamydial DNA (hybridization methods or ligase chain reaction, which are one of the most sensitive research methods. A smear is performed from the affected mucosa, urine collection (the first portion), ejaculate.

Treatment

• Antibiotics that suppress the protein synthesis of bacterial cells (tetracyclines, macrolides) act on most clinical forms of the disease, and are one of the first choice drugs in the treatment of chlamydial infection.
• Tetracycline antibiotics (have a bacteriostatic effect and a wide antibacterial spectrum: aerobic and anaerobic bacteria, chlamydia, mycoplasma, rickettsia, spirochetes and protozoa. The disadvantage is the development of resistance in some types of microorganisms). They penetrate well into the tissues and secretions of the central nervous system. Excreted in bile and urine. To obtain the most effective pharmacokinetic properties, Doxycycline is most often used.
• Macrolides (bacteriostatic against gram-positive microorganisms, chlamydia, mycoplasma, spirochetes and others). They have good penetration into tissues and secretions, do not penetrate the central nervous system. Excreted in urine and bile. Macrolides of the second generation are mainly used due to their favorable pharmacokinetic properties: Azithromycin, Clarithromycin, Roxithromycin. Second generation macrolides have better gastrointestinal tolerance and are characterized by less interaction with other drugs than first generation macrolides, which include, for example, Erythromycin, Spiramycin, Josamycin.
• Quinolone antibiotics (bactericidal active quinolones of the third generation have a wide spectrum of activity against gram-positive microorganisms, act on mycoplasmas, chlamydia and mycobacterium tuberculosis). They penetrate well into tissues and are excreted from the body with bile and urine. For example, Ofloxacin has been used in the alternative treatment of chlamydial infection.

Mycoplasma infections of the genitourinary system

Mycoplasmas are gram-negative bacteria without external cell walls, similar in size to large viruses (100-150 nm). They are often part of the normal microflora (present in approximately 70% of sexually active individuals), in patients with urogenital infection their concentration is 2-4 times higher, and can be the main pathogen, especially in the case of immunodeficiency of the body.

Etiology

Mycoplasmas of the human urogenital system include: Mycoplasma hominis, Mycoplasma genitalium, Mycoplasma fermentas, Mycoplasma incognitum, Ureaplasma urea lyticum.

Clinical picture

Mycoplasmas are part of the mixed flora of nonspecific urethritis, where Mycolasma Hominis makes up more than 20%, and Ureaplasma urealyticum makes up more than 52%.

• Bacteria are directly involved in the development of nonspecific urethritis (18-45%). Clinically manifests itself as pollakiuria. Characteristic features include creamy discharge, erythema and swelling of the urethral opening. If the disease develops, bacteria can cause prostatitis and epididymitis.
• Women may experience mucopurulent cervicitis or pyelonephritis.
• Bacteria may contribute to the formation of Reiter's syndrome.
• The disease may be asymptomatic.

Diagnostics

Diagnostics is quite complex; liquid and solid media (PPLO soil), enzyme-linked immunosorbent assay (ELISA) are used, and nucleic acids are detected using the PCR (polymerase chain reaction) method. Discharge from affected mucous membranes, semen, and urine are examined.

Treatment

Mycoplasma does not have a cell wall; its surface is formed by a three-layer membrane rich in lipids (the bacterium is resistant to penicillin and other antibacterial substances that destroy peptidoglycan or inhibit its synthesis as an essential component of the cell wall). Treatment of the disease is identical to the treatment of chlamydia.

Mycoplasma is characterized by general resistance to Macrolides; the drug of choice is Doxycycline (100 mg 2 times/day for 7 days), another possibility is represented by the drug Clindamycin (300 mg 2 times/day for 7 days).

Viral infections

Genital warts (condylomas acuminata, venereal warts)
Genital warts occur in 10-20% of the population aged 16-49 years. The maximum prevalence is among women during sexual activity, aged 20-24 years, and men aged 25-34 years.

Etiology

Human papillomavirus (HPV). Approximately 25 HPV genotypes have a “preference” for the anogenital region. HPV types are classified into low or high oncogenic potential. The incubation period of the disease ranges from 2 weeks to 9 months.

Clinical picture

The infection affects the skin and mucous membranes. In men, in most cases, it is localized at the opening of the urethra, on the head of the penis and the scrotum. In women, it most often affects the labia.

Extragenital localization, very common, especially among homosexual couples, is most often represented by the perianal. A frequent occurrence, for example, localization in the corners of the mouth, on the legs and other less obvious places, often associated with various sexual activities.

Clinical form: small whitish or pink very fragile wart papules that bleed slightly when injured. They can occur either singly or (in most cases) in a focal manner.

Warts can grow and merge with each other. Pressure, friction, and sweat lead to destruction of their surface, leakage and secondary infection with a strong odor. In case of neglect, possibly in immunodeficiency conditions (for example, in the presence of HIV and cancer), warts become more widespread and grow to large sizes - giant condyloma (associated with HPV 16, 18 - precancerous and malignant lesions).

Subclinical form: flat lesions, can be visualized with 3-5% acetic acid (whitish areas).

