Lee gardnerella. Gardnerella vaginalis: dysbiosis with a characteristic "aroma

A certain microflora is present in the woman's vagina, including a mass of microorganisms - both beneficial (lactobacilli) and conditionally pathogenic. Their ratio in a healthy woman is optimal for the health of the reproductive system and the whole organism.

However, under certain situations, conditionally pathogenic flora begins to actively multiply, displacing the beneficial one.

The microorganism gardnerella vaginalis just belongs to the category of opportunistic pathogens. Normally, its amount in the genital tract is negligible, or there is a complete absence.

Gardnerellosis (synonym: bacterial vaginosis) is caused by an imbalance in the microflora of the vagina. Normally, it is represented mainly by lactobacilli.

These bacteria form lactic acid and hydrogen peroxide, preventing the reproduction of opportunistic microorganisms. The composition of the normal microflora of the vagina in small quantities may include Gardnerella vaginalis, Mycoplasma hominis and anaerobic bacteria (genus Mobiluncus and others). These microorganisms are present in small quantities in the vagina of most healthy women.

As a result of douching; the use of contraceptives containing 9-nonoxynol (candles "Patentex Oval", candles "Nonoxynol"); change of sexual partner, the proportion of lactobacilli in the vaginal microflora decreases. At the same time, the share of Gardnerella vaginalis, Mycoplasma hominis and anaerobic bacteria increases. In this case, there is a dysbacteriosis of the vagina - the so-called gardnerellosis.

For men:

Gardnerellosis, by definition, is a dysbacteriosis of the vagina. Therefore, it is wrong to make such a diagnosis for men. Sometimes pathogens of gardnerellosis cause urethritis in men, which is manifested by burning and pain during urination. In this case, treatment is necessary. In other cases (detection of Gardnerella vaginalis by accurate methods; gardnerellosis in a sexual partner), there is no need to treat men.

With normal immune status about 25% of men are carriers of gardnerella, that is, they do not have any manifestations of infection.

Carriage develops when Gardnerella vaginalis enters the male genital tract. Only under conditions of sufficiently strong immunosuppression is it possible to develop balanoposthitis, urethritis, prostatitis (approximately 15% of all cases).

Gardnerellosis does not apply to sexually transmitted diseases. Sexual transmission has not been proven. However, it is closely associated with risk factors for sexually transmitted diseases (multiple sexual partners, recent change of sexual partner). Therefore, it is advisable to examine women with gardnerellosis for major sexually transmitted diseases.

Causes of gardnerella

• Infection. Often gardnerellosis is accompanied by diseases such as gonorrhea, chlamydia, trichomoniasis, sexually transmitted diseases. The reproduction of pathogenic bacteria provokes inflammation of the mucous membrane and a violation of the normal microflora of the vagina, and if left untreated, it can lead to serious consequences, up to the development of infertility;
• Hormonal disbalance. This phenomenon is also due to various reasons. For example, pregnancy. For pregnant women, gardnerellosis and thrush are quite common. Also, a change in the hormonal background can be triggered by severe stress, taking medications, including contraceptives and antibiotics, and the presence of certain diseases. The exact cause of hormonal failure is determined by a specialist;
• Severe intoxication of the body. Ordinary food poisoning can provoke intestinal and vaginal dysbacteriosis. As a result, symptoms of both diseases may occur;
• Endocrine diseases. In particular, diabetes. Elevated blood sugar contributes to the violation of the alkaline balance of the vaginal mucosa and, as a result, the reproduction of pathogenic microflora in it;
• Any surgical intervention in the area of ​​​​the reproductive system (abortion, therapeutic gynecological manipulations);
• Frequent use barrier contraception, local methods of treatment of inflammatory diseases of the vagina. There is nothing wrong with using condoms, but the lubricant that they contain in some women provokes the growth of gardnerella and the fungus that causes thrush. The same applies to vaginal suppositories indicated for trichomoniasis, candidiasis and other infections;
• sharp decreased immunity. This may be due to internal (disease of the blood, bone marrow, frequent infections of the respiratory system, etc.) and external (dramatic change in climatic conditions, exposure, taking certain medications) causes;
• Frequent change of sexual partners(may cause infection with STIs, the development of gardnerellosis and other unpleasant consequences for health).

At-risk groups

Since gardnerella vaginalis is normally part of the vaginal microflora and is never completely removed. It can appear at any time in women of reproductive age, regardless of sexual life. According to the observations of doctors, gardnerellosis appears in 32% of virgins, and 28% of single women. Sometimes it is transmitted to girls of school age in a domestic way. However, all these cases are the exception, not the rule.

The most susceptible to the disease are women and men who are promiscuous without the use of barrier contraceptives. It is also transmitted to a newborn girl from her mother. Perhaps the development of gardnerellosis in women who have undergone childbirth and abortion.

Why is the disease dangerous?

Previously, it was believed that this gardnerellosis does no harm. Currently, it is considered a risk factor for inflammation of the uterus, female infertility, premature birth, complications of pregnancy and childbirth.

Despite the fact that gardnerellosis is not a sexually transmitted disease, it still requires treatment. If the infection is left unattended, it can cause quite serious complications in both women and men.

Gardnerellosis in women causes the following complications:

• Inflammation of the pelvic organs;
• urethral syndrome;
• Postabortion and postpartum endometritis;
• Infertility;
• intraepithelial cervical neoplasia;
• Bartholinitis or abscess of the Bartholin's gland.

Gardnerellosis in men can cause:

• non-gonococcal urethritis;
• Chronic prostatitis;
• cystitis;
• Balanoposthitis.

