List of drugs for the treatment of gardnerella in women: a review of effective medications. Gardnerella vaginalis: dysbiosis with a characteristic “aroma”

Gardnerellosis in women– an inflammatory process caused by an imbalance of microflora in the vagina. Does not apply to sexually transmitted diseases. Without treatment, it causes chronic inflammatory processes in the reproductive system and can cause recurrent miscarriage.

Gardnerellosis appears due to a violation of the microflora in the vagina

What is gardnerellosis?

The vaginal microflora is represented by lacto- and bifidobacteria. Normally, this is 95% of the total mass of microorganisms populating the reproductive organs. They maintain vaginal pH, produce hydrogen peroxide and perform protective functions. The remaining 5% of microorganisms are various cocci, trichomonas, and fungi of the genus Candida.

Gardnerella under magnification

Gardnerella belongs to opportunistic bacteria, but is a normal inhabitant of the mucous membrane reproductive organs. As long as this ratio is met, the woman is considered healthy.

When gardnerella vaginalis predominates, gardnerellosis develops. According to ICD 10, the disease is assigned code N89.8 “bacterial vaginosis.”

Causes of gardnerellosis

The pathogen is transmitted exclusively by contact. The disease rarely affects men, but they are carriers of Gardnerella vaginalis.

With a normal ratio of lactobacilli and conditionally pathogenic flora the incubation period can last for years. The pathogen will be present in the vagina, but the amounts will be small. In this case, gardnerella is not detected in smears, and there is no inflammatory process.

When exposed to unfavorable factors, lactobacilli die, and opportunistic flora begins to multiply in the vagina.

Factors contributing to the development of the disease:

• frequent change of sexual partners;
• ecological situation;
• the appearance of a new partner;
• unbalanced diet, lack of fermented milk products;
• history or active STD;
• irrational use of antibiotics;
• aggressive treatment of other diseases;
• use of contraceptives;
• douching without a doctor's prescription;
• excessive use of hygiene products with antibacterial properties;
• passion for panty liners and underwear made of synthetic thread;
• endocrine diseases;
• pregnancy – decreasing immune defense, which prevents fetal rejection;
• immunodeficiencies of various etiologies;
• stress;
• overwork;
• dysbiosis of the gastrointestinal tract system.

Disturbances in the endocrine system can cause gardnerellosis

Develops without treatment chronic gardnerellosis. At the same time, the pH of the vagina shifts to the alkaline side, which contributes to the development of other inflammatory processes in the reproductive organs.

Symptoms of gardnerellosis in women

Manifestations of gardnerellosis are similar to those of other sexually transmitted infections.

Symptoms of the disease:

• itching in the vaginal area;
• discomfort;
• discharge – dense, white-gray, homogeneous;
• pain and stinging during urination and sexual intercourse;
• symptoms increase after intimacy;
• odor – the discharge has the aroma of raw fish.

If such symptoms appear, you should stop having sexual intercourse and consult a doctor.

With gardnerellosis, vaginal discharge appears

Which doctor should I contact?

Treatment of this disease. If necessary, the doctor will refer the patient to,.

Diagnostics

To confirm the diagnosis, a woman should visit a doctor. The gynecologist will examine the vagina using a speculum and make a smear of the discharge for flora. The presence of bacteria is not a criterion for diagnosis; the ratio of beneficial and opportunistic flora is important.

Standard diagnosis for gardnerellosis:

• analysis of patient complaints;
• flora smear;
• identification of discharge with a characteristic odor;
• change in vaginal pH to the alkaline side;
• the presence of “key” cells – these are epithelial cells covered with gardnerella;
• amine test - material from the vaginal mucosa is treated with potassium alkali.

A smear on the flora helps to determine the extent of the disease

Gardnerella can be determined using PCR analysis of discharge from the urogenital tract. But the opinions of experts in this case are divided. Some do not consider it advisable to conduct this study in the absence of signs of sexually transmitted diseases. Others insist on conducting this test.

Effective treatment of gardnerellosis

Treatment of the disease is carried out comprehensively. Shown drug therapy and both partners, normalizing the diet, eliminating factors contributing to the relapse of the disease.

Medicines

Drug treatment is carried out in 2 stages. The first shows the suppression of pathogenic flora, the second shows the normalization of the vaginal microflora. Treatment is carried out at home, hospitalization is not required.

For oral administration

Oral antibacterial agents - Metronidazole, Trichopolum, Ornidazole, Dazolic. These are tablet preparations based on metronidazole and ornidazole. Indicated for cases of protozoa and bacterial flora, including gardnerella. The dosage is selected by the doctor.

• tablets Metronidazole, Trichopolum - 500 mg 2 times a day;
• Ornidazole, Dazolic – 2.5 g per day, divided into 2-3 doses.

Metronidazole - antibacterial tablets

When taking metronidazole drugs, drinking alcohol is prohibited, as an intolerance reaction develops with nausea, vomiting, and increased heart rate. Fermented milk products should be introduced into the diet.

Drugs in this group are prohibited for use in children under 6 years of age, in the first 12 weeks of pregnancy, during lactation, and in cases of severe liver pathologies.

Patients complained of the following side effects:

• defecation disorders;
• nausea, vomiting;
• dry mouth;
• candidiasis of the oral cavity and vagina;
• joint pain.

Vaginal preparations

Antibacterial suppositories - Hexicon, Terzhinan, ointments with clindamycin. Inserted into the vagina for 7–10 days. At the same time, douching with Miramistin is prescribed.

Hexicon - the main component is chlorhexedine. From side effects Most often, dry mucous membranes, itching, and minor bleeding are observed.

The drug is not prescribed:

• with individual intolerance;
• children under 12 years old.

Terzhinan is a complex drug. Contains tenidazole and nystatin. The tablet is inserted into the vagina at night. The recommended course is 10 days.

