Disease of gardnerellosis. Gardnerella and gardnerellosis

Bacterial vaginosis is a disease that often occurs in sexually active women. In the vast majority of cases, pathology appears under the influence of the bacteria Gardnerella vaginalis (Gardnerella vaginalis). Strictly speaking, gardnerellosis is not classified as a sexually transmitted infection, however, sexually transmitted diseases provoke the development and aggravate the course of bacterial vaginosis of a similar etiology.

Gardnerella is a conditionally pathogenic microorganism, that is, it is present in small quantities on the mucous epithelium of the vagina. Taxonomically, these pathogens are classified as facultative anaerobic flora. In other words, their life cycle proceeds without oxygen access, however, unlike other anaerobes, gardnerella can also tolerate aerobic conditions.

Outwardly, gardnerella resemble small sticks with oval ends, their size rarely exceeds 1.5 microns. Previously, the pathogenic microorganisms Gardnerella were considered representatives of the genus Haemophilus (they were called Haemophilus vaginalis).

However, in the mid-1980s, they were proven to belong to the Bifidobacteriaceae family. In the vast majority of cases, Gardnerella is gram-negative, although a positive Gram stain is sometimes possible.

Lactobacilli "inhabiting" the mucous epithelium of the vagina produce lactic acid as a result of the destruction of glycogen. It determines the pH value in the range of 3.8 - 4.5, which prevents the multiplication of various microorganisms. In addition, lactobacilli have an enzymatic effect, so their level serves as a kind of indicator of the state of a woman's genitals. Bacvaginosis develops against the background of replacement of microorganisms of the genus Lactobacillus with an association of pathogenic or opportunistic bacteria.

Gardnerella vaginalis produces specific catabolites that inhibit the functional activity of local immunity and leukocytes. As a result, bacteria penetrate deep into the vaginal mucosa, infect the overlying parts of the genital tract, and spread to the urinary tract. In addition, the development of gardnerella contributes to the reproduction of other flora (staphylococci, streptococci, Klebsiella, Escherichia coli, Klebsiella, etc.).

Bacterial vaginosis caused by gardnerella is the most common infectious disease among sexually active women between the ages of 18 and 45. According to various authors, the incidence of such an infection ranges from 30 to 80% in the structure of inflammatory diseases of the genital organs in the fairer sex. This inaccuracy in figures is due to the fact that a third of women have gardnerellosis asymptomatic.

Gardnerella Vaginalis: transmission routes, factors provoking the development of pathology

Some doctors are inclined to believe that gardnerellosis is sexually transmitted. However, in this case, the question remains about the presence of these bacteria in a small amount in the vagina of girls and virgin girls. Therefore, experts believe that this disease can be safely attributed to polyetiological.

The following factors contribute to the appearance of pathological concentrations of gardnerella vaginalis:

promiscuous sex, especially without the use of proper protective measures (condoms);
concomitant sexually transmitted diseases (trichomoniasis, chlamydia, gonorrhea, etc.);
various therapeutic and diagnostic intravaginal manipulations (douching, especially if it is therapeutically unreasonable, colposcopy, etc.);
abortion;
taking drugs that worsen the work of local immunity (corticosteroids, antibiotics and fungicides, including local action in the form of ointments and suppositories, cytostatics, chemotherapy);
extragenital diseases that negatively affect the state of the immune system;
improper diet with a predominance of too sweet dishes and a deficiency of fermented milk products;
the use of topical spermicides;
the use for hygienic purposes of pads, tampons, intimate products with a too high content of synthetic perfumery fragrances and allergens;
wearing tight underwear with a synthetic gusset;
hormonal disorders caused by both natural causes (pregnancy, childbirth, breastfeeding period), diseases or taking appropriate medications;
chronic fatigue, emotional stress and exhaustion;
diseases and conditions accompanied by a violation of the microflora of the digestive and genitourinary tract;
malformations and anatomical features of the structure of the vagina;
inadequate personal hygiene;
foreign bodies in the vagina and uterus (spirals, caps, etc.).

Infection with Gardnerella vaginalis does not occur through sexual intercourse. However, the development of this disease is closely related to the characteristics of sexual relations. The risk of bacterial vaginosis increases with early onset of sexual activity, the presence of a large number of sexual partners, a high frequency of urogenital, rectogenital intercourse, etc.

Gardnerell's infection: symptoms in women, diagnostic methods, possible complications

The symptoms of Gardnerella-induced bacterial vaginosis are nonspecific. Many sexually transmitted diseases (for example, chlamydia, trichomoniasis) can proceed under the guise of gardnerellosis. The incubation period for infection is 3 to 10 days, but on average - a week.

Symptoms characteristic of pathology are:

quite abundant, sometimes foamy vaginal discharge, at the initial stages of the disease they are homogeneous, gray-white, but later they acquire a thicker consistency and a yellowish tint;

the characteristic unpleasant smell of stale fish, it intensifies after sex, during menstruation, after washing with soap, this symptom is due to the breakdown of amino acids produced by anaerobic gardnerella;
itching and burning, but only a third of women with bacterial vaginosis complain of these symptoms.

The emergence of an unpleasant "fishy" odor from the vagina in combination with abundant discharge is the reason for contacting a gynecologist.

The diagnostic criteria for gardnerellosis are:

plaque evenly covering the mucous membrane of the vagina and external genital organs, while pathophysiological signs of the inflammatory process are extremely rare;
pH values above 4.5 after carrying out a pH-measurement of the vaginal epithelium;
a positive amino test result, this is one of the express diagnostic methods, which is carried out by mixing a smear from the vagina with a 10% potassium hydroxide solution on a glass slide, in the presence of gardnerella, a strong smell of rotten fish appears;
detection of cells characteristic of bacterial vaginosis after microscopy of a Gram-stained vaginal smear.

