home Audience 8 What does it mean if leukocytes are elevated according to gynecology. An increase in leukocytes in a smear in women. Consultations of related specialists

What does it mean if leukocytes are elevated according to gynecology. An increase in leukocytes in a smear in women. Consultations of related specialists

Leukocytes are special cells of the immune system designed to protect the body from infections. When a virus appears, white blood cells begin to actively multiply in order to defend themselves. Naturally, this increase is immediately reflected in blood tests and, of course, in a smear. For doctors, the signal for treatment is the presence of more than 15 units of leukocytes in the smear in the field of view. This means that a woman develops an infectious-inflammatory disease. If the number of leukocytes literally goes off scale, it means that the lady has problems with the genitourinary system. This may be inflammation of the bladder, kidneys or genitals.

What do leukocytes in a smear indicate?

Leukocytes can be detected in a smear and are normal. But in this case there will not be so many of them. If the value is outside the normal range, most likely the woman develops an infectious inflammatory disease - vaginitis, bacterial vaginosis, thrush, colpitis, etc. Moreover, the more leukocytes in the smear, the more acute the course of the disease.

Symptoms that may accompany an increased number of white blood cells in a smear are the following:
- frequent urination, which can be quite painful;
- burning sensation in the vagina;
- unpleasant ;
- problems with the menstrual cycle (for example, failure);
- dense whitish discharge.

The reasons for a gynecological smear can be various problems. This includes vaginal dysbiosis, various sexually transmitted infections, E. coli, and genital cancer.

What to do with elevated white blood cells

First of all, in order to reduce the number of leukocytes in a smear, you need to treat the cause that causes this pathology. Treatment must be prescribed by a supervising gynecologist. Sometimes a urologist is also involved in drawing up a treatment regimen.

At the same time, you can try to reduce the discomfort that a particular disease causes. For this purpose, sanitation is usually prescribed to restore the vaginal microflora. The course can be carried out either with the help of medications or with herbs - chamomile, nettle, St. John's wort, etc. Naturally, such treatment can only be used in consultation with a doctor.

You can also take warm baths. The water temperature should be at least 45 degrees, because heat helps fight inflammatory diseases.

Special suppositories are often used to reduce leukocytes in a smear.

By leukocyte level, which specialists can easily determine under a microscope, judge the existing inflammatory process. As for gynecology, white blood cells are determined and counted during the following studies - smears on:

flora (microscopy);
cytology;
degree of purity.

Analysis of microflora composition

A urogenital smear for microflora is taken from three points: the vagina, cervix and urethra. If an inflammatory process is detected, it is called colpitis(if the vagina is affected), cervicitis(if leukocytosis is recorded in the cervical canal) and urethritis(there is a problem in the urethra).

In addition to leukocytes, doctors are interested in the amount of epithelium and mucus. This additionally indicates health or pathology.

So, normally, women should have this number of leukocytes in a smear.

As you can see, the table also indicates 0, which means the absence of leukocytes is also an acceptable option. Not below normal.

Purity Analysis

A smear test for purity is similar to microscopy. And often in the results you will see a numerical indication of the “purity” of the genital tract. If single leukocytes are found - 1-3-5 in the field of view, then they speak of the first degree. In addition, a lot of beneficial microflora - lactic acid rods - are found in a woman’s vagina.

In the second degree, there are still not too many leukocytes, perhaps a little more than normal, for example, 10-15 , but in the vagina, in addition to Dederlein’s bacilli, opportunistic microorganisms are determined - Klebsiella, Candida fungi, gardnerella, etc.

In the third degree, there are many opportunistic bacteria in the vagina. Leukocytes are found in clusters, in large numbers. Their approximate level 25-30 or even 40-50.

With the fourth degree in a smear from 60 white blood cells. Sometimes they cover the entire field of view, that is, their number reaches above 100. Very high white blood cells are diagnosed against the background of other signs of the inflammatory process - coccobacillary flora and the almost complete absence of lactobacilli.

Analysis for atypical cervical cells (oncocytology)

In a cytological smear, information about the number of leukocytes is important if a woman has atypical cervical cells or is suspected of having them. The fact is that cervicitis, which is characterized precisely by leukocytosis, causes reactive processes in cells similar to those that occur in precancerous diseases.

If the leukocytes are high, you first need to be treated, and then, when their level becomes low, after 2-3 months, repeat the analysis. Let us remind you how many white blood cells are normal in the cervical canal - up to 30 units.

Causes of elevated white blood cells in a smear in women, symptoms and treatment

The culprit for this is the inflammatory process. And it is provoked by various bacteria, fungi and viruses.