Terzhinan is a complex drug

Side effects are rare, but possible:

• irritation at the injection site.

Contraindication – only individual intolerance to the components. Medicine approved for use during pregnancy.

Clevazol is a vaginal cream. The product contains the antibiotic clindamycin and the antimycotic miconazole. The drug is administered into the vagina once a day. Effective dosage is 5 ml.

Contraindications:

• hypersensitivity to the components of the cream;
• intolerance to lincomycin;
• intestinal diseases.

Side effects from the use of Clevazole rarely develop. Patients complained of discomfort after administration of the drug.

Miramistin is the main component of the 0.1% Miramistin solution. Active against most types of pathogenic flora. The solution is used for douching. Treatment is carried out 2 times a day. The drug is approved during pregnancy.

Miramistin - solution for douching

Side effects may include:

• burning;

The discomfort goes away on its own within 15 minutes. Contraindication is only individual intolerance to Miramistin.

Normalization of microflora

Preparations for restoring the normal flora of the vagina - Vagilak, Acylact. These drugs contain strains of lactobacilli acidophilus.

Vagilak - a remedy for restoring normal vaginal flora

Medicines in this group are used after suppression of pathogenic flora. Suppositories are inserted into the vagina at night. The duration of the recovery period is from 5 to 10 days. If necessary, the course is repeated after 20 days. Lactic suppositories are approved for use during pregnancy.

Reports of side effects in medical literature are missing. It is not recommended to prescribe drugs of this group to patients suffering from chronic candidiasis– there is a risk of relapse of the disease.

Diet

There is no specialized diet for the treatment of gardnerellosis.

It is enough to follow the principles of healthy eating:

• avoid fried, fatty, spicy foods;
• reduce the amount of sugar and sweets in your diet;
• increase - vegetables, fruits, non-starchy root vegetables.

If you have gardnerellosis, eat more vegetables and fruits

Why is gardnerella dangerous for the female body?

Violation of the microflora is fraught with the development inflammatory diseases reproductive and urinary system.

Possible complications of garnerellosis:

• inflammatory processes of the reproductive system;
• endometritis after childbirth or termination of pregnancy, surgical treatment;
• infertility;
• habitual miscarriage;
• neoplasia of cervical canal tissue;
• bartholinitis;
• the appearance of cysts and abscesses.

If gardnerellosis is not treated, bartholinitis may develop.

Is it possible to get pregnant with gardnerellosis?

The presence of a pathogenic organism in the vagina does not affect the development of the egg. And a shift in pH in the reproductive organs towards a neutral or alkaline environment only promotes sperm activity.

But availability inflammatory process may affect an existing pregnancy and cause a miscarriage. Therefore, during treatment of vaginal dysbiosis, you should refrain from intimate life or use barrier methods protection.

Gardnerellosis during pregnancy

Immunosuppression develops during pregnancy. This prevents fetal rejection. Therefore, the growth of opportunistic flora, including gardnerella vaginalis, is possible.

There is no need to panic with such a diagnosis. The bacterium does not have a direct effect on the fetus. But it is necessary to undergo treatment, since the inflammatory process can cause miscarriage, missed abortion, and the development of endometritis in the postpartum period.

In the first trimester, if there are no signs of obvious inflammation and discomfort in the patient, treatment is not carried out. All therapeutic effects start from the 13th week of the gestational period.

At this time, it is not advisable to use system-wide treatment, but metronidazole and its analogues are approved for use.

In the first 12 weeks of gestation, suppositories must be placed Hexicon, Betadine. Terzhinan suppositories are recommended for use starting from the 13th week of pregnancy. Douching is prohibited during the entire gestational period.

Prevention of sexually transmitted infections

Preventive measures include observing the rules of personal hygiene and sexual intelligibility. But also excessive sterility, washing or douching using antibacterial agents also not required.

Maintain personal hygiene

Wear underwear made from natural fabrics. Avoid thongs and panty liners. Use antibiotics only when indicated.

Gardnerella is found quite often in women with weakened immunity and vaginal dysbiosis; it is the one that causes Gardnerella vaginosis, which will be discussed in this article.

Gardnerella in women - what is it?

Very often, bacterial vaginosis is caused by gardnerella (gram-variable or gram-negative rods). This bacterium belongs to the facultative anaerobes; it does not form capsules and spores, and exhibits good adhesion on the surface of the mature vaginal epithelium. Actively multiplying in the vaginal environment, gardnerella secretes its metabolic products - amino acids. From these amino acids, volatile amines arise - compounds that give vaginal discharge an unpleasant fishy odor.

The main sign of this pathology is considered to be “key cells”. This is the name of mature epithelial cells, on the surface of which a huge number of coccobacilli or gram-variable rods are attached: Gardnerella vaginalis, Mobiluncus spp., obligate anaerobic bacteria.

Gardnerella in a smear

Gardnerella in women - where it comes from

An infectious syndrome of a non-inflammatory nature, which is based on vaginal dysbiosis, is called bacterial vaginosis in the scientific literature. This pathology is characterized by very high level obligate anaerobic microbes and a significant decrease in the number of lactobacilli in vaginal secretions, up to their complete absence.

Due to a pronounced decrease in the level of lactobacilli that produce lactic acid, the pH in the vagina increases, causing it to become neutral. These conditions promote reproduction in the vagina various organisms(both pathogenic and opportunistic). So, bacterial vaginosis is a consequence pronounced violation microflora balance, in which the natural vaginal flora is replaced by anaerobic bacteria - Gardnerella vaginalis, Bacteroides spp., Mobiluncus spp., Mycoplasma hominis, peptostreptococci and some others. The concentration of these microorganisms may exceed valid values very much - 1000 times. Thus, the opportunistic gardnerella living in the woman’s genitals begins to actively reproduce.

Factors for the development of gardnerellosis in women

An increased risk of spreading gardnerella is associated with the following factors:

Inflammatory processes of the genital area.