Instrumental methods of detecting the disease complement the history data and the patient's complaints. Gardnerell's infection requires differential diagnosis with other urogenital pathologies caused by gonococcus, Trichomonas, chlamydia, opportunistic microorganisms. For this, PCR tests are prescribed to identify the DNA of bacteria.

Without appropriate treatment (and sometimes against the background of drug therapy), gardnerellosis is prone to chronic recurrent course. So, six months after the first episode, the symptoms of bacterial vaginosis reappear in a third of patients, and within a year - in 50 - 70% of women. Such violations of the composition of the physiological microflora of the vagina often lead to persistent recurrent candidiasis and other lesions of the urogenital tract. Sometimes gardnerella is also found in the bladder in the process of identifying the causes of cystitis.

In recent years, information has appeared that anaerobic pathogens of bacterial vaginosis secrete nitrosamines. They serve as coenzymes of carcinogenesis and can cause dysplastic and dystrophic processes in the cervix. They, in turn, can cause a variety of pathologies, including malignant cell transformations.

Gardnerellosis in women: features of the course and therapy during pregnancy, manifestations of the disease in men

Often, bacterial vaginosis, triggered by bacteria of the genus Gardnerella, occurs during pregnancy. As a rule, this is due to concomitant changes in hormonal balance. For early detection of pathology, a regular gynecological examination is required, especially in women at risk (with previous or concomitant venereal infections, chronic inflammatory lesions of the genitourinary system, etc.)

But to date, a clear connection has been established between the development of such a disease and infertility, an unfavorable outcome of pregnancy, the threat of miscarriage, and premature birth. In addition, in the absence of therapy, gardnerellosis is dangerous by early rupture of amniotic fluid, intrauterine infection of the fetus, and various inflammatory lesions of the uterus in the postpartum period.

Therefore, with the appearance of a discharge of a characteristic consistency and with a specific smell, it is necessary to urgently begin therapy. Most medicines used to treat bacterial vaginosis are contraindicated in the first trimester. Therefore, at this stage, even doctors recommend using folk remedies.

Starting from the second trimester, gardnerellosis in women is treated with:

Clindamycin (Dalatsin, Clindacin) in the form of a cream or suppositories, 5 g or one piece, respectively, at night for 3 to 5 days;
Metronidazole (Metrogyl, Metrovagin, Trichopolum, Trichocept, Flagil) cream (0.75%), suppositories - 2 times a day intravaginally or 0.5 g tablets twice a day, the course of therapy is 5-7 days.

In men, gardnerellosis is usually asymptomatic. As a rule, the representatives of the stronger sex are carriers of the infection. However, if immunity is weakened as a result of any diseases or medication, there is a risk of developing bacterial urethritis (inflammation of the urinary tract) or balanoposthitis (lesions of the head of the penis, foreskin).

Such pathologies manifest themselves in the form of burning sensation during urination, discharge with an unpleasant odor from the urethra. Often, the appearance of a grayish-white sticky plaque on the head of the penis, redness and slight swelling of the skin in the foreskin is noted.

How to treat gardnerella: drug and alternative therapy, restoration of local immunity, prevention methods

Anaerobic pathogens of bacterial vaginosis are highly sensitive to various antibacterial drugs from the group of fluoroquinolones, penicillins (but only in combination with clavulanic acid), macrolides. Antibiotics of the tetracycline series (for example, Minocycline) are less active against Gardnerella. However, most experts believe that the use of potent antimicrobial agents for the treatment of uncomplicated vaginosis is not warranted.

Therefore, the first-line drugs are:

Nitroimidazoles(Metronidazole, Ornidazole, Tinidazole). They are used internally, intravaginally in women and externally locally in men. The dosage and duration of treatment is determined individually. As a rule, Metronidazole (or its analogs under other trade names) is taken 2.0 g once or 0.5 g twice a day for a week. Ornidazole is drunk 0.5 g twice a day for 5 days, Tinidazole - 2.0 g once. Preparations of this group in the form of suppositories or ointments are used twice a day for 5 days.
Lincosamides... Of the drugs in this class, Clindamycin is the most effective. It is applied topically (applied to the head of the penis or inserted into the vagina) once a day at night for 6 days. Possible oral administration of 0.3 g twice a day for a week.

Additionally, doctors emphasize that metronidazole is absolutely incompatible with alcohol. Therefore, it is necessary to refrain from taking alcoholic beverages for the entire duration of treatment and within 24 hours after its termination. Clindamycin creams and suppositories can damage the latex from which condoms and vaginal diaphragms are made. Therefore, when treating with this drug, it is better to give up sexual life (sexual intercourse with gardnerella without a condom can aggravate the course of the disease).

Some patients prefer to treat bacterial vaginosis and urethritis with alternative medicine.

Pour 3 tbsp. dry herb celandine with a liter of boiling water, squeeze out a few cloves of garlic, insist for 3-4 hours, strain and use for douching.
Pass pine and juniper needles through a meat grinder (take in a 1: 1 ratio), squeeze out the juice from the resulting gruel, moisten a regular swab in it and insert it into the vagina overnight. To increase the effectiveness of treatment, alternate with gauze or cotton swabs dipped in a mixture of onion juice and horseradish. The course of therapy lasts 12 days.
Mix 10 g each of lavender herb, cherry and Chernobyl flowers, 20 g each of calendula, sage and dried crushed grass, oak bark, birch leaves, 30 g of chamomile flowers. Pour two tablespoons of the mixture with a liter of hot water, wrap the dishes with a towel, leave for 2 - 3 hours, strain and douche overnight for 2 weeks.
Purchase yarrow and eucalyptus tinctures at the pharmacy, mix and drink 25 drops in 50 ml of water three times a day on an empty stomach.
Mix in equal proportions mistletoe and yarrow herb. Brew a couple of spoons with half a liter of boiling water, leave overnight and drain. Can be used for douching or taken orally 1 tbsp. three times a day.
Grind a tablet of Trichopolum into powder, add a teaspoon of honey and the same amount of onion gruel. The resulting mass is applied to a tampon and inserted into the vagina at night. Alternate with calendula ointment tampons (available at your pharmacy).
Pour a tablespoon of tansy baskets with a glass of boiling water, simmer in a water bath for 15 minutes, cool to room temperature and strain. Use the solution for douching.
Mix in equal proportions black poplar buds, calendula and chamomile flowers, eucalyptus and bird cherry leaves. Take 2 - 3 tablespoons, pour a liter of boiling water, insist overnight and strain. First, do douching with this solution, then insert a tampon with lanolin-based propolis ointment into the vagina (if it is not in the pharmacy, you must mix 10 g of crushed propolis and melted lanolin). Treatment period is 2 weeks. In parallel, you can drink a decoction of wormwood.
Pour a tablespoon of bird cherry fruits with 300 ml of boiling water, boil over low heat for 20 minutes, cool and strain. Drink 1/3 three times a day half an hour before meals. Also, this solution can be used for douching.
For men for hygiene of the penis, the following composition is recommended: half a liter of chamomile decoction, 1 tbsp. soda, 5 drops of potassium permanganate and 2 drops of iodine.