Urogenital infection. Chronic or acute cystitis

In girls, it often occurs simultaneously with vulvovaginitis, that is, the mucous membrane of the labia and vagina turns red and becomes swollen. Cystitis is a very common disease in women due to their anatomical features - a short distance separating the vagina, rectum from the urethra and a very short and wide urethra, through which infection easily enters the bladder.
Hypothermia or the so-called cold plays a negative role and leads to rapid progression of inflammation.

In this case, the following pathogenic microorganisms are diagnosed by culture or smear using the PCR method:

Chlamydia trachomatis (chlamydia);
Mycoplasma genitalium (genital mycoplasma);
Ureaplasma urealyticum (ureaplasma);
Mycoplasma hominis (mycoplasma hominis);
E. coli (Escherichia coli);
Staphylococcus saprophyticus (saprophytic staphylococcus);
Enterococcus faecalis (fecal enterococcus);
Klebsiella (klebsiella);
Proteus mirabilis (Proteus miribilis).

Thrush (vaginal candidiasis)

The causative agent is yeast-like fungi of the genus Candida. Yeast is not sexually transmitted. This is an opportunistic microorganism that is present in the vaginal microflora of almost every woman, but it causes disease only when the number of lactobacilli decreases, or if its number increases.

Contribute to the development of candidiasis:

diabetes;
pregnancy;
taking antibiotics;
HIV infection.

Signs of the disease:

itching and burning in the labia area;
white cheesy or creamy discharge that gets worse before menstruation;
pain during sex;
painful urination if the urethra is also affected by fungi.

Diagnosis of candidiasis is carried out using bacterial culture. Microscopy does not always show obvious signs of disease.

Treatment tactics depend on whether the disease is chronic, how often it recurs, and how severe and painful the symptoms are.

The following drugs are used for local treatment (intravaginally):

clotrimazole tablets (100 mg once a day for 7 days, or 200 mg once a day for 3 days);
clotrimazole cream (if the labia are affected) for 1-2 weeks;
natamycin (100 mg for 6 days);
butoconazole 2% cream once;
itraconazole (200 mg for 10 days).

For oral administration (oral):

fluconazole (150 mg once);
itraconazole (200 mg 3 days).

During pregnancy, medications for topical use with the active ingredients clotrimazole (from the second trimester of pregnancy) and natamycin (from the first trimester) are prescribed.

Vaginal candidiasis is not sexually transmitted, but there are conditions that promote the growth of fungi and should be avoided:

uncontrolled use of antibiotics and hormonal drugs;
wearing thick synthetic underwear;
endocrine, gastrointestinal, gynecological diseases;
frequent use of sanitary pads;
douching;
one sexual partner (getting used to his microflora occurs).

Complications of thrush include:

inflammatory diseases of the pelvic organs;
urethrocystitis;
during pregnancy - infection of the fetus, intrauterine death, premature birth;
postpartum candidal endometritis.

Allergic vulvitis or vulvovaginitis

The cause is sanitary pads, tampons, and intimate hygiene products. The labia become swollen and itchy. It goes away on its own. The main thing is not to use an allergen.

Trichomoniasis (Trichomonas vaginitis)

The causative agent of the disease is Trichomonas vaginalis. It is transmitted sexually, very rarely through household contact (through bed linen, towels, etc.). It is detected in a general smear or bacterial culture and is one of the most common causes of leukocytosis in a smear.

From infection to the appearance of the first symptoms, it takes from 7 to 28 days:

foamy vaginal discharge of yellow or gray color;
redness of the genital mucosa;
pain during sexual intercourse;
pain when urinating;
pain in the lower abdomen.

Trichomoniasis is dangerous for pregnant women, as it causes premature rupture of the amniotic sac and premature birth.

Causes paraurethritis, salpingitis.

metronidazole - 2 g orally once or 500 mg orally 2 times a day for one week;
tinidazole - 500 mg 2 times a day for 5 days or 2 g once;
ornidazole - 500 mg 2 times a day for 5 days or 1.5 g once.

In case of complicated and relapsing course of the disease, changes are made to the indicated treatment regimens - higher doses of drugs and longer administration are recommended. Antimicrobial drugs are also prescribed intravaginally: metronidazole in the form of tablets of 500 mg one at a time for 6 days or vaginal cream of the same name for 5 days.
During pregnancy, treatment is carried out with the same drugs, but not earlier than the second trimester of pregnancy (13-14 weeks).

Hidden sexually transmitted infections (ureaplasmosis, mycoplasmosis, chlamydia)

There are three infectious pathogens that can cause an inflammatory type of smear with an increase in leukocytes, but they are not detected in a regular smear for flora. Only using a special PCR method. These are chlamydia, ureaplasmosis and mycoplasmosis. They are provoked by the following microorganisms: Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum.