Violations menstrual cycle.

Taking certain medications (antibiotics, medications containing hormones, immunosuppressants).

Long-term use of intrauterine contraception.

Weakened immune system.

Disturbed intestinal biocenosis.

Mental stress and stress.

How is gardnerella transmitted?

Gardnerella can be passed from one sexual partner to another. In men who have sexual contact with a woman who has been diagnosed with gardnerella, it is also often found in the urethra. True, treatment of the sexual partner is not required if there are no additional pathogens of sexually transmitted infections and acute symptoms.

Gardnerella in women: symptoms

Gardnerellosis can occur in chronic or acute form. At chronic course symptoms may not be present or may be very sparse. The symptoms are not specific, they are typical for many STDs. In the acute form of gardnerellosis the following is noted:

Itching and burning in the genitals;

Pain during sexual intercourse;

Copious discharge;

An unpleasant fishy smell is perhaps the only difference from other infections.

Detailed differential diagnosis bacterial vaginosis with trichomoniasis, ureaplasmosis, thrush in women is on our website.

Symptoms of the disease become obvious when the leukocyte response is reduced. Scientists have suggested that gardnerella is capable of producing a leukotoxic factor. Under its influence, functional and even structural changes leukocytes.
Changes in vaginal flora associated with gardnerellosis can lead to serious consequences. Endometritis or salpingoophoritis may develop. Pregnant women face a difficult birth and a high risk of spontaneous abortion.

Gardnerella in women: photo

Methods for diagnosing gardnerella in women

Diagnostic criteria for this pathology are:

■ Presence of so-called “key cells” in smears. Lactobacilli, as well as polymorphonuclear leukocytes, are absent.

■ Homogeneous creamy consistency of the discharge.

■ Positive result on amino test. (A sample of the secretions is placed on a glass and a little potassium hydroxide solution is added. When gardella is present, the smell of rotting fish appears).

■ The pH value in the vagina is greater than or equal to 4.5.

If at least three of the four specified criteria are present, the diagnosis can be considered confirmed.

Normal indicators in a smear

Additional diagnostic methods include:

Gas chromatography of vaginal discharge, mass spectrometry (trimethylamine is detected).

High-voltage electrophoresis for the detection of volatile amines.

Microbiological tests (detection of Gardnerella vaginalis). The norm in tests is less than 10 to 5 degrees CFU or no more than 103 - 105 CFU/ml.

LSC (laser correlation spectroscopy) method.

Gardnerella in women: treatment

The goal of treatment is to kill gardnerella and restore normal vaginal microflora.

Antibacterial therapy for gardnerellosis in women

Gardnerella exhibits high sensitivity to such drugs: ornidazole, ampicillin, clindamycin and metronidazole. But this bacterium is resistant to aminoglycosides, tetracyclines, sulfonamides, and cephalosporins.

Treatment regimen for gardnerellosis in women

For gardnerellosis, the drugs of choice include the following:

- metronidazole (efloran, metrogil, metrid, flagyl, trichopol) – take 1 g per day in 2 divided doses for a week;

Ornidazole (meratin, tiberal) - take 500 mg 2 times a day, for a ten-day course;

Nimorazole (naxogin) - 500 mg twice a day, for a six-day course. (recommended when vaginosis is combined with trichomonas and bacteroides).

Alternative drugs

List of alternative remedies for the treatment of gardnerella:

- Dalacin (clindamycin hydrochloride) in capsule form (considered the main alternative means) – 300 mg twice a day. Duration of treatment is a week.

- Dalatsin C in the form of a cream (2%) – 5 g once a day topically for a week.

- Ampicillin. Used in combination with metronidazole 4 times a day, 500 mg. Duration of treatment: from a week to 10 days.

- Tinidazole. Take according to the following scheme. On the first and second days - 2 g once a day. On the third and fourth days - 0.5 g twice a day. Total for the course – 6 g.

- Terzhinan. 1-2 candles per day. The duration of the course is 12 days.

- Meratin-combi. 1 candle before bed. Course – 12 days.

- Betadine. 1 candle per day. Course duration is from 1 to 2 weeks.

- Ginalgin. 1 candle at night. Course – 10 days.

- Klion-D 100. One tablet is placed deep into the vagina before bed. The course of treatment lasts 10 days.

All medications can only be used after consulting a doctor; only a specialist can prescribe the treatment you need.

Restoration of normal vaginal microflora

After etiotropic treatment, they move on to the next stage of therapy - restoration of the natural biocenesis of the vagina.

Preparations for restoring normal vaginal microflora:

Contains lyophilisate of bifidobacteria. The product is used vaginally once a day. To do this, 5 or 6 doses need to be diluted with boiled water. Full course lasts from 5 to 8 days. Used in the form of suppositories twice a day for 5-10 days.

- Lactobacterin. Contains lyophilisate of lactobacilli. 5 doses of the drug are diluted in clean water and used vaginally once a day (from 5 to 10 days).

Vaginally, 5 or 6 doses are applied once a day. Treatment course lasts from a week to 10 days.

- Dry colibacterin. 5-6 doses once a day for 5-10 days.

- Vagilak(a drug based on lactobacilli). Use vaginally, one capsule twice a day. Course – 10 days.

- Acylact. For 10 days, one candle every evening before bed.

- Simbiter 2. One bottle of the drug is added to boiled water in a ratio of 1:2, the resulting composition is injected into the vagina with a syringe. Duration of therapy: at least 10 - 15 days.

Treatment of gardnerellosis in pregnant women

Treatment for gardnerellosis can begin after the 2nd trimester of pregnancy. The drugs of choice are:

Ornidazole 2 times a day, 1 tablet for 5 days

Metronidazole 250 mg - 1 tablet 2 times a day.

The course of treatment for pregnant Gardnerella is 10 days.

In addition, they produce local treatment metronidazole or Neo-Penotran forte in the form of cream or suppositories.

