Contents
Vaginal dysbiosis or bacterial vaginosis
– this is a violation of the normal biocenosis of the vagina.
The vaginal mucosa is protected by persistent microflora. The composition of this microflora, which has developed over the years, is able to resist the introduction of pathogenic microorganisms or fungi.
In a healthy woman, more than 90% of microorganisms colonizing the vaginal mucosa are Dederlein’s lactic acid bacilli (lactobacteria) and bifidobacteria. The vital activity of these microorganisms ensures an acidic vaginal environment due to the release of hydrogen peroxide, which is destructive for many pathogenic microbes.
Other microorganisms present on the walls of the vagina belong to the conditionally pathogenic flora – among them streptococci, gardnerella, ureaplasma, fungi of the genus Candida, etc. may be present. While the growth and reproduction of representatives of the conditionally pathogenic microflora is restrained by an acidic environment, these microorganisms are in the minority and cannot actively reproduce, causing harm to women’s health.
Factors developing dysbiosis
- any factors that undermine the health of the immune system can lead to disruption of the normal microflora of the vagina, that is, to the development of vaginal dysbiosis. Among these unfavorable factors are stress, hypothermia and overheating, long-term illnesses, acclimatization, nutritional disorders such as strict diets or hypovitaminosis;
- microbial aggression, that is, penetration of obligately pathogenic pathogens or a large number of opportunistic microorganisms onto the vaginal mucosa;
- frequent change of sexual partners without the use of appropriate protective equipment;
- infectious diseases of the genitourinary system;
- traumatic damage to the vaginal mucosa;
- hormonal changes in a woman’s body caused by pregnancy, abortion, gynecological and somatic diseases, menopause, etc.;
- long-term antibiotic therapy.
As often happens in real clinical practice, the causes of persistent dysbiosis are often a combination of several unfavorable factors.
When the vaginal microflora is disrupted, the number of lacto and bifidobacteria primarily decreases. Instead, opportunistic flora grows, each representative of which, if overgrown, can cause inflammation of the vaginal mucosa – colpitis. Nonspecific inflammation caused by mixed flora develops more often. This condition is also called “mixed infection”. During examination, inflammatory nonspecific diseases of the vaginal mucosa are found in every third woman.
How does dysbiosis manifest?
Clinically, early forms of vaginal dysbiosis can be asymptomatic or asymptomatic.
- changes in the amount of vaginal discharge (leucorrhoea), its color, consistency and smell. As the disease develops, the amount of discharge becomes abundant;
- itching, burning, pain during sexual intercourse and urination.
In fact, it is not the violation of the vaginal flora itself that brings the patient to the gynecologist, but the development of complications – colpitis, urethritis, etc. A decrease in the protective function of the normal vaginal microflora serves as an additional risk factor for infection with sexually transmitted diseases, the treatment of which requires a visit to a venereologist, the development of an ascending urinary tract infection, and complicated pregnancy.
Treatment of vaginal microflora dysbiosis.
A 100% indication for the treatment of asymptomatic dysbiosis is the fact of pregnancy planning. In other cases, in the absence of clinical manifestations and complaints, at the stage when disruption of the vaginal biocenosis is only a “laboratory phenomenon,” a wait-and-see approach can be adopted. In this case, the patient should be recommended to normalize the work and rest regime, nutrition, reduce stress load and treat concomitant somatic diseases. When treatment of vaginal dysbiosis becomes necessary, the venereologist faces a complex task, which consists of:
- Elimination of the leading infectious pathogen;
- Restoring the normal microflora of the vaginal mucosa;
- Promoting the activation of normal immune defenses;
To eliminate excess amounts of the pathogen, they try to use products with a selective effect designed to spare the normal microflora. After achieving an antibacterial effect, topical preparations containing live beneficial bacteria, so-called eubiotics, are prescribed. After completion of treatment, the woman should be under medical supervision for a year. Regular examinations by a gynecologist are recommended, once every 1 months, and repeated tests if necessary. If the doctor detects a tendency towards unfavorable changes in the microflora, a repeat course of treatment has to be carried out. Most often, this happens in situations where it is not possible to eliminate the root cause of vaginal microflora disorders. If no problems arise during the first year of observation, then the woman is recommended to be monitored with a frequency of visits once every 3 months; in this case, the risk of relapse is reduced, and regular monitoring helps prevent re-exacerbation of the disease.