Classification

• bacterial vaginosis of the compensated type - with this course of the disease, according to the analyzes, there is a slight presence of opportunistic flora in patients;
• bacterial vaginosis of the subcompensated type - the number of beneficial lactobacilli decreases significantly with an increase in opportunistic flora, including gardnerella;
• vaginosis of the decompensated type - the beneficial flora is almost completely replaced by the pathogenic one, the inflammatory process is strong, pronounced, the nature of the change in the epithelial layer.

Clinical picture

How does gardnerella manifest itself in women? Pathology can develop:

• asymptomatic - the disease is diagnosed by tests, the woman does not present any complaints, pain and discharge are not observed;
• with a pronounced clinical picture - pain and cramps, discharge, feeling unwell.

The incubation period of gardnerellosis in women - from the moment gardnerella enters the genital tract until the moment of manifestation - ranges from a week to 20 days. During this period, the pathogenic flora begins to gradually spread, displacing the beneficial one.

The onset of the disease is characterized by mild symptoms - slight discomfort, weak discharge. A vivid clinical picture appears on the 14-20th day - the symptoms are pronounced, the discharge is plentiful, the pain syndrome and discomfort are maximum.

The main signs indicating the development of gardnerellosis:

• Bad smell from the genital tract - often this is the first symptom of the development of vaginosis; the smell is fetid, sharp, similar to the aroma of decomposing fish, which is due to the decomposition of amines due to the rapid reproduction of gardnerella;
• Allocations from the vagina - their nature varies depending on the severity of the disease. At the initial stage of the discharge, they look like a mucous translucent and turbid liquid, as the pathological process worsens, the discharge becomes gray, opaque, viscous, acquires a green or yellow tint. At the advanced stage of the discharge, layers form on the walls of the vagina, causing swelling and redness. A characteristic feature of discharge in gardnerellosis is a bad smell;
• Sudden menstrual irregularities may indicate the development of bacterial vaginosis;
• Discomfort in the area of ​​​​the urogenital organs - as the pathogenic flora multiplies, itching and burning appear in the urethra, labia, vagina, mucous membranes may look swollen, inflamed;
• The development of diseases affecting the organs of the urinary system - urethritis, cystitis indicate the presence of gardnerellosis. This is due to the close proximity of the location of the genital organs and urinary tract;
• Pain during sexual intercourse - soreness can occur directly during proximity and persist after;
• Pain during urination- occur when the infection spreads to the urethra;
• General malaise- the pathological process can lead to a general disturbance of well-being, a feeling of weakness, possibly an increase in temperature as a result of the active reproduction of negative microbes.

Diagnostics

Sensitivity to antibiotics

Name of the group and drugs	Sensitivity gardnerella	Application methods
Nitroimidazoles: metronidazole, tinidazole, ternidazole, ornidazole		Orally, intravaginally, topically. The method of application depends on the location and severity of the inflammatory process.
Lincosamides: clindamycin	Sensitive/first line drugs	Orally, intravaginally, topically. More commonly used local forms (suppositories, creams and gels with clindamycin)
Macrolides (josamycin, azithromycin, erythromycin)	sensitive	Orally, intravenously, are used for severe forms of infection, a combination of bacvaginosis with chlamydia, mycoplasmosis
Tetracyclines: doxycycline	Moderately sensitive	Orally, as one of the antibiotics in an STI (chlamydia) regimen
Aminoglycosides: gentamicin, amikacin	insensitive	Not used to treat gardnerella infections
Protected penicillins (amoxiclav)	sensitive	Sensitivity is established experimentally, currently not used for treatment
Fluoroquinolones (ofloxacin)	sensitive	Can be used in treatment regimens (more often when combined with STIs)

Prevention

Prevention is reduced to the refusal of douching and the use of contraceptives containing 9-nonoxynol. Condoms should be used for casual sexual intercourse and for contacts with non-permanent sexual partners.

The use of broad-spectrum vaginal tablets and suppositories (Terzhinan, Polygynax, Betadine) can also contribute to the development of gardnerellosis. The composition of these drugs includes broad-spectrum antibacterial agents that suppress the normal microflora of the vagina.

Treatment of gardnerellosis in women at home, as well as what is the danger of gardnerellosis in pregnant women, causes and symptoms of the disease, stages of diagnosis.

Gardnerellosis in women is a bacterial infection, a type of vaginal dysbacteriosis. Since, in addition to bacteria of the genus Gardnerella, this condition occurs with the participation of other opportunistic microorganisms, this disease is more often called.

General description of gardnerellosis

This is a phenomenon in which there is an imbalance in the microflora of the vagina. It does not belong to the group of sexually transmitted infections.

The disease is associated with accelerated reproduction in the vagina of conditionally pathogenic microorganisms, among which gardnerella predominates.

Gardnerella vaginalis is a type of microorganism that, under normal conditions, is present in the microflora of the vagina. This bacterium thrives in the absence of air. In the presence of favorable conditions, it develops rapidly and displaces the bacteria that make up the normal microflora of the urethra and vagina. Under such conditions, the level of lactobacilli that produce lactic acid is significantly reduced.

Gardnerella in the process of reproduction releases amino acids from which amines are formed - compounds that give vaginal secretions a specific unpleasant odor.

These pathogenic microorganisms create conditions for the development of diseases of the genital area, so gardnerellosis must be treated.

Causes

Violation of vaginal dysbacteriosis and the development of diseases of the urogenital area against its background occurs due to factors such as:

• unbalanced nutrition, lack of fermented milk products in the diet;
• promiscuity in sexual relations;
• wearing underwear made of synthetic materials that fits snugly to the body;
• taking antibacterial drugs;
• prolonged use of intrauterine contraceptives;
• the presence of sexually transmitted diseases (trichomoniasis, chlamydia);
• the use of hygiene products containing chemicals, flavors, fragrances;
• vaginal douching using antiseptics;
• immune system disorders;
• diabetes mellitus and other pathologies of the endocrine system;
• stress, emotional tension;
• hormonal disorders;
• frequent use of barrier contraceptives. Lubrication of condoms can cause the reproduction of fungi and gardnerella in the microflora of the vagina;
• the presence of chronic diseases that reduce the body's defenses.

