Among them there are potentially “harmful” or opportunistic bacteria (cocci, gardnerella, Candida fungi, etc.), and there are lactobacilli.
It is lactobacilli that inhibit the proliferation of “bad” bacteria and are responsible for the condition of the vaginal microflora.
Normally, there are no more than 4-8% of opportunistic bacteria and in the normal state they are not activated - their growth and quantity are completely “controlled” by lactobacilli, which create a special environment with an acidic pH, in which most microorganisms are “uncomfortable”.
But the female body is like a fragile vessel. And even a “harmless”, at first glance, imbalance of bacteria in the vagina can turn into very serious problems for women’s health.
When the immune system is weakened, the body does not have the strength to replenish the army of our “defenders” - lactobacilli. The vacated space is quickly taken up by other, not entirely useful microorganisms. Most often, this is Gardnerella vaginalis - a rather harmful bacterium, which in very small quantities is always present on the mucous membrane, but in case of excess causes vaginal dysbiosis or bacterial vaginosis.
Causes of microflora disturbances
The vaginal microflora can be influenced by many different factors:
Use of antibiotics or hormonal drugs.
Once in the body, antibiotics fight the causative agent of infection, but at the same time destroy other microorganisms, including lactobacilli.
As a rule, pathogenic microorganisms are more active, aggressive, they manage to multiply before the content of “good” bacteria returns to normal. As a result, vaginal dysbiosis occurs.
According to a similar pattern, microbial imbalance develops when treated with hormonal drugs, for example, corticosteroids. They suppress the immune system and create conditions optimal for the proliferation of opportunistic bacteria.
Pregnancy.
While carrying a child, a woman’s hormonal levels and the functioning of her immune system change, and the properties of the vaginal mucosa also change somewhat. All these factors can lead to a decrease in the number of lactobacilli and the growth of pathogenic bacteria, causing dysbiosis.
The presence of acute or chronic infection.
These conditions require constant “mobilization” of the immune system in order to prevent the infection from spreading throughout the body. But often the efforts of the immune system are not enough to support the normal biocenosis of the vagina. In this case, the number of opportunistic bacteria also begins to increase and dysbiosis occurs.
Stress, psychological disorders, depression.
The strong influence of stress factors leads to maladaptation - disruption of the entire body, including the immune system. As a result, the general and local immune balance is disrupted, including in the vagina, and “bad” bacteria have the opportunity to actively reproduce.
Features and activity of sexual life.
Bacterial vaginosis often appears when changing sexual partners. This, to some extent, is normal - two organisms need to get used to each other. But if sexual partners change often enough, the vaginal microflora has virtually no chance of finding time to build a new protective barrier against infections.
Frequent vaginal douching with the use of chlorine-containing antiseptics, use of intrauterine devices for contraception, vaginal deodorants.
Excessive hygiene is not beneficial - this is a proven fact. Always give your body a chance to recover and protect itself from bacteria.
At the same time, failure to maintain personal hygiene, as well as wearing tight or synthetic underwear, can lead to changes in microbial composition and provoke dysbiosis.
Previous operations or injuries.
The same principle works here as with recovery after a course of medication - the immune system’s own efforts may not be enough to maintain the vaginal biocenosis, so the number of lactobacilli begins to decrease, and the number of opportunistic bacteria begins to increase.
How to restore microflora
To restore the vaginal microflora, it is important to follow some recommendations.
Use special intimate hygiene products.
Products intended for intimate hygiene do not contain aggressive substances that can negatively affect the mucous membrane. They do not upset the balance of the intimate area and allow you to accelerate the restoration of microflora to restore calm and lightness.
Treat diseases that provoke dysbacteriosis.
If microflora disturbances are caused by any disease, it is important to pay attention to its treatment. This will eliminate the factor that provoked dysbiosis, and additional normalization measures will help quickly restore the health of the intimate area. The attending physician will recommend how exactly to treat the disease that caused the change in balance.
The use of products that restore vaginal microflora
. Preparations for restoring vaginal microflora are one of the most reliable companions on the path to health. But you should be careful when choosing the right product. Thus, special circumstances must be taken into account. For example, pregnant women should not use medications that are not approved for use while pregnant. In addition, you need to pay attention to the range of problems that the chosen remedy solves: should you additionally buy drugs with anti-inflammatory, analgesic and other effects, since microflora disorders are always accompanied by inflammation and discomfort in the intimate area.
What is dangerous about microflora disturbance?
When bacterial vaginosis occurs, women most often complain of the appearance of discharge (grayish-white in color, emitting the smell of stale fish), itching and burning in the vagina, pain when urinating, pain during sexual intercourse.
What happens as a result of dysbiosis?