Latent type: cytological diagnosis, hybridization. Complications may include balanitis, balanoposthitis, phimosis and paraphimosis.

Diagnostics

Clinical examination, anamnesis. In case of doubt, histological examination or hybridization methods can be performed. A venereologist always performs a full examination aimed at excluding overlap with other sexually transmitted diseases, including a serological study.

Treatment

• Surgical: abrasion (more suitable for single lesions), general excision of large deposits. The disadvantage is a possible relapse in the scar, and further, already complex, treatment.
• Physical: cryo-destruction with liquid nitrogen (very effective, often long-term, painful, destructive method, requiring regular re-treatment), electrosurgical ablation, electrodiathermocoagulation.
• Chemical: 10-25% solution of Podophyllin, Podophyllotoxin (0.15%), bi- and trichloroacetic acid.
• Immunomodulatory, antiviral, cytostatic: Aldara (Imiquimod 5%), alpha-interferon, 5-fluorouracil.
• Laser.

Conclusion

Treatment of any sexually transmitted disease belongs to the hands of a specialist! Insufficient therapy, as well as self-medication, can lead to serious complications requiring long-term, expensive treatment!

It is advisable for prevention purposes to always give preference to safe sex. Proper personal hygiene is important.

STIs (sexually transmitted infections)- a group of diseases that are transmitted from person to person through sexual contact. They affect not only the genitals, but the entire body, and often lead to serious consequences.

STIs have been known to humanity since ancient times, but over time the number of cases of infection does not decrease, but rather increases. As “familiar” infections are overcome, new ones appear. Almost every person is at risk, regardless of gender and social status.

Modern medicine lists about 30 infections that can be classified as STIs. Most of them can be asymptomatic, and this makes them very dangerous for the health of various organs and systems.

Species

STIs are classified depending on the causative agent. In total, there are 4 types of sexually transmitted infections:

• bacterial;
• viral;
• fungal;
• protozoans.

Methods of transmission of STIs

STIs are spread through sexual contact—vaginal, oral, or anal. The gender of a person does not matter - they can go from a man to a woman, from a woman to a man, from a man to another man, or from a woman to another woman.

Many sexually transmitted infections can be spread through any contact between the genitals, mouth and anus, even if there is no penetration. For example, genital herpes is transmitted through direct skin-to-skin contact - microdamages on its surface are enough for infection.

Some STIs are transmitted in other ways. For example, HIV and hepatitis B are transmitted through sharing of injection needles and blood transfusions.

The use of barrier methods of contraception does not always guarantee safety. When using condoms for safe sex, it is important to follow the instructions on the package. Proper use of condoms makes them more effective. The following precautions must be observed:

• check the expiration date and integrity of the packaging;
• wear a condom before sex, not during it;
• use lubricant during sexual intercourse with a condom;
• remove and dispose of condoms correctly;
• never remove a condom and try to put it on again;
• never reuse a condom.

Symptoms

There are seven main signs that indicate an STI. If they are detected, you must immediately consult a doctor: gynecologist or urologist. The doctor will conduct an initial examination and prescribe further tests and examinations.

The presence of an STI may be indicated by:

• rashes and redness in the intimate area;
• enlarged lymph nodes.

There are quite a few sexually transmitted infections, and each of them manifests itself differently. To describe them you will need a whole medical reference book. Here we will consider only the most common STIs, which can be contracted by every person on the planet, regardless of gender, age and social status.

Syphilis is an infectious disease that has been known to mankind since ancient times. The causative agent is a bacterium called spirochete pallidum. You can become infected with syphilis through any sexual contact. The first symptoms appear 10 days after infection - a hard chancre appears on the genitals or perineum (less often, other parts of the body). Over time, similar rashes appear in the mouth and on the fingers. There is a significant increase in lymph nodes, especially in the inguinal and cervical ones.

There are three stages of syphilis in total. In the absence of timely treatment, the disease can develop into a more severe form. As a result, ulcers spread throughout the body, including the mucous membranes. The patient is worried about inflammatory processes, headaches, aching bones, and deterioration in general health. At the third stage, meningitis may occur - inflammation of the membranes of the brain. Complications of syphilis can lead to paralysis and even death.

Chlamydia- one of the most insidious sexually transmitted diseases. Most people in the early stages of the disease have virtually no symptoms. In women they are less noticeable than in men, and may not appear at all. However, chlamydia is one of the main causes that leads to ectopic pregnancy, inflammatory processes in the pelvic organs and female infertility.

In male patients, chlamydia manifests itself with a number of characteristic symptoms. They are bothered by cutting pain during ejaculation and urination. This is caused by inflammation of the epididymis and urethra, which is caused by bacteria.

Gonorrhea - Another fairly common STI, especially among people aged 15 to 24 years. Like chlamydia, it can be spread through oral, vaginal or anal contact. And just like with chlamydia, most infected women do not notice any symptoms in the first stages. However, in men, gonorrhea appears almost immediately. Patients are concerned about purulent discharge from the urethra, painful and frequent urination, and discomfort in the anal area.