These causes cause a violation of the composition of the microflora and the appearance of characteristic symptoms.

Symptoms of the disease

Gardnerellosis in women is expressed in non-specific symptoms that are similar to the manifestation of most sexually transmitted diseases. Signs of dysbiosis include:

• burning sensation and itching in the vaginal area;
• an unpleasant smell, reminiscent of the smell of rotten fish, which cannot be eliminated even if hygiene standards are observed;
• pain when emptying the bladder and during sexual intercourse;
• pain in the lower abdomen;
• vaginal discharge. They are not plentiful, have a homogeneous creamy consistency. The color of the discharge may be gray, yellowish or greenish.

The symptomatology of the disease is aggravated after sexual intercourse: when seminal fluid enters the vagina, bacteria receive additional conditions for development in its alkaline environment.

Diagnostics

Vaginal dysbacteriosis is diagnosed using the following methods:

• smear from the vagina;
• study of the pH level of the vagina;
• isonitrile test.

Also, if gardnerellosis is suspected, an external examination of the genital organs plays an important role in terms of diagnosis.

Incubation period

The incubation period of the disease lasts about 10 days. Approximately 1.5 weeks after the onset of the pathological process, the first signs of vaginal dysbacteriosis appear in a woman.

Treatment approaches

The goal of therapy for gardnerellosis is to suppress the pathogens of the pathological process, normalize the composition of the microflora and increase local immunity.

With gardnerellosis, antibiotics must be prescribed. These include:

1. Metronidazole. This drug is recommended to be taken twice a day, the daily dose is 1 g (one tablet contains 0.25 of the active substance);
2. Trichopolum. The dosage is determined by the doctor, the tablets are taken twice a day. The course of treatment does not exceed a week;
3. Azithromycin. The drug is taken within 5 days. Use this drug very carefully, following the instructions of the doctor;
4. Unidox Solutab. You can continue treatment of gardnerellosis with this drug for 7-14 days. You need to take the tablets once a day. The daily dose will be 100 mg in case of an acute course of the disease. With a complicated course of the pathological process, the specialist increases the dosage.

In addition to antibiotic therapy, gardnerellosis requires measures to restore the normal composition of the vaginal microflora. For this, the following drugs are prescribed:

• Bifidumbacterin in the form or solution for injection into the vagina;
• Vagilak - capsules for vaginal administration;
• Terzhinan in the form of vaginal suppositories;
• Acylac suppositories.

Sexual partners should also be treated: although men do not show symptoms of gardnerellosis in most cases, they still act as carriers of this bacterium and therefore re-infect a woman.

Preventive measures do not completely protect against the development of gardnerellosis, but significantly reduce the risk of developing a pathological process. They should include the following:

• the use of barrier contraceptives during sexual intercourse with unverified partners;
• avoidance of casual sexual relations;
• compliance with personal hygiene standards;
• wearing underwear made from natural materials, which should not be tight;
• timely treatment of diseases of any organs and systems of the body;
• maintaining a healthy lifestyle.

Gardnerellosis not only worsens the quality of life of a woman, but also reduces local immunity, contributing to the development of serious inflammatory processes in the organs of the genitourinary system. That is why the disease cannot be started.

The danger of gardnerellosis in pregnant women

In pregnant women, gardnerellosis can be caused by hormonal changes occurring in the body.

Gardnerella cannot overcome the placental barrier, but in the case of a running process, the risk of developing inflammatory processes in the vagina increases. This can provoke uterine bleeding, early discharge of amniotic fluid, diseases of the genitourinary system. This often causes infection of the fetus, and in the most difficult cases - miscarriage.

Treatment at home

Gardnerellosis can be treated at home only after consulting a doctor.
In this case, you can use various candles, as well as douching procedures.

To suppress the number of pathogenic microorganisms in the vagina, vaginal suppositories such as Terzhinan And Metronidazole. Candles are recommended to be administered before going to bed so that, having melted, they remain in the vagina and have the desired effect.

Douching can be done in the following ways:

1. using hydrogen peroxide. You need to take 100 ml of hydrogen peroxide (3%) with 300 ml of warm water. Pour the resulting solution into a syringe, insert the tip into the vagina, pour in the liquid in a jet. Continue manipulation for 10-15 minutes. You need to spend it in the bathroom or in bed, with legs apart;
2. using herbal and vegetable infusions. For cooking in equal parts take chamomile, violet, oak bark, wormwood. A tablespoon of the resulting mixture is poured with a liter of water, insisted for 12 hours. After that, the composition is filtered, douching is carried out in the morning and evening.

Is gardnerellosis transmitted to a man

Gardnerella can be passed from woman to man, but does not harm his body. They have this bacterium for a short time: from several days to several weeks. However, at this point in the asymptomatic course, the man is the carrier of the infection and can pass it on to the woman.

Review

Alena, 30 years old

“For the treatment of gardnerella, I was prescribed the antibiotic Trichopol and Terzhinan suppositories. Symptoms disappeared in 1.5 weeks, but, unfortunately, dryness and burning in the vagina due to disturbed microflora had to be treated for another month.

Gardnerellosis, or bacterial vaginosis, is a disease of the genital tract, which is characterized by a violation of the normal composition of the microflora. As a result, this leads to the predominance of anaerobic microorganisms (they do not use oxygen in the process of life), which is not observed normally.

Most often, gardnerellosis occurs in women, but it can also occur in men. Its frequency in women reaches 20-30%, and according to some sources it reaches 80%.

What it is?

Gardnerellosis is an inflammatory disease of the urogenital area, caused by an imbalance in the microflora of the vagina.