In more than half of cases, latent infections are asymptomatic. If signs of the disease appear, they are as follows:

mucopurulent discharge;
pain during sexual intercourse;
itching and burning;
pain when urinating;
aching pain in the uterine area.

Chlamydia also causes intermenstrual bleeding and erosion on the cervix.

If the infection spreads higher, to the uterus, fallopian tubes, ovaries, then it is diagnosed with sapingoophoritis and endometritis.

Possible treatment regimens (one of the drugs is prescribed orally):

doxycycline monohydrate - 100 mg 2 times a day for a week;
azithromycin - 1.0 g, taken once;
josamycin - 500 mg 3 times a day for a week;
ofloxacin - 400 mg 2 times a day for a week.

In some cases, longer therapy is required - 2-3 weeks. Pregnant women are treated with the same antibacterial agents.

If microorganisms M. Hominis and/or Ureaplasma spp. are detected, and there are high white blood cells and there are symptoms of the disease, then the doctor should look for more obvious pathogens: Trichomonas, gonococcus, mycoplasma genitalium.

Treatment is not carried out in the absence of symptoms of the disease, that is, the accidental detection of ureaplasma in an amount of even more than 10 to 4 degrees. The exception is expectant mothers. If they have a history of frozen, undeveloped pregnancies, premature rupture of amniotic fluid, or intrauterine infection of the fetus, they need to be treated.

Vaginal microflora disorder or nonspecific vaginitis

In addition to cocci (staphylococci, streptococci, etc.), the culprits of nonspecific vaginitis are other opportunistic representatives of the flora: Escherichia (intestinal microorganisms), fungi, Trichomonas.

Symptoms:

itching and burning;
pain during sexual intercourse and slight bleeding;
swelling of the vaginal mucosa;
serous-purulent discharge.

Diagnostics. Microscopy reveals highly elevated leukocytes, many gram-positive and gram-negative microorganisms, and desquamated epithelium.
Cultures are carried out to accurately diagnose pathogens and determine their sensitivity to antibiotics.

Stage 1 - antibiotics and antibacterial agents locally:

Stage 2 - restoration of microflora:

Vagilak;
Bifidumbacterin;
Lactobacterin;
Biovestin.

Gonorrhea

The causative agent of the disease is gonococcus (Neisseria gonorrhoea - gram-negative diplococci). A common cause of female and male infertility.

Symptoms:

difficulty urinating;
itching in the vagina;
purulent discharge from the cervix.

If the disease does not affect the urethra and bladder, then it can only be detected with the help of an analysis - a smear on the flora or bacterial culture, since there are no vaginal signs of the disease in women. Leukocytes in the smear are elevated and pathogenic microorganisms are present.

If the disease rises higher and affects the reproductive organs, then the following symptoms are possible:

temperature up to 39 degrees and above;
nausea, vomiting - intoxication;
menstrual irregularities.

They provoke an ascending infection:

abortions;
diagnostic and therapeutic curettage;
probing the uterine cavity;
cervical biopsy;
intrauterine device.

The inflammatory process usually worsens after menstruation or childbirth.

Gonorrhea is dangerous due to the following complications:

Treatment is quick and simple, with one of the following medications:

Ceftriaxone (500 mg) intramuscularly once;
Cefixime (400 mg) orally once;
Spectinomycin (2 g) intramuscularly once.

The same drugs are used to treat pregnant women, at any stage.

True erosion

This is a wound on the cervix. It may appear as a result of sexual intercourse, examination by a gynecologist, taking tests, careless insertion of a suppository (suppository) into the vagina, etc. It heals on its own within 10 days.

Diagnosed by examination using a gynecological speculum or with. Sometimes Depantol suppositories, sea buckthorn suppositories, methyluracil suppositories, and calendula douching are prescribed for its treatment. Various folk remedies and healing products are used

But, as medical practice shows, within 10 days it goes away on its own - with or without treatment.

Herpes simplex virus

If there are no infections, the causative agent of the disease is not visible in the smear, hidden infections are not detected, you should look for viruses using the cultural method (analysis for HSV-1,2). This must also be done if a woman was treated with an antibacterial drug or a broad-spectrum antibiotic, but her white blood cells only became even higher or did not decrease. Antibiotics do not work on viruses.
Leukocytosis in a smear is also detected in HIV infection.

Oncology - cervical cancer (CC)

A malignant tumor itself rarely provokes an increase in the level of leukocytes. Therefore, we put this reason in last place.