In the absence of timely treatment for gonorrhea, complications arise. Women experience spotting after sex and cutting pain during it, body temperature rises and the general condition of the body worsens. Gonorrhea at any stage requires quick and effective treatment.

Trichomoniasis- a bacterial infection caused by Trichomonas vaginalis. At first, the disease does not show itself at all. The first symptoms appear approximately two weeks after infection. Men feel a burning sensation in the urethra, and discharge from the penis may appear.

In women, trichomoniasis manifests itself more clearly. Patients are concerned about painful sensations during sexual intercourse, which is caused by inflammation of the mucous membranes of the genital organs. One of the characteristic symptoms is thick yellow-green vaginal discharge with an unpleasant odor.

Genital herpes- a viral disease with extremely high susceptibility. It is transmitted not only through sexual intercourse, but also through skin-to-skin contact. The causative agent is herpes simplex virus type 2 (HSV-2). A day after infection, small blisters appear on the external genitalia. They are accompanied by itching and slight tingling. Over the next few days, the blisters turn into painful sores, fever and enlarged lymph nodes are observed.

Rashes are only the visible part of the disease. Even after they disappear, the herpes virus remains in the body for life. Lack of treatment in pregnant women can lead to serious complications, including fetal death.

Human papillomavirus (HPV)- sexually transmitted viruses. HPV types 16 and 18 are one of the main causes of cervical cancer in women. Regardless of gender, the disease manifests itself in the same way - in the form of small warts in the perineum and anus. In men, they can be hidden behind the foreskin and in the urethra. An asymptomatic course of the disease is also possible. In this case, the presence of infection can only be determined using special tests.

Ureaplasmosis- a disease that tends to be chronic. The causative agent is a single-celled microorganism called ureaplasma. Modern medicine classifies it as a conditionally pathogenic flora. This means that a small amount of ureaplasma is present in a healthy person. The disease begins when microbes become active and multiply rapidly, thereby displacing healthy microflora.

The first symptoms appear after 14-20 days. Patients experience inflammation of the genitourinary system, burning sensation when urinating, cloudy vaginal discharge. Women may be bothered by pain in the lower abdomen and cervicitis. Over time, the disease becomes chronic, which entails many complications:

• stricture (narrowing) of the urethra;
• cystitis, etc.

Untimely treatment of the infection often leads to infertility, missed abortion and premature birth.

Mycoplasmosis - like ureaplasmosis, it is caused by opportunistic microorganisms that can be in a “dormant” state in the body of a healthy person. However, sometimes mycoplasmas provoke a number of diseases of the genitourinary system. In women, they manifest themselves as nagging pain in the lower abdomen, burning during urination and pain during sexual intercourse.

HIV or human immunodeficiency virus - the most dangerous sexually transmitted disease. HIV does not make itself felt immediately - the incubation period of the disease lasts from 21 to 90 days. Symptoms appear only at the stage of manifestation of the infectious process.

Patients complain of inflammation of the lymph nodes, chronic weakness, headaches and loss of appetite. A characteristic symptom of HIV is inflammation of the tonsils (tonsillitis), which does not go away for a long time. In patients, the body temperature rises to 37-37.5 degrees, but it is not possible to normalize it with the help of antipyretic drugs.

The lack of antiretroviral therapy has an extremely negative impact on the patient’s condition. The body is attacked by all kinds of viral and bacterial diseases: pneumonia, herpes, tuberculosis, candidiasis. As a result, AIDS develops.

Diagnostics

There are quite a lot of pathogens that are included in the group of STIs. Modern medicine offers many diagnostic methods that can be used to detect them and prescribe an effective treatment regimen. Conventionally, they can be divided into several groups:

• microscopic methods;
• cultural methods or cultures;
• DNA diagnostics.

After detecting symptoms that indicate the presence of a sexually transmitted infection, you should immediately consult a doctor. Women should make an appointment with a gynecologist, male patients with a urologist. If there are obvious signs of a sexually transmitted disease (chancres or other rashes on the genitals), you need to go to a venereologist.

Despite the extensive choice of diagnostic methods, an accurate laboratory method does not yet exist. If an STI is suspected, one method cannot be used; most often they are used in combination for the most reliable result. Diagnosis often takes a lot of time on the part of the patient.

The first thing a person who is concerned about the symptoms of a sexually transmitted infection should do is take a smear for microflora. This is a standard procedure, which is also performed during a routine examination by a gynecologist or urologist. In men, a smear is taken from the urethra, in women - from the vagina and urethra.

The simplest methods also include bacterial culture. The doctor takes a certain amount of genital secretions for analysis. The taken material is placed in a nutrient medium, which promotes the rapid proliferation of bacteria: both “correct” and pathogenic.

In addition to microbiological analysis, if necessary, an enzyme-linked immunosorbent assay (ELISA) is prescribed. With its help, you can identify antibodies with which the body fights STIs. For some diseases that affect the entire body (syphilis, HIV), a blood test is performed (HIV determination and Wasserman reaction).

The most accurate diagnostic method is PCR (polymerase chain reaction). It allows you to identify hidden diseases characterized by an asymptomatic course. The infection is detected using DNA testing. This method is effective in cases of suspected HPV and other diseases that can remain dormant in the body for a long time.