However, the treatment carried out does not guarantee re-infection. Its likelihood increases if provoking risk factors are not excluded. It is possible to increase the activity of local immunity with the help of drugs designed to restore the normal composition of the vaginal microflora. They are used both in the form of suppositories and in the form of tablets.

In order not to face the problem of how to treat gardnerella, it is better to timely prevent infection. Wearing tight synthetic underwear and clothing should be minimized, especially during hot seasons. Panty liners and sanitary towels should be changed at least every three hours. Too frequent and unnecessary douching should also be avoided. In addition, it is necessary to adhere to the rules of safe sex and use condoms.

Sexual infections are characterized by a protracted course and long-term therapy. One of them, gardnerellosis in women, can hardly be attributed to classic venereal diseases. It occurs frequently and causes a lot of inconvenience. Let's consider 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 beneficial species, such as lactobacilli. The rest are conditionally pathogenic microbes that demonstrate disease-causing properties only in favorable conditions for themselves. 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 the beneficial microflora. The former includes bacteria of the type Gardnerella vaginalis. In a healthy body, they are few or not at all.

The reasons for this imbalance are as follows:

Taking antibacterial agents.
Promiscuous sex life.
The use of contraceptive suppositories.

The consequence of these actions is the development of gardnerellosis (bacterial vaginosis) in the genital tract of a woman. The pathogenic microbe negatively affects the state of the mucous membrane, provokes its inflammation.

Symptoms of gardnerellosis in women

The infection occurs regardless of age. The clinical picture can be asymptomatic, without discomfort and discharge. In such cases, they learn about the disease only by test results.

Another option is possible with pronounced symptoms, general malaise, profuse discharge, cuts in the lower abdomen.

Gardnerellosis gives out the following symptoms:

Stench from genital tract, as from decomposing fish. The reason is the destruction of amines due to the active increase in the number of gardnerella.
Discharge, initially thin, viscous over time, opaque, yellowish or greenish in color.
Menstrual irregularities.
Burning, itching.
Development of cystitis, urethritis.
Painful urination.
Feeling unwell.

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

The period from the moment of infection until the appearance of weak discharge and slight discomfort (incubation) lasts from 7 to 20 days. During this time, pathogenic microbes spread through the vagina and displace lactobacilli. After 2 weeks, the symptoms become pronounced, the 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.
Has sexual intercourse without contraceptives.
Uses contraceptives with 9-nonoxynol, which destroys lactic acid bacteria.
It douches and thereby washes away the beneficial microflora, or, even worse, uses antiseptics that have a strong antibacterial effect.

Gardnerella reproduces actively under several conditions. But with 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 is questioned, since the oral cavity is not suitable for the life and reproduction of the microbe.

Accurate diagnosis

Bacterial vaginosis is dangerous for its asymptomatic course, 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. He differentiates gardnerellosis from chlamydia, colpitis and other pathologies of the genitourinary system.

The following methods help in making a diagnosis:

Examination on a gynecological chair, collection of data on sexual activity, the course of the menstrual cycle, the use of contraceptives.
Taking a smear to establish pathogenic microflora and markers of gardnerellosis.
Testing to determine the pH of the vagina.
Isonitrile test is a compound that detects fetid 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 useful 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 of the female body.

By analyzing urine and blood, it is possible to find out how far the infection has spread. Colposcopy will detect inflammation of the cervix.

Treatment of gardnerellosis in women

Bacterial vaginosis does not belong to sexually transmitted diseases, but requires concomitant therapy, since over time it can lead to serious consequences, including:

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

Treatment of gardnerellosis is carried out in three stages:

Suppression of gardnerella.
Restoration of the microflora of the vagina.
Strengthening the immune system.

Even at an advanced stage, bacterial vaginosis is successfully cured if you seek medical help.

Preparations, treatment regimens

To destroy pathogenic microbes and prevent their further reproduction, antibiotics are used. 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 are:

Antibiotic treatment lasts 7 to 10 days. Doses are calculated by the doctor based on the degree of inflammation, weight and age of the patient. The average daily dose for the drug Trichopolum is 500 mg, Clindamycin - 300 mg. A single dose of the drug Metronidazole with a volume of 2 g copes with a disease that is mild or moderate.

In the case of not started gardnerellosis, candles are relevant. Suppositories have a local, non-systemic effect. They can treat gardnerellosis in women who are pregnant. The duration of therapy is a week, in more difficult cases, 10 days. The dosage is selected individually by the gynecologist, the maximum for the first 3 days, then adjusted downward.

Of the candles they use:

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

The disease can recur with hypothermia and stress. Therefore, if necessary, treatment with drugs is repeated.

Folk remedies

Basically, the recipes contain medicinal plants: string, sage, chamomile, oak bark, which have antimicrobial action. Sea buckthorn and olive oils are used to heal damaged mucous membranes.

