Vaginal dysbiosis (bacterial vaginosis), symptoms and treatment. Composition of vaginal microflora. Disturbance of vaginal microflora during pregnancy

Dysbacteriosis is any disorder of microflora in the body. The problem is diagnosed in adults, children and even newborns. If we talk about women, there is a special type of imbalance – vaginal. It is asymptomatic or accompanied by pronounced symptoms. Dysbacteriosis in women is a common problem (occurs in 90% of the fair sex).

Dysbiosis is an imbalance of harmful and beneficial bacteria

Composition of vaginal microflora

The microflora of the vaginal cavity is formed as follows:

• lactobacilli. They are called Dederlein sticks. The number of lactobacilli reaches 90%;
• bifidobacteria. They are part of the microflora of the female genital organs in an amount of 9-10%;
• key cells. Includes Candida, Leptothrix, Gardnerella, and others. Their number is insignificant (1%).

The ratio of microorganisms on the mucous membranes of a woman’s genital organs is stable. The immune system plays a key role in this process. It controls the number of pathogenic microorganisms. The body is able to independently normalize microflora without additional measures. In case of significant violations, local immunity cannot cope with the problem, which causes violations.

What causes imbalance?

Dysbacteriosis in women occurs due to certain reasons. This violation provokes any negative impact on the fragile organism of the fair sex.

Helicobacter pylori, a bacterium that influences the development of dysbiosis

Main causes of vaginal imbalance:

• poor nutrition. Eating foods containing easily digestible carbohydrates, fried, and fatty foods increases blood glucose levels. The resulting environment is favorable for the development of pathogenic microorganisms (especially for fungi of the genus Candida);
• intestinal dysbiosis. Disruption of the digestive system directly affects women's health. The walls of the vagina are in contact with the intestines. When disorders of the digestive system occur, pathogenic microflora penetrates the mucous membranes of the genital organs;
• failure to comply with generally accepted rules of personal hygiene. Diligent cleansing of intimate areas or lack of appropriate procedures leads to an imbalance of microorganisms on the mucous membranes;
• untimely change of pads and tampons during menstruation;
• wearing the wrong underwear. Passion for tight panties and thongs leads to changes in the microflora of intimate places. Wearing underwear made from synthetic fabrics also has a negative effect;
• long-term use of antibiotics. The use of antibacterial agents leads to the destruction of beneficial bacteria in the female body;
• hormonal imbalances. Affect changes in the condition of the mucous membranes, which entails dysbacteriosis;
• infections. This problem can be caused by sexually transmitted diseases and inflammatory processes of the pelvic organs.

In order to prevent dysbacteriosis, it is necessary to monitor the hygiene of your body

Nonspecific adverse factors

The causes of dysbacteriosis in women are:

• decreased immunity;
• hypothermia;
• chronic stress, nervous tension;
• excessive physical and mental stress;
• lack of sleep;
• travel (during sudden climate change);
• long-term use of oral contraceptives containing estrogen, progesterone;
• smoking;
• alcohol abuse.

Bad habits contribute to the development of dysbiosis

Main symptoms

In women, symptoms of vaginal dysbiosis manifest themselves as follows:

• change in the nature of discharge. They become abundant, acquire an uncharacteristic color (white, yellowish, greenish), smell (fishy, ​​putrid), consistency (excessively viscous);
• the appearance of itching, burning, discomfort in intimate places;
• discomfort during sexual intercourse and urination.

The nature of the changes and the number of unpleasant symptoms depend on the degree of disruption of the microflora of the mucous membranes. Emerging problems may indicate the development of completely different diseases. If characteristic signs of imbalance are identified, it is imperative to consult a doctor.

Dangers for pregnant women

Disorders of the mucous membranes of the genital organs are often found in pregnant women. This is due to hormonal changes. A pregnant woman is susceptible to a variety of negative influences caused by decreased immunity. If a change in the balance of microorganisms on the mucous membranes of the genital organs is not caused by infections, this condition is not dangerous. Pregnant women are not prescribed aggressive treatment that could negatively affect the development of the fetus. When unpleasant symptoms appear, local remedies are used to help eliminate pathogenic microorganisms.

During pregnancy, dysbiosis does not pose a danger to the child, but the need for treatment does not disappear

Treatment during pregnancy is aimed at preparing the body for the upcoming birth. During birth, the child receives microflora from the mother. Normally, Dederlein's bacilli colonize the baby's intestines. If pathogenic microorganisms are present on the walls of the vagina, they enter the child’s body. The consequence is the development of dysbiosis in the newborn baby.

Intimate problems in children

A change in the balance of microorganisms on the vaginal mucosa occurs in little girls. An unpleasant condition is associated with the presence of an infection of the genitourinary system, with neglect of personal hygiene standards. Sometimes the main reason is the entry of foreign objects into the genital slit.

In young children, dysbiosis develops against the background of enterobiasis. Pinworms crawl from the anus into the vagina, which causes an inflammatory process and disrupts the balance of microflora.

Symptoms of vaginal dysbiosis in girls are:

• the presence of uncharacteristic discharge from the genital opening;
• there is an increased interest in the genitals;
• the girl becomes capricious and restless;
• The child does not fall asleep for a long time and fidgets in bed.

At the first symptoms of dysbiosis, you should consult a doctor

Parents may observe white discharge in newborn girls, but this is not associated with dysbiosis. Estrogens enter the child's body from the mother. They are the ones who cause this condition. As maternal estrogen levels decrease, the discharge disappears.

Diagnosis of the problem

Diagnosis of dysbiosis in women includes a gynecological examination. The woman undergoes the following tests:

• smear from the mucous membrane to determine the flora;
• PCR diagnostics of infectious diseases;
• seeding of mucus discharged from the vagina.

The analysis is taken by a gynecologist during an examination using a special spatula. A smear is obtained from three areas - the cervical canal, from the walls of the vagina, from the surface of the opening of the urinary canal. In order not to distort the analysis, 2 days before visiting the gynecologist, it is recommended to refrain from sexual intercourse, not to use intimate lubricants, and not to douche.

If problems are identified, special treatment is prescribed, after which it is necessary to retake tests. It is important to determine how much the situation has changed in order to decide on further actions.

To diagnose dysbiosis, it is necessary to undergo certain tests

How does imbalance affect the sexual partner?

An imbalance of the microflora of the vaginal cavity does not affect a woman’s sexual partner. There is no negative effect with regular contact without contraception. The appearance of unpleasant symptoms is possible if a man has a tendency to nonspecific urethritis or other genitourinary diseases. If the sexual partner is completely healthy, he is not in danger.

A woman cannot become infected with dysbacteriosis from a man. This happens when one of the partners has sexually transmitted diseases.

Principles of treatment

Treatment of dysbacteriosis is based on the principles:

• the proliferation of pathogenic microorganisms stops;
• means are taken for the growth of beneficial microflora;
• normalization of the immune system to prevent relapse of the disease.

When a sexually transmitted infection is detected, medications are prescribed to help eliminate it. Doctors prescribe antibacterial therapy. When infections are not diagnosed, antibiotics are useless. It is more effective to use local procedures aimed at restoring microflora and increasing immunity. The use of antiseptics has a positive effect, since pathogenic microorganisms are destroyed when exposed to them.

Treatment of the disorder necessarily includes immunotherapy. It is aimed at increasing the protective functions of the vaginal wall. For minor deviations, local immunomodulators are prescribed. Treatment of serious disorders involves taking broad-spectrum drugs. Immunostimulating drugs and antibiotics are prescribed. The course of treatment for imbalance is 3-4 weeks.

When treating dysbiosis, it is necessary to undergo a course of therapy

Drugs to treat the disease

The imbalance of the female body is eliminated using the following medications:

• "Lactobacterin". Produces an antimicrobial effect. It has a wide spectrum of action. For use, Lactobacterin powder is dissolved in water. The resulting liquid is injected into the vaginal cavity. The duration of treatment is determined by the doctor;
• "Bifidumbacterin". Normalizes the microflora of the vaginal cavity. Suppositories are administered intravaginally. The duration of treatment with Bifidumbacterin is 1.5 weeks;
• "Neo-Penotran". Has antimicrobial, antifungal effect. Suppositories "Neo-Penotran" are used for local therapy. Use during pregnancy and lactation is contraindicated;
• "Terzhinan." It has a wide spectrum of action (antibacterial, antifungal). Vaginal tablets "Terzhinan" are indicated for pregnant and nursing mothers. The drug is prescribed exclusively by a doctor. The drug is recommended to be used before bedtime;
• "Ginolact". The drug contains lactic acid bacteria that activate the body's natural defenses. Ginolact capsules are inserted deep into the vagina before bed. The medication is indicated for pregnant and nursing mothers;
• "Acylact". Suppositories contain lactobacilli. Used after antibacterial therapy to restore normal microflora of the vaginal cavity. The duration of treatment with Acylact is determined by the doctor after testing.

Neo-Penotran is available in the form of suppositories (suppositories)

Complications

Complications of imbalance of the microflora of the vaginal cavity are:

• the appearance of inflammatory processes in the genitourinary system;
• reproductive dysfunction;
• the appearance of dangerous diseases of the reproductive system (endometritis, adnexitis);
• discomfort during sex, caused by pain, burning, dryness;
• the appearance of copious discharge.

