Bacterial vaginosis is a clinical syndrome that does not apply to infections (referring to those that are transmitted only through sexual contact). The syndrome is characterized by optimal vaginal microflora, which consists of lactobacilli and is replaced by anaerobic bacteria.
The most common cause of unpleasant odors and vaginal discharge is bacterial vaginosis. It is advisable to begin treatment of this disease at the first manifestations. However, half of all women who have clinical criteria for bacagnosis do not show symptoms. The very reason for the changes in microflora is not fully understood. Although this disease is not associated with sexual activity, it is often associated with the presence of a large number of sexual partners and is quite rare in those women who do not live sexually. However, it is not regarded as a real, true STD.
The reasons for the change in the (environmental) vaginal microflora are not fully understood. It has been partially proven that bacterial vaginosis (treatment is simple) is not transmitted sexually, despite the fact that its frequency is often associated with the number of partners and sexual activity.
Risk factors
Hormonal disorders, the use of any antibiotic therapy, frequent inflammatory processes of organs in the pelvis, immunosuppressants, diabetes mellitus (uncompensated).
Symptoms
The main symptoms of bacquinosis are complaints of unpleasant profuse leucorrhoea with a bad smell. The onset of the disease is accompanied by liquid whites, white or with a grayish tint. If the disease lasts a long time, they acquire a yellowish-green color, become more dense, often resemble a granular curd mass, have not the most pleasant property of foaming, sticky, slightly viscous, distributed evenly on the walls of the vagina. Some women report unbearable discomfort, dyspareunia, a burning sensation and itching in the vulva. A feature of bacterial vaginosis is the absence of any signs of inflammation (hyperemia, edema) of the vaginal walls. Inside, everything (the mucous membrane) usually looks - it is pink. And the usual colposcopic picture can be characterized by the presence of only dystrophic changes.
Vaginosis. How to treat?
The standard procedure for the gynecological doctor with a diagnosis of “bacterial vaginosis” (treatment is prescribed after all points are completed):
- a message about the diagnosis of the patient;
- providing her with information about sexual behavior during treatment;
- collection (mandatory) of a sexual history;
- discussion with the patient of the need and possibility of testing for other STIs. Recommended vaccination (it is not required) against hepatitis B;
- identification of various predisposing factors and the possibility of eliminating them;
If there are no results from treatment, you should consider these possible causes:
- inadequate therapy, non-compliance with the treatment regimen;
- false positive results of the study;
- the presence of other supporting and predisposing factors.
A two-stage gradual treatment method is used, where the main principle is the creation of the most optimal conditions (physiological) of the vaginal environment and the complete restoration of microbiocenosis. The first stage involves local antibiotic therapy (clindamycin, chloramphenicol, metronidazole), laser therapy, any lactic acid is prescribed to lower the pH, according to indications, prostaglandin inhibitors, immunocorrections and antihistamines, estrogens. If there is pain, itching, burning, some local anesthetics are used. At the second stage, bacterial biological preparations are used: lactobacterin, bifidin, bifidumbacterin, acylact (topically) to completely restore the imperfect vaginal microflora.
The principal goal of such therapy is to significantly eliminate the vaginal signs and symptoms. Consequently, almost all women with symptoms need treatment. Bakvaginosis, the treatment of which during pregnancy is mistakenly considered undesirable, actually provoke a premature birth.
Bacterial vaginosis, treatment for non-pregnant women:
1) Metronidazole 500 mg taken orally 2 r / day - 7 days.
2) Clindamycin cream, 2%, 5g (1 full applicator) for the night intravaginally - 7 days.
3) Metronidazole gel, 0.75%, 5g (1 full applicator) intravaginally 1-2 r / day - 5 days.
With adequate therapy, bacterial vaginosis (treatment described above) has a favorable prognosis.