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

Douching Recipes:

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

In 2 months, as a rule, it is possible to completely get rid of gardnerella. In time, about a week is spent on antibiotic therapy, a month to restore 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 in them is not characterized by a severe course. It is possible to destroy the pathogen with Metronidazole, acting locally, only on the site of inflammation.

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

Diet during treatment

Gardnerellosis depends on immunity, and that, in turn, on food, which should be fractional, consist of small portions. The menu is balanced, contains micro and macro elements, vitamins, carbohydrates, fats, proteins.

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

It is necessary to limit:

Pickles, smoked meats.
Coffee Tea.
Alcoholic drinks, sweets.
Fried, fatty, spicy.

Prevention of gardnerellosis

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

Avoid psycho-emotional overload.
Observe the mode of work and rest.
Give up smoking and alcohol.
Eat varied.
Do not overcool.
Monitor the cleanliness of the genitals, including during menstruation.
To avoid infection, make contact with a trusted partner using contraceptives.
After unprotected sex, treat the vagina with Chlorhexidine or Miramistin.

Alarming symptoms in the genital tract should be a reason for visiting a gynecologist.

Bacterial vaginosis (gardnerellosis) is a common infection that affects the female genital area. Today we will talk about what is gardnerellosis in women, and what are the causes, symptoms and methods of treatment of the disease. The designated topic does not lose its relevance, since almost every third woman of childbearing age is faced with this problem and is looking for ways to solve it.

What is gardnerellosis in women?

Gardnerellosis is an inflammatory disease of the genitourinary system caused by an imbalance of the vaginal microflora. The causative agent of the infection is the anaerobic bacterium Gardnerella vaginalis. The vaginal microflora is represented mainly by lactobacilli, which produce lactic acid, which prevents the reproduction of opportunistic microflora. However, even in a healthy woman, other microorganisms are present in the vagina - gardnerella, mycoplasma, klebsiella and others.

The bacterium Gardnerella belongs to anaerobic microorganisms that can exist in an anoxic environment and multiply rapidly under favorable conditions, suppressing beneficial lactic acid bacteria. Other pathogenic microorganisms are actively involved in this process, provoking dysbiosis (changes in the composition of normal microflora) and causing the development of the inflammatory process. Mass reproduction of gardnerella occurs against the background of a weakened immune system and is accompanied by characteristic symptoms, which we will talk about below. And now let's dwell in more detail on the reasons provoking vaginal dysbiosis.

The reasons for the development of gardnerellosis

Vaginal dysbiosis is dangerous because it creates conditions for the development of infection of the genital tract - colpitis, vaginitis or chlamydia, and also increases the risk of dysplasia (precancerous condition of the cervix). Gardnerellosis is one of the reasons for an unfavorable outcome in gynecological interventions, abortion and childbirth. The main factors triggering the multiplication mechanism of pathogenic anaerobic microorganisms are:

weakening of immunity after illnesses;
unprotected and promiscuous sex;
the haphazard use of antibiotics and local antiseptics that disrupt the balance of the vaginal microflora;
uncontrolled use of contraceptives;
hormonal disruptions;
chronic diseases of the female genital organs (uterus, appendages);
tumor processes (fibroids, cysts), malformations;
endocrine diseases (in particular, diabetes mellitus);
immunodeficiency states (HIV);
treatment with immunosuppressants and cytostatics.

Most often, gardnerellosis is diagnosed in women who are sexually active and use contraceptive suppositories as contraceptive measures or who often use the douching procedure with antiseptics (Miramistin, Chlorhexidine). With this approach, the vaginal microflora is disturbed - the number of beneficial lactobacilli decreases, while pathogenic bacteria begin to multiply actively.

In addition, women at risk are women who often change partners (if they refuse to use barrier methods of contraception - condoms). In this case, in addition to gardnerellosis, the risk of infection with gonococcus, Trichomonas, chlamydia and other sexually transmitted diseases increases.

Symptoms

The multiplication of Gardnerella bacteria triggers an inflammatory process in the vagina and cervix. The main manifestations of infection are as follows:

there is a sticky, frothy discharge from the vagina of a white, or yellowish-gray tint;
the discharge has a very unpleasant odor, comparable to the smell of rotten fish;
there is a sensation of irritation, itching and burning in the vagina, accompanied by frequent urge to urinate;
painful sensations in the lower abdomen increase, which indicates an increase in the inflammatory process;
during intercourse, discomfort and pain intensify.

The appearance of a persistent unpleasant odor is due to the decay of waste products of gardnerella. This symptom gives a woman significant discomfort and makes her often hygiene intimate places. But upon contact with the alkaline medium of the soap, the situation is only aggravated and the period of "cleanliness", that is, the absence of odor, becomes shorter and shorter.

Sexual intercourse is accompanied by an exacerbation of painful symptoms and contributes to an increase in the volume of secretions, since the alkaline environment of the sperm causes pathogenic microorganisms to multiply even more intensively. In the future, urination disorders appear, urine is secreted in small portions, and the process itself becomes difficult and painful.

In some cases, the symptoms of gardnerellosis may be mild and persist for many years. If untreated, the likelihood of developing serious consequences associated with dysfunction of the genitourinary system increases.

Possible complications

The long course of gardnerellosis becomes the cause of the development of many gynecological pathologies. Bacterial vaginosis leads to inflammation of the female genital organs, and in advanced cases it provokes cervical cancer. A woman with a similar diagnosis has problems while carrying a child. Uterine bleeding, premature rupture of the amniotic membranes, infection of the child during childbirth, and the development of postpartum endometritis are noted.

Women with gardnerellosis often develop complications after a cesarean section and other gynecological procedures. And newborns are often diagnosed with pneumonia or are born prematurely. To avoid possible complications, the treatment of gardnerellosis must be started immediately after the pathology is detected.