Disease prevention

Imbalance in the female body can be prevented by following the rules:

• regular visits to a gynecologist. Timely testing allows you to prevent serious disorders of the female body;
• use of intimate hygiene products. Depending on the age of the woman, a certain preparation is used for daily toilet. It must have a suitable pH level and contain lactobacilli;
• compliance with the rules of hygiene during menstruation. Tampons and sanitary pads are changed every 3 hours. During this time, pathogenic microorganisms do not have time to multiply on their surface. Panty liners are changed after 4 hours. It is not advisable to use them regularly;
• balanced diet. You should limit the consumption of foods containing preservatives, refined fat, and sugar. Fermented milk products, fruits, vegetables, properly cooked meat and fish have a positive effect on the female body;
• hygiene of the intimate area. When washing intimate places, move towards the anus;
• the right underwear. Panties should be comfortable and made from natural fabrics;
• sexual culture. Having one partner excludes sexually transmitted infections;
• controlled use of antibiotics. Treatment with antibacterial agents is carried out under the supervision of a doctor. Self-prescribing medications is prohibited.

Dysbacteriosis is a disease that is widely found in women. His treatment is comprehensive, exclusively under the supervision of a gynecologist. Awareness of the problem and implementation of specialists’ recommendations produces a positive effect. The unpleasant symptoms of the disease disappear, the woman becomes healthy and happy.

Specialization: infrared coagulation of hemorrhoids; sclerotherapy; ligation of hemorrhoids with latex rings. Education: diploma in “Pediatrics”, Omsk State Medical Academy (1995) Residency in the specialty…

Violation of the vaginal microflora has bothered every woman at least once in her life. Girls who have never been sexually active also face this disease. The disease is asymptomatic, but can cause the most severe consequences, accompanied by an inflammatory process. Gynecologists call the pathology dysbiosis or dysbacteriosis.

What is dysbiosis?

Dysbiosis is defined as a violation of the microflora of the vaginal environment. If left untreated, the disease will progress, causing a number of very negative consequences.

Violation of the vaginal microflora does not manifest itself in any way at the first stage. The secretions change only slightly. In a normal state, a woman does not have them, and if they do, they are in small quantities. With a healthy microflora, there are no stings, pain, odor, burning sensation, dryness during sexual intercourse or discomfort.

An unpleasant odor and an increase in quantity indicate the presence of a pathology such as a violation of the vaginal microflora. Why is this happening? This will be discussed further.

Normal microflora consists of 90% lactobacilli and 9% bifidobacteria. The remaining 1% are those that rarely provoke any disease. A woman’s body can easily tolerate minor changes, especially with good immunity. In case of serious disorders, where the number decreases and the percentage of opportunistic microorganisms increases, the reproductive system may fail. As a result, harmful bacteria such as fungus, gardnerella, streptococcus, proteus, E. coli, chlamydia, etc. multiply. Vaginal dysbiosis occurs and, as a result, an inflammatory process. The immune system continues to fight pathogenic bacteria, but without treatment, the body’s protective functions no longer provide the desired effect.

The most common types of disease include:

• bacterial vaginosis;
• candidiasis;
• thrush

If dysbiosis occurs in a latent form, then pronounced symptoms are rarely observed. Without tests and a doctor’s examination, it can be difficult to recognize a disease of this type. Therefore, women are recommended to visit a gynecologist twice a year.

Causes of vaginal microflora disturbances

There are many factors influencing the appearance of dysbiosis:

• Single and constant hypothermia, which reduces immunity and contributes to the development of dysbacteriosis.
• Changes in hormonal levels. Unsystematic sexual life, menopause, pregnancy, childbirth, abortion, menstrual irregularities, etc.
• Change of climatic zones.
• Stressful situations.
• Chaotic sex life. Frequent change of sexual partners. Ignoring contraceptive methods.
• Inflammatory and pelvic.
• Infections acquired after sexual intercourse.
• Long-term treatment with antibiotics.
• Intestinal diseases.
• Improper insertion and use of menstrual tampons.

All these and other reasons cause disruption of the vaginal microflora.

Symptoms of the disease

The symptoms of the disease will help to recognize a violation of the vaginal microflora in time. Although in many cases, especially at the initial stage of the disease, they are simply absent. If bacteriosis begins to progress, the following may occur:

• white and yellow discharge;
• unpleasant odor;
• discomfort in the genital area;
• dryness during sex;
• burning, itching and pain in the genital area.

These are the main signs of a violation of the vaginal microflora. If dysbiosis is not treated, endometritis, inflammation of the appendages, cervix or vaginal walls may occur. If the infectious process affects the genitourinary organs and urethra, then, as a rule, cystitis or urethritis develops.

Disorders of the vaginal microflora during pregnancy and after childbirth

Pregnancy and hormonal changes can provoke an acute stage of vaginal dysbiosis. During pregnancy, the symptoms of the disease worsen. There is an abundance of discharge, an unpleasant odor, itching and burning in the genital area, and pain occurs during sex.

Many drugs are contraindicated for women during pregnancy, so it is not possible to carry out full treatment here. All actions are aimed only at temporary elimination of symptoms, and the necessary treatment with antibiotics is carried out after delivery.

A microflora disorder may occur. How to treat a patient in this situation? This issue can only be decided by a doctor. Often, young mothers are diagnosed with thrush, which is caused by yeast. This process is influenced by hormonal changes in the body, as well as a number of medications that the woman giving birth was forced to take.

In this case, therapy is carried out with antifungal agents in combination with probiotics, which have a positive effect on the vaginal microflora and prevent the secondary appearance of the disease.

Vaginal dysbiosis and sexual partner

Often, an imbalance in the vaginal microflora does not affect a woman’s sex life and does not cause any special problems for her sexual partner. The exception is the advanced stage of dysbiosis. In this case, the man may develop signs of balanoposthitis or nonspecific urethritis, and then only if the stronger sex has a predisposition to the disease.

As a rule, diseases of the sexual partner do not affect the woman’s vaginal environment; of course, we are not talking about sexually transmitted diseases.

Treatment of vaginal dysbiosis is carried out only in women, without the involvement of a partner, unless the pathology is caused by a sexually transmitted infection.

If STDs occur, they are accompanied by severe dysbiosis. Cause an imbalance in the vaginal environment. They provoke the appearance of an inflammatory process and disrupt the microflora of the vagina. However, there are no situations where the causative agent is only a sexually transmitted infection. The disease is always accompanied by negative changes in the body. This should be taken into account in the fight against the disease. Here, taking antibiotics alone is unlikely to help, since it will not restore the normal level of microflora.

The course of treatment should always end with pribiotics that restore the vaginal environment. Serious problems caused by chlamydia and trichomonas are solved through antibacterial therapy, after which it is necessary to restore the microflora. These courses must be divided and taken one after the other.

In situations where the disease is mild, a urogenital diagnosis should be performed. And the necessary background can be restored simultaneously with the elimination of sexually transmitted infections.

Dysbacteriosis in girls

Violation of the vaginal microflora occurs even in girls who have never had sexual intercourse. A variety of factors come into play here. These include hormonal changes in the body during puberty, the structure of the hymen, non-compliance with hygiene rules (including improper washing of the genitals), and the use of antibiotics and other drugs. The reasons in this case are similar to the factors contributing to the development of dysbiosis in women who are sexually active. But there are also nuances.

Unlike women, girls rarely experience heavy discharge, since the hymen does not allow it to come out of the vagina in full. A certain part of them accumulates in the pelvis, which causes an inflammatory process. Also, at the beginning of the development of sexual activity in girls, a lot of bacteria enter the urethra from the vagina, which can cause “honeymoon cystitis.”

Therapy for dysbiosis in virgins is quite complicated, since the hymen does not allow for thorough treatment of the vagina. In some cases, even a hymenectomy is indicated, in which the hymen is broken.

Development of dysbiosis and intestinal environment

Often, some diseases of the stomach and intestines lead to disruption of the microflora both in the intestinal walls and in the vagina.

The rectum is in close contact with the vaginal cavity, as a result, bacteria easily pass through the walls of the organs. When intestinal dysbiosis develops and progresses, bacteria (Escherichia coli, enterococci, etc.) that cause this disease easily penetrate the walls of the vagina, where they also disturb the background. What to do in such a situation? Of course, contact a specialist, in no case resorting to “amateur” and the help of folk remedies.

Treatment of vaginal microflora disorders in this case is a complex process, since the likelihood of a new infection is quite high. Here simultaneous therapy of both the vagina and intestines should be carried out. This is the most severe form of dysbiosis.

Diagnosis of dysbacteriosis

In order for treatment to produce results, the disease must be correctly diagnosed. First of all, a gynecological examination of the patient is performed. Then tests are prescribed. Typically this is:

• PCR diagnostics, which allows you to verify the absence or presence of sexually transmitted infections;
• a smear on the flora, indicating the state of the vaginal microflora;
• culture of vaginal discharge;
• The patient's sensitivity to antibiotics is determined.

The laboratory data obtained allows us to establish the cause of the disease and the degree of its complexity.

Treatment of dysbiosis

Therapeutic measures to restore vaginal microflora are divided into several stages:

• Destroying pathogenic bacteria that caused this disease.
• Restoration of vaginal microflora.
• Boosting immunity.

If dysbiosis occurs due to sexually transmitted infections, then the causative agent of the disease is first eliminated by prescribing a course of antibiotics. If a violation of the vaginal microflora is caused by another reason, then antibiotics may not be used. And if such therapy is prescribed, it is for a period of no more than five days.

It is very important to carry out external procedures in case of dysbiosis. These are various baths and tampons. Such measures inhibit the development of pathogenic microorganisms and restore immunity. Treatment of vaginal microflora disorders with antiseptics - in this case they are used topically - is much more effective than antibiotics, and their area of ​​influence is much wider. Almost all bacteria are susceptible to their influence. Antiseptics also help develop the immunity of the vaginal walls and normalize its microflora. Inhibits the proliferation of pathogenic bacteria.

An advanced form of dysbiosis is difficult to cure with immunomodulatory therapy alone; in addition, antibiotics are almost always prescribed.

