- Honey, are you prepared for dinner fish?
– No … a couple of tablets of bacterial vaginosis.
Nonfictional dialogue
Bacterial vaginosis was first described by Gardner in 1980, he found as the causative agent of this disease-specific wand – Gardnerella vaginalis. However, further studies have shown that the disease is associated with polymicrobic associations, which include not only gardnerella. Mycoplasmas (Micoplasma hominis, Ureaplasma urealiticum), bacteria of the genus Mobiluncus, fuzobakterii, prevotelly – not the whole list of infectious agents that are found in bacterial vaginosis. Their waste products – volatile amines – cause an unpleasant smell of fish in this disease.
It should be noted that in “pure” form gardnerellez, ureaplasmosis and mycoplasmosis are found only in men. No gonorey urethritis caused by these pathogens, virtually asymptomatic. Less frequent are small whitish discharge from the urethra, discomfort during urination. In the chronic course of Urea-, and mycoplasma gardnerella affect the prostate, epididymis, and kidney.
Women ureaplazmoz and mycoplasmosis are not considered as separate diseases. We can only speak of the predominance of one or the other organisms in the vaginal biotope.
Another feature is the presence of gardnerella, mycoplasma and ureaplasma in normal conditions (about 80% of women sexually active). The fact that this flora is concomitant opportunistic. Only with the development of favorable conditions for reproduction (the oppression of lactobacilli, vaginal environment shifts to the alkaline side) may be their activation and transformation in the course pathogenic flora. Therefore, the diagnosis of these infections is important is not the fact of their presence in the vagina, and the number of microbes.
What reasons can cause bacterial vaginosis?
The most common causes of bacterial vaginosis is incorrect intimate hygiene, use of antibiotics, use of tampons, synthetic underwear, chlorinated water, pregnancy, diabetes mellitus.
Bacterial vaginosis is not part of a group of infections transmitted through sexual contact. And yet, there is a clear relationship between sexual behavior and the emergence of bacterial vaginosis.
Number of sexual partners – more than good reason, than all of the above. In support of sexual transmission and said the presence of the incubation period (time from intercourse prior to the onset of symptoms of the disease is 7-10 days).
Symptoms of bacterial vaginosis
It is well known four main symptoms of bacterial vaginosis:
1. Sticky homogeneous vaginal discharge gray-white color with no signs of inflammatory reaction;
2. change in pH in the alkaline side in the range 5.0-7.0;
3. “Fishy” odor emissions. Can be so intense that his feelings. Fishy odor increases and even becomes a “rotten” in the appendix to belyam 10% KOH solution;
4. the presence of “clue cells” in the smear (this epithelial cells containing the association of microbes).
In the presence of three of these symptoms, the diagnosis is obvious.
The prevalence of vaginal mycoplasmas and ureaplasmas biotope has implications for treatment, so if bacterial vaginosis should be screened for these infections. This will help:
• «Growing” Urea-and mycoplasma on special media (culture methods) – is the “gold standard” of diagnosis, but is too expensive and time consuming;
• PCR – Polymerase Chain Reaction – finding in vlagalishnyh DNA extraction agent.
Determination of antibodies to Mycoplasma and Urea-has no diagnostic value, because, again, it is important to their presence in the body, and the amount.
How dangerous is bacterial vaginosis?
Polymicrobic association with bacterial vaginosis are a major risk factor for ascending infection (endometritis, an inflammation of the uterus). They lead to purulent-inflammatory complications after instrumental abortion.
Treatment of bacterial vaginosis
In the sexual transmission of bacterial vaginosis treatment is carried out for both partners.
In all other cases, try to remove the risk factors that cause disease (correct intimate hygiene, etc.)
With the predominance of ureaplasma and mycoplasma complement treatment with antibacterial drugs (clindamycin, tetracycline, doxycycline, erythromycin, clarithromycin). To improve the efficiency of treatment using immunomodulatory agents (tincture of Siberian Ginseng, Echinacea, imunomaks, tsikloferon), enzymes (Wobenzym, Serrati).
If the dominant gardnerella – enough local therapy or in combination with pills metronidazole (inside).
After the main course of treatment for bacterial vaginosis, be sure to restore the normal vaginal microbial landscape.
Bacterial vaginosis and pregnancy
The negative impact of bacterial vaginosis in reproductive function is mainly due to mycoplasma (Micoplasma hominis, Ureaplasma urealiticum). Actually, and pregnancy can not be – mycoplasmosis causes persistent violations of the endometrium, preventing attachment of ovum. And men with this infection are slow spiral-shaped sperm immature youths, completely incapable of fertilization.
Mycoplasmas during penetration into the endometrium induce changes affecting the attachment of ovum, and it dies. Even if the pregnancy takes place, optimistic hopes for a favorable outcome bleak. Spontaneous abortion, stillbirth, intrauterine infection, preterm birth, developmental delay, chorioamnionitis – not the whole list of complications may encounter a woman.
In addition, mycoplasma can affect the unborn child’s genetic material and cause chromosomal abnormalities (Down syndrome).
The spectrum of therapeutic drugs during pregnancy is extremely limited due to more serious complications that threaten the fetus (of antibiotics approved for use only erythromycin and its derivatives). In the first 12 weeks of pregnancy when the fetus is not protected by the placenta, generally can not prescribe treatment. But do not ask mycoplasmosis wait until 13 weeks!
What do you do? Do not rely on the “Russian maybe”! Bacterial vaginosis and other infections like genital mutilation, should be treated before pregnancy! Now the family plans to have 1-2 children, but the question of buying a car responsibly than this event, and yet immeasurably more important than the health of children.
Take care of your health in time, and then the infectious problems and not be overshadowed by the happiness of motherhood!