Diagnostic methods

It is difficult to make a correct diagnosis based on one clinical picture, since its symptoms are similar to vaginal candidiasis (thrush). Therefore, before treating a disease, it is necessary to differentiate it from other pathologies with similar symptoms. For this, a collection of vaginal secretions is made for research.

Examination of a smear under a microscope allows you to identify the presence of gardnerella and count the number of anaerobic bacteria. In addition, an assessment of the alkaline reaction of the vagina is performed, an increase in the pH is considered the basis for confirming the diagnosis. Unlike the normal, acidic environment created by lactic acid bacteria, an alkaline reaction indicates the multiplication of gardnerella.

In addition, when examining stained smears under a microscope, the following specific signs of the disease are revealed:

the presence of pathological key cells, on the squamous epithelium of which gardnerella and other pathogenic microorganisms are fixed;
a large number of desquamated cells are found on the mucous membrane;
insufficient volume or complete absence of lactic acid bacteria;
the presence of leukocytes, indicating an inflammatory process.

There are other methods for diagnosing gardnerellosis. The most informative and accurate of them is the PCR (polymerase chain reaction) method, which allows you to identify pathogens at any stage of its development and detect harmful microorganisms, even if they are present in small quantities.

Treatment regimen for gardnerellosis in women

Treatment of gardnerellosis should be started as early as possible in order to prevent the transition of the disease to the chronic stage and eliminate the likelihood of complications. The main method of fighting bacterial vaginosis is antibiotic therapy. Oral preparations (in tablets) and local remedies (suppositories, creams, gels) are used. Treatment measures consist of several stages:

the use of antibacterial drugs;
treatment aimed at restoring the normal balance of microflora in the vagina;
preventive measures aimed at strengthening the immune system and preventing further relapses of the disease.

Drugs

At the first stage, the main drugs are antibiotics, or Clindamycin. The tablets should be taken twice a day, at the dosage indicated by the doctor. The course of treatment usually takes 7 to 10 days. The bacterium Gardnerella vaginalis is resistant to antibiotics from the group of tetracyclines, cephalosporins, sulfonamides. Therefore, they are not used in the treatment process.

Pregnant women are not prescribed Clindamycin, as this antibiotic has a toxic effect on the fetus. In the first half of pregnancy, Ampicillin is prescribed, in the third trimester - Metronidazole. Treatment cannot be postponed, since it is possible that the baby becomes infected during childbirth and other complications - from the birth of a premature baby to the development of postpartum endometritis.

When gardnerellosis is combined with vaginal candidiasis (thrush), combined agents are prescribed, which include an antifungal and antibacterial component. The drugs Terzhinan and Mikozhinaks, which are produced in the form of vaginal tablets, have proven themselves excellently. A popular remedy in the treatment of bacterial vaginosis is McMiror, which contains the powerful antiseptic nifuratel and the antifungal component nystatin.

External use

The number of means for external use for gardnerellosis includes Metronidazole gel or Cleocin vaginal cream. A good effect can be achieved by using the Salvagin antiseptic gel. Candles, Natalsid or Ginopevaril are used as means to prevent the attachment of a fungal infection. The optimal treatment regimen for gardnerellosis is selected by the attending physician, taking into account the severity of the disease and the individual characteristics of the patient.

Bacterial vaginosis is not sexually transmitted, therefore, treatment of a woman's sexual partner is carried out only when a man is diagnosed with urethritis (inflammation of the urethra). In other situations, the partner is not prescribed medication, but it is recommended to use a condom during sexual intercourse.

Second phase

At the second stage, it is necessary to restore the microflora of the vagina and repopulate it with lactic acid bacteria. For this purpose, vaginal suppositories are used:

Lactobacterin;
Lactonorm;
Atzilact.

To prevent the development of dysbiosis in the intestines, after a course of antibacterial agents, probiotics are prescribed - Bifidumbacterin, Linex, Acipol.

On average, the course of treatment for gardnerellosis can last up to 2 months. Of these, 10 days are given for taking antibiotics, the rest of the time is for the restoration of the microflora of the genital tract. In the future, measures are being taken to strengthen the immune system and prevent relapse of the disease.

During the course of therapy, a woman should not bathe in the bath; it is enough to take a shower every day. Other recommendations are related to the diet. The daily menu should be revised and fatty, fried and spicy foods should be excluded from it, and sweet and starchy foods should be completely abandoned. During antibiotic treatment and within a week after its end, the use of alcoholic beverages should be excluded.

Preference is given to a light, plant-based, dairy diet that helps to normalize bowel function. The basis of the diet should be fresh vegetables and fruits, fermented milk drinks, diet meats, cereals. In addition, it is recommended to drink more fluids (up to 2-2.5 liters per day).

Prophylaxis

To eliminate the risk of repeated relapses of the disease will help to comply with certain medical recommendations:

timely treat diseases of the genitourinary sphere, which can cause gardnerellosis;
avoid promiscuous sexual intercourse, have one, constant partner;
use barrier methods of contraception during sexual intercourse;
carefully observe personal intimate hygiene;
wear cotton underwear;
strengthen the immune system, play sports, lead a healthy lifestyle, eat properly and balanced;
after antibiotic therapy, it is imperative to use drugs to restore the normal microflora of the vagina;
undergo a preventive examination by a gynecologist twice a year.

Additionally, in order to prevent or treat often recurrent gardnerellosis, the doctor may suggest the introduction of a special vaccine called Solkotrichovak. Its action is aimed at suppressing opportunistic microflora, increasing the number of beneficial lactobacilli and maintaining general immunity.

A certain microflora is present in a woman's vagina, including a mass of microorganisms - both useful (lactobacilli) and opportunistic. Their ratio in a healthy woman is optimal for the health of the reproductive system and the whole body as a whole.

However, in certain situations, conditionally pathogenic flora begins to actively multiply, displacing useful ones.

The microorganism gardnerella vaginalis belongs to the category of opportunistic pathogens. Normally, its amount in the genital tract is negligible, or there is a complete absence.