Drugs for the treatment of dysbiosis

Violation of the vaginal microflora (drugs are usually prescribed in the form of ointments, suppositories, vaginal tablets and creams) is a rather complex disease that often requires an integrated approach.

Dalatsin cream, which is an antibiotic with a broad spectrum of action, is often used to treat dysbiosis. The active ingredient is clindamycin phosphate 2%. It intensively affects the vaginal microflora. Dalatsin suppositories also effectively restore the background in case of pathologies such as disturbances of the vaginal microflora. They contain up to 100 mg of antibiotic.

Flagyl suppositories provide good results for vaginal dysbiosis. The drug is used once a day, at night. Also, to treat the disease, doctors recommend using Hexicon - these are suppositories with chlorhexidine. They are inserted into the vaginal cavity once a day. Course - 10 days.

To treat vaginal dysbiosis, many today choose Betadine and Terzhinan suppositories. Metronidazole gel also gives a good effect.

If the disease is advanced, and only topical drugs cannot be used, then tablets are prescribed for oral administration. This:

• "Ornidazole".
• "Naxojin."
• "Meratin".
• "Tiberal".
• "Tinidazole."
• "Trichopol" or "Metronidazole".
• "Clindamycin."

Medicines are taken for a week. It should be remembered that when using oral medications, alcohol consumption is prohibited. This is especially true for Trichopolum.

In combination with other medications to normalize the microflora, the following are prescribed: “Linex”, “Probifor”, “Bifidumbacterin”, “Bifiform”, “Bifidin” or “Bifiliz”. To increase the number of lactobacilli in the vaginal environment, Acylact, Lactobacterin, Acepol, etc. are prescribed. It is recommended to take the medicine in a course, starting from the second day of taking antibacterial agents. They also prescribe drugs to maintain immunity - “Immunal”, “Cycloferon”, etc.

If the cause of microflora disturbance is sexual intercourse, then the sexual partner should also be examined and treated.

About preventive measures

Treatment of dysbiosis can take up to four weeks. In some cases, it can be difficult to prevent this disease, since the real cause of the disease is difficult to establish. The only thing a woman can do is strengthen her immune system and follow the necessary rules of hygiene.

After restoring the vaginal microflora, you should visit a gynecologist every three months for a year. This is necessary in order to detect a relapse in time and take appropriate measures. In the future, under normal circumstances, you can see a doctor once a year.

Attention!!! In this section you can familiarize yourself with the answers of Dr. I.S. Markov. to questions from patients on the topic "Urogenital dysbacteriosis. Thrush." If the answers do not help you, then You can contact the Markov Clinic in Kyiv directly or get an individualonline consultation. Our clinic specializes in the treatment of infectious diseases, including thrush in pregnant women.

TO GET A CONSULTATION

Question 53. After a course of treatment for chlamydia, thrush began to bother me. Could this be related? I take Diflucan and everything goes away. Is one tablet enough or would it be preferable to add a suppository? And what advice would you give to your partner? How does thrush manifest itself in a man? Mine has no symptoms. And after antibiotics I have already 2 times in a month.

Answer 53. One capsule is not enough. It is necessary to take the drug for 3-4 days in a row (Diflucan-150) in combination with antifungal suppositories (10 days). If the partner has no complaints, then there is no need to examine and treat him.

Question 54. Once again I was diagnosed with thrush. My gynecologist insists on “drastic” treatment and pours hydrogen peroxide into the vagina, then brilliant green, and only then “Kanizon” cream. The whole procedure is very painful, then everything swells and I can hardly walk. Because of the pain, I have already forgotten what sex life is. I want to ask, is this method of treatment really practiced in medicine or is it still not worth using brilliant green in that place?

The answer is negative: this is a barbaric method and is not very effective for treating thrush. Advise your doctor to undergo a similar procedure herself once - I think she will no longer have the desire to mock women like that. You need to make bacterial cultures from the urethra, the enemy and the cervical canal, prepare an autovaccine from the isolated bacteria and candida and undergo a course of immunization. Your thrush cannot be treated because it is combined with other microbes (coliform bacteria) that cannot be treated with antifungal medications.

Question 55. Good afternoon! I am undergoing a three-week course of treatment for thrush (nystatin, terzhinan, fluconazole 3 tablets at weekly intervals). Now I'm delayed. If it turns out that during all this time I was already pregnant, how will this affect the fetus? Thank you.

Answer 55. Nystatin and terzhinan will not have any effect, but fluconazole is contraindicated during pregnancy (see instructions). But three tablets at intervals of a week are unlikely to pose a real threat to the fetus. Wear it for your health. Please.

Question 56. Hello! Please tell me, is it true that thrush can lead to premature birth if left untreated?

Answer 56. No, it cannot.

Question 57. Hello, please tell me. My husband and I were treated for ureaplasma and herpes 3 years ago. Six months ago I gave birth to a child. Now the discharge, itching, burning have begun. Nothing worries my husband. What could it be? Please advise what tests should be done? I visited a gynecologist, she prescribed iodoxide suppositories, but did not say anything about medications for my husband. I had a general smear and they said it was good.

Answer 57. Your complaints are related to urogenital dysbiosis and have nothing to do with the infections you have had, but with the treatment given (antibiotics). Now you need to do bacterial culture of smears from the urethra, vagina and cervical canal, as well as urine culture. Prepare an autovaccine from the isolated microbes (usually not related to STDs) and undergo a course of specific immunization.

Question 58. I have been undergoing treatment for dysbiosis for two years. An allergy started from antibiotics and other pills, the body does not take any more medications (first vomiting, dry mouth, then colitis, indigestion and other symptoms). How to help yourself? The first treatment was prescribed after surgery for an ovarian cyst 2 years ago. Neither this nor subsequent courses of antibiotics produced any results. Escherichia coli, staffylococcus, gardnerella, and ureaplasma were found in the discharge. Help me please. Natasha.

Answer 58. Hello, Natasha. It is necessary to prepare an autovaccine from bacteria obtained from secretions (Escherichia coli and staphylococcus). And gradually carry out vaccination step by step, each time preparing a new vaccine from bacteria (they will change) obtained from new bacterial cultures. I think that in total at least 3-4 times over 9-12 months. Locally - drugs that restore normal microflora, for example, Vagilak suppositories, as well as drugs that increase the local immunity of the mucous membranes of the urogenital area (for example, polyoxidonic suppositories). It takes a long time, but there is no other way: you have already experienced antibiotic treatment for yourself for 2 years. There is no need to touch Gardnerella and ureaplasma yet, they do not pose a real danger.

Question 59. Hello! Please advise me. The test results showed that I have ureaplasma and E.coli IV growth stage, st.epidermid III growth stage. I was prescribed a very large number of medications. After reading your article about dysbiosis, I had doubts. Please help me. Natalia.

Answer 59. Hello, Natasha. Well, it’s not in vain that this article was written, since you stopped in time. If the main component of the prescribed treatment is antibiotics, then the treatment is unlikely to be beneficial. If there are no complaints, you can use local drugs that normalize the urogenital microflora. If there are clinical symptoms from an isolated culture of Escherichia coli (if it is not preserved, you will have to make a new smear), it is necessary to make an autovaccine and immunize you according to a certain scheme to increase the local immunity of the mucous membranes of the urogenital area. If you don’t find a doctor you can contact at your place of residence, come to us in Kyiv.

Question 60. Igor Semenovich, I have a question: if I am pregnant, how will dysbacteriosis affect the child, is it dangerous, will he be infected? What should I do, how should I treat it? I'm looking forward to your answer. Thank you.

Answer 60. Dysbacteriosis in the mother during pregnancy does not pose a threat to the fetus. The danger can only come from dysbacteriosis, in which secondary foci of chronic bacterial inflammation have already formed, and primarily in the uterine cavity (endometritis). You can treat with local drugs that normalize the vaginal microflora - I do not prescribe an autovaccine during the first 3 months of pregnancy, in the future - individually.

Question 61. Hello! Please tell me how to boost immunity if you are constantly worried about thrush and the same situation with Staphylococcus aureus. Sow in throat, nose. After different treatment options, the positive result lasts about a month, and then everything starts all over again. As far as I understand, this can be treated indefinitely if the immune system is weakened and the body itself cannot cope with these problems. Thanks in advance for your answer. Vika.

Answer 61. Hello, Vika! The fact is that when carrying Staphylococcus aureus, candida (fungi) and other bacteria on the mucous membranes, which is a sign of local or systemic dysbiosis, it may not be the general, but the local immunity that suffers primarily. In order to understand the situation, it is necessary to conduct a study of the general immune status and, possibly, repeat or do additional bacterial cultures from the surface of various mucous membranes. If the assumption is confirmed, then it is necessary to undergo a course of immunization, use standard (industrially produced) bacterial vaccines, or prepare an autovaccine from a mixture of isolated microbes. The path to recovery is not immediate, but it is the only real one.

Question 62. Hello! I would like some clarification on the problem. In 2002, I had cervical erosion, which I treated for four months. She tested for chlamydia, trichomoniasis, and papilloma virus. Nothing was found. There was discharge (thrush and yeast). Everything seems to be fine. In November 2004, I was again diagnosed with cervical erosion, discharge and papilloma virus (which was not there in 2002), Mycoplasma hominis (DUO) in low titer, Ureaplasma urealiticum (DUO) in high titer. Also dysbiosis of the vagina and cervical canal. Rods and cocci were found in the microflora. Chlamydia and Trichomonas, gonococci, and gardnerella were not detected. I am interested in the question: could the papilloma virus have been overlooked in 2002 or could it have been a disorder in my body? What does low and high titer mean, and how much will it cost me? Thanks in advance for your answer. Olga.