In bacterial vaginosis, the white blood cell count is normal. For this reason, it is not on the list above. Signs of vaginal dysbiosis are the presence of key cells in the smear and a decrease in the number of lactobacilli, against the background of the appearance of opportunistic flora (Gardnerella, Klebsiella, Leptothrix, etc.). By the way, a very common disease during menopause, when the protective function of the vaginal and cervical mucosa becomes weaker due to a lack of estrogen.

Growth of leukocytes depending on the phase of the menstrual cycle and during pregnancy

There are always more leukocytes in the cervical canal than in the vagina. Moreover, this amount increases in the middle of the cycle (when ovulation) and before menstruation. Doctors often take a smear incorrectly - there is too much material or they rub it too thoroughly on the glass, which causes the destruction of epithelial cells. But it is the ratio of leukocytes to that is the most important sign of inflammation or its absence. Normally, this is approximately 10 polymorphonuclear leukocytes (PMN, and there are other types) per epithelial cell.

For some women, for unknown reasons, white blood cells remain high for some time. And this is with a clear absence of inflammation and other good tests. Trying to reduce your white blood cell count or get rid of them altogether is not a good idea. It is not the test result that is treated, but the disease, if there is one.

There are even more leukocytes during pregnancy. Physiological process. And if nothing else bothers you, you can be observed. However, doctors play it safe and often prescribe a local antiseptic for a “bad” smear - Hexicon suppositories (active ingredient - chlorhexidine). They can be used in any trimester of pregnancy. And at the end, before childbirth, the vagina is sanitized in this way.

During pregnancy, a cervical plug is formed from leukocytes and mucus. It is she who protects the uterus from infection.

Questions from our readers on the topic

Do leukocytes prevent you from getting pregnant? If a woman does not have a gynecological disease that would prevent her from conceiving, for example, endometritis, then there will be no infertility for this reason. However, it is imperative to get tested for infections and treat them. After all, they are most often to blame for leukocytosis.

Will they be allowed into IVF with microscopy pathology? If the problem is only the number of white blood cells, it may make sense to retake the smear a little later, in a different phase of the menstrual cycle. Perhaps there was a medical error when collecting material or laboratory. But if the result is confirmed, and there are no other problems, the doctor may prescribe a short course of antiseptic. This is not dangerous.

Is an IUD placed on a smear of the third or fourth degree of purity? No, as this will lead to the spread of microbes into the uterus and endometritis, adnexitis, salpingo-oophoritis.

Is hysteroscopy done if the smear is imperfect? If you have an elective procedure, it may have to be postponed.

Can white blood cells be elevated due to endometriosis? Yes, this can happen.

If after a miscarriage there is a bad smear - what to do? Get tested for hidden infections and the herpes virus. Remember that infection interferes with carrying a child to term and leads to early abortion.

When preparing the material, clinical recommendations of the Russian Ministry of Health were used.

Taking a bacterioscopy of discharge from the genitourinary organs (smear for flora) is an integral part of every examination by a gynecologist. The examination is used both to determine leukocytes in a smear and to assess the effectiveness of antibacterial therapy. The method combines simplicity, non-invasiveness and information content.

Leukocytes - what are they and when can they be detected?

This name refers to a whole group of human white blood cells that perform a protective function in the body. When pathogenic microorganisms find themselves in the genitourinary tract, leukocytes also penetrate there from the bloodstream through the capillary wall. They neutralize foreign flora during the process of phagocytosis. If there are too many bacteria, white blood cells are destroyed, causing local inflammation. If the infection is not stopped (with antibacterial therapy, for example), then the number of dead white cells increases, forming pus.

Normally, leukocytes can be detected in a woman’s gynecological smear in small quantities or slightly increased for physiological reasons. A significant deviation from the norm, accompanied by signs of phagocytosis (the presence of destroyed white cells) is a sign of the presence of an infection caused by pathogens of various types (bacteria, Proteus, viruses, fungi).

Norm of leukocytes in a smear

A smear from the vaginal mucosa is a mandatory part of the examination, regardless of the patient’s complaints. It can be taken from three points; accordingly, the leukocyte norm will be:

0–5–10 – when taken from the urethra (U);
0–10–15 – from the vagina (V);
0–30 – from the cervix (cervical canal, C).

The following results will also be normal:

15–20 (V) – during pregnancy;
35–40 (V) – a few days before the start of menstruation.

The number of leukocytes is also taken into account when determining the degree of vaginal cleanliness; the norm is indicators of degrees 1 and 2:

1st degree – leukocytes 0–5;
2nd degree – leukocytes – 5–10;
3 degree – more than 10, but less than 50;
4th degree – leukocytes completely.