Gardnerellosis (synonym: bacterial vaginosis) is caused by an imbalance in the microflora of the vagina. Normally, it is represented mainly by lactobacilli.

These bacteria form lactic acid and hydrogen peroxide, preventing the reproduction of opportunistic microorganisms. The normal vaginal microflora may contain small amounts of Gardnerella vaginalis, Mycoplasma hominis and anaerobic bacteria (genus Mobiluncus and others). These microorganisms are present in small amounts in the vagina of most healthy women.

As a result of douching; the use of contraceptives containing 9-nonoxynol (candles "Patenteks Oval", candles "Nonoxynol"); change of sexual partner decreases the proportion of lactobacilli in the microflora of the vagina. At the same time, the proportion of Gardnerella vaginalis, Mycoplasma hominis and anaerobic bacteria is increasing. In this case, vaginal dysbiosis occurs - the so-called gardnerellosis.

In men:

Gardnerellosis is by definition a vaginal dysbiosis. Therefore, it is wrong to make such a diagnosis for men. Sometimes the causative agents of gardnerellosis cause urethritis in men, which is manifested by burning sensation and pain when urinating. In this case, treatment is necessary. In other cases (detection of Gardnerella vaginalis by precise methods; gardnerella in a sexual partner), there is no need to treat men.

With a normal immune status about 25% of men are carriers of gardnerella, that is, they do not have any manifestations of infection.

Carriage develops when Gardnerella vaginalis enters the male genital tract. Only in conditions of sufficiently strong immunosuppression is the development of balanoposthitis, urethritis, prostatitis possible (approximately 15% of all cases).

Gardnerellosis is not a sexually transmitted disease. Sexual transmission has not been proven. However, it is closely related to risk factors for sexually transmitted diseases (multiple sexual partners, recent sexual partner change). Therefore, women with gardnerellosis should be examined for major sexually transmitted diseases.

Causes of gardnerella

Infection. Often gardnerellosis is accompanied by diseases such as gonorrhea, chlamydia, trichomoniasis, sexually transmitted diseases. The reproduction of pathogenic bacteria provokes inflammation of the mucous membrane and disruption of the normal microflora of the vagina, and if untreated, it can lead to serious consequences, up to the development of infertility;
Hormonal disbalance. This phenomenon is also due to various reasons. For example, pregnancy. For pregnant women, gardnerellosis and thrush are quite common. Also, a change in hormonal levels can be triggered by severe stress, taking medications, including contraceptives and antibiotics, and the presence of certain diseases. The exact cause of the hormonal imbalance is determined by a specialist;
Strong intoxication of the body. Common food poisoning can provoke intestinal and vaginal dysbiosis. As a result, symptoms of both diseases may occur;
Endocrine diseases. In particular, diabetes mellitus. An increased blood sugar level contributes to a violation of the alkaline balance of the vaginal mucosa and, as a result, the reproduction of pathogenic microflora in it;
Any surgical intervention in the reproductive system (abortion, medical gynecological manipulations);
Frequent use barrier contraception, local treatments for inflammatory diseases of the vagina. There is nothing wrong with the use of condoms, but the lubricant included in their composition in some women provokes the multiplication of gardnerella and the fungus that causes thrush. The same applies to vaginal suppositories, indicated for trichomoniasis, candidiasis and other infections;
Sharp decreased immunity... This may be due to internal (blood disease, bone marrow, frequent infections of the respiratory system, etc.) and external (a sharp change in climatic conditions, radiation, taking certain medications) reasons;
Frequent change of sexual partners(can cause infection with STIs, the development of gardnerellosis and other unpleasant health consequences).

At-risk groups

Since gardnerella vaginalysis is normally part of the vaginal microflora and is never completely removed. It can appear at any time in women of reproductive age, regardless of sexual activity. According to the observations of doctors, gardnerellosis appears 32% of virgins, and 28% of single women. Sometimes it is transmitted to girls of school age in a household way. However, all of these cases are the exception, not the rule.

The most susceptible to the disease are women and men who are promiscuous without the use of barrier contraceptives. It is transmitted to the newborn girl from the mother. Perhaps the development of gardnerellosis in women who have undergone childbirth and abortion.

Why is the disease dangerous?

Previously, it was believed that this gardnerellosis is not harmful. Currently, it is considered a risk factor for inflammation of the uterine appendages, female infertility, premature birth, complications of pregnancy and childbirth.

Despite the fact that gardnerellosis is not a sexually transmitted disease, it still requires treatment. If left unaddressed, the infection can cause quite serious complications for both women and men.

Gardnerellosis in women causes the following complications:

Inflammation of the pelvic organs;
Urethral syndrome;
Post-abortion and postpartum endometritis;
Infertility;
Intraepithelial cervical neoplasia;
Bartholinitis or abscess of the Bartholin gland.

Gardnerellosis in men can cause:

Non-gonococcal urethritis;
Chronic prostatitis;
Cystitis;
Balanoposthitis.

Classification

bacterial vaginosis of the compensated type - with this course of the disease, according to the analyzes, there is an insignificant presence of conditionally pathogenic flora in patients;
subcompensated bacterial vaginosis - the number of beneficial lactobacilli significantly decreases with an increase in opportunistic flora, including gardnerella;
decompensated vaginosis - the beneficial flora is almost completely supplanted by the pathogenic, the inflammatory process is strong, pronounced, the nature of changes in the epithelial layer.

Clinical picture

How does gardnerella manifest in women? Pathology can develop:

asymptomatic - the disease is diagnosed by tests, the woman does not present any complaints, pain and discharge are not observed;
with a pronounced clinical picture - pain and cramps, discharge, feeling unwell.

The incubation period of gardnerella in women - from the moment gardnerella enters the genital tract to the moment of manifestation - ranges from a week to 20 days. During this period, the pathogenic flora begins to gradually spread, displacing the useful.