Answer 62. Hello, Olga! Most adults have human papillomavirus (HPV). Therefore, its discovery in 2004 is more associated with a weakening of the specific immune response to this virus than with a primary, fresh infection. Its oncogenicity should not be exaggerated (after all, even the influenza virus is potentially oncogenic), much less rush to treat it immediately. With a high degree of probability, the next time it is determined after some time, even without antiviral therapy, it may not be detected again. Regarding mycoplasma and ureaplasma. Tests performed on the French Mycoplasma diagnostic system (DUO) give consistently accurate results. Therefore, the data obtained indicate that you have these two urogenital microbes that are sexually transmitted. The only classic way to treat them is to prescribe antibiotics. But! Firstly, in most countries of the world this path has long been abandoned, considering the detection of various variants of mycoplasmas as a manifestation of urogenital dysbiosis (UGD). And, secondly, the use of antibiotics is absolutely contraindicated for you, huh. You have already been diagnosed with UGD, which most likely has been going on since at least 2002. In such cases, a short time after stopping antibiotics, it becomes much worse than it was before their use. Moreover, cervical erosion is largely supported by UGD, and not by mycoplasmas or HPV. What to do? Treat dysbiosis and under no circumstances use antibiotics. It is necessary to do bacterial cultures from the urethra, vagina, cervical canal, and urine. Prepare an autovaccine from all isolated bacteria and fungi and, simultaneously with local treatment (vagilac, etc.), carry out specific immunostimulating therapy. The path is not fast, but it is the only successful and harmless one.

Question 63. Good afternoon! I took a bacterial culture from the vagina and cervical canal, the result: leukocytes 60-70, cocci, diplococci, streptococci and gardnerella, as well as staphylococci and abundant growth of Candida. The doctor prescribed me Nizoral, Klion D, Vagilak, and also Metronidazole (1 tablet, 2 times a day for 7 days). But this drug affects the liver and I do not want to take it. Please tell me whether I should be treated with these drugs and whether it is possible to replace Metronidazole? Thank you in advance! Tanya.

Answer 63. Hello, Tanya! Metronidazole is used to treat gardnerellosis and, unfortunately, it can only be replaced with an antibiotic, which you also do not want to take given the abundant growth of Candida fungi. But this is secondary, huh. leukocytosis is more likely due to staphylococci rather than gardnerella. But staphylococci and streptococci, as well as candida, cannot be cured with antibiotics. These are typical signs of urogenital dysbiosis, which can only be cured with an autovaccine in combination with antifungal drugs (nizoral is possible), Vagilac and other means that restore the normal microflora of the vagina and cervical canal. And talk about what comes first. Diplococci found during bacterioscopy of a vaginal smear may be gonococci. Therefore, before starting treatment, you and your partner (if you have a regular one) need to undergo an in-depth examination for gonorrhea.

Question 64. Good afternoon! Please tell me, if I have a thrush fungus in my body (not at the moment, but just like a herpes virus in the blood), can I pass it on to a young man? And will this fungus manifest itself somehow? And if I get thrush, should my partner also be treated? Thank you very much.

Answer 64. Good afternoon! Fungi that cause thrush can be transmitted through sexual contact, both in active and latent form. But transmission does not mean getting sick. If the partner has healthy mucous membranes, then the infection will not lead to illness - the mushrooms will simply die without any treatment. Therefore, there is no need to preventively treat your partner in company with you.

Question 65. Hello, dear doctors! Please help me decipher my bacterial culture: in the 1st culture, the growth of Escherichia coli was detected - 10 (6) CFU/g, in the 2nd culture, the growth of Enterococcus faekalis was detected - 10(5) CFU/g. How scary is this? And sensitivity to antibiotics is listed. Tell me, if there is sensitivity to this antibiotic, does that mean they need to treat it? Thanks in advance for your answer!

Answer 65. Hello! You have been diagnosed with dysbiosis, apparently urogenital, caused by a nonspecific bacterial infection of the intestinal group, not related to STDs. Dysbacteriosis cannot be cured with antibiotics in principle. It will only heal and make it worse. Therefore, the only adequate way to cope with this disease is to prepare an autovaccine from isolated bacteria and undergo a course of immunization. This requires a living microbe, and not an analysis result on paper. Nutrition 66. When the foreskin is exposed, cracks appear on it. This occurs when the head of the penis is migrating, or after sexual intercourse. After a day, three cracks on the skin of the upper flesh will heal, but as a rule, they will appear again after more mysterious actions. It started here just like that. Please tell me what's on the right. Evidence 66. This will predict staged candidiasis (thrush) and will require a specific anti-candidal treatment: clotrimazole ointment, microcouples with 5% grub soda, systemic diflucan supplements. It’s better to go crazy before the doctor, because you can virtually knock him down.

Question 67. Good afternoon! I finished a course of treatment for Gardnerella two weeks ago, and just a couple of days ago I started having frequent urges to go to the toilet. Maybe I didn't finish my treatment? And did my husband need treatment? They didn’t even check him, the doctor didn’t say anything about it.

Answer 67. The deterioration in your health is not due to the fact that you were “not fully treated”, but because you were given antibiotics or other antibacterial treatment. The fact is that gardnerellosis is today considered as one of the variants of urogenital dysbiosis, in which the use of antibacterial drugs is not justified at all. The deterioration in your health is associated precisely with the exacerbation of dysbacteriosis. It is recommended to carry out bacterial cultures (urethra, vagina, cervical canal, urine), prepare an autovaccine from isolated microbes, and carry out specific vaccination in combination with local use of probiotics.

Question 68. Good afternoon! In a 9-month-old girl, Eschicheria colli was found in urine culture. What is it and what treatment is possible? We drank Amoxiclav (but, as it turned out, it has no effect on this bacterium). Now they want to prescribe antibiotics again. Thank you.

Answer 68. Treatment with antibiotics of Escherichia urogenital dysbiosis (as it is called), which can eventually transform into chronic cystitis or pyelonephritis, is completely ineffective. It only transforms this condition into a chronic form, which can subsequently relapse at any time. In my clinic, I treat such conditions in children and adults with an autovaccine prepared from isolated bacteria.

Question 69. Good afternoon. My question is this: after having sex with my boyfriend without a condom, I feel a burning sensation in my vagina. Can sperm cause such a reaction and is this reaction normal, what else could cause such a reaction, can it be avoided?

Answer 69. Good afternoon. No, this is not a normal reaction and sperm cannot cause it. You are advised to carry out bacterial cultures from the urethra, vagina and cervical canal to diagnose and treat dysbacteriosis, which can cause such a reaction.

Question 70. Hello! A few weeks ago I started having whitish, mucus-like discharge. Upon examination, the local doctor said that it was vaginal candidiasis and prescribed nystatin suppositories. I used the packaging, there was no discharge for some time, but then it started again, but a little less. One of my friends said that this is possible, since some types of candidiasis are “immune” to certain drugs, and this requires additional research. In response to this question, my local police officer rolled her eyes and re-prescribed the same suppositories. Since the competence of the city district police officer is, for obvious reasons, in doubt, I had several questions, the answer to which I would like to receive from more competent specialists: 1. What is vaginal candidiasis (more details), what causes it? 2. Is it true that it is necessary to additionally determine its resistance to different drugs? 3. Is it possible to cure it with a second course of nystatin if nothing has changed after the first? 4. If not, what medications do you recommend? Thanks in advance for the information!

Answer 70. Hello! 1) Vaginal candidiasis, also known as dysbacteriosis, occurs due to a weakening of the local immunity of the mucous membranes of the urogenital area. There are many reasons for this weakening, but overall immunity usually remains at a fairly good level. 2) Vaginal dysbiosis can be caused not only by Candida fungi (hence - candidiasis), but also by other fungi and nonspecific bacteria that are not related to sexually transmitted infections (staphylococcus, E. coli, enterococcus, Proteus, etc.). Therefore, it is necessary to do a bacterial culture from the urethra, vagina, cervical canal, name the infection that caused the dysbacteriosis by name and patronymic and treat it, but! without the use of antibiotics. 3) A repeated course of nystatin (in general, this is an outdated drug and today new generations of antifungal drugs are used for these purposes, including necessarily for topical use) is unlikely to be effective after an unsuccessful first course. 4) The drugs that are suitable for you are fluconazole and its derivatives (from mushrooms) and probiotics for topical use (vagilac suppositories, biosporin, yogurt, etc.). Dysbacteriosis can go away without treatment as unexpectedly as it appeared.

Question 71. Good afternoon, please comment on the situation. I'm 24, nulliparous. A year ago, I don’t even know for what reasons, my immunity was undermined. I lost my appetite, lost 10 kg (now 45), candidiasis began: odorless white discharge 3-4 days before my period. Everything there becomes inflamed, but after menstruation it almost goes away. The gynecologist prescribed the following tests: chlamydia, ureaplasma, mycoplasma, papilloma virus; herpes 1/2 PLR (u/g), - all results are negative. Culture for microflora: will only find Enterococcus faecalis 10*6, leukocytes 1-3 in the field of view. As the doctor explained, I need to boost my immunity and fight infections. The question is this: maybe I have something else and I will have to get tested for all other infections? And since they are not cheap, I cannot afford to go through them all at once. Maybe you know some pathogen that camouflages itself like this. Or maybe I'm nervous for nothing. Thank you in advance.

Answer 71. Good afternoon. The pathogen you are looking for does not disguise itself - it is fecal streptococcus, also known as enterococcus. You have already found it. There is no need to take additional tests. Your diagnosis is urogenital enterococcal dysbiosis, secondary vulvaginitis, possibly cervicitis (everything that becomes inflamed before menstruation). It must be treated locally (without antibiotics!), using douching with herbal decoctions, pio- or sextabacteriophage and probiotics (Vagilak suppositories, yoghurts).