The causative agent of infection is the anaerobic bacterium Gardnerella vaginalis. The microflora of the vagina is mainly represented by lactobacilli, which produce lactic acid, which prevents the reproduction of opportunistic microflora. However, even in a healthy woman, other microorganisms are also present in the vagina - gardnerella, mycoplasma, Klebsiella and others.

Reasons for development

The main cause of the imbalance is the vaginal gardnerella, hence the name of this condition - gardnerellosis. The negative role of gardnerella lies in the fact that it forms a favorable background for the development of a large number of other bacteria - yeast-like fungi, mycoplasmas, Trichomonas, coccal species. At the same time, the vaginal mucosa suffers, many infections enter the woman's body, and inflammatory diseases of the genitourinary system develop.

There are many reasons that provoke the development of gardnerellosis in women:

1. Failure to comply with the rules of intimate hygiene.
2. Long term antibiotic treatment.
3. A sharp decrease in the immune system.
4. Untimely (not frequent enough) replacement of gaskets. This is especially true of the period of menstruation, when the microflora in the vagina is especially vulnerable and prone to the ingress of various pathogenic microorganisms.
5. Frequent changes of sexual partners (unprotected sexual contact, both in men and women).
6. Daily use of thin pads, which creates all the conditions for the spread of infection.
7. A sharp violation in the hormonal background (may occur during puberty or during pregnancy).

In addition, untreated dysbacteriosis, frequent observance of an unbalanced diet, various optional pathologies of the reproductive system, as well as long-term use of contraceptives can contribute to the emergence of Gardnerella vaginalis disease.

Symptoms

The reproduction of Gardnerella bacteria triggers an inflammatory process in the vagina and cervix. The main symptoms of gardnerellosis in women are expressed as follows:

• sticky, frothy discharge from the vagina of a white or yellowish-gray tint appears;
• discharge has a very unpleasant odor, comparable to the smell of rotten fish;
• pain in the lower abdomen intensifies, which indicates an increase in the inflammatory process;
• there is a feeling of irritation, itching and burning in the vagina, accompanied by frequent urge to urinate;
• during sexual intercourse, discomfort and pain intensify.

The appearance of a persistent unpleasant odor is due to the decay of waste products of gardnerella. This symptom gives a woman significant discomfort and often makes her intimate hygiene. But upon contact with the alkaline environment of soap, the situation only worsens and the period of “purity”, that is, the absence of smell, becomes shorter and shorter.

Sexual intercourse is accompanied by an exacerbation of painful symptoms and contributes to an increase in the volume of secretions, since the alkaline environment of sperm causes pathogenic microorganisms to multiply even more intensively. In the future, urination disorders appear, urine is excreted in small portions, and the process itself becomes difficult and painful.

In some cases, the symptoms of gardnerellosis may be mild and persist for many years. If left untreated, the likelihood of developing serious consequences associated with dysfunction of the genitourinary system increases.

Diagnostics

Basically, the diagnosis is based on the clinical manifestation of the disease and a number of some laboratory tests. The first step in the examination is taking a smear from the woman's vagina for microscopic examination, which is the most informative method. Under a microscope, the amount of Gardnerella vaginalis in the microflora is calculated. All other methods of laboratory research are uninformative and practically useless.

The next diagnostic method is to establish the pH value of the vagina, since with a large reproduction of gardnerella and other anaerobic bacteria, the pH increases, that is, the environment becomes alkaline. The final method of determination is a test for isonitrile, which reveals the presence of a large number of Gardnerella vaginalis.

Criteria giving the right to establish a clinical diagnosis:

• finding pathological cells (key) - anaerobic bacteria are attached to the squamous epithelium of cells;
• alkaline vaginal pH;
• homogenous discharge from the vagina with a rotten smell.

Only if all three criteria are found can a diagnosis be established, since the presence of only one of them is not an accurate indicator of the disease.

How to treat gardnerellosis in women?

Before treating gardnerellosis, it is necessary to eliminate the causes that contributed to its development:

1. Refusal to frequently change sexual partners or the use of barrier methods of protection (condoms);
2. Use rational antibiotic therapy for other inflammatory diseases, which excludes prolonged and uncontrolled use of antibiotics that suppress lactobacilli;
3. Restoration of normal microflora in the intestine - oral probiotics are used (preparations containing live bacteria of normal intestinal microflora) - Bifidumbacterin, Linex;
4. Normalization of the hormonal background of the body - hormonal two- or three-phase contraceptives are used, only after consulting a gynecologist;
5. Increased activity of the immune system - synthetic (biomax, vitrum) or plant (echinacea, eleutherococcus, ginseng) immunomodulators are used;
6. Avoid frequent douching of the vagina with antiseptic solutions and the use of antibacterial vaginal suppositories.

The main and mandatory method of treatment of bacterial vaginosis is the appointment of antibiotics.

Treatment regimen for gardnerellosis in women:

1. Systemic antibiotics (clindamycin twice a day, 300 mg; metronidazole also twice a day, 500 mg). Take pills for a week. At the same time, local forms of these drugs are used.
2. After antibiotic therapy, it is necessary to restore the vaginal microflora. For this, probiotics are taken orally and in the form of suppositories. For internal use, Laktonorm, Lactobacterin are recommended. They must be consumed for 30 or more days. Three weeks apply candles Laktonorm or Atsilakt.

Treatment with drugs of the penicillin group (Ampicillin) is possible. Gardnerella is resistant to tetracyclines (Doxycycline, Tetracycline), cephalosporins (Claforan, Ceftriaxone), sulfonamides (Septrin, Biseptol), aminoglycosides (Neomycin, Kanamycin).