The onset of the disease is characterized by mild symptoms - slight discomfort, weak discharge. A vivid clinical picture appears on the 14-20th day - the symptoms are pronounced, the discharge is abundant, the pain syndrome and discomfort are maximum.

The main signs indicating the development of gardnerellosis:

Bad smell from the genital tract - often this is the first symptom of the development of vaginosis; the smell is offensive, pungent, similar to the aroma from decaying fish, which is due to the decomposition of amines due to the rapid multiplication of gardnerella;
Allocations from the vagina - their character changes depending on the severity of the disease. At the initial stage, the discharge looks like a mucous translucent and turbid liquid, as the pathological process aggravates, the discharge becomes gray, opaque, viscous, acquires a green or yellow tint. When the stage of discharge is advanced, layers form on the walls of the vagina, causing it to swell and redness. A characteristic feature of discharge with gardnerellosis is a bad smell;
Sudden disruption of the menstrual cycle may indicate the development of bacterial vaginosis;
The discomfort in the area of the genitourinary organs - as the pathogenic flora multiplies, itching and burning appear in the urethra, labia, vagina, mucous membranes may look swollen, inflamed;
The development of diseases affecting the organs of the urinary system - urethritis, cystitis indicate the presence of gardnerellosis. This is due to the close proximity of the location of the genitals and urinary organs;
Painful sensations during intercourse - soreness can occur immediately with proximity and persist after;
Pain while urinating- occur when the infection spreads to the urethra;
General malaise- the pathological process can lead to a general disturbance of well-being, a feeling of weakness, possibly an increase in temperature as a result of the active reproduction of negative microbes.

Diagnostics

Antibiotic sensitivity

Name of the group and drugs	Gardnerella sensitivity	Application methods
Nitroimidazoles: metronidazole, tinidazole, ternidazole, ornidazole		Orally, intravaginally, topically. The method of application depends on the location and severity of the inflammatory process.
Lincosamides: clindamycin	Sensitive / first-line drugs	Orally, intravaginally, topically. Local forms are more often used (suppositories, creams and gels with clindamycin)
Macrolides (josamycin, azithromycin, erythromycin)	Sensitive	Orally, intravenously, used for severe forms of infection, combination of bacvaginosis with chlamydia, mycoplasmosis
Tetracyclines: doxycycline	Moderately sensitive	Oral as one of the antibiotics in the STI regimen (chlamydia)
Aminoglycosides: gentamicin, amikacin	Insensitive	Not used to treat gardnerella infection
Protected penicillins (amoxiclav)	Sensitive	Sensitivity has been established experimentally, currently not used for treatment
Fluoroquinolones (ofloxacin)	Sensitive	Can be used in treatment regimens (more often when combined with STIs)

Prophylaxis

Prevention comes down to giving up douching and using contraceptives containing 9-nonoxynol. Condoms should be used for casual sex and contact with non-regular sexual partners.

The use of vaginal tablets and broad-spectrum suppositories (Terzhinan, Polygynax, Betadine) can also contribute to the development of gardnerellosis. These drugs contain broad-spectrum antibacterial agents that suppress the normal microflora of the vagina.

Bacterial vaginosis or gardnerellosis in women is quite common. This is an infection that in women is caused by a special bacterium - gardnerella vaginalis. A small amount of these microorganisms is completely harmless to the body, but as soon as their number begins to increase due to a decrease in lactobacilli, the first signs of the development of gardnerellosis appear. You should not be ashamed of this female disease, because it does not belong to sexually transmitted diseases, does not depend on compliance with intimate hygiene standards, and can develop at any time in women of different ages. Even small girls who do not have a single sexual contact are capable of having a rather adult female disease - gardnerellosis.

You cannot find a female person who would have an absolutely sterile vagina. Only newborn girls do not have any microorganisms in their genitals at all, but already about a week after birth, the composition of their microflora begins to change. Before puberty, in about all, it normally has an acidity of pH 5.0.

Everything is different in the body of female adults. They constantly have various organisms in their vagina, so the acidity of the environment decreases (pH 4.0-4.5). Some of the bacteria are completely harmless and must be present in the microflora (lactobacilli), others, like gardnerella vaginalysis in women in the photo, under favorable conditions for her, becomes a real threat and leads to changes in the microflora.

Every healthy woman has a certain amount of lactobacilli in her vagina. These are her protective bodies. They regulate the level of acidity, determine the composition of microflora, and fight microorganisms that can harm health. When one day lactobacilli lose their activity, this is immediately noticed by harmful microorganisms that were previously oppressed. This is where the time comes to come to the fore gardnerelle. Its rate in a healthy woman is about 103-105 CFU / ml, as soon as this indicator increases, there is a threat of developing gardnerellosis in the woman shown in the photo. They can develop very quickly, but they do not show any resistance. In this case, the female disease either manifests itself or subsides a little. This condition is called chronic gardnerellosis in women. During chronic gardnerellosis, bacteria go deep into the genitourinary system and move into the urethra or cervix. It can last for several years, until one day, upon accidental examination, the doctor diagnoses the disease.

Causes of gardnerella in women

An excessive increase in the number of vaginalis bacteria in women is the cause of gardnerellosis. Its amount increases significantly due to a sharp decline in the number of lactobacilli. This disproportionate relationship in the vagina between the two groups of bacteria can occur as a result of antibiotic treatment, menopause, or diabetes. It leads to dysbiosis. This is nothing more than gardnerellosis. The number of lactobacilli can be reduced when using intimate hygiene products that cause dry skin. Excessive care of the female genital organs also does not do anything good, but can cause a large number of gardnerella vaginalis in women.

Sex without a condom with a man who had previously had an affair with an infected partner and became infected also becomes the cause of gardnerellosis in a perfectly healthy woman.