Question 72. Good afternoon! I gave birth 4 months ago. As expected, I was examined after giving birth 2.5 months later. We did a colposcopy, an ultrasound, and took tests (smear). I'm worried about itching and leucorrhoea, but tests show no fungi or inflammation. At the moment I am breastfeeding my child and would not like to burden him with various medications. How to solve the problem, because... really worrying? Please advise what this could be?

Answer 72. Something is wrong with the tests: with such complaints, they cannot be so ideal. Therefore, it is necessary to repeat the smears and do bacterial cultures in another laboratory. Clinically, this is dysbacteriosis, but targeted treatment can only be prescribed based on test results.

Question 73. Dear doctor, at what period of the cycle is it best to take a bacterial culture of urogenital secretions, or does it not matter at all? Thank you!

Answer 73. If there are periods of exacerbation (intensification) of discharge before or before menstruation - then during this period, if stable - at any time.

Question 74. When taking tests, it was found: positive for HPV (highly oncogenic) PCR and during bacterial examination - the growth of Enterococcus faecalis. What is this? At the same time, I have repeated cervical erosion for the third time.

Question 75. How to treat candidiasis in men?

Answer 75. The same as for women. Locally - antifungal ointments (clotrimazole, for example), systemically - drugs based on fluconazole.

Question 76. My son is 11 months old. We donated urine for bacterial culture. Enterococcus faecalis 10*7 was found. A few weeks later, the test was retaken (no treatment was carried out) and something completely different was sown - Candida albicans 10*4. Tell me, how can this be? And please explain how to collect urine for such an analysis at home. Thank you

Answer 76. Your son has bladder dysbiosis or nephrodisbacteriosis (kidneys), caused by intestinal bacteria and fungi. The microbe that is currently the most aggressive is sown first, although there may be not 2, but 4-5 or more such microbes. Therefore, this can happen. Collect as you wish, but only in sterile containers. Treat without the use of antibiotics.

Question 77. Please tell me effective (folk, any) methods of treating thrush and preventing it. Often, due to circumstances, there is no access to a gynecologist. The problem returns periodically, despite different treatment methods and different specialists. Vaginosis also appeared (is that what inflammation of the vagina is called?). I treated it, and the thrush came back.

Answer 77. Your main diagnosis is urogenital dysbiosis caused by fungi (thrush) and other nonspecific (non-genital) bacteria. That’s why your dysbacteriosis recurs because you treat only fungi, i.e. from thrush, without taking into account the rest of the pathogenic microflora. It is recommended to carry out bacterial cultures from the urethra, vagina, cervical canal and complex treatment of dysbiosis, preferably using an autovaccine and other probiotic preparations, but absolutely without the use of antibiotics!

Question 78. Good afternoon! I have the same problem, “key cells” were discovered - I was treated for gardnerellosis with Tiberal and Citeal (my sexual partner also took Tiberal). After the course of treatment, I was tested for bacteria, the results are as follows: microflora gr. (-) rods, cocci; gonococci, trichomonas, gardnerella, fungi - not identified. But there is a large number of leukocytes: 40-50 per cell and growth of Pseudomonas aeruginosa is detected. I'm worried about this stick... What is it? Where could it come from, how to treat it correctly? My doctor prescribed me rovamycin, mycogynax: my partner and I took it. Now I want to take the test again. Please tell me what tests a man needs to take? Or maybe I need something else? Please answer me, because I am very scared... Alena.

Answer 78. Hello, Alena! Pseudomonas aeruginosa was most likely introduced to you during gynecological examinations - it is a nosocomial infection. Treatment of its carriage with antibiotics is not always successful. Establishing a diagnosis of gardnerellosis using “key cells” today is not entirely correct and requires confirmation by PCR. The second course of treatment prescribed for the partner was completely unfounded - this stick does not apply to sexually transmitted infections. Your current condition is a typical urogenital dysbiosis, in the treatment of which the use of antibiotics is simply not acceptable. If the partner has no complaints, then there is no need to examine him. Dysbacteriosis is a disease of one person that is usually not contagious to the other partner. The only real salvation from such dysbacteriosis is the preparation of an autovaccine from the bacteria isolated from you. This requires living microbes, and not the result of a study on paper. There is no threat to life, although such a life, of course, cannot be called full and high-quality.

Question 79. Good afternoon. I have urogenital enterococcal dysbiosis. There are no more infections. My gynecologist doesn’t really say anything about what is possible and what is not, why this happens, everything has to be looked up on the Internet. It seems to me that it was not my partner who infected me, these are women’s diseases. Am I right? He has no problems. Is it possible to continue an intimate relationship with him?

Answer 79. Good afternoon. You are absolutely right. Feel free to continue your relationship with your partner. Enterococcal dysbacteriosis is not a sexually transmitted infection and is not associated with infection through sexual contact, but is caused by a weakening of the local immunity of the mucous membranes of the urogenital area. And intestinal bacteria (enterococcus, E. coli, enterobacter, etc.), which cause dysbacteriosis, can and do get onto the mucous membranes, usually through household contact and from the skin as an autoinfection.

Question 80. Good day! I would be very grateful for your consultation. About 3 weeks ago, unexpectedly (since there were no complaints), during an examination by a gynecologist, it was discovered that she was sick with trichomoniasis and gardenellosis. I completed a course of treatment for 7 days: efioran + cycloferon + tricaside + nystatin, then 10 days of treatment (hydrogen peroxide, chamomile, sodium tetraboride, Klion D). During the procedures, fairly abundant discharge appeared, without a strong odor, and curdled (which was not the case before). How can this be explained?

Answer 80. There is only one explanation for this: you experienced side effects from the medications that the gynecologist prescribed to you, and above all, antibiotics. If there were no complaints, such examination results had to be repeated in another laboratory before starting treatment. Errors are possible. But even if gardnerellosis had really been confirmed, the use of antibiotics was completely unjustified, as you have seen from your own experience. Now you need to treat urogenital dysbiosis. Gardnerellosis, if it really existed and remains, should not be touched at all, but trichomoniasis must be confirmed by PCR in different laboratories.

Question 81. After long-term treatment with antibiotics, dysbiosis occurred. The doctor prescribed some insanely expensive nutritional supplements. Please recommend a standard disbak circuit.

Answer 81. There is no standard treatment regimen for dysbiosis - treatment is prescribed depending on the flora secreted. Fundamentally: 1) nutritional supplements do not cure this; 2) do not use antibiotics; 3) the use of probiotics and phages is mandatory. You can read more on our website (www.. New. Article “Dysbacteriosis lives not only in the intestines” from the magazine “Family World”.

Question 82. Hello! I have been treating thrush for many years (8-10). In addition to her, she treated gardnerellosis and chlamydia (2 years ago). Please tell me, is it possible to completely get rid of candidiasis or will I have to constantly swallow pills and put on suppositories? Is there any effective remedy against this disease? And can it cause cervical dysplasia or erosion? Please advise where I can go to get 100% cured. Thank you in advance.

Answer 82. Hello. Long-term and unsuccessful treatment of thrush is usually associated with an unidentified nonspecific (not related to STD) mixed bacterial agent, which usually accompanies thrush. We treat such conditions quite successfully with a polyvalent autovaccine in combination with “local therapy.” But usually within 6-12 months in several courses.

Question 83. Please tell me, can thrush occur without discharge? I am worried about itching and redness, but there is no discharge. I recently did a colon cleanse, maybe this has something to do with it?

Answer 83. Thrush can occur without discharge for a certain period of time. “Cleansing” the intestines is unlikely to have anything to do with your complaints. More accurate information can be obtained by conducting bacterial cultures from the urethra, vagina, and cervical canal.

Question 84. Hello, I am 13-14 weeks pregnant. Exacerbation of thrush, I really don’t want to take even local antibiotics. What can be done to relieve the aggravation?

Answer 84. Hello. You can use probiotics (vagilac, biosporin, yogurs, etc.) in suppositories, pimafucin and other antifungal drugs in suppositories, if this is not prohibited by the instructions for these drugs, tampons with a 20% solution of sodium tetraborate (borax) in glycerin, washing skinny kefer. Antibiotics in any form are contraindicated.

Question 85. Good afternoon! I have this question. I'm not working yet, because... I stay at home with my child, but I used to work as a nurse. Friends often come to me for injections and just for advice. A friend was prescribed the drug IMUNOFAN - the doctor said it was for thrush. Inject 5 days, 1 ml. But in the annotation to the medicine there is not a word about thrush (not even a mention of fungal diseases), and it must be used, as it is written there, once every 3 days. Overall a mystery drug. I didn’t give the injection, you never know. So here is my question: can I be treated with THIS drug (for thrush) according to the SCHEME given by the doctor???

Answer 85. Good afternoon. Imunofan is not a drug that has an antifungal effect. The use of various immunomodulatory drugs is possible in the treatment of various infectious diseases as an additional component to the main drugs, but not as monotherapy. It is also better to adhere to the treatment regimen according to the instructions for the drug. Incl. Your doubts are completely justified - I would not carry out such treatment either. Treatment of thrush (if there are complaints!) is better to start with the use of probiotics (vagilac, biosporin, yogurt, etc.) in suppositories, pimafucin and other antifungal drugs in suppositories, tampons with a 20% solution of sodium tetraborate (borax) in glycerin.

Question 86. A week ago I took tests in a commercial laboratory, which was recommended to me by a gynecologist. They found Ureaplasma urealyticum in me. But I’m afraid that I got some other infection in this laboratory. Over the course of the day and the next week, I began to have bloody discharge with a lot of moisture. Panty liners get wet through the day and smell disgusting.