- Local immunity is impaired, and a chronic infection develops in the external genital area. Discharge, unpleasant odor, itching, the appearance of painful wounds - all this significantly worsens a woman’s quality of life.
- The risk of infection with the human papillomavirus increases. It, in turn, is considered a risk factor for the development of cervical cancer.
- The risk of developing infertility increases. Infection and inflammation are among its leading causes.
- Intrauterine infection of the fetus often occurs against the background of intimate microflora disorders in pregnant women.
- The risk of recurrent miscarriage and other obstetric pathologies increases.
- The risk of developing placental insufficiency with delayed fetal development and the formation of a pathological course of pregnancy.
- Risk of premature birth.
Dysbiosis can cause the development of serious pathologies of internal organs. Infections have the ability to spread vertically: from the mucous membrane of the external intimate area to the internal membranes of the pelvic organs (cervix and uterus, into the fallopian tubes), to the mucous membrane of the bladder and urinary tract, and into the abdominal cavity. Since these organs are closely located, their mucous membranes have a similar structure and are susceptible to the same microorganisms.
The bacteria Gardnerella vaginalis create special biofilms on the surface of the vaginal epithelium to “protect” themselves from the effects of antibiotics. Such biofilms are foci of chronic infection, which is why relapses of bacterial vaginosis occur so often1.
Even a simple list of possible risks when intimate microflora is violated shows: these symptoms cannot be ignored!
Normal vaginal microflora
The vaginal flora represents beneficial and transient microorganisms, the balance of which must be strictly maintained.
About 96% of the vaginal microflora consists of lactobacilli. They are the ones who can destroy glycogen, resulting in the appearance of lactic acid, which is responsible for creating an acidic environment and protecting against microbial damage. The remaining 4% are gram-positive and gram-negative cocci, anaerobic rods.
All representatives of microflora constantly interact with a woman’s body, not causing harm, but protecting from pathologies. Under normal conditions, harmful microbes entering the vagina are destroyed by an acidic environment.
Depending on a woman’s age, the state of the vaginal flora may change under the influence of internal and external factors.
Treatment of vaginal dysbiosis (bacterial vaginosis) during pregnancy
In the I, II and III trimester, for the prevention of bacterial vaginosis, it is very useful to take bifilact “BIOTA” 1 glass 2-3 times a day 20-30 minutes before meals or 40 minutes after meals. You can take bifilact BIOTA instead of second breakfast and afternoon snack. This prevents the development of vaginosis, improves immunity, is a dietary food for a pregnant woman, and saturates the body with calcium necessary for the formation of the fetus.
If bacterial vaginosis is diagnosed during pregnancy, then it is treated with drugs only at the 20th week of pregnancy due to the possible negative effect of metronidazole drugs on the fetus. In this case, Metronidazole (or Clindamycin) can be prescribed orally at a dose of 250 mg 2-3 times a day for 7 days. It is more advisable to use dosage forms of the drug that are applied topically in the vagina, since this method has a more pronounced therapeutic effect. However, more than 30% of pregnant women experience a relapse of the disease within 1 to 3 months. The use of bifilact “BIOTA” will help avoid relapses.
One of the most common complications when using the above drugs is candidal vaginitis. To prevent it, nystatin should be prescribed 2000 mg per day orally, simultaneously with the initiation of treatment with Metronidazole. In addition, during pregnancy, drugs such as clotrimazole, pimafucin, etc. are widely used to treat candidiasis.
If a woman, before becoming pregnant, treated intestinal dysbiosis with the use of bifilact BIOTA, then the composition of her vaginal microflora also stabilized. During pregnancy, such women are recommended to continue taking bifilact BIOTA at least once a day, 1 glass, so that the vaginal microflora remains stable. If a woman has not prevented intestinal dysbiosis before pregnancy, then to maintain normal vaginal microflora during pregnancy she needs to take Bifilact BIOTA 150-200 ml 2 times a day 20-30 minutes before meals or 40 minutes after meals.
Necessary tests
Since pathologies are often asymptomatic, many women find out about their presence only during an examination by a gynecologist. If the doctor suspects that something is wrong with women’s health, then he takes the appropriate tests.
Most often, a urogenital smear is done to determine the state of the microflora.
Laboratory tests will help determine the presence of certain diseases, inflammatory processes, and the cause of dysbiosis.
Before taking the test, you must follow the following recommendations:
- the day before the tests, refrain from sexual intercourse;
- within 3 days, stop using tampons, suppositories and other means that can worsen hygiene;
- stop taking antibacterial agents for several days.
You can find out the results in 2-3 days. According to the test results, the doctor prescribes appropriate treatment, which must be started immediately.