Acylact in suppositories can also be used in early pregnancy if there is no thrush.

Prevention of gardnerellosis in women

Preventive measures should be aimed at complying with the following rules:

1. maintain personal hygiene of the genitals;

2. during menstruation, change pads and tampons as often as possible;

3. underwear should be made from natural fabrics and should not rub;

5. lead a healthy lifestyle: eat right, exercise, don’t overwork, etc.

6. undergo examination by a gynecologist once a year.

Despite the fact that gardnerellosis in women is not dangerous and can be treated quite easily, it significantly worsens the quality of life and can become a platform for the development of other pathological processes reproductive organs, so if any abnormalities in the discharge occur, consult a doctor immediately.

Sexual infections are characterized by a protracted course and long-term therapy. One of them, gardnerellosis in women, is difficult to classify as a classic venereal disease. It occurs frequently and causes a lot of inconvenience. Let's look at the pathology in detail: signs, treatment, possible complications.

What is gardnerellosis

The vagina is a habitat for many microscopic organisms that form a biocenosis in it with their complex connections. Most of the community consists of frankly useful species, for example, lactobacilli. The rest are opportunistic microbes that demonstrate pathogenic properties only under favorable conditions. Normally, there is an optimal ratio of both. This balance is important for a woman’s reproductive function and overall health.

When a situation favorable for opportunistic microbes is created in the vagina, their number increases so much that they displace beneficial microflora. The first includes bacteria of the species Gardnerella vaginalis. In a healthy body there are few or none of them.

The reasons for this imbalance are the following:

• Taking antibacterial agents.
• Messy sex life.
• The use of contraceptive suppositories.

The consequence of these actions is the development of gardnerellosis (bacterial vaginosis) in the woman’s genital tract. A pathogenic microbe negatively affects the condition of the mucous membrane and provokes its inflammation.

Symptoms of gardnerellosis in women

The infection occurs regardless of age. The clinical picture may be asymptomatic, without discomfort or discharge. In such cases, the disease is known only from test results.

Another option is also possible with pronounced symptoms, general malaise, heavy discharge, cramping in the lower abdomen.

Gardnerellosis shows the following signs:

• Stench from the genital tract, like rotting fish. The reason is the destruction of amines due to the active increase in the number of gardnerella.
• The discharge is initially liquid, but over time becomes viscous, opaque, yellowish or greenish in color.
• Menstrual irregularities.
• Burning, itching.
• Development of cystitis, urethritis.
• Painful urination.
• Bad feeling.

The advanced stage of bacterial vaginosis is characterized by the presence of layers on the mucous membrane, causing redness and swelling of the tissues.

The period from the moment of infection to the appearance of faint discharge and minor discomfort (incubation) lasts from 7 to 20 days. During this time, pathogenic microbes spread throughout the vagina and displace lactobacilli. After 2 weeks, symptoms become pronounced, pain syndrome intensifies.

Reasons how it is transmitted

Gardnerellosis appears when a woman:

• Uses potent antibacterial drugs that disrupt the optimal ratio of microorganisms in the vagina.
• Engages in sexual intercourse without contraception.
• Uses contraceptives with 9-nonoxynol, which destroys lactic acid microbes.
• He syringes and thereby washes away the beneficial microflora, or, even worse, uses antiseptics that have a strong antibacterial effect.

Gardnerella actively reproduces under several conditions. But when weak immunity even one factor can become a signal for the start of bacterial vaginosis.

Gardnerellosis is transmitted, as a rule, in the absence of barrier contraception during sexual intercourse. The oral route of infection has been questioned because oral cavity not suitable for microbial life and reproduction.

Accurate diagnosis

Bacterial vaginosis is dangerous due to its asymptomatic, when a woman, unaware of anything, continues to infect new sexual partners. When the onset of the disease is pronounced, an urgent visit to a doctor is necessary. It differentiates gardnerellosis from chlamydia, colpitis and other pathologies of the genitourinary system.

The following methods help in making a diagnosis:

• Examination in a gynecological chair, collection of data on sexual activity, the course of the menstrual cycle, and the use of contraceptives.
• Taking a smear to determine pathogenic microflora and markers of gardnerellosis.
• Testing to determine vaginal pH.
• Analysis for isonitrile - a compound that determines foul odor from the vagina.

According to the results of the study, it turns out that in the vagina of an infected woman there are 3 times less beneficial lactobacilli, but there are many leukocytes and the alkaline reaction of the environment has replaced the acidic one. The smear shows gardnerella covering the tissues female body.

Urine and blood tests can help determine how far the infection has spread. Colposcopy will reveal inflammation of the cervix.

Treatment of gardnerellosis in women

Bacterial vaginosis is not a sexually transmitted disease, but requires concomitant therapy, as over time it can lead to serious consequences, including:

• Inflammation of the muscular lining of the uterus (metroendometritis).
• Adhesive disease.
• Obstruction fallopian tubes.
• Pyelonephritis.
• Endometritis.
• Infertility.

Treatment of gardnerellosis is carried out in three stages:

1. Gardnerella suppression.
2. Restoration of vaginal microflora.
3. Strengthening the immune system.

Even in an advanced stage, bacterial vaginosis can be successfully cured if you seek medical help.

Drugs, treatment regimens

Antibiotics are used to destroy pathogenic microbes and prevent their further reproduction. For the success of therapeutic measures, the sensitivity of the pathogen to various antibacterial drugs is first determined, and then they are prescribed to the patient. The most effective include:

Treatment with antibiotics lasts from 7 to 10 days. The doctor calculates the dose based on the degree of inflammation, weight and age of the patient. Average daily dose for the drug Trichopolum is 500 mg, Clindamycin – 300 mg. A single dose of 2 g of the drug Metronidazole copes with the disease in mild or moderate form.

