Vaginal dysbacteriosis


General description of the disease

Vaginal dysbacteriosis is a disease with several names: vaginal dysbiosis and bacterial vaginosis. Pathology is characterized by vaginal microflora balance disruption which occurs because of different disorders and conditions. Due to a certain reason, lactic acid bacteria on the mucous membrane are destroyed and their amount decreases. Destroyed healthy flora is replaced by a conditionally pathogenic one.

Vaginal dysbacteriosis is not sexually transmitted and it is not an infectious disease. Recently, this disease has become very widespread in the world affecting, predominantly, women over 35 years old.

Causes of vaginal dysbacteriosis

  • Decreased immunity (excessive heat loss, past infections, HIV and other immunodepressive diseases);
  • Sudden climate change (in travelings or spontaneous moving homes);
  • Sexually transmitted diseases;
  • Various infectious diseases of the urogenital system;
  • Hormonal imbalance both pathological and physiological (menopause, pregnancy and delivery, puberty);
  • Antibiotic therapy;
  • Pathologies accompanied by intestinal microflora imbalance;
  • Too frequent douching;
  • Promiscuous sexual activity;
  • Neglecting the rules of personal hygiene, including a wrong use of tampons during menstruations (not changing a tampon frequently enough).

Under the influence of these factors, the symptoms of vaginal dysbacteriosis do not necessarily occur. The disease develops only when aggressive factors are significant enough to change the vaginal microflora. Immunity helps to resist this pathology.

Pathogenic mechanism

Normally, female vaginal mucous membrane is colonized by microorganisms. Its composition and ratio is stable and may change only in different life periods of a woman.

Normal microflora composition:

  • Lactic bacteria (around 90%);
  • Bifidobacteria (less 10%);
  • Conditionally pathogenic flora (candida, ureaplasma, colon bacillus, Klebsiella etc.).

Minor changes in the bacterial ratio do not cause the symptoms of vaginal dysbacteriosis as compensatory mechanism of the organism is activated. However, when the situation is aggravated, the amount of the first two types of bacteria (lactic and Bifidus) decreases but conditionally pathogenic flora is increased or pathogenic strains are  propagated.

If vaginal dysbacteriosis is left untreated, it can lead to the development of vaginitis and other serious conditions. There is a great risk of infection by conditionally pathogenic bacteria and high probability of sexually transmitted infections development.

Symptoms of vaginal dysbacteriosis

A clinical presentation of this disease is non-specific. Most of the symptoms indicate complications of vaginal dysbiosis. Often women do not have any symptoms.


Symptoms of vaginal dysbacteriosis:

  1. White with yellow foul-smelling vaginal discharge (normally, female discharge is colorless and without any smell);
  2. Discomfort during sex or after it;
  3. Vaginal dryness.

Subjective sensations such as pain and itching in uncomplicated dysbiosis are absent.

Complications of vaginal dysbacteriosis

If vaginal dysbacteriosis is left untreated, it leads to the inflammation of the mucous membrane or to vaginitis. Its further extension to the cervix causes cervicitis. Then infection penetrates the uterine causing endometritis and metritis and, finally, it covers appendages and adnexitis develops (inflammation).

General symptoms of inflammation in the female reproductive system are the following:

  • itching;
  • pain in affected organs;
  • burning;
  • more copious discharge of an unusual character;
  • discomfort during sex and after it.

In neglected cases infection spreads to the female urinary tract and reaches the bladder causing the development of urethritis and cystitis.

Diagnosis of vaginal dysbacteriosis

Diagnostic criteria for vaginal dysbiosis:

  • Clinical presentation (discharge);
  • Reduction in vaginal acidity. This is a very simple test but it is not precise and non-specific. The test is performed with pH-indicator papers.
  • Vaginal smear. Material for the test is collected in the vaginal mucous membrane and studied under the microscope. Dysbacteriosis is confirmed in case of decreased number of lactic and bifidobacteria and significant increase of other strains.
  • Inoculation of medium. To confirm the results of the tests, a culture-based analysis is performed which clearly shows all the types of bacteria in the vagina and their ratio.

In case the number of pathogenic and conditionally pathogenic organisms is significantly increased, antibiotic susceptibility test is performed to choose the most effective medications to treat vaginal dysbacteriosis when it is complicated by the infection.





How to treat vaginal dysbacteriosis?

Vaginal dysbiosis therapy is complex and aimed at the reason of the disease, its mechanism and at relieving the symptoms.

  1. To inhibit the growth of pathogenic microorganisms, antibiotics are used for topical administration in the form of suppositories to treat vaginal dysbacteriosis. Also anti-inflammatory and antiseptic medications are indicated.
  2. Immunomodulators are used for boosting immunity.
  3. Therapy should be oriented at curing major disease (intestinal dysbiosis, urogenital system infections, hormonal imbalance).
  4. To populate the mucous membrane with useful microorganisms, suppositories to treat vaginal dysbacteriosis are used. They contain lactic acid and bifidobacteria. Additionally, physiotherapy and biologically active supplements are recommended.

Even when the bacterial ratio in the vagina is restored, it is necessary to use medications to treat vaginal dysbacteriosis containing useful bacterial strains for some time.

Characteristics of vaginal dysbacteriosis

  • Vaginal dysbacteriosis in pregnancy.

 

Clinical presentation of the disease in pregnant women is more evident and intensive. Women have copious discharge and they are more susceptible to complications. It is explained by hormonal imbalance during pregnancy and all the processes in the body (including immune system) work to their limits.

Vaginal dysbacteriosis therapeutic scheme for these women will be different as it is not reasonable to indicate antibiotics and immunomodulators. Frequently, women try to hold the disease in the limits to prevent complications and start treatment after delivery.

  • Antibiotic-induced vaginal dysbacteriosis.

 

The use of antibacterial medications always poses a risk of destroying body’s microflora. The most common consequence of antibiotic use is intestinal dysbiosis which is a precursor to vaginal dysbacteriosis.

In this case, in a woman’s body an excessive amount of colon bacillus and enterococcus is observed.  The symptoms of vaginal dysbiosis will be combined with the signs of  intestinal dysbiosis.

As it is difficult to treat vaginal dysbacterioisis in this situation, the therapy is combined with simultaneous intestinal flora restoration. Otherwise, there is a great risk of a relapse.

  • Vaginal dysbacteriosis caused by sexually transmitted diseases.

Any sexually transmitted disease is always accompanied by vaginal microflora disruption. Besides, if the disease is left untreated, it will lead to aggravation of vaginal dysbacteriosis. Thus therapy for sexually transmitted diseases should always be combined with the use of medications to treat vaginal dysbacteriosis. Otherwise, female urogenital system will be at a risk of inflammation shortly after a woman cured a sexually transmitted disease. Depending on the severity of the sexually transmitted disease, the therapy is performed either alternatively or simultaneously.

Prevention of vaginal dysbacteriosis

  • Treatment of major disease which can cause dysbiosis;
  • Consultations at gynecologist once in three months after curing the disease;
  • Measures to boost immune system;
  • Observe proper personal hygiene;
  • Carefulness with the use of contraceptives;
  • Avoid too frequent douching.

As clinical presentation of vaginal dysbacteriosis is not specific and is rapidly aggravated by inflammations, if a woman notices unusual vaginal discharge she should immediately visit a gynecologist to detect the problem as early as possible and to start proper therapy.