Drugs to restore condition
Only a doctor can prescribe certain medications. Under no circumstances should you self-medicate, which can only worsen the condition.
Probiotics
These are medications that contain lactic acid microorganisms. Their action is aimed at improving the state of microflora and treating certain diseases and problems that arise as a result of taking antibiotics. Such drugs are available for both local and oral use.
Candles
These are small oblong-shaped preparations that look similar to a ball, cylinder or oval. They reach up to 1.5 cm in diameter and weigh 2-6 g. Intended for local use. Such candles are made exclusively from natural substances that cannot harm the female body.
Pills
To improve the condition of the vaginal flora, you can take oral or vaginal tablets and capsules. As a rule, they have a fatty membrane, which facilitates unhindered insertion into the vagina. The tablets contain granular powder. Many experts advise taking lactozhinal.
Treatment of bacterial vaginosis
Eliminate intestinal dysbiosis
Treatment of intestinal dysbiosis is accompanied by taking bifilact “BIOTA” 1 glass 2-3 times a day for 1.5 – 2 months along with drugs prescribed by the doctor to normalize the intestinal microflora - the main reservoir of normal microflora, from where normal microflora is infused into the vagina. After completing the main treatment, Bifilact BIOTA must be taken for at least another month to stabilize the result. Without restoring the intestinal microflora, vaginal dysbiosis cannot be cured.
Eliminate pathogenic microflora in the vagina
- Metronidazole is prescribed orally at a dose of 500 mg 2 times a day for 7 days;
- Metronidazole gel 0.75%, which is administered intravaginally using a standard applicator in a dose of 5 g once a day for 7 days;
- Metronidazole in the form of vaginal tablets 500 mg, 1 pc. at night for 10 days;
- Vaginal tablets Klion-D, (Metronidazole -100 mg, miconazole nitrate 100 mg), which are prescribed 1 tablet per day at night for 10 days;
- Atrican orally 500 mg 2 times a day for 5 days;
- Tiberal (Ornidazole) orally 500 mg 2 times a day for 10 days;
- Vaginal suppositories Betadine are prescribed for 14 days 1 time per day at night or 2 times per day, one suppository in the morning and evening;
- Terzhinan locally in the form of vaginal tablets, 1 tablet for 10 days;
- Clindamycin hydrochloride orally 300 mg 2 times a day for 7 days;
- Dalatsin vaginal cream 2% is prescribed in 5 g doses. (adequate 100 mg of clindamycin) by intravaginal administration using a special applicator (attached to the package), 1 time per day (preferably before bedtime), for 3 days. Similarly, Dalacin can be used in the form of vaginal suppositories.
The use of condoms or vaginal diaphragms for contraception during treatment should be avoided, as the cream contains mineral oil, which has a destructive effect on latex or rubber products. Clindamycin-based drugs can also be used during pregnancy after 20 weeks. As an immunocorrective therapy in the treatment of bacterial vaginosis, it is advisable to use Kipferon suppositories (suppositories), which are administered rectally 2 times a day for 10 days. The prescription of desensitizing drugs is also justified: claritin 10 mg once a day, suprastin 25 mg 2-3 times a day, etc.
Restore microflora in the vagina
After a course of eliminating pathogenic microflora from the vagina, normal microflora should be replenished. The basis for colonizing and maintaining a constant microbial balance in the vagina is the constant replenishment of beneficial bacteria (bifidumbacteria and lactobacilli) from the intestines. Therefore, eliminating intestinal dysbiosis with the use of bifilact BIOTA is a fundamental factor in the health of the vaginal microflora. To speed up the process of colonization of normal microflora in the vagina, biological products are used topically.
3 weeks after the end of the main course of treatment, the composition of the vaginal microflora should be examined. If the presence of candidiasis is not detected, biological preparations Lactobacterin, Bifidin are prescribed (they are administered intravaginally in 2.5 - 3 doses 2 times a day at 10 -12 hour intervals, for 7-10 days. Before use, the drugs are diluted in 5 ml of boiled water with added lactose). Acylact suppositories are prescribed intravaginally 2 times a day for 7-10 days. Bifidumbacterin, Gynoflor E, Vaginorm-S, Laktonorm are also used for these purposes.
If candidiasis is detected during a smear examination, you should first treat it and only after that (after making sure that there are no symptoms of candidiasis) prescribe the above-mentioned biological products. For the treatment of candidiasis, it is recommended to use Fluconazole drugs (Diflucan, Flucostat) once orally 150 mg.
The criteria for the effectiveness of treatment of bacterial vaginosis are the disappearance of clinical symptoms of the disease and normalization of laboratory parameters. The first control clinical and laboratory examination should be carried out a week after completion of all therapy, and a second one after 4-6 weeks.