1. When diagnosing a disease, her sexual partner is also treated at the same time. Often, bacterial vaginosis, combined with candidiasis, requires simultaneous antifungal therapy. In this case, suppositories for gardnerellosis are prescribed, which have a combined antifungal / antibacterial composition (Clomezol, Gynotran), vaginal tablets (Terzhinan, Mikozhinaks) are also effective.
2. Treatment of gardnerellosis in women at home on a course of antibiotics and a "clean" re-analysis does not end. To exclude the subsequent reproduction of bacteria, it is necessary to restore the vaginal microflora and thereby strengthen the local immune defense.

For this, medications such as Vagilak (vaginal capsules) and Epigen-intim (gel) are used. The average duration of application is 2 weeks.

Treatment of gardnerellosis during pregnancy

Treatment of gardnerellosis during gestation has its own nuances. Everyone knows that during pregnancy, taking almost all medications is contraindicated.

• It is impossible to completely destroy the gardnerella during the bearing of a child, since this requires the use of antibiotics, which are prohibited for the expectant mother. Treatment consists in the use of local antibacterial drugs that help reduce the manifestations of the disease and reduce the pathological activity of gardnerella. A woman can undergo full treatment after childbirth.
• The main task of the gynecologist during pregnancy is to monitor the number of gardnerella in order to prevent the development of concomitant diseases of the genitourinary system. In order to control the condition of the vaginal mucosa with gardnerellosis, a woman should be examined once a month on a gynecological chair. During this examination, the doctor takes smears for microscopic examination. If symptoms of a concomitant infection are detected, local procedures are urgently prescribed (douching, irrigation of the genitals, sitz baths, etc.). With inflammation of the pelvic organs, vaginal suppositories cannot be used.

As well as in the treatment of the disease for non-pregnant women, the therapy of gardnerellosis of pregnant women is carried out in two stages: a decrease in the amount of pathogenic microflora and the normalization of lacto and bifidobacteria in the vagina. A positive effect of treatment is observed only if the woman consulted a gynecologist in a timely manner and the disease did not become chronic.

Prevention

Preventive measures against gardnerellosis include:

• the presence of one sexual partner, the fight against sexual promiscuity;
• refusal to use intrauterine devices;
• prevention of inflammatory processes in the genital tract;
• the use of antibiotics according to strict indications, followed by correction of dysbacteriosis;
• exclusion of too early onset of sexual activity.

Thus, gardnerellosis, for all its seeming frivolity, is a very serious pathological process that must be treated in a timely manner. The drugs prescribed for this, allow you to normalize the qualitative and quantitative composition of the microflora of the genital tract.

Bacterial vaginosis or gardnerellosis in women is quite common. This is an infection that in women is caused by a special bacterium - gardnerella vaginalis. A small amount of these microorganisms is completely harmless to the body, but as soon as their number begins to increase due to a decrease in lactobacilli, the first signs of the development of gardnerellosis appear. You should not be ashamed of this female disease, because it does not belong to a sexually transmitted disease, does not depend on the observance of intimate hygiene standards, and can develop at any time in women of different ages. Even small girls who do not have a single sexual contact are capable of having a rather adult female disease - gardnerellosis.

It is impossible to find a female person who would have an absolutely sterile vagina. Only newborn girls do not have any microorganisms in their genitals at all, but already about a week after birth, the composition of their microflora begins to change. Before puberty, for about everyone, it normally has an acidity of pH 5.0.

Everything is different in the body of adult females. They constantly have various organisms in their vagina, so the acidity of the environment decreases (pH 4.0-4.5). Some of the bacteria are completely harmless and must be present in the microflora (lactobacilli), others, like gardnerella vaginalization in women in the photo, under favorable conditions become a real threat and lead to changes in the microflora.

Every healthy woman has a certain amount of lactobacilli in her vagina. These are her protective bodies. They regulate the level of acidity, determine the composition of microflora, fight microorganisms that can harm health. When once lactobacilli lose their activity, this is immediately noticed by harmful microorganisms that were previously oppressed. This is where the time comes to come to the fore gardnerelle. Its norm in a healthy woman is about 103 -105 CFU / ml, as soon as this figure increases, there is a threat of developing gardnerellosis in the woman shown in the photo. They can develop very quickly, but they do not show any resistance. In this case, the female disease manifests itself, then subsides a little. This condition is called chronic gardnerellosis in women. During chronic gardnerellez bacteria go deep into the genitourinary system and move into the urethra or cervix. It can last for several years, until one day, during a random examination, the doctor diagnoses the disease.

Causes of gardnerella in women

An excessive increase in the number of vaginalis bacteria in women is the cause of gardnerellosis. Its quantity increases significantly due to a sharp decrease in the number of lactobacilli. This disproportionate ratio in the vagina between the two groups of bacteria can occur as a result of antibiotic treatment, menopause or diabetes. It leads to dysbiosis. This is nothing but gardnerellosis. The number of lactobacilli can decrease when using intimate hygiene products that cause dry skin. Excessive care of the female genital organs also does not bring anything good, but can cause a large number of gardnerella vaginalis in women.

Sexual contact without a condom with a man who had previously had an affair with an infected partner and was infected also causes gardnerellosis in a perfectly healthy woman.

Among other reasons involved in the appearance of a gardnerella infection in women, one can distinguish:

Symptoms and signs of gardnerellosis in women in life and in the photo

Not all even adult ladies know how gardnerella manifests itself in women, and therefore they do not even find obvious signs in themselves in time. When visiting a gynecologist, patients sometimes complain of an unpleasant smell from the vagina, which is somewhat reminiscent of the stench emanating from rotten fish. At this time, they do not even realize that these are the first signs of gardnerella in women, and such a bad smell appeared as a result of the active breakdown of amines under the influence of anaerobic bacteria on them.

