Bacterial vaginosis: truth and myths

Health Tips

Probably, each of us at least once in our lives faced the problem of dysbiosis or heard about such a misfortune for sure. When talking about dysbiosis, most people have in mind a change in the microflora in the intestines. But not everyone knows that such violations of the species or quantitative composition of microorganisms can be not only in the organs of the digestive system, but also in the sexual. Goodshapetips talks about bacterial vaginosis.

Dysbiosis of the vaginaalso called differentlybacterial vaginosis.

Why, who develops it and why is it dangerous?

Millions of different microorganisms constantly live, multiply and “work” in the human body. And this does not mean at all that a person, inside whom there are so many microscopic creatures living their own lives, is mortally ill or even slightly unhealthy. On the contrary, it is these microbes that help us fight various diseases.

Microorganisms living normally in the human body perform a number of vital functions for it: they improve digestion, accelerating the absorption of nutrients from the intestines into the blood; synthesize vitamins and other biologically active substances, the lack of which causes severe diseases.

These bacteria, like filters, “trap” toxins that have got inside a person and adsorb them on themselves, preventing the penetration of these harmful compounds into the bloodstream. But the most surprising thing is that the normal microflora prevents the development of infection.

At the meeting of pathogenic microorganisms and representatives of the normal flora, a real competitive struggle begins, a battle for a place in the human body, for the right to further growth and reproduction within it. And the more beneficial bacteria, the more coordinated their work, the easier it is for us to cope with the infection.

In the genitals of a woman, as well as in the intestines, various beneficial bacteria also live, which, among other things, protect against the invasion of pathogenic microbes. 95-98% of these necessary bacteria are classified as lactobacilli (lactobacilli).

These microorganisms got their name because in the course of their life they produce lactic acid (lactate), which causes the pH of the vagina to be acidic (3.5-4.5). Lactic acid is detrimental to a number of pathogenic bacteria, and therefore their ability to protect against infection depends on how many lactobacilli and how well they “work”.

Other representatives of the normal microflora of the vagina are various types of streptococci, bacteroids, fusobacteria, enterobacteria, staphylococci, etc. In a healthy woman, even yeast-like fungi (Candida) and vaginal gardnerella can be detected.

However, such microorganisms should normally be much less than lactobacilli. Lactic acid, which is produced by lactobacilli, keeps the acidic environment in the vagina, thereby preventing the overgrowth and reproduction of other bacteria. Violation of this microbial hierarchy of vaginal microorganisms leads to the development of quite serious infectious diseases of the genital organs.

In case of violation of the species and quantitative ratio in the composition of the vaginal microflora (decrease in the number or weakening of the properties of lactobacilli), a disease such as bacterial vaginosis or vaginal dysbiosis.

According to statistics this pathology occurs in 60-80% of gynecological patients. In pregnant women, the incidence of bacterial vaginosis ranges from 9 to 35%. But the worst thing is that every fourth woman who does not make any complaints and does not notice a deterioration in well-being reveals violations in the composition of the vaginal microflora, and, consequently, a greater susceptibility to the development of an infectious inflammatory process of the genital organs.

Why is bacterial vaginosis dangerous?

It can cause serious infectious and inflammatory diseases of the female genital organs.

And during pregnancy, this pathology can lead to:

  • infection of the membranes of the fetus and amniotic fluid (chorioamnionitis);

  • premature termination of pregnancy at various times (miscarriages, premature births);

  • the birth of children with low body weight;

  • purulent-septic complications in a newborn;

  • inflammation of the inner lining of the uterus in the postpartum period (endometritis).

Who is prone to developing vaginal dysbiosis?

At-risk groups

Women who have one or another violation of the menstrual cycle (its regularity, duration, volume, etc.).

Women who have had inflammatory diseases of the genital organs in the past (colpitis, adnexitis, salpingitis, endometritis, cervicitis).

Women with cervical pathology (erosion, polyps, etc.)

Women who have been using intrauterine devices (IUDs) as contraception for a long time (more than 5 years).

More than others, the risk of bacterial vaginosis also occurs in women:

  • after prolonged treatment with antibiotics, including after “self-medication” (use of antibacterial agents without a doctor’s prescription);

  • with chronic inflammatory diseases of internal organs (tonsillitis, laryngitis, rhinitis, bronchitis, colitis, etc.);

  • with a decrease in the immune forces of the body (including during pregnancy);

  • in the presence of intestinal dysbiosis (in every second woman suffering from intestinal dysbacteriosis, violations of the vaginal microflora are detected);

  • in the presence of diseases associated with metabolic disorders and hormonal regulation.

Up to this day the question of whether bacterial vaginosis is transmitted to a partner during sexual intercourse remains without a definite answer. Some authors insist that this pathology is a sexually transmitted disease, which is confirmed by the following facts: a large number of patients with vaginal dysbiosis had an early onset of sexual activity and a large number of sexual partners.

In addition, quite often pathogens of bacterial vaginosis are detected in the urethra of the sexual partners of sick women. However, all these facts are rather ambiguous and cannot be considered as evidence of the sexual transmission of bacterial vaginosis, which today is still not classified as a sexually transmitted disease.

The main manifestations of vaginal dysbiosis are:

profuse discharge from the female genital tract (10 times more than usual), which differ in a watery consistency and have an unpleasant pungent odor (sometimes the smell of rotten fish). Such discharge (leucorrhoea) is usually white or grayish in color, but can sometimes be yellowish green. With a long course of the disease, whites become thicker, sticky, viscous, sometimes even cheesy, can foam;

itching, burning in the perineum and external genitalia, a feeling of discomfort;

pain during intercourse impossibility of sexual intercourse;

When contacting the clinic, the doctor, in addition to a conversation clarifying complaints and features of the course of the disease, conducts an examination of the patient and special studies for the specific and quantitative assessment of the composition of the vaginal microflora. It matters how many lactobacilli were found, their activity, the number and activity of other microbes and their ratio with lactobacilli, etc.

Taking into account the data obtained during the diagnosis, treatment is prescribed, which is purely individual. Often the doctor is forced to prescribe antibacterial agents.

Such measures can lead to aggravation of the existing dysbiosis, since antibiotics, unfortunately, act not only on “bad” bacteria, but also on beneficial lactobacilli. However, the appointment of these drugs is justified in most cases, because only antibiotic therapy can quickly and effectively suppress overgrown pathogenic microbes.

After such treatment, which eliminated almost all types of bacteria, it is necessary to populate the woman’s body with the “correct” flora in the right ratio. In the arsenal of doctors, there are a number of medicines that restore the normal microflora of the body, although this task, unfortunately, does not belong to the category of easy and quickly resolved.

Often, the treatment of bacterial vaginosis is quite lengthy and expensive, and therefore it is in the interests of the woman herself to prevent its development, eliminating, if possible, the risk factors for the appearance of dysbiosis initially.

Elena VYSOTSKA,
gynecologist

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