Among other reasons involved in the appearance of gardnerella infection in women, one can single out:

Symptoms and signs of gardnerellosis in women in life and in the photo

Not all even adult ladies know how gardnerella manifests itself in women, therefore, they do not even reveal obvious signs in time. When visiting a gynecologist, patients sometimes complain of an unpleasant odor from the vagina, which is somewhat reminiscent of the stench emanating from rotten fish. At this time, they do not even realize that these are the first signs of gardnerella in women, and such a nasty smell appeared as a result of the active decomposition of amines under the influence of anaerobic bacteria on them.

In addition to the unpleasant odor, other symptoms of gardnerellosis in women are also known. Quite often, a symptom of the disease is previously uncharacteristic discharge. Their color is not the same for everyone. It happens that the discharge is grayish-green or yellowish. Very rarely, the discharge can be white, then they are called "whites", or transparent. Their consistency resembles a cream. They stick to the walls of the vagina and hold tight to them. The number of bacteria in vaginosis increases rapidly, so the discharge becomes more and more abundant. Doctors consider such vaginal discharge to be pathological, so they will have to be dealt with immediately, reducing the amount of gardnerella in the body.

Often, vaginosis occurs against the background of inflammation of the genitourinary system. Then, to the mentioned signs of a female disease, other symptoms of gardnerella in women are added. The inflammatory process is accompanied by severe burning or itching, which becomes especially noticeable during intercourse or immediately after it.

Unreasonable irregularities in the menstrual cycle, the appearance of mucous impurities in the bloody discharge, resembling flakes of pus or pieces of cottage cheese, can also become a sign of gardnerella vaginalis.

Approximately 25 - 30% of women who had gardnerellosis had no symptoms at all in the photo. This is a common occurrence in illness, but it cannot be said that the absence of symptoms is a safer course of the disease. On the contrary, when a woman notices the symptoms of gardnerellosis or at least feels discomfort in the genital area, she goes to the clinic and tries to start treatment as soon as possible. If the disease is asymptomatic, this often happens, you can expect various complications, which will be much more difficult to cope with than with the disease detected in the early period of development.

In terms of symptoms, gardnerellosis resembles other genital infections, so a correct diagnosis can be made only after passing a smear.

Treatment of gardnerellosis in women with drugs

Before starting treatment for gardnerellosis in women, each doctor invites his patient to undergo a diagnosis in order to exclude the presence of other microorganisms that may also be involved in the disease. The most common and accessible is the study of vaginal discharge, if any, or a smear for culture from the mucous membranes of the vagina, according to the results of which the amount of gardnerella and lactobacilli in the microflora is determined. Based on this ratio, the doctor decides how to cure gardnerellosis in a woman using topical preparations and auxiliary procedures such as baths, douching and others.

The treatment regimen for gardnerella in a woman is based on the form of the disease, the reaction of her body to drugs, the patient's condition, and even the cause of the disease. The most effective drug in the treatment of gardnerella vaginalis in a woman is metronidazole. Let the doctor's decision in choosing pills not scare patients who have already treated trichomoniasis with this medicine, because this drug is ideal for combating many genital infections. And when the question is how to effectively treat gardnerella in women, feel free to use the drugs according to the scheme indicated by the doctor.

Being wary of the side effects of metronidazole, patients will learn how to treat gardnerella in women with other drugs. You can use clion or efloran, but in their composition, the active substance is also metronidazole. Alternatively, choose drugs with clindamycin: clindamycin, dalacin.

When deciding how to treat gardnerellosis in women, doctors prescribe suppositories for the treatment. Suppositories with metronidazole are considered very effective. They create a high concentration of a drug that fights the virus in the vagina, and thereby contribute to a quick recovery by reducing the amount of the virus. In addition to treating gardnerella in women, suppositories are also effective for candidiasis, which is often found in pairs.

When choosing how to treat gardnerella in women, many opt for creams. These are also quite effective remedies that are injected into the vagina twice a day. Your doctor may recommend using creams or gels that contain metronidazole. This is a flagil or metrogil. The course of such therapy usually lasts from 5 days and can reach 10 days if a woman has chronic gardnerellosis.

As an alternative group of creams are drugs with clindamycin. Just once a day for a week, it is enough to inject dalacin into the vagina to reduce the concentration of the virus.

Although the amount of gardnerella vaginalis in a woman's body has decreased, thanks to antibiotic treatment or the use of suppositories, it is too early to talk about complete recovery until the required amount of lactobacilli in the microflora is restored. For this, the doctor prescribes drugs that contain lactobacilli.

Treatment of gardnerella in women with traditional medicine

Since it does not belong to sexually transmitted infections, herbal preparations are quite effective in treatment. For baths, both tinctures bought at a pharmacy and decoctions of herbs prepared at home are suitable. Effective in this fight are calendula and chamomile, thyme and oak bark, wormwood and yarrow, celandine and eucalyptus, birch leaves and mint. These same herbs can be taken in the form of tea to strengthen the immune system.

At home, you can make tampons soaked in carrot juice and apple cider vinegar. For 1 tampon, take a tablespoon of carrot juice and half of the same spoonful of vinegar. The tampon is inserted into the vagina for 20 minutes after taking hygiene procedures and douching.

Doctors recommend taking baths with salt and potassium permanganate during illness, if there is abundant discharge. This solution kills bacteria and helps to significantly reduce their number. If it is impossible to do such baths every day, you can use the same solution for tampons that are inserted into the vagina in the morning and evening. Medical workers are very wary of douching and do not recommend using them often in the treatment regimen for gardnerellosis in women, because such a procedure promotes the washing out of the beneficial microflora from the vagina, which is not enough there anyway.

For the prevention of bacterial vaginosis, traditional medicine is recommended to drink tea made from sage more often.

Some consider gardnerellosis to be a frivolous female disease and wait until it goes away on its own without the use of drugs for treatment. The imbalance can recover over time and on its own if the reasons that caused it have disappeared (for example, the use of an IUD or condoms with lubricants has been discontinued), but such an independent restoration of the microflora can take a very long time. Think about whether you want to endure such fetid odors, reminiscent of illness, and communicate with your spouse, having unpleasant discharge?