In case of unadvanced gardnerellosis, suppositories are relevant. Suppositories have a local, non-systemic effect. They can treat gardnerellosis in women expecting a child. The duration of therapy is a week, in more complex cases 10 days. The dosage is selected individually by the gynecologist, the maximum for the first 3 days, then adjusted downward.

From candles use:

• Hexicon containing chlorhexidine, which inhibits pathogenic microflora.
• Metrovagin with metronidazole in its composition destroys anaerobes in the vagina.
• Terzhinan, which has antifungal and antibacterial effects.
• Macmiror kills pathogenic as well as opportunistic microbes.

The disease can recur due to hypothermia and stress. Therefore, if necessary, drug treatment is repeated.

Folk remedies

The recipes are based on medicinal plants: string, sage, chamomile, oak bark, having antimicrobial effect. Sea buckthorn and olive oils are used to heal damaged mucous membranes.

Traditional medicine recipes are considered the safest, but before taking them you should consult a doctor. He may authorize their use as an addition to drug treatment.

Recipes for douching:

• Infusion of a glass of boiling water and 10 g of oak bark. The course of application is a week.
• A mixture (20 g) that includes chamomile and plantain (1:1), and 250 ml of hot water. Treat with the composition for 10 days.
• Sterile gauze soaked in warm sea ​​buckthorn oil, and rolled into a tampon. Insert into the vagina for 10 nights.

In 2 months, as a rule, it is possible to completely get rid of gardnerella. It takes about a week for antibiotic therapy, a month to restore the microflora and 14 days to increase immunity.

An important point is the treatment of the partner. In men, the urethra may become inflamed, although gardnerellosis is not characterized in them severe course. The pathogen can be destroyed with Metronidazole, which acts locally only on the site of inflammation.

Bacterial vaginosis is considered defeated if the pathogen is not detected in a smear of both partners and there are no symptoms of infection.

Diet during treatment

Gardnerellosis depends on immunity, and that, in turn, on nutrition, which should be fractional and consist of small portions. The menu is balanced, containing micro- and macroelements, vitamins, carbohydrates, fats, proteins.

The diet should include dishes made from lean meat, fish, and lactic acid products. Cereal porridges, black bread, vegetables and fruits are allowed. Preferred cooking methods: stewing, steaming and boiling.

It is necessary to limit:

• Pickles, smoked meats.
• Coffee Tea.
• Alcohol, sweets.
• Fried, fatty, spicy.

Prevention of gardnerellosis

Bacterial vaginosis is a disease that is easier to prevent than to cure. To do this you need:

• Avoid psycho-emotional overload.
• Observe the work and rest schedule.
• Quit smoking and alcohol.
• Eat a varied diet.
• Don't get too cold.
• Keep your genitals clean, including during menstruation.
• To avoid infection, have contact with a trusted partner using contraceptives.
• After unprotected sex, treat the vagina with Chlorhexidine or Miramistin.

Warning symptoms in the genital tract should be a reason to visit a gynecologist.

In our body there are a huge number of not only harmful, but also beneficial bacteria. They live everywhere: on the surface of the skin, in the intestines, on the mucous membranes and in the vagina. Thus, almost every organ has its own individual microflora, which provides it normal functioning. Beneficial bacteria, living in the vagina, allow it to fight various infections. But quite often the delicate balance of microflora is disrupted, resulting in more harmful microbes, the most common of which are Gardnerella. This leads to the development of the disease of the same name, which causes harm to the body and requires treatment.

Definition of gardnerellosis in women

Gardnerellosis, or bacterial vaginosis, is pathological condition, in which the microorganism Gardnerella predominates in the vagina. It is a tiny bacterium that normal conditions also lives in human body along with many others. It is believed that healthy woman In the vagina, acidifying lactobacilli predominate, which create an optimal environment. If this ratio is violated, gardnerellosis occurs with all the accompanying symptoms.

The disease occurs in both women of different ages, and in men. Representatives of the stronger sex suffer from the disease much less frequently, since they have a smaller volume of mucous membrane compared to girls.

What number of microorganisms in a smear is considered normal?

If the number of Gardnerella exceeds the permissible values, the patient begins to develop the main symptoms of the disease. Under normal conditions, this bacterium can also be detected in tests. The following indicators are important for diagnosis:

• 10 5 –10 6 microorganisms in a smear of a healthy woman is considered normal;
• 10 7 –10 9 - indicates persistent infection;
• 10 4 microorganisms in a smear during pregnancy is a cause for concern.

Can gardnerella be in the mouth?

If the disease exists in the body for a long enough time (six months or more), the bacteria gradually spread through the bloodstream and migrate into the oral cavity. Infection can also occur through unprotected oral sex. Gardnerella settles on the oral mucosa and begins to actively grow and multiply, accumulating in the area of ​​the tonsils and pharynx. This often ends with the development of inflammatory processes (stomatitis, pharyngitis, laryngitis).

Table: difference between gardnerellosis and thrush

Existing varieties of the disease

Classification of the disease according to the course of the pathological process:

• acute (occurs when a large dose of the pathogen enters the body through sexual contact, symptoms increase over 2–3 days);
• subacute (forms in one and a half to two weeks);
• chronic (exists for six months);
• recurrent (phases of exacerbation followed by remission).

Varieties of the disease according to the nature of the discharge:

• serous form - the yellow tint of the discharge predominates;
• purulent - mostly green color secret;
• fibrinous - there are bloody streaks in the discharge.

Classification of the disease according to the presence of secondary infection:

• isolated gardnerellosis;
• combination with:
  • chlamydia;
  • syphilis;
  • trichomoniasis;
  • gonorrhea;
  • candidiasis.

Why does gardnerellosis occur?