In addition to examination by highly specialized specialists, patients with STIs may sometimes need the help of other doctors. Some diseases affect not only the genitourinary system, but also other organs. This applies to infections such as:

• syphilis;
• HPV, herpes, etc.

They can affect vision, joints, skin, circulatory system, and anus. Depending on the type of complications, it is necessary to contact an immunologist, proctologist, dermatologist, infectious disease specialist and other specialists.

It is important to remember that in the case of an STI, only a doctor can make a diagnosis. Many diseases have almost identical symptoms, so self-medication can only aggravate the situation and lead to dangerous complications.

Treatment

Treatment of STIs involves an individual and comprehensive approach to each patient. The main methods of treatment include the following types of therapy:

• antibacterial;
• immunostimulating;
• antiviral;
• physiotherapy;
• vitamin therapy.

Effective treatment is impossible without a combination of several types. It should be aimed at correcting the condition of the whole organism, and not just the genital organs. Local treatment gives only short-term results and, as a rule, does not eliminate the infection 100%.

A lasting therapeutic effect can be achieved with the help of complex drug therapy. In this case, local antibacterial agents (suppositories, creams, gels or ointments) and oral medications for oral administration are prescribed. Sometimes invasive treatments such as injections or IVs may be needed.

Before taking any medications, you must be tested for susceptibility to antibiotics. Modern pharmacology offers a huge selection of antibiotics against STIs in different release forms and price categories. But not all of them are equally effective; drugs must be selected based on individual factors. Therefore, it is strictly forbidden to self-medicate.

Correctly selected treatment with antibiotics and antiviral drugs lasts from 7 to 10 days. In cases where the disease becomes chronic, therapy is extended to 21 days. As a rule, the patient is advised to have sexual rest during treatment. Sometimes a second course of therapy may be prescribed, but the treatment regimen changes.

Treatment of both partners is imperative, otherwise re-infection cannot be avoided. You shouldn’t be ashamed of sexually transmitted diseases—it’s easy to get infected with them, and every person who is sexually active is at risk. The main method of prevention is confidential sexual relationships, refusal of promiscuous sex life and the use of barrier contraception. Even after complete recovery, it is necessary to take a control smear and undergo regular examinations.

Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) can be contracted through many different types of sexual contact. Many STIs have obvious symptoms that make it easy to identify the disease. Other STIs are more difficult to recognize and may have mild or delayed symptoms. In addition to feeling uncomfortable, many STIs can lead to long-term health problems if left untreated. If you think you have an STI, see your doctor to check if you have it.

Steps

Signs of a bacterial STI

Look for possible signs of unusual vaginal or penile discharge. Trichomoniasis, gonorrhea and chlamydia are accompanied by genital discharge. Although it is normal and healthy to have vaginal discharge, an unusual color or smell may indicate a bacterial STI. Discharge from the penis, other than urination and ejaculation, is also a sign of a bacterial STI.

Pay attention to pain during intercourse or pain in the pelvic area. STIs such as chlamydia or trichomoniasis usually cause local or general pain during sexual intercourse. Pain caused by an STI may include discomfort in the pelvic or genital area, or pain when urinating.

• In men, STIs are often accompanied by testicular pain, which is not necessarily associated with sexual intercourse or ejaculation.

1. Pay attention to difficulty or painful urination. Urination may be accompanied by pain and increased temperature in the pelvic area in women or a burning sensation in men. Such signs may indicate chlamydia and other STIs.

2. Take a closer look at irregular vaginal bleeding. Irregular periods may indicate an STI. This is especially true for chlamydia and gonorrhea. In addition, bacterial infections may cause excessive bleeding during menstruation.

   • Please note that chlamydia can be difficult to diagnose because it causes mild symptoms in the early stages. Typically, symptoms do not appear until three weeks after infection.

3. Pay attention to open sores in the genital area. Painful round sores may indicate herpes and appear 2-3 weeks after infection. Painless, open sores called chancre that appear on the infected area (usually the genitals) may be a sign of syphilis or chancre. Such ulcers usually appear 10–90 days after infection.

   • Other symptoms of herpes include high fever, chills, general discomfort (painful condition) and extremely difficulty urinating.
   • If syphilis is not treated, the symptoms of the infectious disease worsen: larger, multiple ulcers appear, the patient experiences fatigue, vomiting and high fever, which is accompanied by a rash. There are 4 stages: primary, secondary, latent (latent) and tertiary syphilis. The disease is relatively easy to treat in its primary and secondary forms. If you notice any signs of syphilis, contact your doctor for tests and, if the diagnosis is confirmed, appropriate treatment.
   • Symptoms of chancroid include fever, chills, and general discomfort. In addition, some patients experience discharge and difficulty urinating. Over time, the ulcers may burst and their number increases.

Symptoms of a viral STI

1. Check for small warts or sores in the genital area. With many viral STIs, including genital herpes, small red bumps, blisters, warts, or even open sores may appear on or around the genitals. Typically, these warts and bumps cause itching and a burning sensation.