Answer 86. Your problems are definitely not related to ureaplasma and are unlikely to be related to “infection.” Still, today in commercial medical institutions they mainly use disposable gynecological instruments (if not, it is better not to take tests in such an institution). Clinically, your complaints are characteristic of an exacerbation of urogenital dysbiosis caused by intestinal bacteria - an unbearable fecal odor that cannot be eliminated even for half an hour. It is recommended to carry out bacterial cultures from the urethra, vagina, cervical canal and urine, which help to carry out “targeted” treatment using probiotics and phages. The autovaccine helps a lot. In any case, no matter what microbe is isolated, the use of antibiotics is contraindicated and simply pointless (dysbacteriosis). Before culture, you should not wash yourself and you need to have a full bladder.

Question 87. Results of a smear for flora, as well as for STIs: Ur - 2-3 leukocytes, Vag - 10-12, Cerv - 20-25, squamous epithelial cells - in small quantities, flora - abundant rods; Chlamydia, mycoplasma, ureaplasma - not detected, as well as highly ocogenic IDP (16,18, 31, 33, 35) - not detected. I was told that it was vaginal dysbiosis, but no treatment was prescribed. Please tell me how to treat it. If possible, give me a treatment regimen, because... I don't trust my doctor. Thank you in advance.

Answer 87. First of all, you need to find a treating doctor whom you trust. Because virtual treatment, even according to my scheme (I wrote to you, and you treated yourself and reported to me) will be similar to phone sex with a surrogate result. In case of urogenital dysbiosis, it is necessary to carry out bacterial cultures (urethra, vagina, cervical canal, urine), which will help carry out “targeted” treatment using probiotics, phages and local immunostimulating drugs. The autovaccine helps a lot. In any case, no matter what microbe is isolated, the use of antibiotics is contraindicated and simply pointless. Before culture, you should not wash yourself and you need to have a full bladder.

Question 88. Good afternoon. Please advise on this issue. 2 days ago I started showing signs of cystitis (I want to go to the toilet, but when I’m there, the effect is small). These signs gradually pass, but are present. On the same day, I went to the gynecologist and took tests. They found ureaplasma, more than 7,000, and said that the virus was transmitted to me sexually and has been in the body for more than a year. The doctor said that this is what caused the cystitis. He said that I needed treatment, which would cost me 1,500 hryvnia. But I read on the Internet that treatment is prescribed only for grade 10*4 ureaplasma, and I only have 7000. Is it possible that cystitis is not caused by this? I also read that ureaplasma is present in the body of every 2nd woman (this is the norm, so to speak), and that a man may not be infected. The question is: do they just want to “treat” me or do I really need it? What amount of ureaplasma is considered normal?

Answer 88. Good afternoon! The norm for ureaplasma (this is a bacteria, not a virus) is when it is not present at all. Any amount of ureaplasma a) can be considered as urogenital dysbiosis and b) is not a reason for treatment, at least not for the use of antibiotics. Therefore, they really “want” to treat you. Moreover, the amount of detected ureaplasma under no circumstances can indicate the duration of infection (1 day or 1 year, or more). Your cystitis (urogenital dysbiosis with the formation of a chronic focus of bacterial inflammation in the bladder) is caused by some intestinal bacterium, which can be detected by bacterial cultures from the urethra, vagina, cervical canal and urine. However, once identified, do not use antibiotics under any circumstances: this is also dysbacteriosis.

Question 89. Dear doctor! During the examination, gardnerella and a high level of leukocytes were found. She completed a course of treatment, the key cells were gone, but bacterial culture revealed Staphylococcus epidermidis 10*3. Another long course of treatment. Please tell me if your partner needs examination and treatment? And how serious are these diseases? If at the end of treatment the analysis is good, when will it be necessary to do a follow-up test? Thank you in advance for your attention!

Answer 89. Gardnerella is a sign of urogenital dysbiosis; their treatment with antibiotics is not effective and is simply contraindicated. Staphylococcus epidermidis in a smear is generally a normal variant and does not give an increased level of leukocytes. There is no need to examine your partner if there are no complaints: dysbacteriosis is not a contagious infection and its development is not associated with sexual transmission, but with a weakening of the local immunity of the mucous membranes of the urogenital tract.

Question 90. Hello! I am in my second month after very painful periods, my ovaries ache and there is strong liquid discharge. A diagnosis of adnexitis was made. At the same time, I was tested for STIs. So: in one clinic they found ureaplasma in me and said that it is the cause of adnexitis, it must be cured and there will be no adnexitis. And in another clinic, when testing for sensitivity to antibiotics, ureaplasma was not found at all! (both clinics are public). Tell me how to treat adnexitis now: with what is prescribed for ureaplasma (vilprofen)? And how is it generally treated?

Answer 90. Hello! It is better and more effective to treat adnexitis under the supervision of a gynecologist. Ureaplasma does not cause adnexitis and does not require antibiotic treatment. A priori, you can think about the presence of urogenital dysbiosis caused by nonspecific bacterial flora, with the formation of a secondary focus of bacterial inflammation in the ovaries (adnexitis). To clarify the situation, it is necessary to carry out bacterial cultures from the urethra, vagina and cervical canal, as well as bacterial cultures of secretions, which will help answer the question about the cause of adnexitis. Chronic adnexitis cannot be cured with vilprofen (like any other antibiotic). It can only be “healed” for a while. And then it worsens again. Complete cure is possible only through repeated immunization against those bacteria that will be isolated during bacterial culture.

Vaginal dysbiosis is expressed in disruption of the normal vaginal microflora. This disease occurs in most representatives of the fair sex. In most cases, this disease manifests itself to a minor extent, but can cause the development of a number of serious inflammatory diseases of the female genital area of ​​an infectious nature.

It is worth mentioning right away that several terms can be used to refer to vaginal dysbiosis. Vaginal dysbiosis or vaginal dysbiosis is considered the most accurate of the existing terms, since literally translated it means a violation of the vaginal microflora. But despite all this, this term is used extremely rarely. As a rule, this disease is called bacterial vaginosis, which also means a violation of the vaginal microflora. Meanwhile, many doctors define bacterial vaginosis as gardnerellosis, which is a special case of vaginal dysbiosis. As a result, when using this term it is not always possible to be sure that vaginal dysbiosis is meant.

In addition, quite often any kind of manifestation of a violation of the vaginal microflora is considered “candidiasis” (thrush), which is completely unfounded. Candidiasis, or thrush, is a manifestation of one type of microflora disorder, expressed in an increase in the number of fungi of the genus Candida, which happens extremely rarely. As a rule, women and many doctors call any vaginal discharge thrush, often without understanding the nature of its occurrence.

Causes of vaginal microflora disturbances.
Various factors can provoke the development of vaginal dysbiosis. Let's name the most common of them:

• The predominance of fungi of the genus Candida in the vagina, and dysbiosis will be called thrush.
• This can be either a one-time severe or frequent hypothermia of the female body, which reduces general and local immunity, which, naturally, cannot but affect the vaginal microflora.
• Any hormonal changes or disruptions in the body, in particular: puberty, irregular sex life, pregnancy and childbirth, menstrual irregularities, abortion, premenopausal period, menopause, etc.
• Change of climate zone.
• Constant stress.
• Promiscuous sexual relations with different partners, neglect of contraceptives.
• Any diseases of the pelvic organs of an infectious-inflammatory nature.
• Sexual infections (ureaplasmosis, trichomoniasis, chlamydia).
• Long-term or frequent treatment with antibiotics.
• Intestinal diseases, constant problems with stool, intestinal dysbiosis.
• Incorrect use of tampons during menstruation. Not everyone knows that during menstrual bleeding, when using tampons, they should be changed every two hours, even at night. This is not only inconvenient, but contributes to the development of perfect conditions in the vagina for the growth of various infections. Using sanitary pads will eliminate this problem.
• It could be Gardnerella. In this case, the disease will be called gardnerellosis (bacterial vaginosis). This type of disease most often develops asymptomatically. Only rarely can it manifest itself as itching and profuse vaginal discharge with an unpleasant fishy odor.
• Any microorganisms with pathogenic activity.

Of course, these factors may not always immediately cause bacterial vaginal vaginosis, since the immune system is responsible for maintaining the microflora in a normal state, helping it recover in case of a minor disturbance. But since there are a lot of factors that provoke the occurrence of bacterial vaginosis and they occur quite often, and the immune system cannot always cope with its task, the development of the disease in women still occurs.

Mechanism of disease development.
Violation of the vaginal microflora occurs due to an imbalance of bacteria that live in the vagina. Normally, a woman’s vagina contains about 90% of beneficial lactobacilli (the so-called Dederlein bacilli), about 10% - bifidobacteria, and less than 1% of the “key cells of the vagina” (leptothrix, gardnerella, fungi of the genus Candida, mobiluncus and some other representatives). It is one of the representatives of the key cells that can become the causative agent of dysbiosis. In addition, they can be one of the sexually transmitted infections or any saprophytic pathogen (streptococci, E. coli, Proteus, staphylococci, etc.). When the vaginal microflora is disrupted, there is a significant reduction in the number of beneficial bacteria and a predominance of pathogenic microflora.

The microorganisms that inhabit the vagina never behave hostilely towards the walls of the vagina; they do not allow a negative change in the ratio of beneficial organisms and pathogens. In this case, the immune system provides active support. It is the immune system that helps restore normal microflora in case of minor disturbances. But this does not always happen, unfortunately.

