Eczema, Immunity and the Skin Microbiome - Heidi Kong
Vaginal microflora: norm, deviations, methods of treatment
The composition of the microflora depends on the day of the menstrual cycle, the woman's age, her immune status, climatic conditions, race. Compliance with hygiene measures, the use of intimate hygiene products, even the fabrics from which underwear is made, have a huge impact on her.
Classification and norms
The vagina is inhabited by microflora, the types of which can be classified into groups:
- Obligate microorganisms - they are divided into beneficial, non-pathogenic, and opportunistic.
Obligate flora maintains the normal state of the vagina;
- Optional microorganisms - these include cultures that are found in each organism individually;
- Transient microorganisms - foreign microorganisms introduced by chance.
The main microflora of the vagina should be Dederlein's sticks or lactobacilli, which normalize the environment. They acidify the vagina, create a pH level at which conditionally pathogenic microorganisms are not able to actively develop, prevent the introduction of pathogenic flora. Some lactobacilli synthesize hydrogen peroxide, creating a reliable protective barrier.
Together with bifidumbacteria, which are slightly less in the vagina, lactobacilli inhibit the growth of staphylococci, Klebsiel and Escherichia.
The most famous opportunistic microorganisms are gardnerella and Candida fungi, pathogenic - bacteroids, streptococci, peptostreptococci and staphylococci. The other types of microorganisms are much smaller.
It is worth lacto- and bifidumbacteria to pass positions, a violation of the vaginal microflora occurs and dysbacteriosis occurs - bacterial vaginitis or vaginosis. It is very important to know how to restore the vaginal microflora, and in a short time. A change in acidity leads to the active reproduction of pathogenic cultures and the occurrence of inflammatory processes.
If the number of beneficial microorganisms has decreased and pathogenic bacteria began to multiply vigorously, dysbiosis appears. It is diagnosed using a smear during a routine examination.
A woman usually seeks a doctor if she has the following symptoms:
- notsweet smell;
- increased amount of discharge;
- discoloration of the discharge to grayish or yellowish;
- painful sensations in the vulva;
This symptomatology indicates that bacterial vaginosis has already developed against the background of dysbiosis, since the initial stage of the disease proceeds without pronounced changes in the state. Most often, with bacterial vaginosis, a large amount of gardnerella or Candida fungus is found in the smear.
Diseases are called gardenellosis or thrush. An increase in the activity of pathogenic flora of a different type causes more severe inflammatory processes. The increased number of inclusions of key cells in the smear indicates that inflammatory processes are starting.
A smear may show that there is a mixed microflora in the vagina. His condition in this case is assessed by the number of leukocytes present in the field of view. This clinical picture is considered the norm during the menstrual cycle, in menopause, at the beginning of puberty.
The presence of small sticks indicates the onset of the inflammatory process - lactobacilli do not have time to ripen, they are suppressed by pathogenic microorganisms. The need for treatment is reviewed by a doctor.
If there are no health-threatening diseases, the mixed flora is corrected with drugs designed to restore the vaginal microflora. Having found unpleasant discharge in yourself, you should not start self-medication, as most women do, considering all the thick white discharge from thrush.
Some sexually transmitted infections in the initial stage manifest themselves in a similar way, the activity of candida is manifested against the background of the reproduction of pathogenic cultures. Therefore, without waiting for menstrual irregularities and pain, it is necessary to consult a doctor if any unknown signs appear.
Ways to restore the acidic environment of the vagina
Dysbacteriosis is caused by various reasons:
- hormonal disorders;
- taking certain medications;
- changing climatic conditions;
- misuse of tampons;
- intestinal dysbiosis;
- violation of hygiene requirements;
- gynecological operations;
- irregular sex life.
In cases of sexually transmitted infections, bacterial vaginosis also occurs.
In order for the normal microflora of the vagina to again protect the body from the penetration of pathogenic microorganisms, it is necessary to establish the cause of the dysbiosis. Treatment with medications necessary to restore the acidic environment is selected depending on the severity of the condition.
After the pathogenic flora is identified in the analysis of a smear from the genitals, it may be requiredThere are additional examinations: PCR diagnostics - detection of genital infections - and seeding of secretions to determine the sensitivity of microflora to antibiotics.
Preparations for the restoration of microflora are prescribed only when genital infections are eliminated. If no sexually transmitted diseases or acute inflammatory processes are found, a course of antibiotics may not be required.
Drugs that are included in the treatment for bacterial vaginosis can be as follows:
- Immunomodulators that restore the immunity of the vaginal wall;
- Topical anti-inflammatory drugs in the form of suppositories and vaginal tablets, and general medications, for oral administration;
- Suppositories consisting of lacto- and bifidumbacteria;
- Medicines made according to traditional medicine.
Special baths and tampons with medications effectively restore the acidity of the vagina.
Douching used to be popular, but now they try not to resort to it. When douching, not only pathogenic, but also normal microflora is washed out. Suppositories with metronidazole, vaginal tablets and ointments are most often used to suppress pathogenic microorganisms: Kion-d , Clotrimaxozole , Metronidazole , Terzhinan , Polygynax , and others. The choice of such funds is huge, they act selectively on the prevailing pathogenic microorganisms, so you should not prescribe them yourself.
At the same time, vaginal tablets have an anti-inflammatory and restorative effect. Vagilac , Gynoflor , Ecofemin and similar drugs. In addition to useful crops, they contain iodine or chlorhexidine, which destroy pathogenic microorganisms. Means for restoring the microflora of the vagina are represented by candles: Bifidumbacterin , Lactobacterin , Lactovag , Bifolact …
Typically, a therapeutic course is conducted as follows:
- the activity of pathogenic cultures is stopped first;
- the normal acidity of the vagina is then restored.
The treatment regimen for infectious and inflammatory diseases is selected individually, suppositories to restore microflora are introduced in a course of 7 to 10 days, 2 candles a day, morning and evening.
After the disappearance of the main symptoms in a week, it is advisable to supplement the therapy with vaginal tablets after 7 days Vaginorm S.
This optimally normalizes the acidity of the environment, ensuring rapid growth of lactobacilli.
Vaginal dysbiosis recedes for a long time with the following treatment:
- oral Normoflorins B and L, within a month;
- 3 courses of candles Kipferon at intervals of 7-10 days.
No matter how the treatment is carried out, it is necessary to take a smear during it - to adjust the therapeutic regimen. After the smear results show the restoration of normal microflora, therapeutic measures are stopped.
A control smear is taken 3 months after the end of treatment. If the results are normal, then we can assume that bacterial vaginosis is destroyed.