Pathological deviations 3 and 4 are also characterized by an increase in indicators of opportunistic and pathogenic flora, mucus and epithelium.

Reasons for increase in women

Deviation from the norm can be caused by several groups of reasons, primarily inflammatory processes in the reproductive or urinary organs (if a smear is taken from the urethra):

The pathogenic microflora that causes the listed diseases can also be represented (but not necessarily) by infections that enter the body through sexual contact. These same pathogens can also cause their own specific pathologies (STDs). They can be divided into 4 groups. In group 1, bacteria can cause:

Gonorrhea(gonococci) and chlamydia(chlamydia) - can cause cervicitis, endometritis and proctitis.
syphilis(pale spirochete) , lymphogranuloma venereum and inguinal granuloma(klebsiella) – common to these venous diseases are specific skin manifestations (ulcers).
Ureaplasmosis and mycoplasmosis– cause vaginitis, may be accompanied by inflammatory processes in the pelvic organs. Characterized by copious gray or whitish discharge with a “fishy” odor.
Tuberculosis of the genital organs(Koch bacillus) - the infection can enter the body not only sexually, but also through the lymphogenous or hematogenous route (in the presence of other foci). It can be asymptomatic, or manifest itself in the absence of menstruation and sudden weight loss, low-grade fever, acute pain and night sweats.

Group 2 are protozoal infections represented by Trichomonas. It ranks first in prevalence among sexually transmitted diseases. Trichomoniasis is characterized by pain (during sexual intercourse and urination), copious yellow-green discharge with a “fishy” odor, swelling, itching, etc.

Group 3 consists of viral infections:

HIV – causes the course of AIDS and other related diseases;
herpes simplex viruses type 2 and human papilloma – pathologies have pronounced skin manifestations;
cytomegalovirus - develops almost imperceptibly, causeless fever is possible.

Group 4 (fungal infections) should primarily include thrush. The main cause of candidiasis is a decrease in general immunity, but the disease is also transmitted to a sexual partner, which allows it to be included in the list. Symptoms include itching, burning, cheesy discharge, a strong odor from the vagina, as well as intimacy.

The cause of deviation from the norm may be oncological diseases of the genital area - the key symptom will be bloody discharge without physiological reasons. However, routine inspections are a more effective detection measure.

The reason for the increase in leukocytes in the smear may also be vaginal dysbiosis, which develops against the background of active reproduction of conditionally pathogenic microflora - Escherichia coli, gardnerella, fungi. If the disease is not accompanied by other inflammations, the woman may have no complaints at all, or there may be a foamy, dirty-white discharge with a fishy odor, which intensifies after sexual intercourse or before the onset of her menstrual period.

The causes of dysbacteriosis can be:

hormonal changes during puberty, pregnancy or its interruption, menopause, as well as endocrine disorders;
decreased general and local immunity;
uncontrolled use of antibiotics;
passion for douching;
physical and mental overwork;
chemical and radiation methods of therapy;
frequent change of partners, oral contacts, intimate microtraumas;
foreign bodies in the vagina (hygienic tampons);
frequent use of local spermicidal contraceptives;
deformations of the vaginal vault due to anatomical features, difficult childbirth or surgical interventions;
intestinal dysbiosis.

Allergic reactions can also cause an increase in white blood cells; mucous membranes can react to:

intravaginally administered dosage forms or douching, including their organic components (herbs);
intimate cosmetics (lubricants);
partner's sperm (infrequently).

A general allergic reaction of the body, regardless of the cause, can provoke an increase in the level of white blood cells.

Also, irritation of the external genitalia, causing local inflammation, can occur against the background of:

poor hygiene;
hypothermia or overheating;
wearing uncomfortable underwear;
using chemicals without consulting a doctor;
systemic diseases (diabetes, hepatitis, genitourinary pathologies).

A noticeable increase in leukocytes during pregnancy requires more attention, as it may indicate hidden pathologies that have worsened against the background of restructuring of the body and a physiological decrease in general immunity.

Functional can be provoked by intimate contact, less than a day before taking a smear, taking certain medications or a recently installed intrauterine device (7-10 days before the test).

Diagnostic methods

The first step is often a repeat smear to rule out improper preparation for the test or other physiological factors. If leukocytes are again far from normal, then the following diagnostic measures are justified:

You may also need examinations and consultations with specialized specialists - an endocrinologist or an allergist.

Therapy is carried out in three main directions:

treatment of a systemic disease of an infectious nature, as well as endocrinological or immune disorders;
local funds - aimed at combating pathogenic microflora in the external genitalia;
restorative and preventive measures - strengthening the immune system and maintaining normal microflora in the body.