In addition to an unpleasant odor, other symptoms of gardnerellosis in women are also known. Quite often, a sign of the disease is previously uncharacteristic discharge. Not all of them are the same color. It happens that the discharge is grayish-green or yellowish. Very rarely, the discharge can be white, then they are called white, or transparent. Their consistency is like a cream. They stick to the walls of the vagina and hold tightly to them. The number of bacteria in vaginosis is rapidly increasing, so the discharge becomes more and more abundant. Doctors consider such vaginal discharge to be pathological, so they will have to be dealt with immediately, reducing the amount of gardnerella in the body.

Often, vaginosis occurs against the background of inflammation of the genitourinary system. Then, to the mentioned signs of a female disease, other symptoms of gardnerella in women are added. The inflammatory process is accompanied by a strong burning sensation or itching, which becomes especially noticeable during intercourse or immediately after it.

Causeless violations of the menstruation cycle, the appearance of mucous impurities in the bloody discharge, resembling flakes of pus or pieces of cottage cheese, can also become a sign of gardnerella vaginalis.

Approximately 25 - 30% of women who had gardnerellosis had absolutely no symptoms in the photo. This is a common occurrence in the disease, but it cannot be said that the absence of symptoms is a safer course of the disease. On the contrary, when a woman notices symptoms of gardnerellosis or at least feels discomfort in the genital area, she goes to the clinic and tries to start treatment as soon as possible. If the disease is asymptomatic, this often happens, you can expect various complications, which will be much more difficult to cope with than with a disease detected in the early period of development.

According to the symptoms, gardnerellosis resembles other sexual infections, therefore, it is possible to correctly establish the diagnosis only after taking a smear.

Treatment of gardnerellosis in women with drugs

Before starting the treatment of gardnerellosis in women, each doctor suggests that his patient undergo a diagnosis in order to exclude the presence of other microorganisms that may also be involved in the disease. The most common and accessible is the study of vaginal discharge, if any, or a smear for cultural inoculation from the mucous membranes of the vagina, the results of which determine the amount of gardnerella and lactobacilli in the microflora. Based on this ratio, the doctor decides how to cure gardnerellosis in a woman using topical preparations and auxiliary procedures such as baths, douching and others.

The treatment regimen for gardnerella in a woman is built taking into account the form of the course of the disease, the reaction of her body to drugs, the patient's condition, and even the cause of the disease. The most effective drug in the treatment of gardnerella vaginalis in a woman is metronidazole. Let not scare patients who have already treated trichomoniasis with this medicine, such a doctor's decision in choosing pills, because this drug is ideal for combating many sexual infections. And when the question is how to effectively treat gardnerella in women, feel free to use the drugs according to the scheme indicated by the doctor.

Beware of the side effects of metronidazole, patients learn how to cure gardnerella in women with other drugs. You can use klion or efloran, but metronidazole is also an active substance in their composition. Alternatively, choose drugs with clindamycin: clindamycin, dalacin.

When deciding how to treat gardnerellosis in women, doctors prescribe suppositories for the treatment. Suppositories with metronidazole are considered very effective. They create a high concentration of a drug that fights the virus in the vagina, and thus contribute to a quick recovery by reducing the amount of the virus. In addition to the treatment of gardnerella in women, suppositories are also effective for candidiasis, which is often found in pairs.

When choosing how to treat gardnerella in women, many opt for creams. These are also quite effective means that are inserted into the vagina twice a day. Your doctor may recommend creams or gels that contain metronidazole. It is flagyl or metrogil. The course of such therapy usually lasts from 5 days and can reach 10 days if a woman has chronic gardnerellosis.

As an alternative group of creams are preparations with clindamycin. Just once a day for a week, it is enough to inject dalacin into the vagina to reduce the concentration of the virus.

Although the amount of gardnerella vaginalis in a woman's body has decreased due to antibiotic treatment or the use of suppositories, it is too early to talk about complete recovery until the required amount of lactobacilli in the microflora is restored. For this, the doctor prescribes drugs that contain lactobacilli.

Treatment of gardnerella in women with traditional medicine

Since it does not apply to sexually transmitted infections, herbal preparations are quite effective in treatment. For baths, both tinctures bought at a pharmacy and herbal decoctions prepared at home are suitable. Effective in this fight are calendula and chamomile, thyme and oak bark, wormwood and yarrow, celandine and eucalyptus, birch leaves and mint. These same herbs can also be taken as a tea to strengthen the immune system.

At home, you can make tampons soaked in carrot juice and apple cider vinegar. For 1 tampon, a tablespoon of carrot juice and half the same spoon of vinegar are taken. The tampon is inserted into the vagina for 20 minutes after taking hygiene procedures and douching.

Doctors recommend taking baths with salt and potassium permanganate during an illness in the presence of abundant discharge. This solution kills bacteria and helps to significantly reduce their number. If it is impossible to do such baths daily, you can use the same solution for tampons that are inserted into the vagina in the morning and evening. Medical workers are very wary of douching and do not often recommend using them in the treatment of gardnerellosis in women, because such a procedure helps to wash out the beneficial microflora from the vagina, which is already insufficient there.

To prevent bacterial vaginosis, traditional medicine recommends drinking tea made from sage more often.

Some consider gardnerellosis a non-serious female disease and wait until it goes away on its own without the use of drugs for treatment. The imbalance can recover on its own over time if the causes that caused it disappear (for example, the use of IUDs or condoms with lubricants is stopped), but such an independent restoration of the microflora can take a very long time. Think about whether you want to endure such fetid odors, reminiscent of illness, and communicate with your spouse, having unpleasant discharge?

What's happening? Such a question is asked by a woman at the sight of an abundant, unpleasant odor,. Tests for all kinds of sexual infections are negative. The reasons for this condition can be very different. One of them is gardnerellosis.

Whether Gardnerella vaginalis is the causative agent of infection or not is an open question, since this rod-shaped bacterium is part of the vaginal microflora in small quantities. In a healthy body, it behaves quietly, does not betray its presence in any way and does not actively reproduce.