   • If you have recently had oral or anal sex that could cause an oral or anal STI, check for warts and bumps on your lips, mouth, buttocks, and around the anus.
   • Herpes may not appear for a long time after infection. Subsequent outbreaks of herpes may be less painful than the first outbreak. An infected person may experience frequent outbreaks of herpes for decades.
   • Oral herpes can be contracted through contact with the genitals (or genital area), and after an initial outbreak, this form of herpes usually becomes hidden.

2. Note the fleshy bumps and blisters. Fleshy, raised lumps and warts on the genital area or mouth may be a sign of genital warts or human papillomavirus (HPV) infection. HPV is a serious STI, but it can be difficult to detect. This infection can cause gray lumps to form on the genitals, which may coalesce and form areas similar to the surface of a cauliflower.

   • Although genital warts are not a particularly serious STI, they can cause discomfort and frequent itching.
   • Some strains of HPV can increase the risk of cervical cancer. If you suspect that you have HPV, talk to your doctor or gynecologist: you may need to get tested and have gynecological examinations more often.

3. Pay attention to persistent fever, fatigue, and nausea. Although these signs are common symptoms, they can indicate two serious viral STIs: some strains of hepatitis or the early stages of HIV infection. In the early stages of HIV infection, lymph nodes may also become enlarged and a skin rash may appear. Hepatitis affects the liver and often causes pain in the lower abdomen and dark urine.

   • Strains of hepatitis and human immunodeficiency virus can be transmitted through sexual contact. In addition, both diseases can be transmitted through contact with contaminated blood (or other body fluids) or sharing an intravenous needle.

Genital (vaginal) infection, or vaginitis, is an inflammation of the vagina, resulting in abnormal discharge, odor, irritation or itching. Vaginitis is not easy to detect because it has many different causes. To treat itching, discharge and discomfort caused by this infection, women Various over-the-counter products are used.

... cycle. Maintaining hygiene standards, maintaining a hygienic environment, and health education will help limit transmission infections. Infection- this is the introduction of pathogenic microorganisms into the tissues of the host body, their reproduction, as well as the reaction of the tissues...

The most common symptoms of various forms of vaginitis are vaginal discharge, itching and burning. Although the symptoms of these infections can be very similar, there are some differences in the color and smell of the discharge.

Some vaginal discharge is quite normal for women of childbearing age. Normally, the glands of the cervix produce a cleansing mucous secretion, which flows out of the body, mixing with bacteria, separated vaginal cells and the Bartholin gland of the vaginal vestibule. These substances give the mucus a whitish color depending on the amount of mucus, and the discharge turns yellow when exposed to air. There are times during the menstrual cycle when the glands in the cervix produce more mucus than others, depending on the amount of estrogen produced. This is fine.

In women, sexual arousal and emotional stress also affect normal vaginal discharge. Such discharge is a clear substance similar to mucus.

If your discharge has changed in color, for example, turned green, is accompanied by an unpleasant odor, changes in consistency, or has significantly increased or decreased in quantity, then you may be developing a form of vaginitis.

• Bacterial vaginosis may cause pathological discharge with an unpleasant odor. Some women have a strong fishy odor, especially after sexual intercourse. The discharge is usually white or gray in color and may be thin. This may be accompanied by a burning sensation when urinating or itching in the vaginal area, often both. Some women have no symptoms of bacterial vaginosis at all.
• Yeast infection or candidiasis lead to a thick white-gray “curdy” discharge and are accompanied by itching. There may be severe itching in the genital area. In this case, pain during urination and sexual intercourse is common. Vaginal discharge may not always be present. Men with genital candidiasis may have an itchy rash on the penis. In men, this infection does not cause any symptoms or other infections.
• Trichomoniasis is the cause of foamy vaginal discharge, which may be yellow-green or gray, accompanied by itching and irritation in the genital area, burning when urinating, which is often mistaken for a urinary tract infection. During sexual intercourse, discomfort and unpleasant odor may occur. Because trichomoniasis is a sexually transmitted disease, symptoms may appear within 4-20 days after sexual intercourse. Symptoms are rare in men, but when they occur, they may include a thin, whitish discharge from the penis, pain, or difficulty urinating.
• Pain itself is not a common symptom of vaginal infections, other than itching. But this is a sign that you need to see a doctor.
• If you have vulvodynia, it may be accompanied by burning, sharp pain, irritation, and sores on the genitals, but without infections or skin diseases of the vulva or vagina. The pain may come and go. This is a completely different disease that requires further measures and consultation with a doctor.

When to Seek Medical Help

You should seek medical attention if you have pain. Although vaginal infections may cause uncomfortable itching, they are not painful.

Make an appointment with your doctor the first time you experience symptoms of a yeast infection unless you are sure it is a yeast infection. And if you are sure, then you need to undergo a course of treatment with over-the-counter medications. But if symptoms do not go away after this treatment, then you may have a yeast infection.