The following medications correspond to the first direction:

antibiotics and antiviral drugs - if we are talking about a common or venereal infection;
hormonal drugs (if dysbiosis is caused by endocrine disruptions).

Local remedies can be presented:

douching - they need to be carried out carefully, for a course of no more than 4-5 days. Suitable medications include Miramistin, potassium permanganate solution, chlorophyllipt or chlorhexidine;
ointments – for the treatment of urogenital herpes (Zovirax);
suppositories that eliminate foreign flora - Clotrimazole, Pimafucin and analogues are indispensable in the fight against vaginosis and thrush;
suppositories that neutralize local inflammation - Polygynax.

After completion of treatment, the following are used for recovery and prevention:

suppositories and vaginal tablets that restore the natural balance of microorganisms - Laktozhinal, Vagilak;
probiotics, lacto- and bifidobacteria for oral administration - Linex, Lactobacterin, Acylact - are designed for a long course of treatment.

A difficult task will be the choice of adequate therapy during pregnancy - antibacterial and antifungal agents may be contraindicated during certain periods of fetal development. Therefore, it is worth paying more attention to diagnostics in order to timely identify processes in the early stages.

The uncomplicated course of the disease allows the use of safer traditional medicine, for example:

warm baths from herbal decoctions - St. John's wort, aloe, chamomile, oak bark, sage, calendula. The water should not be hot;
douching using the same herbs;
“homemade” sea buckthorn candles. To prepare them, 10 grams of oil must be added with beeswax and stirred while heating in a water bath. Then add 3 g of pine resin. Now all that remains is to pour the composition into molds and cool.

These recipes can only be used after consulting a doctor. If an allergic reaction is noticed, this type of treatment will have to be abandoned.

An increase in leukocytes in a smear should not cause panic. However, subsequent diagnosis and therapy should be taken seriously, avoiding uncontrolled use of antibiotics or indulging in douching. Correctly structured treatment is the key to rapid recovery and restoration of the body.

Women, unlike men, have to visit a doctor more often to treat the genitourinary system. So, during pregnancy, the expectant mother should regularly visit the gynecologist and undergo some tests. When applying for a job or an educational institution, they now also require a gynecologist's opinion. This article will talk about what leukocytes are in a smear. The norm for the content of these bodies will also be indicated below. You will learn why a smear is taken for flora and how this procedure goes.

Vaginal smear

This test is taken at every visit to the doctor. It is worth noting that the study is carried out quite simply and quickly, but nevertheless it can say a lot about the state of the female reproductive system. That is why gynecologists primarily prescribe this test.

How is a flora smear done?

A smear is taken at least three times during pregnancy (the norm of leukocytes will be indicated below). If there are any deviations and treatment is required, then a repeat analysis is always taken a few weeks after the course of drug therapy.

The analysis is very simple. The woman is asked to sit on the gynecological chair and relax. The doctor inserts a speculum into the vagina and takes material from the cervix, from the walls of the vagina and from the urethra. When deciphering the result, the place from which the material was collected must be taken into account.

Duration of the study and data obtained

A smear on the flora is examined quite quickly. You will receive your results within one or two business days. Remember that it is the doctor who must decipher them. Surely a woman will not be able to understand all the data and correctly interpret the conclusion on her own.

Typically, the result always indicates the names of the elements being examined and the resulting value. Thus, the number of leukocytes and the condition of the epithelium must be determined. The analysis examines the presence or absence of cocci and trichomoniasis pathogens.

Further studies are more detailed. They are carried out only when necessary.

Leukocytes in smear: normal

After receiving the result, you can confidently draw a conclusion about the state of the woman’s reproductive system. When deciphering, it is necessary to take into account the day of the cycle, the presence of pregnancy and colds. So, what is the norm of leukocytes in a smear for representatives of the fairer sex?

Typically, the number of white cells in the field of view should not exceed 10. So, if the analysis says that single leukocytes were detected, the smear is “normal.” In women who have just finished menstruating, the number of these cells may be slightly higher. In this case, it does not exceed 25 units in the field of view. These data are also considered absolutely normal. However, it is worth warning your doctor in advance about your recent menstruation.

In expectant mothers, the level of white cells may also be increased. If you are expecting a child and have had a smear for flora, the norm allows leukocytes in an amount of no more than 30 units per field of view. This applies to all sites from which material was collected.

In the presence of a viral or bacterial disease, the level of white cells may increase slightly. Moreover, the more acute the infection, the higher the value obtained. That is why doctors do not recommend taking a smear for flora during illness. If there is no other way out, then you need to warn the doctor about the existing pathology.