In the female body (as well as in the male body), about 10 thousand species of microorganisms constantly live. Their total weight is about a kilogram. If we take into account the size of bacteria (10 bacterial cells live in each human cell), then we can imagine the scale of this neighborhood. Many bacteria do not cause any harm to humans. Moreover, people simply cannot live without them. Each variety of our satellites occupies its own niche and quantitatively does not leave it.

Problems arise when the biological program fails. For some reason (internal or external), the number of some bacteria decreases, while others immediately seek to occupy the vacated space. This also happens in the case of bacterial vaginosis (gardnerellosis): due to a decrease in the number of beneficial lactobacilli in the vagina, opportunistic microorganisms actively multiply. Among them is gardnerella vaginalis.

Causes of vaginal dysbacteriosis and gardnerellosis

Normally, the vagina is dominated by bacteria that constantly secrete lactic acid. Milk in Latin lactis, therefore, microorganisms are called lactobacilli (another name is Doderlein sticks). An acidic environment does not contribute to the reproduction of pathogenic bacteria, including gardnerella.

Gardnerella, appearing in a healthy body (for example, as a result of unprotected sexual contact), is destroyed by the human immune system. Sometimes a safe amount of bacteria remains in the vagina.

In the case of a weakening of the body's defenses, a decrease in the number of lactobacilli and an active reproduction of opportunistic gardnerella occur. Dysbacteriosis of the vagina develops. Often this leads to an inflammatory process in the vagina - nonspecific vaginitis and other ailments.

With dysbacteriosis, gardnerella (or other pathogenic bacteria) stick around the epithelial cells of the vagina, forming the so-called. "key cells"

There are many reasons for the development of an imbalance in the vaginal microflora. The root cause is immune suppression. Both external and internal factors lead to this state.

The internal causes leading to vaginal dysbacteriosis and, as a result, to gardnerellosis include:

• Changes in the hormonal status of a woman (including during pregnancy);
• stressful state;
• physical exhaustion;
• Diseases of a chronic nature.

External causes of gardnerellosis include:

1. The use of antibiotics, hormonal agents;
2. Bad ecology;
3. Venereal diseases;
4. Change of sexual partners;
5. Operations, including abortions;
6. Violation of the menstrual cycle;
7. Allergy;
8. The use of intrauterine contraception;
9. The effect of toxicants on the body;
10. Use of contraceptive suppositories with 9-nonoxynol;
11. Unreasonably frequent douching, as a result of which the protective microflora of the vagina is washed out;
12. The use of tampons, pads, various cosmetic liquids for intimate hygiene;
13. Tight synthetic underwear.

Signs and manifestations of the disease

Very often infectious diseases of the genitourinary system occur without any symptoms. Even specific vaginal discharge is not observed. The woman is not bothered by abdominal pain, bleeding, irregular menstruation. However, the consequences of the excess content of gardnerella will not keep you waiting. To prevent complications, it is necessary to undergo an examination by a gynecologist at least twice a year.

Untreated gardnerellosis leads to nonspecific vaginitis- inflammatory disease of the vagina. Its signs:

• Bad smell;
• Allocations;
• Burning;
• Pain sensations.

Any alkali aggravates the symptoms, especially the smell. An alkaline reaction has an ordinary soap, sperm.

With nonspecific vaginitis, it is necessary to take tests for microflora to accurately identify the causative agent of infection and undergo a course of adequate therapy. In addition to gardnerella, this disease can cause:

1. Staphylococci;
2. Streptococci;
3. Protea;
4. coli;
5. candida;
6. Enterococci and others.

A pathogen in vaginitis along with bacteria can be a fungus. Therefore, gardnerellosis should first of all be differentiated from the equally common

Possible consequences of gardnerellosis

Gardnerella are conditionally pathogenic bacteria. “Possibly pathogenic” means not very dangerous. However, a bacterium, having taken a foreign niche, attracts its own kind there. For example, her "faithful companion" is often mobiluncus, which enhances the negative effect of gardnerella on the vaginal biocenosis. Thus, one should not treat them with complete indifference, since they do not always forgive this. Untreated gardnerellosis can become the basis for the development of other, more serious diseases:

• Women sometimes develop vaginitis progressing to(inflammation of the vagina).
• It is assumed that against the background of chronic gardnerellosis occurs intestinal dysbacteriosis which leads to problems with the gastrointestinal tract.
• Inflammation from the vagina can spread to the appendages and cervix. It is possible that the occurrence endometriosis.

Close attention should be paid to bacterial vaginosis during pregnancy. In this case, early diagnosis is especially important in order to prevent complications.

How to recognize bacterial vaginosis?

Diagnosing an infection is not difficult. Let us make a reservation right away that such common methods as PCR, seeding, PIF, in the diagnosis of gardnerellosis are secondary. With their help, only the presence of the pathogen is detected. However, this is not particularly necessary, because gardnerella can also be present in the vagina of healthy women. The most informative technique -. This analysis allows not only to see the microbe itself, but also to estimate its abundance.

“Key” cells, the pH of the vaginal contents, and the presence of isonitrile are also determined. By the way, it is this substance - isonitrile - that gives the vaginal discharge the smell of rotting fish. Sometimes a blood test for leukocytes is prescribed (with gardnerellosis, they become smaller). But this is an additional analysis.

When gardnerella is identified, the gynecologist may be interested in the number of her and the remaining lactobacilli. These tests are needed to establish a complete picture of the microflora of the vagina.

Be sure to conduct a survey on the inflammatory processes of the genital area.