• Although a yeast infection is uncomfortable, it is not a life-threatening condition. But you need to see a doctor. Moreover, seek medical help if you:
• Vaginal discharge is yellow and has an unpleasant odor
• Abdominal or lower back pain
• Nausea or fever
• Symptoms return within two months
• You should check for other pelvic conditions with similar symptoms by contacting an emergency room doctor. Seek medical attention if the following symptoms occur:
• If vaginal discharge is accompanied by fever, nausea or abnormal pain, or if there is blood in the discharge, it is not considered a normal menstrual period - you should go to the emergency room.
• If symptoms have not improved after three days, the discharge continues in large quantities or if the initial symptoms have worsened.
• You have greenish or heavy discharge or a fever.
• You are taking antifungal medications for yeast infections and your skin and eyes have turned yellow (the whites of the eyes) or have pale stools.
• Pathological changes and rashes appear everywhere, that is, painful, red, pus-filled bumps that can spread to the thighs and anus.
• I felt dizzy.

Tests for vaginal infections

Your doctor will ask you about your symptoms and perform a physical examination. Most likely, you will need to submit urine and smears of discharge for analysis.

• You may be asked the following questions:
• When did the first symptoms appear? Were there any changes in discharge during the month?
• What does this discharge look like? What color and consistency are they? Is there a smell?
• Do you have pain, itching or burning?
• If you have a sexual partner, does he also complain about discharge from the penis?
• How many sexual partners do you have?
• Do you use condoms?
• What relieves the symptoms of discharge? How often do you take baths? Have you taken over-the-counter medications? Will you douche?
• What other symptoms do you have?
• What medications do you take for other diseases?
• Have you changed the detergents and soaps you use?
• Do you often wear tight underwear, trousers or jeans?
• During a pelvic exam, the doctor examines the vagina and cervix for discharge and inflammation. During a pelvic examination, your doctor will determine the size and location of your uterus and cervix, and will determine if you have pain or tenderness to movement of the cervix and uterus or in the area adjacent to it, which corresponds to the fallopian tubes and ovaries.
• To examine the cervix, a speculum is inserted into the vagina. To determine whether a woman's infection is fungal (thrush), protozoal (trichomoniasis) or bacterial (bacterial vaginosis), a smear of any discharge is taken. The laboratory then examines a sample of vaginal discharge under a microscope to determine the presence of microorganisms that cause vaginal infections.
• In some cases, a Pap test is performed to rule out the possibility of cervical cancer. For this test, a swab is sent to a laboratory and results are available within a week.
• You may be prescribed a colposcopy or biopsy if your doctor determines that your cervix is ​​pathological. Colposcopy uses an illuminating microscope to obtain a magnified image of the surface of the cervix. In the case of a biopsy, tissue samples are taken for analysis.
• Some blood tests may show antibodies to yeast, an infection that causes Candida white. This test is not very reliable and is only needed if the infection affects the patient's entire body.
• If Trichomonas is detected and confirmed by laboratory tests, the doctor may prescribe additional tests to detect other sexually transmitted diseases (STDs).

Treatment of sexually transmitted infections in women

The diagnosis is usually made based on symptoms and the results of urine tests and vaginal microflora cultures, that is, smears examined in the laboratory. Treatment is prescribed based on the type of microorganism causing the infection. Depending on the cause of the infection, your doctor may prescribe vaginal suppositories, antifungal tablets, or antibiotics in tablet or injection form. Treatment varies and depends on the type of vaginitis, the severity, duration and frequency of the infection, and whether you are pregnant.

Treatment at home

Bacterial vaginosis and trichomoniasis will not go away if you treat yourself with over-the-counter medications. This requires antibiotics. You need to see a doctor.

Only a yeast infection can be treated with over-the-counter medications. If you have never had such an infection and think you may have one, it is important to have a doctor diagnose it before you try self-treatment at home or take over-the-counter medications. Typically, the first case of yeast infection should be treated by a doctor.

• If the infection appears for the second time, and you have no doubt that it is a yeast infection, then you can self-treat with over-the-counter medications, for example, miconazole (trade name Monistat, etc.) and vaginal antifungal medications.
• Due to the availability of over-the-counter medications, many women self-diagnose that they have a yeast infection. When in fact, about two-thirds of all yeast infection remedies purchased at pharmacies were used by women who did not actually have one. Using medications when they are not needed can lead to infection resistance. Such infections are very difficult to treat with modern drugs. If in doubt, consult your doctor.
• Many of today's over-the-counter medications are designed for mild illness. The success rate for treatment with over-the-counter medications is 75%-90%.
• The drugs are sold in the forms of vaginal suppositories or creams. They are inserted into the vagina using an applicator, usually every day for a week. Higher dosages can only be used for 1-3 days. Most women can treat a yeast infection at home with the following medications:
• Miconazole (Monistat-7, M-Zole)
• Tioconazole (Vagistat Vaginal)
• Butoconazole (Femstat)
• Clotrimazole (Femizol-7, Gyne-Lotrimin)
• Introduce these products with massage movements into the vagina and apply to surrounding tissues for 1-7 days, or insert the suppository into the vagina in accordance with the form and instructions. In case of increasing irritation in the area of ​​application, immediately stop taking the drug.
• If you are pregnant, consult your doctor before starting to use the drug.
• If symptoms continue for more than 1 week, consult your doctor. You may have a more severe form of yeast infection or another condition that has symptoms similar to those of a yeast infection.
• Methods for treating infections in women at home have been used for many years, although scientific research has not confirmed their effectiveness.
• Douching with vinegar. Although women douche to cleanse after a menstrual period or sexual intercourse, doctors do not approve of this method. The vagina is designed in such a way that it cleans itself. Douching can also flush out healthy bacteria from the vagina. Trying to treat pathological vaginal discharge with douching can worsen your condition. If your discharge is abnormal, do not douche without telling your doctor and do not douche 24 hours before visiting your doctor.
• Eating yogurt that contains live lactobacilli acidophilus or the same bacteria in capsules. Yogurt creates an environment for certain beneficial bacteria to thrive. Despite popular belief, research on the benefits of consuming lactobacillus acidophilus in preventing yeast infections has produced controversial results. The benefits of consuming yoghurt cultures have not been scientifically proven.
• Other retail products contain antihistamines or local anesthetics, which only mask symptoms and do not treat infections in women.