Any pathogen that leads to dysbacteriosis can provoke a serious complication in the form of vaginitis or colpitis (inflammation of the vagina). The occurrence of this complication occurs depending on the number and pathogenicity of the pathogen, as well as on how strong the immunity of the vaginal walls is. Initially, the protection copes with its task and prevents the progression of the disease and its complications. However, if you do not undertake timely and competent treatment, then inflammation in this situation is simply inevitable.

Symptoms of the development of the disease and its main complications.
As already noted, at first the disease is practically asymptomatic. The changes concern the nature of vaginal discharge, but, as a rule, women do not pay much attention to this. Normally, a woman may experience slight transparent discharge without an unpleasant odor; there should be no other kind of discharge, just as there should be no unpleasant sensations of dryness in the vagina during intimacy, pain, itching and burning in the vagina. As a rule, with vaginal dysbiosis, the amount of discharge increases sharply, and it may have a whitish or yellowish tint with an unpleasant odor, reminiscent of rotten fish. There are no other symptoms for this disease. Itching and burning, vaginal dryness indicate the duration of the disease and the lack of treatment, as a result of which complications have developed.

In general, this disease is chronic, accompanied by periods of exacerbations and remissions. In the absence of adequate therapy, constant infection of the uterus with bacteria from the vagina can lead to the development of inflammation of the uterine mucosa (endometritis) and its appendages (adnexitis). In addition, long-term untreated treatment can contribute to the development of vaginitis or colpitis, in which the discharge becomes purulent, pain and pain occur in the genitals, and often an increase in body temperature. Another complication of dysbacteriosis can be cervicitis - inflammation of the cervix, in which pain in the lower abdomen is observed, and intimacy becomes very painful. In addition, with this disease, constant infection of the urethra occurs, which ultimately leads to the development of cystitis, the main symptoms of which are pain and burning when urinating.

Bacterial vaginosis of the vagina during pregnancy.
Quite often, pregnancy causes an exacerbation of bacterial vaginosis. Since during this period the female body undergoes enormous hormonal changes, immunity decreases, nutrition and lifestyle changes, against this background discharge, itching or burning in the genitals, pain during sexual intercourse, etc. may appear or intensify.

Since any drug therapy is generally contraindicated during pregnancy, it is not possible to receive full treatment. Any treatment for this disease, even if without the use of antibiotics, is always accompanied by immunocorrection, which is unacceptable during pregnancy. That is why local therapy is prescribed to eliminate the symptoms of this disease.

Taking antibiotics after childbirth can provoke dysbacteriosis, which also manifests itself in increased discharge, dryness, itching and burning, and pain. Treatment of this disease in women during breastfeeding is undesirable, therefore local therapy is prescribed, which reduces to symptomatic treatment or, in other words, elimination of the manifestations of the disease. This includes vaginal sanitation and antibacterial suppositories. Then, at the end of breastfeeding, if necessary, treatment is repeated using other drugs.

Bacterial vaginosis and sexually transmitted infections.
In any case, sexually transmitted infections are associated with a violation of the vaginal microflora. The appearance of a genital infection in the vagina shifts the pH, contributing to the occurrence of an inflammatory reaction and further progression of the disease.

Sexual infection is always associated with opportunistic microflora, so this must be taken into account when treating STDs, since there may be a situation when antibiotic treatment completely kills the STD pathogen, while the number of opportunistic infections only increases.

The final stage of treatment for STDs in women should be restoration of the vaginal microflora. In case of serious infections or the presence of several STDs, antibacterial therapy should be carried out and only then restore the vaginal microflora. In simple cases, you can first carry out a comprehensive diagnosis of the entire urogenital microflora, and then begin to restore it while simultaneously eliminating sexually transmitted infections.

Bacterial vaginosis and intestinal diseases.
In the presence of severe intestinal dysbiosis, bacterial vaginosis should also be expected. This is due to the fact that the wall of the rectum is in close contact with the wall of the vagina, as a result of which bacteria can easily pass through it. As a rule, one of the intestinal infections is cultured from the vagina - E. coli, enterococci, etc.

In this case, treatment is complex, since there is a high probability of relapse. In this case, restoration of normal vaginal microflora is carried out while simultaneously treating intestinal diseases.

Bacterial vaginosis of the vagina in girls.
This disease occurs very often in girls who are not yet sexually active, which is due to many factors: hormonal instability, the formation of the menstrual cycle, and the anatomical features of the structure of the hymen.

Bacterial vaginosis in girls only in rare cases occurs with heavy discharge, since the small opening of the hymen does not allow it to be completely removed from the vagina. Because of this, stagnation of vaginal discharge occurs, which sharply increases the risk of developing inflammatory diseases. Meanwhile, during the first intimate relationship, a large number of bacteria are thrown from the vagina into the bladder, which can provoke the so-called “honeymoon cystitis.”

Treatment of this disease in virgin girls is complicated by the structure of the hymen, which does not make it possible to treat the vagina with medicine as much as necessary. Therefore, sometimes doctors are forced to resort to artificial disruption of the integrity of the hymen (hymenectomy) in order to provide optimal treatment.

Bacterial vaginosis and sexual partner.
The disturbed microflora of a woman during intimate intimacy with a man does not affect his health in any way, even without the use of contraceptives. Very rarely, in cases of severe vaginal dysbiosis, a man may experience balanoposthitis and nonspecific urethritis. However, this happens if the man had a clear predisposition to these diseases. An absolutely healthy male body is not afraid of these inflammatory diseases. They will not develop in a completely healthy body.

It is worth noting that no diseases of the partner affect the microflora of a woman’s vagina, except for sexually transmitted diseases. Treatment of disturbed microflora in a woman does not require mandatory treatment of the sexual partner, unless he has a sexually transmitted infection. Therefore, the sexual partner must also undergo examination.

Diagnosis of the disease.
For an experienced specialist, diagnosing bacterial vaginosis will not be difficult. In addition to a visual examination, the diagnosis of this disease includes taking a general flora test, PCR diagnosis of sexually transmitted infections and culture of vaginal discharge or a special study of the vaginal microflora. A smear shows the state of the microflora of the vagina and vaginal wall, the degree of their disturbance and the severity of the inflammatory process, and the diagnosis of sexually transmitted infections and culture make it possible to identify the pathogens that caused the disturbance of the microflora and to identify the sensitivity of bacteria to antibiotics. The correct course of treatment cannot be determined from just one smear.

Treatment of bacterial vaginosis should be comprehensive and include three areas:

Suppression of bacteria.
If a violation of the microflora is associated with the presence of a sexually transmitted infection, then first treatment should be aimed at completely eliminating the causative agent of the infection. In this case, treatment consists of taking antibiotics while carrying out other measures. If there are no sexually transmitted infections, then antibiotic therapy is not necessary. In this situation, either a short course of antibacterial therapy is used, about three to five days, or local application of antibiotics and antiseptics is used. Their action simultaneously fulfills all treatment objectives (suppression of pathogenic flora, population of normal inhabitants of the vagina and local immunocorrection). And the use of antiseptics generally eliminates the possibility of bacteria being immune to them. To suppress pathogenic bacteria, antibiotics (Amoxiclav, Sumamed, Doxacycline, Trichopolum, etc.), local antiseptics (Miramistin, Chlorhexidine), and antibacterial suppositories (Terzhinan, Ginopevaril, etc.) are most often prescribed.

Population of normal vaginal microflora.
This point is the main one in the treatment of dysbiosis. The remaining measures are aimed at creating conditions for the engraftment and growth of normal flora. However, in practice, most doctors neglect this stage of treatment. For the population of normal vaginal microflora, massive doses of eubiotics (preparations with live bacteria) of general and local action are used. But using only eubiotics to restore microflora without suppressing pathogens is simply useless.

Restoring the immunity of the vaginal walls.
Local immunocorrection should also be one of the stages in the treatment of dysbiosis, otherwise other measures taken will not have the expected effect. In simple situations for immunocorrection, as a rule, they are limited to the use of local immunomodulators (Polyoxidonium, Cycloferon, Genferon, Immunal), as well as taking any probiotics with lactobacilli (Lactobacterin, Linex, Narine, Normoflorin-b, etc. In addition, it is recommended to include add as many fermented milk products as possible to your diet.In cases where the disease is advanced, restoring the immunity of the vaginal walls will require the implementation of more complex measures.

According to traditional medicine, douching with lemon juice diluted with water, lactic acid, as well as inserting tampons soaked in kefir into the vagina are effective for treating dysbiosis. All this contributes to the creation of an acidic environment in the vagina, without which there can be no growth and activity of good lactobacilli bacteria.

Prevention of vaginal microflora disorders.
Those who have been treated for this disease should be examined every three months for a year. At the appointment, the patient talks about her condition, is examined and, if necessary, tests are taken. If a tendency to microflora disturbance is detected, a short preventive course of treatment is prescribed. Restoring microflora at the initial stage of its disturbance is very easy.

If no serious problems arise during the year, then you can see a doctor once every six months. This allows you to assess and identify the presence of a tendency to relapse and prevent the disease from developing again.

Oddly enough, most girls and women remember the vaginal microflora only when it begins to be disrupted. Leading experts rightly believe that maintaining normal vaginal microflora creates serious barriers to the occurrence of various infectious and inflammatory processes in the internal genital organs. As recent statistics show, from 20 to 30% of women of reproductive age have a violation of the vaginal microflora.

Normal vaginal biocenosis

Thanks to clinical studies, scientists have found that the natural microflora of the vagina is a combination of beneficial and opportunistic microorganisms. Normally, beneficial bacteria significantly outnumber opportunistic species. It is reliably known that approximately 95–97% of the vaginal biocenosis consists of lactobacilli, which, by producing lactic acid, provide an acidic environment in the vagina and protect it from infection. Opportunistic microorganisms (3–5%) are represented by the following types:

• Gram-positive rods.
• Gram-positive and gram-negative cocci.
• Anaerobic rods.
• Enterobacteriaceae.