Degree of vaginal cleanliness

After receiving the result, you can make a preliminary conclusion. Most often, doctors classify the fairer sex according to the degree of vaginal cleanliness. This classification directly depends on the number of leukocytes and other impurities. So, if leukocytes are found in a smear, is this normal or pathological?

First degree

In this case, the result of the analysis is the following data. Leukocytes are detected in the amount of several units in the field of view. The microflora is represented by beneficial bacteria. There are no cocci, pathological mucus and Trichomonas. The conclusion will indicate: smear analysis (leukocytes) is “normal”.

Second degree

There are also single cells of white bodies in the field of view. However, beneficial microflora is represented along with cocci and yeast fungi. Usually, in the absence of complaints of itching and unusual discharge, a woman is considered absolutely healthy. However, if there are unpleasant symptoms, then minor treatment is required. If such microflora is detected in the expectant mother, then she is prescribed therapy without certain symptoms.

Third degree

In this case, the result of the analysis may be the following data: the number of leukocytes exceeds the norm (more than 30 cells in the field of view), cocci, yeast and other pathogens are present. This result is always considered a deviation from the norm. The woman is prescribed treatment.

Fourth degree

This is the very last step. In this analysis, a large number of leukocytes are present. Beneficial microflora is depleted, pathogenic bacteria and microorganisms are revealed. If such a result is obtained, additional diagnostics are necessary, after which the woman is prescribed appropriate treatment.

Leukocytes in a smear: deviations

If you took a smear for flora and a large number of leukocytes were found in it, then this is a deviation. In this case, the woman is prescribed a number of additional tests. In this case, it is necessary to take into account the presence of a permanent sexual partner and the method of protection. If a representative of the fair sex is not “friendly” with such a means of protection as condoms, then there is a possibility of an infection that is transmitted through sexual contact.

So, if the level of leukocytes increases, it is recommended to undergo a detailed analysis of the flora, conduct research for the presence of sexual diseases, and also do a bacterial culture. After receiving the results, you can talk about the diagnosis and prescribe treatment. What can cause an increase in the level of leukocytes in a smear?

Bacterial infections acquired through sexual contact (mycoplasma, trichomonas, chlamydia, gonorrhea, syphilis and others).
Inflammatory process in the vagina against the background of decreased immunity (during colds, during pregnancy, and so on).
Diseases of the uterus and appendages (endometritis, salpingitis, adnexitis).
A decrease in the level of beneficial bacteria against the background of the proliferation of cocci and fungi (thrush, gardnerellosis, and so on).
The development of tumors of a benign or malignant nature.

Conclusion

Now you know what leukocytes are in a smear. The norm is always indicated on the form with the analysis result. If you deviate from it, you should visit a doctor as soon as possible and carry out appropriate treatment. Otherwise, you may experience serious complications. Get tested on time and be healthy!

Which shows the level of leukocytes in the human body, is taken by gynecologists and dermatovenerologists. A gynecologist, as a rule, takes it at every scheduled appointment, regardless of whether the patient has complaints or not.

An increased level of such cells in a woman’s body indicates a problem with the system and requires clarification of the cause of the changes.

Briefly about leukocytes

Leukocytes, or white blood cells as they are also called, are cells in human blood that have different functions and shapes. This group is distinguished by the presence of a nucleus and lack of color. Their main purpose in the human body is specific and nonspecific protection against harmful agents (bacteria, viruses, etc.).

White blood cells of any type can actively move and penetrate through the walls of the thinnest vessels in the human body into the space between cells to absorb and digest foreign particles. As a result, a large number of leukocytes collect at the site where the body is damaged by foreign microorganisms, and inflammation begins. If there are too many harmful agents, white blood cells begin to increase and die, leaving with pus.

Flora and cytology - what is their difference?

For microscopic examination, it is taken from the urethra, vagina or rectum using a special spatula or spatula. Such instruments are used to take secretions that accumulate in the lumen of the above organs without damaging their mucous membrane. If the culture is taken from the vagina, a special speculum is also used.

Important! If a smear is taken from a girl who has not previously had sexual intercourse, a speculum cannot be used during the analysis, since it can damage the hymen.

Interpretation of a gynecological smear for flora in women is carried out in the laboratory. The resulting material is applied to glass, stained with dyes, dried and examined using a microscope. While studying, the laboratory technician assesses the amount of mucus, leukocytes and microorganisms. Such a study also helps to detect inflammatory processes.
Cytomorphological examination of cultures is carried out to identify atypical cells that signal problems with the cervix (cancer, etc.). More attention is paid to the epithelium and its cells. Such a smear is taken from the vagina (with a spatula) or from (with a brush).

The result and accuracy of both types of studies depend on the woman’s proper preparation for the tests.