Treatment of the disease

How to cure bacterial vaginosis? First of all it is necessary to get rid of the reasons, as a result of which there was a surge in the number of microorganism. Necessary:

1. Refuse uncontrolled intake of antibiotics;
2. Do not frequently change sexual partners or use condoms. However, it should be remembered that condoms with spermicidal lubricant containing 9-nonoxylol are contraindicated in case of bacterial vaginosis;
3. Use hormonal drugs only after consulting a gynecologist;
4. Raise the number of lactobacilli with the help of Linex, Bifidumbacterin;
5. Do not interfere with the body's self-healing by minimizing douching.
6. Avoid antibacterial suppositories.
7. Use vegetable (Eleutherococcus, ginseng) or synthetic (Vitrum, Biomax) immunomodulators.

Not every antibacterial agent is suitable for fighting gardnerella. In addition, if antibiotics are prescribed, then local drugs are preferred, and only in the case of a severe course of nonspecific vaginitis, general antibacterial drugs are prescribed. The treatment regimen consists of two parts:

• Systemic antibiotics (clindamycin twice a day, 300 mg; metronidazole also twice a day, 500 mg). Take pills for a week. At the same time, local forms of these drugs are used.
• After antibiotic therapy, it is necessary to restore the vaginal microflora. For this, probiotics are taken orally and in the form of suppositories. For internal use, Laktonorm, Lactobacterin are recommended. They must be consumed for 30 or more days. Three weeks apply candles Laktonorm or Atsilakt.

Not superfluous, as with any dysbacteriosis, will be the observance of proper dietary nutrition. Spicy, fried, fatty foods and alcohol should be replaced with fermented milk products.

A smear (control study) is performed after 1.5–2 months. During the treatment period during sexual intimacy, condoms must be used.

Gardnerellosis and pregnancy

Immediately reassure expectant mothers - gardnerellosis is not transmitted to the child. The bacteria are unable to cross the placenta and infect the fetus. And in the process of childbirth, this will not happen due to the low pathogenicity of gardnerella.

Gardnerellosis is dangerous for the mother herself. Under the influence of bacteria, chronic ailments are exacerbated or new ones appear in the form of inflammatory processes of the pelvic organs, which, in turn, can lead to premature birth or fetal malnutrition. because of which there is a threat of miscarriage. For this reason, gynecologists suggest that a pregnant woman take a smear from the vagina and fight vaginal dysbacteriosis.

The pregnant woman does not experience any special symptoms of gardnerellosis: all the same pains, rotten smell, itching. Often, these signs may not be. Especially if the bacteria are in the vagina in an uncritical amount. Most importantly, they do not suppress beneficial lactobacilli. But if, nevertheless, there are any signs of infection, a woman should contact a medical institution for help.

Treatment of infection in pregnant women

Treatment of gardnerellosis during pregnancy has its own characteristics. Firstly, only local remedies are used. These are gels and ointments with clindamycin. Secondly, even ointments cannot be used in the first three months. In extreme cases, Betadiene and Hexicon candles are used. The problem is that such antiseptics affect not only unwanted microorganisms, but also beneficial ones.

Important! During pregnancy, any medications can be used only after agreement with the gynecologist.

How to be treated with traditional medicine?

What is good about traditional medicine is its relative safety. Women who fundamentally do not want to use chemicals can try to get rid of the germ with the help of folk remedies.

This disease is new. Rather, they began to recognize it not so long ago. Therefore, folk recipes fight only with unpleasant secretions and restore the vaginal microflora.

Despite the seeming harmlessness of folk methods, pregnant women should in no case use them without consulting a gynecologist!

Folk recipes for douching

The use of tampons with folk remedies

You can make a tampon yourself from folded gauze, or you can purchase it at a pharmacy. Soak the swab with sea buckthorn oil or a mixture of aloe juice and olive oil (1:1). The procedure is done in the evening, leaving the tampon overnight.

For more effective treatment, you can independently prepare an immunomodulatory tincture:

• Place a tablespoon (tablespoon) of dry mountain ash in boiling water (200 ml) and boil for 15 minutes. Then add a spoonful of honey and grated onion to the broth. Use 4 times a day for 1 tablespoon.

And the main folk treatment is proper nutrition: fresh vegetables, unsweetened bakery and sour-milk products, cereals.

Gardnerellosis in men - myth or reality?

In women, a certain amount of gardnerella may be present in the vagina - and this is the norm. These microorganisms are not part of the male microflora. A man can "get" them after sexual contact with a woman.

Symptoms of infection in men

Men do not have gardnerellosis as such. Bacteria do not take root on the male genital organs, but manage to “give” a man a wide variety of diseases: urethritis (inflammation of the urethra), (inflammation of the head and foreskin of the penis), cystitis (inflammation of the bladder). Usually the first signs appear 2 weeks after intimacy with a woman. Manifested in the form, difficulty urinating, burning.

Very rarely occur and. They manifest as pain in the scrotum or lower abdomen.

Treatment

Since the male body itself copes well with gardnerella, treatment is mainly aimed at suppressing the inflammatory processes caused by these microbes. It is recommended for this period to give up smoked meats and spicy snacks, alcohol, and also to use protective equipment during sexual intercourse. The diet should include vegetables, cereals and dairy products. To maintain immunity, it is useful to take immunomodulating agents.

Prevention of gardnerellosis

No matter how banal the expression may seem, it is still much easier, cheaper, safer to prevent any ailment than to treat. This also applies to gardnerellosis. Measures that will help prevent this disease will also protect against many other ailments. At the core is a healthy lifestyle. As well as:

1. Refusal of intrauterine contraceptives;
2. Prevention and timely treatment of inflammatory diseases of the genital area;
3. Fight against sexual promiscuity;
4. Refusal of uncontrolled use of antibiotics;
5. Exclusion of the early onset of sexual activity.

These measures will help maintain the balance of the vaginal microflora at the required level to ensure women's health.

Video: specialist on gardnerellosis in women and men