Drugs for sexually transmitted infections

• Bacterial vaginosis: Your doctor may prescribe the antibiotics metronidazole (Flagyl) or clindamycin (Cleocin). Male partners are not usually treated for this condition. Many women with symptoms of bacterial vaginosis do not seek medical help, and those women who do not have symptoms do not receive treatment. This disease does not go away on its own without treatment.
• Yeast infection: If you have a yeast infection for the first time, you should consult your doctor before starting home treatment with over-the-counter medications. Typically, your doctor will recommend using vaginal creams and other products more often than oral medications. Pregnant women with this infection are treated longer and under close supervision.
• More severe infections require antifungal medications, which are usually taken orally in one dose. This may be fluconazole (Diflucan) or itraconazole (Sporanox). These medications have a treatment success rate of over 80% and can be prescribed to be taken for 3-5 days. The drugs may cause liver disorders. Symptoms of the disorder in some cases may include yellow skin and eyes, pale stools. If you experience any of these symptoms, contact your doctor immediately. He will most likely immediately stop taking the medications, order a blood test, and prescribe a liver function test.
• In cases of less severe infection in women, vaginal tablets or creams with an applicator may be prescribed as medications. An example would be nystatin (Mycostatin) with a treatment success rate of about 75% - 80%. The success rate for treatment with Micnazole (Monistat-7, M-Zole) and clotrimazole (Micelex, Gyne-Lotrimin) is about 85%-90%.
• In some cases, a single dose of the drug has been shown to be effective in treating yeast infections. In other cases, a longer dose of the drug may be prescribed for 3 to 7 days.
• If the infection occurs periodically, i.e., more than 4 cases per year, then it may be necessary to use drugs such as fluconazole and itraconazole orally or clotrimazole inserted into the vagina for 6 months.
• Pregnant women require a longer course of treatment. It is very important to consult your doctor before starting treatment.
• Trichomoniasis: For trichomoniasis, metronidazole is prescribed. It is usually taken in a single dose. Do not drink alcohol while taking this drug because these two substances may cause severe nausea and vomiting in some cases. This drug is prescribed to both partners, even if they do not have symptoms of this disease.

Aftercare

If you are diagnosed with vaginitis, then make sure that the genital area remains clean and dry. Take a shower instead of a bath. This will also prevent future infections. During the course of treatment, do not douche or use feminine hygiene products in the form of aerosols. Avoid sexual intercourse during treatment.

After returning from your doctor, abstain from sexual intercourse until treatment is completed and symptoms have subsided.

Further observation

Ask your doctor for the results of your cervical tests and Pap tests. It is recommended to have a full physical examination every year, regardless of the presence of symptoms.

• The chemical balance in the vagina is very sensitive, so it is better to let the vagina cleanse itself on its own. This cleansing process occurs naturally through the secretion of mucus. It is best to clean the outside of the vagina using warm water and mild, unscented soap while taking a bath or shower. Products such as intimate hygiene soaps, powders and sprays are not at all necessary, they can even be harmful.
• Douching is washing or cleansing the vagina by squirting water or another solution into the vagina, such as a vinegar solution, baking soda, or a douching solution that can be purchased at the pharmacy. Water or solution is sold in a bottle and injected into the vagina using a special device with a nozzle. Although women in the United States often use douching, doctors do not recommend this procedure for cleansing the vagina. Douching changes the sensitive chemical balance of the vagina, making women more likely to develop vaginal infections. Research shows that women who douche frequently are more likely to develop vaginal infections than those who do not douche at all or do so very rarely.
• Douching does not help prevent pregnancy; there is no need to do it after sexual intercourse.