For such a disease to develop, not only the presence of bacteria is necessary, but also some operating factors. Most often these include:

• frequent change of sexual partners;
• uncontrolled use of antibacterial drugs;
• daily douching;
• usage regular soap as a means for intimate hygiene;
• visit public places by type of bathhouse, sauna, swimming pool, gym;
• neuro-emotional shocks;
• wearing tight underwear made of synthetic fabrics;
• work in conditions elevated temperature and humidity;
• infectious diseases;
• pathology immune system(HIV, primary bone marrow injury).

Ways of transmission of the disease

The disease can occur in a completely healthy woman if normal microflora vagina, even if she did not have unprotected sexual intercourse. However, the leading route of infection remains sexual (oral, anal and vaginal penetration have the same risk of infection). Gardnerellosis can also be transmitted by wearing shared underwear or using insufficiently treated sex toys.

Length of incubation period

Average clinical symptoms illnesses begin to appear 2–14 days after infection. Their intensity depends on the patient’s age, her state of health and the presence of other sexually transmitted diseases.

In elderly people, in 80% of cases the disease is practically asymptomatic, which is associated with slower metabolic processes.

Video: the doctor talks about the peculiarities of the disease

Main symptomatic signs of pathology

Bacterial vaginosis is characterized by a predominance local manifestations over the general ones. The disease progresses extremely slowly, and an increase in symptoms is observed after viral infection(ARVI, colds), stress, physical activity or sexual activity.

Main symptoms of the disease:

1. Pain in the pelvic area. She wears a weak one aching character, intensity increases with urination. During menstruation discomfort intensify several times, become compressive and cramping.
2. Pathological discharge. They have bad smell, which can be felt several meters away, as well as a yellow, brown or green color. The discharge is quite difficult to wash off from clothes and can overfill your panty liner.
3. Swelling of soft tissues. The labia minora and clitoris swell, become extremely sensitive and sharply painful. After some time, in the absence of wiping and the use of absorbent wipes, it appears on them. dark coating, which is easy to clean.
4. Itching and burning when urinating indicate the penetration of bacteria into the urethra and bladder. This symptom occurs in the later stages of the development of the disease.

Gardnerellosis and childbearing

For a long time existing disease The likelihood of getting pregnant decreases every year. If conception does occur, the expectant mother faces a huge risk of infection of the baby: bacteria enter the fetus’s body through the baby’s place. There is a high probability of infection during childbirth.

Symptoms of the disease intensify during pregnancy: the woman experiences unbearable itching and burning, and the amount of discharge increases to 300–350 milliliters per day. Often, during a night's sleep, the victim injures the mucous membrane of the external genitalia with her nails, which ends with the addition of a secondary infection.

I had the opportunity to participate in the birth of a woman, long time suffering from gardnerellosis. She was unable to cure the disease before pregnancy, as a result of which the baby was also confirmed to have this infection. The child was born much ahead of schedule, as a result of which he could not breathe on his own. Doctors decided to nurse the baby in intensive care. After a few months he began to recover, but in the future such an infection causes a serious lag in physical and neuropsychic development from his peers.

How is the disease diagnosed?

The external manifestations of gardnerellosis have similar symptoms to many other pathologies that are sexually transmitted. This makes making a diagnosis much more difficult. Bacterial vaginosis must be differentiated from:

• trichomoniasis;
• candidiasis;
• chlamydia;
• ureaplasmosis;
• mycoplasmosis;
• gonorrhea.

Remember that before visiting a gynecologist and taking a smear, you should not douche the vagina with antiseptic solutions. During my time working in a medical laboratory, I more than once had to deal with the fact that women themselves washed off all the pathogenic microflora; as a result, the study had to be redone again. If you want to get a reliable result, it is recommended to postpone hygiene measures for a while. This is the only way to identify the disease at an early stage.

Methods to confirm the diagnosis:

Leading methods of treatment of gardnerellosis in women

Treatment of bacterial vaginosis is based on normalizing the vaginal microflora. For this, doctors use not only pharmaceuticals, but also special diet. And also in recovery period It is permissible to use various physiological procedures that help strengthen the immune system. In most cases, treatment is mandatory for the disease. Episodes of self-relief of the disease without drug intervention are extremely rare (mainly in patients young).

A woman's sexual partner requires therapy only if he also has elevated Gardnerella levels. To do this, a man needs to undergo special tests from a urologist (smear from the urethra).

Video: doctor’s opinion on the need for therapy

Treatment of illness with pharmaceuticals

Drug therapy for gardnerellosis includes the use of both local and generic drugs. The former can be used in the form of suppositories and douching solutions, as well as in the form of ointments and gels. The latter are represented by tablets, capsules and injections for intramuscular or intravenous administration. The duration of therapy and the choice of drugs is determined by the gynecologist. Self-treatment can lead to aggravation of existing problems in the body.

Gardnerella is sensitive to antimicrobial agents. That is why they are the first group of drugs that help cope with the disease.

Local medications used to combat the disease:

1. Antibiotic suppositories help prevent the growth of gardnerella and its further development in organism. The most commonly used drugs are:
   • Metronidazole;
   • Clindamycin;
   • Acylact;
   • Iodoxide;
   • Hexicon.
2. Antifungal ointments and suppositories prevent the development of fungal microflora and prevent thrush from forming. For this purpose use:
   • Nystatin;
   • Pimafucin;
   • Levorin;
   • Fluconazole;
   • Flucostat.
3. Candles containing a large number of lactobacilli, help normalize internal environment vagina. The most famous drugs:
   • Lactobacterin;
   • Vaginorm-S;
   • Vagilak;
   • Lactozhinal.
4. Antiseptic rinses help remove harmful microflora. For this purpose, dilute solutions of Miramistin, Chlorhexidine, Furacilin are used.