Indications for taking a smear

The prerequisites for taking a smear are the following factors:

Preparing for the test

The accuracy of the analysis results depends not only on the professionalism of the doctor and laboratory assistant and the quality of the equipment, but also on the patient. Before taking the test, you must adhere to the standards that your doctor should tell you about on the eve of the test:

1-2 days before taking a smear, abstain from sexual intercourse;
do not douche for several days;

Did you know? - this is not only a hygienic procedure with a therapeutic effect, but also one of the remedies that is used immediately after unprotected sexual intercourse. However, you should not hope for the high effectiveness of this method, much less use it often, since this can disrupt the normal state of the vaginal microflora.

do not use vaginal products;
for several hours before taking a smear, do not go to the toilet or wash yourself.

What do you pay attention to when deciphering the analysis

The number of leukocytes (below is data on the norm of leukocytes in a smear in women).
The presence of squamous epithelium, the number of epithelial cells.
Mucus content.
Number of lactobacilli.
The presence of fungi of the genus Candida, “key” cells, leptothrix, gonococci, trichomonas, E. coli, etc.

The purity of the vaginal smear has several degrees:

Exemplary condition, presence of vaginal bacilli and epithelial cells, acidic vaginal environment.
Characterized as normal, but requires minimal treatment. It is distinguished by a small number of vaginal bacilli. There are single leukocytes and anaerobic bacteria of the comma variabile type, and many epithelial cells. The vaginal environment is acidic.
Characterized by inflammatory processes, the presence of itching and. The analysis shows a small number of vaginal bacilli, many pathogenic bacteria, cocci and leukocytes.
The fourth degree is characterized by: inflammation, the presence of all possible pathogenic microorganisms, and many white blood cells.

Leukocytes in a smear - the norm in women, table

Depending on how many white blood cells are found in your smear, your doctor will prescribe treatment. The table shows data on what amount is normal for women. If deviations are present, it is necessary to follow all the doctor’s recommendations in order to stabilize the state of the microflora.

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Therefore, after reviewing your tests, the doctor should provide a form with the results in which the above number of white blood cells is considered normal. The discrepancy between their numbers and the norm in the analysis is a cause for concern.

However, this table does not indicate the rate of leukocytes in a smear in women by age, and it may differ. For example, after 40-50 years, the ideal level of these cells in the vagina and urethra can change by two units, and in the cervix - by one. Such deviations are possible due to the fact that it is approaching, and with age, women become more likely to have diseases of the genital organs in remission.
This table shows the norm of leukocytes in a smear in women after 40 years of age:

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The formation of an embryo in the body stimulates the launch of a number of processes that must proceed smoothly. For this, it is important that all endocrine organs, which produce, work in a balanced manner.

Changes in the hormonal balance provoke changes in the functioning of the organs and systems of the female body, the load on the kidneys increases, the vaginal microflora changes and, accordingly, the number of leukocytes. Thus, in the number of leukocytes in a smear in women, deviations from the norm are possible not only by age, but also by time (by 1-3 units).

The norm of leukocytes in a smear before menstruation

Often, a significant change in the number of white blood cells before (in 40% of cases) is associated with the presence of hidden STIs in the body. However, in 1% of subjects, such changes may be natural and not indicate problems with the genitals. The following table shows the norm of leukocytes in a smear in women before.

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The norm of leukocytes in a smear after menstruation

If you take a smear for flora immediately after, you can notice a significant deviation in the number of white blood cells from the standard by 1-3 units, since in the first 48-72 hours after it may not be completely cleared.

If you do not adhere to the rules of hygiene or use tampons incorrectly during monthly bleeding, the number of white blood cells can increase significantly, but these indicators, as a rule, normalize after a few days if hygiene is improved.

The norm of leukocytes in a smear in virgins

The permissible number of leukocytes in girls who have not previously had sexual relations corresponds to the norm for women who are sexually active. Causes of leukocytosis in virgins:

failure to comply with hygiene rules;
masturbation;
petting;
hypothermia;
using someone else's underwear;
wearing only purchased underwear without washing;
going to a public pool/sauna.

Did you know?Every 15 seconds, a person in the world is diagnosed with a disease transmitted during sexual intercourse.

Reasons for the decrease in the number of leukocytes

A low level of white blood cells in girls or their complete absence is a normal condition if you adhere to the rules of hygiene, do not have sexual activity and do not use it as a remedy. Then there are no factors that attract leukocytes. However, when the level of leukocytes in the blood decreases with a decrease in the level of these cells in the flora, this may be a sign of:

viral disease;
gastrointestinal diseases;
diseases of the endocrine system;
exhaustion of the body.