The symbiotic relationship between beneficial and opportunistic microorganisms not only does not cause any harm, but even protects the internal genital organs from infection. Most infectious agents entering the vagina are neutralized in an acidic environment. However, it is worth noting that changes in microflora can occur during the menstrual cycle. For example, at the beginning of the cycle there is some deviation in vaginal pH towards the alkaline side. There will be a characteristic decrease in the number of lactobacilli, which is accompanied by an increase in opportunistic microorganisms. But immediately after menstruation, a rapid restoration of balance is observed.

If you notice any unnatural discharge from the genitals, do not delay visiting a doctor.

Violation of vaginal biocenosis

Not so long ago, a violation of the vaginal microflora was considered a clinical syndrome. However, it is now classified as a separate nosological entity, which is given the name bacterial vaginosis. In this pathological condition, there is a sharp decrease or absence of lactobacilli and an increase in the number of opportunistic microorganisms, in particular gardnerella and gram-negative anaerobic bacteria. It should be noted that neither sexually transmitted bacterial infections, nor fungi or pathogenic protozoa are the cause of bacterial vaginosis.

As a result of the development of vaginal dysbiosis, the pH of the environment in the vagina shifts to the alkaline side and becomes more than 4.5. Such changes are associated with the presence of a large number of anaerobic bacteria, which produce volatile amines that have an extremely unpleasant odor, reminiscent of rotten fish. Changes in the biocenosis and pH of the environment deprive the vagina of a biological protective barrier, creating all the conditions for the occurrence of infectious and inflammatory diseases of the woman’s reproductive system.

What causes dysbiosis?

Bacterial vaginosis does not appear out of nowhere. The following may act as a provoking factor leading to disruption of the vaginal microflora:

• Hormonal imbalance. Often observed during pregnancy and breastfeeding, during abortion, menopause, irregular sex life, etc.
• Taking antibacterial agents. If you use antibiotics, they destroy not only dangerous, but also beneficial bacteria and other microorganisms. Uncontrolled long-term use of antibacterial drugs is particularly harmful to health.
• Constant hypothermia, physical fatigue, unbalanced psycho-emotional stress, leading to decreased immunity.
• Failure of the menstrual function of the ovaries of various types.
• Past infectious and inflammatory diseases of the reproductive system.
• Too active sexual life (several sexual partners or frequent changes).
• Both insufficient and overly thorough hygiene of the intimate area.
• Use of hormonal oral contraception and/or use of intrauterine contraceptives.

Violation of the vaginal microflora is a disease that needs to be treated purposefully.

Manifestation of dysbiosis

In the vast majority of cases, bacterial vaginosis is manifested by local symptoms. In some patients, subjective sensations may be absent. Typical clinical picture of vaginal dysbiosis:

• There is copious discharge from the internal genital organs (whitish-gray in color, strong unpleasant odor). Quite often observed after intimacy or during menstruation.
• If the disturbance of the vaginal microflora is chronic, then the discharge becomes yellowish-green, more saturated and thick, and looks like a cheesy mass.
• The amount of discharge can vary from slight to very heavy.
• Women rarely complain of itching and problems with urination. If present, they usually appear periodically.
• A characteristic symptom of bacterial vaginosis is the absence of inflammation of the vagina.
• Sometimes there is heavy menstrual bleeding and a feeling of pain in the lower abdomen.

A woman who has a violation of the vaginal microflora can contribute to the development of inflammation of the head and foreskin in her sexual partner.

How to determine dysbiosis?

Basic clinical and laboratory criteria indicating bacterial vaginosis:

• Abundant cheesy discharge with a whitish-gray tint and a very unpleasant odor, evenly covering the walls of the vagina.
• The pH of the vaginal environment is more than 4.5.
• Positive amine test. By mixing samples of vaginal discharge with a solution of potassium hydroxide in equal proportions, a characteristic fishy odor appears.
• Microscopic examination identifies “key cells.” These are desquamated epithelial cells to which various opportunistic microorganisms are attached. Normally, key cells are not detected.

If at least three of the above criteria are detected, then we can safely talk about a violation of the vaginal microflora, characteristic of bacterial vaginosis. If necessary, the diagnosis is supplemented with a bacteriological research method, which makes it possible to determine the qualitative and quantitative composition of the vaginal biocenosis.

If the vaginal microflora has been disturbed for a long time, this can affect the woman’s reproductive function.

Restoration of vaginal biocenosis

To successfully eliminate bacterial vaginosis, two main tasks must be completed:

• Suppress excessive growth and reproduction of opportunistic bacteria (especially anaerobes) through the use of antibacterial drugs.
• Restore normal vaginal biocenosis with the help of eubiotics, which will help increase the proportion of beneficial microorganisms.

Currently, antibacterial therapy to suppress opportunistic flora includes the administration of the following medications:

• Clindamycin.
• Metronidazole.
• Tinidazole.
• Ornidazole.

The therapeutic course can last for 5–7 days. If a woman is pregnant and suffers from bacterial vaginosis, then Clindamycin in the form of a cream is usually used. After completion of antibacterial treatment, measures are taken to restore normal vaginal biocenosis. There are no special restrictions regarding sexual activity during therapy. To boost immunity, it is recommended to take vitamin-mineral complexes and biogenic stimulants (Actovegin, aloe extract, etc.).

With proper adherence to the regimen and compliance with all the instructions of the attending physician, the normal microflora of the vagina is restored within several weeks.

Preparations for normalization of biocenosis

How to improve vaginal microflora? Having effectively dealt with opportunistic bacteria, they move on to taking eubiotics that help restore the vaginal biocenosis. This group of drugs includes:

• Lactobacterin.
• Lactonorm.
• Bifidumbacterin.
• Acylact.
• Ecofemin.
• Gynoflor.

Lactobacterin

One of the most popular eubiotics used to correct vaginal biocenosis is Lactobacterin. Live bacteria contained in the drug ensure the normalization of microflora, maintaining the pH of the vaginal environment at a level of no more than 4.5. In the acidic environment created by lactobacilli, many pathogenic and opportunistic microorganisms cannot grow and reproduce. Allergy to the components of the drug, vulvovaginal candidiasis and childhood are considered contraindications for use.

Side effects in the form of allergic reactions are very rare. Due to a decrease in the therapeutic effect, the simultaneous use of Lactobacterin and antibacterial drugs is not recommended. Restorative therapy using intravaginal suppositories can last 10–14 days. If necessary, repeated courses of treatment may be prescribed after 2–3 weeks. The cost of the drug Lactobacterin ranges from 130–150 rubles.

Gynoflor

Gynoflor is widely used to normalize vaginal microflora. Unlike the previous drug, this medicine contains not only lactobacilli acidophilus, but also a small amount of estrogen (estriol). Lactobacilli successfully cope with pathogenic and opportunistic flora. Estriol ensures the restoration of the vaginal epithelium, maintaining the biocenosis and pH of the environment, without having a systemic effect on the female body. In healthy epithelium, glycogen accumulates, which is necessary for the normal functioning of lactobacilli. Contraindications include the following conditions and diseases:

• Allergy to the main and auxiliary components of Gynoflor.
• Neoplasms sensitive to estrogen (tumors of the breast, reproductive system, etc.).
• Any form of endometriosis.
• Bloody discharge from the genitals of unknown origin.
• Young age.

I would like to note that Gynoflor does not change the level of natural hormones in the blood. In the early stages of pregnancy (1st trimester) it is not recommended to prescribe the drug. At the same time, in later stages its use is allowed if there are appropriate indications and there are no contraindications. However, there is no reliable data on the effect of Gynoflor on the course of pregnancy and fetal development, since long-term clinical studies have not been conducted.

Side effects are recorded quite rarely. Some women experienced local adverse reactions, such as redness and a burning sensation in the genital area. In addition, simultaneous use with antibiotics may lead to a decrease in the effectiveness of the drug. Spermicidal agents are also not recommended to be combined with Gynoflor. The course of treatment is determined solely by the attending physician, but on average it can last 1–2 weeks. During therapy, it is better for girls and women to use sanitary tampons.

In most pharmacies, the price for the domestically produced drug Gynoflor does not exceed 950 rubles per package (6 vaginal tablets). Packs of 12 tablets are also available for sale, costing about 1,300 rubles.

Solcotrichofac

In prolonged and recurrent forms of bacterial vaginosis, the immunostimulating vaccine Solcotrichofac is used to normalize the vaginal microflora. The use of this specific drug not only helps to stabilize vaginal biocinosis, but also prevents the likelihood of relapses and mixed infections in approximately 80% of women. Solcotrichofak is actively used as both a therapeutic and prophylactic agent for bacterial vaginosis.

Vaccination with this drug should only be carried out by a doctor. The course includes 3 intramuscular injections. The interval between each administration is 14 days. The exact time of vaccination is calculated in advance so that injections do not coincide with menstruation. Revaccination is carried out after 12 months. The main contraindications to the use of Solcotrichofac are:

• Allergy to vaccine components.
• Various infections in the acute stage.
• Tuberculous organ damage.
• Diseases of the blood system.
• Severe cardiovascular pathology.
• Serious kidney problems.
• Immunodeficiency states.

During pregnancy, whether to vaccinate with Solcotrichofak or not is decided by the doctor, taking into account the benefits for the woman and the possible risk for the child. There are practically no side reactions. In rare cases, headaches, chills, fever, general weakness, etc. were observed. The drug is also effective for recurrent trichomoniasis. You can purchase the Solcotrichofac vaccine in pharmacies with a prescription.