Photo gallery: drugs for local therapy for gardnerellosis

Polygynax - suppositories with an antibiotic that affects gardnerella Clotrimazole helps prevent thrush Lactonorm promotes the growth of lactobacilli Miramistin creates conditions for the death of harmful bacteria

Systemic drugs

Medicines for systemic treatment diseases:

1. Antibiotics in tablets and capsules are used when local therapy did not bring the expected effect. The most common drugs:
   • Azithromycin;
   • Ornidazole;
   • Dalatsin;
   • Unidox Solutab.
2. Non-steroidal anti-inflammatory drugs help get rid of itching and burning, and also reduce the severity of discomfort in the pelvic area. For this purpose use:
   • Diclofenac Sodium;
   • Indomethacin;
   • Ibuprofen;
   • Pyroxyfer;
   • Ortofen;
   • Rodanol;
   • Celecoxib;
   • Rofecoxib;
   • Viox;
   • Celebrex;
3. Immunostimulants improve recovery processes, occurring in the body, promoting the formation of new cells. The most famous medications in this group:
   • Viferon;
   • Wobenzym;
   • Amiksin;
   • Polyoxidonium;
   • Tsitovir.

Photo gallery: drugs for systemic therapy of gardnerellosis

Doxycycline is an antibiotic that causes the death of gardnerella Meloxicam relieves inflammation Immunal helps strengthen the immune system

Traditional medicine as an aid

Quite often, patients do not have the opportunity to see a doctor immediately (business trip, vacation), or the doctor’s appointment is scheduled a few days later, but the discomfort continues to overcome. In these cases, the use of traditional medicine is acceptable. Various douches and tampons will help get rid of the main manifestations of the disease and make the wait easier. Remember that such treatment will not completely solve the problem, since pharmaceuticals are required to restore normal microflora.

I happened to encounter a patient who completely abandoned traditional therapy, preferring to use herbs and plants to eliminate bacterial vaginosis. Regular douching with high-dose solutions led to the fact that the patient not only did not cure gardnerella, but also acquired serious chemical burn vaginal mucosa. The victim was taken by ambulance to the gynecology department, where she underwent reconstructive surgery. Plastic surgery. Unfortunately, as a result of this procedure, the woman has lost sensitivity and has problems with sex life.

The most popular folk recipes:

Table: physiotherapy in the treatment of the disease

Photo gallery: physiotherapy in gynecology

Radon baths cause the death of pathogenic microbes Electrical stimulation accelerates the formation of new cells Drug electrophoresis is used to administer anti-inflammatory and antibacterial agents

Changes in diet and lifestyle for gardnerellosis

To restore normal vaginal microflora, doctors recommend that women follow a certain diet. To do this, you must adhere to the following rules:

• use only fresh and natural products without chemical additives (can be purchased on the market or from private sellers);
• Be sure to have breakfast, lunch and dinner. There should also be two snacks so that the breaks between meals do not last longer than three hours;
• drink up to one and a half liters of clean water daily;
• stop drinking alcohol;
• bake, stew or boil food so that it retains vitamins;
• do not eat sweets, as they contain a lot of fast carbohydrates and sugars, which create an optimal environment for the growth of bacteria;
• reduce the amount of salt to 5 grams per day.

What foods should you include in your diet:

Rules for women during the treatment period

During treatment for gardnerellosis, you will have to slightly change your usual lifestyle and give up some habits until full recovery. Don't forget that following these rules will help you achieve positive results in just a few weeks. What is not recommended to do with bacterial vaginosis:

• perform epilation of the bikini and perineum - these procedures are stressful for the body;
• visit baths, saunas, for a long time lie in a hot bath or jacuzzi;
• have sex - there is a risk of infecting your partner;
• take antibacterial drugs on your own;
• wear shapewear;
• swim in open reservoirs and pools.

Treatment prognosis and possible unpleasant consequences

Therapy for gardnerellosis is an extremely complex and lengthy process. It often takes a lot of time to restore normal microflora, and some women quit treatment before even halfway through it. Remember that rehabilitation after such an illness proceeds much more slowly with the following ailments:

• diabetes;
• hypertension;
• phlebeurysm.

In teenage girls and young people, gardnerellosis goes away with virtually no visible consequences if therapy is started in a timely manner. In older women and the elderly population, due to slow metabolic processes rehabilitation lasts up to several years.

The disease is prone to recurrence. Cure does not guarantee that in a couple of months or years you will not have gardnerellosis again.

Compliance with the rules of personal hygiene plays a special role in restoring normal vaginal microflora. During treatment, it is extremely important that you have the opportunity to clean your perineum and change pads every few hours. I had the opportunity to participate in the treatment of a patient who was in a hot shop for twelve hours at work. She had practically no opportunity to wash herself, and in the hot season, even despite the ventilation, the temperature in the room was high, as a result of which the woman was constantly sweating. Excessive formation of sebum contributed to the appearance of itching and burning, and all the therapy for gardnerellosis was useless. Only after the patient managed to take a vacation for two months and go to a sanatorium did the treatment become effective. Sea water and warm air, combined with pharmaceuticals and hygiene rules, helped the woman forget about her illness.

What complications and negative consequences occur in patients with gardnerellosis:

• problems with conception - altered microflora causes the death of sperm when they do not have time to reach the egg;
• formation of adhesions - growths connective tissue in the pelvic cavity, which disrupt the normal attachment of the embryo in the uterus;
• long-term infertility of various types;
• inflammatory diseases of the pelvic organs: uterus, tubes, ovaries, bladder and urethra;
• decreased immunity;
• intrauterine infection of the fetus;
• penetration of bacteria into the child’s body during childbirth.

Photo gallery: complications of the disease

Long-term jaundice indicates infection of the newborn Inflammation of the ovaries occurs when microflora penetrates from the vagina Adhesive process characterized by the proliferation of connective tissue and disrupts the processes of conception and fetal development

How to protect yourself from developing the disease

Treatment of gardnerellosis requires costs large quantity strength and means. That is why it is much easier to protect your body from the development of such a disease than to undergo a course of therapy. For this purpose, doctors have developed rules for individual prevention of the disease.