Prevention of sexually transmitted infections in women

• The best ways to prevent bacterial vaginosis are not yet known. However, a connection has been established between bacterial vaginosis and a woman’s change of sexual partner or with the presence of several partners. This disease is rarely found in women who have never had sexual intercourse. The main methods of preventing the disease include using condoms, limiting the number of partners, abstaining from douching, and taking all prescribed medications, even if symptoms have disappeared.
• In most cases, yeast infections can be easily prevented.
• Keep your vagina dry, especially after showering.
• After using the toilet, wipe from front to back.
• Wear looser cotton underwear.
• Change your swimsuit after swimming.
• Don't wear skinny jeans or tights.
• Pregnant women should consult a doctor immediately if any symptoms appear.
• Do not use deodorized tampons; they contain chemical irritants. Do not douche or use feminine hygiene products. Regular bathing is usually sufficient to cleanse the vagina.
• Trichomoniasis can also be prevented. If you are diagnosed with this infection, your partner also needs to be examined. He or she may have other sexually transmitted diseases, and there is a possibility of reinfection if the partner is not treated. Safe sex using condoms and counseling about sexually transmitted diseases will help reduce the risk of infection and re-infection.

Forecast for sexually transmitted infections

With proper diagnosis and treatment, all forms of vaginitis usually respond well to treatment, and symptoms will decrease and disappear completely. If symptoms do not go away or return again, you should be re-examined by a doctor.

• Bacterial vaginosis is associated with pelvic inflammatory disease, which leads to infertility and ectopic pregnancy. Bacterial vaginosis can lead to premature birth and low birth weight babies. Your doctor will monitor you closely if you are pregnant or if you have already had a preterm birth. Bacterial vaginosis poses a risk for gonorrhea and HIV infection.
• A connection has been established between trichomoniasis and an increased risk of HIV transmission, as well as with the birth of children with low body weight and premature birth.

List of STI infections in women, how tests are taken, first signs

• Smearfor microflora. A sample of discharge from 3 points of the genital canal is taken from a woman with a special probe. Next, the material is placed on glass, stained with a special acidic medium for a detailed study of the composition of the secretion, and carefully examined under a microscope. This method identifies pathogens of fungal and bacterial origin. Viruses cannot be detected using a genital swab.
• Culture of secretions. The culture procedure is carried out in a bacteriological laboratory and takes a long time (about a week). The result of this examination unmistakably indicates the presence of any disease.
• PCR (polymerase chain reaction). One of the most informative tests that allows you to accurately confirm a preliminary diagnosis. To perform it or pass a DNA pathogen test, a sample of discharge from the genital canals or urine is taken. The duration of a study using this method does not exceed two days, the accuracy of the analysis is up to 95%.
• ELISA – transcript (enzyme immunoassay). If a woman has purulent inflammation, specialists prescribe ELISA. A sample of discharge taken from the vagina is examined. The study is carried out quite quickly, its result is ready 5-6 hours after taking the sample.
• Blood test. To determine specific antibodies, a venous blood test is prescribed. The purpose of such a study is to determine whether an immune response will occur to the presence of a particular pathogen. This method is effective when it is necessary to confirm the diagnosis of viral origin (genital herpes, HIV) and syphilis. The method is not used to diagnose bacterial infections, including chlamydia.

In addition to the tests listed, the venereologist prescribes a clinical and biochemical blood test, which can reveal an increase in ESR and leukocytosis. Not all sexually transmitted infections in women can be treated; for example, human papillomavirus infection and genital herpes can only be stopped.

The need for long-term treatment of these diseases and a wide range of complications should motivate you to consult a doctor in a timely manner.

Treatment

A number of pathogens of sexually transmitted diseases respond quite well to treatment with modern medications, but it is recommended to start treatment as early as possible, before serious inflammatory processes begin.

Appropriate therapy for STIs is prescribed according to a special scheme only by the attending physician based on the results of the examination. Depending on the pathogen, complex treatment is used, since the complex course of such diseases requires the use of not only drug therapy.

Most sexually transmitted diseases can be successfully treated, but today there are some that are incurable:

• herpes type 1 and 2;
• hepatitis C;

Important! To avoid relapse, after completing the course of treatment for an STI, a woman must take all tests again. This will ensure that the disease is cured.

Complications and consequences

Delayed treatment of sexually transmitted diseases in women or its complete absence, as well as self-medication, causes the following serious complications:

• transition of the disease to the chronic stage;
• spread of infection throughout the body;
• infertility;
• development of cancer of the cervix, rectum, etc.

Prevention

It is much easier to prevent any disease than to cure it, and diseases included in the list of STIs are no exception. You can protect yourself from these diseases by the following methods:

• using a condom protects against many infections;
• by avoiding contact with people at risk (alcoholics, drug addicts, etc.), you can avoid many risks;
• You can engage in non-traditional forms of sex (anal, oral) only with a partner with whom you have a trusting relationship and whose health there is no reason to doubt.

The additional use of special medications can help in some cases to cope with certain types of infection. However, these drugs have contraindications and side effects. They should be used irregularly, for example, during the first contact with a partner as additional protection along with a condom.

Sexually transmitted diseases are transmitted in most cases through sexual contact. It is important to remember: unprotected sex, promiscuous sex life and a sick partner are a high risk of contracting such ailments. Diagnosis of such diseases is somewhat difficult due to the late onset of the disease and the paucity of symptoms. Their treatment is problematic, since the resistance of microorganisms to antibiotics is increasing every year.

STIs have severe complications, so the appearance of specific symptoms: rashes, discomfort, irritation, uncharacteristic discharge from the genitals is a signal to consult a doctor.