During my fourth year of study medical university I had the opportunity to do an internship for several months in the gynecology department in Serbia. At this time, doctors were just conducting research on the topic of preventing bacterial vaginosis by taking lactobacilli and dairy products. For the study, a group of patients was selected who, throughout their lives, winter time years we have encountered Garnerellosis and its unpleasant consequences. More than half of them had problems with immunity (they often got sick or caught colds). Throughout the fall, doctors recommended that they take certain pills with high content Latobacteria, and women added dairy products (cheese, sour cream, sourdough) to their diet, which they consumed several times every day. As cold weather approached, doctors took from patients necessary tests- vaginal smears. In 95% of the studied patients, practically no gardnerella was observed in the material. Another 5% admitted that they did not always strictly follow doctors’ recommendations and drank alcoholic beverages. Thanks to this technique, most of the victims were able to forget about their illness forever.

Rules for individual prevention of gardnerellosis in women:

In the treatment of gardnerellosis, several types of therapy are used, general and local. At general treatment The gynecologist prescribes antibiotics and other drugs that reduce the number of gardnerella in the vaginal microflora. Such drugs include trichopolum and metronidazole. Treatment with these drugs lasts one week. It is also important to carry out local treatment with baths, suppositories and douches. Typically, vaginal treatment with miramistin solution or the same metronidazole in gel, betadine in suppositories and douching are prescribed soda solution or chamomile. Local treatment is slightly longer and lasts ten days.

During treatment of this disease Vitamins and immunostimulating drugs are also prescribed to increase the body's protective functions. It is useful to take medications that normalize the vaginal microflora, for example, containing lactobacilli and bifidobacteria.

Before treatment, it is very important to undergo tests to determine the degree of vaginal dysbiosis, as well as the presence of other bacteria in the microflora, since gardenerellosis often appears when not only gardnerella bacteria are present in the body, but also other bacteria. Also, if these bacteria are detected in a woman’s smear, it is necessary to prescribe treatment for both herself and her partner. A man may simply be a carrier of gardnerella, which, if ingested by a woman during unprotected sex, can cause inflammatory processes.

During treatment, it is advisable to abstain from sexual intercourse or use a condom to avoid infecting the partner and re-infection.

Gardnerellosis appears in connection with the bacterium gardnerella, which is not a pathogenic flora, so this disease is not venereal. In small quantities this bacterium contained in the microflora of any woman. This bacterium is activated in women who frequently change partners, during unprotected sex, and when hygiene is not observed when using sex toys.

Vaginal dysbiosis also occurs after the use of certain vaginal tablets and suppositories like Polygynax and Betadine, when using local contraceptives, when douching, which is a common causative agent of the disease, as well as when taking antibiotics. All these means lead to the fact that natural microflora The vagina changes and the number of gardnerella and other bacteria in its composition increases. These bacteria also become active if a woman has suffered severe stress, if she has a reduced immune system or impaired hormonal background.

Scientists still do not agree on whether this disease is a sexually transmitted disease or not. The fact that this disease can be found not only in women, but sometimes also in men, may indicate that gardnerellosis is sexually transmitted. True, the term “gardenerellosis” is not applicable to men, since it means vaginal dysbiosis, which only women have.

According to statistics, today every fifth woman has this disease. childbearing age. Pregnancy, childbirth, puberty can also provoke this disease.

Gardnerellosis can only be diagnosed in a laboratory. The following methods are used for this:

Measuring the acid-base balance of vaginal discharge
- microscopy of a vaginal smear
- amino test
- identification of the main cells.

What indicators can indicate the presence of this disease?
First, it is the identification of key cells (cells on which pathogenic bacteria are located). Secondly, there is vaginal discharge with an unpleasant odor of spoiled fish. Thirdly, if the acid-base balance is higher than normal, this indicates an inflammatory process in the vagina, most likely caused by gardnerella. And fourthly, during the amino test, a few drops are added to the smear special drug: If there is a fishy smell, this indicates the presence of pathogenic bacteria in the smear.

The doctor makes a diagnosis if at least 3 signs of the disease are present. Very often, the detection of key cells with gardnerella does not indicate the presence of an inflammatory process.

Gardnerella is always considered with other bacteria, since this bacterium is present in the body of every woman in any case, albeit in smaller quantities.

Antibiotics are used to treat this disease. Local treatments are also recommended to balance the level of bacteria in the vagina. After treatment, the smell and discomfort should disappear, the smear readings should normalize, and the discharge should disappear. Tests are carried out 7 days after the end of treatment. If necessary, the woman’s partner is also treated, as he may be a carrier of pathogenic bacteria.

Gardnerellosis in pregnant women is not as rare as we would like. Pregnancy stimulates natural changes in a woman’s body, which can cause increased activity of gardnerella, which is contained in small quantities in the body of every woman. The hormonal background of a woman changes, the protective functions of the body decrease, thereby provoking pathogenic bacterium to activity.
Also, a woman could become infected with this infection from a male carrier even before pregnancy, which could cause an exacerbation of the disease.

This disease does not pose any problem for the unborn child. If a pregnant woman has gardnerella in her smear, there is nothing to worry about, and there is no point in going for an abortion. These bacteria do not come into contact with the fetus in any way, so it cannot become infected. If an infection occurs during childbirth, it disappears without a trace in the newborn, since these bacteria themselves cannot cause inflammatory processes.

What is unpleasant about this disease in pregnant women is that inflammation of the vagina may begin, since the causative bacteria always travels in pairs with other bacteria. To prevent this from happening, a pregnant woman should undergo monthly smear tests in order to begin treatment in time if the need arises.

The main task of a gynecologist when detecting gardnerella in a pregnant woman is not treatment, but to prevent an increase in the number of these bacteria and the onset of the inflammatory process. If a woman has an exacerbation of the disease before giving birth, then local treatment and special preparation for childbirth are carried out. Thorough treatment of the disease is carried out after childbirth.