What are the symptoms of gardnerella in women, how to treat it? Gardnerella vaginalis: description of the pathogenic microorganism and the diseases caused

Sexual infections are characterized by a protracted course and long-term therapy. One of them, gardnerellosis in women, is difficult to classify as classic. venereal diseases. 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 own 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 to perform reproductive function and for her health in general.

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

The reasons for this imbalance are the following:

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 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.
Violations menstrual cycle.
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 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. It differentiates gardnerellosis from chlamydia, colpitis and other pathologies of the genitourinary system.

Help in making a diagnosis following methods:

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 establish pathogenic microflora and for markers of gardnerellosis.
Testing to determine vaginal pH.
Testing for isonitrile, a compound that detects 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 of the 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 of the fallopian tubes.
Pyelonephritis.
Endometritis.
Infertility.

Treatment of gardnerellosis is carried out in three stages:

Gardnerella suppression.
Restoration of vaginal microflora.
Strengthening the immune system.

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

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 the drug Metronidazole 2 g copes with a disease occurring in the lungs or average shape.

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 downwards.

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, which have antimicrobial effects. Sea buckthorn and olive oils are used to heal damaged mucous membranes.

Recipes traditional medicine are considered the safest, but before taking them you should consult a doctor. He may approve their use as an adjunct 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), which includes chamomile and plantain (1:1), and 250 ml 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 in them is not characterized by a 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.

Gardnerellosis is an infectious process that develops mainly in women. It is not accompanied by an inflammatory reaction, but in the absence of proper therapeutic measures it can cause the development of infectious complications.

Now let's look at this in more detail.

What is gardnerellosis?

The term gardnerellosis defines the change normal microflora vaginal mucosa in women, represented by lactobacilli. Their number decreases, microorganisms of the bacteria Gardnerella vaginalis (Gardnerella vaginalis) and other representatives of opportunistic (opportunistic microflora) appear. In this case, inflammatory changes on the mucous membrane have not yet developed. Lactobacilli are representatives of normal microflora; when present in sufficient quantities on the mucous membrane, they prevent the activation of representatives of opportunistic microflora, and also prevent pathogenic microorganisms from multiplying. With a decrease in the number of lactobacilli, nonspecific protection of the mucous membrane of the vagina and vulva decreases, which contributes to the activation of opportunistic microorganisms, primarily Gardnerella. The process is not accompanied by the development of an inflammatory reaction, but without restoration of normal microflora, the risk of developing other infectious diseases increases.

In men, gardnerella can develop on the mucous membrane of the urethra (urethra), where normally there should be no microorganisms at all. Infection occurs when having unprotected sex with a woman suffering from gardnerellosis.

An infectious process accompanied by an increase in the number of gardnerella is more often recorded in women.

What gardnerellosis looks like from a photo

In women, visual changes during the development of gardnerellosis remain minimal. This is due to the lack of an inflammatory response. The most common visual change is the appearance of vaginal discharge, which is mucous in nature, grey colour and an unpleasant “fishy” smell.

In men, gardnerella bacteria enter the mucous membrane urethra, as well as the head of the penis leads to the development
inflammatory reaction. It is accompanied by several characteristic visual changes. They include redness (hyperemia) of the mucous membrane of the corresponding localization, as well as slight swelling, which is noticeable in the area of the external opening of the urethra. The appearance of mucous discharge, which is usually characterized by a small volume and an unpleasant odor, is also visually determined.

Features of gardnerellosis in women

The genitourinary system of men and women has significant anatomical and physiological differences, so the course of gardnerellosis has certain characteristics. For the female body the most characteristic features currents pathological process are:

Garnerellas for the female vaginal mucosa are representatives of opportunistic microflora, therefore in small quantity are constantly present. The activity and number of microorganisms increase under certain conditions favorable to them.
The infectious process with gardnerellosis in women occurs mainly on the vaginal mucosa. As the pathological condition progresses, microorganisms spread to the cervix.
The development of gardnerellosis is always accompanied by a change in the normal microflora of the vagina, in which the number of lactobacilli decreases.
Together with Gardnerella, the number of other microorganisms representing opportunistic microflora may increase.
The infectious process is not accompanied by an inflammatory reaction only if the number of gardnerella alone increases. If gardnerellosis is accompanied by the activation of other pathogenic or opportunistic organisms, a pathological inflammatory process develops, which is called.
Since there is no inflammatory reaction in gardnerellosis, the pathological infectious process is also called vaginosis.

In women, gardnerellosis is a common infectious process that develops as a result of exposure to a significant number of provoking factors and requires adequate therapeutic measures, as it increases the risk of developing inflammatory pathology.

Features of gardnerellosis in men

Due to certain anatomical and physiological differences reproductive system and structures of the urogenital tract in men, the course of gardnerellosis has several of the following features:

The mucous membrane of the glans penis and urethra does not contain microorganisms.
Gardnerella are not representatives of the opportunistic microflora of the mucous membranes of the structures of the male urogenital tract.
Gardnerellosis in men develops against the background of infection. The entry of microorganisms into the mucous membranes of the urethra and glans penis usually occurs after unprotected sex with a woman who suffers from vaginosis.
The infectious process, unlike the female body, always occurs with the development of an inflammatory reaction and the appearance of corresponding clinical symptoms.

Isolated gardnerellosis in men is a rare occurrence. Usually the inflammatory process occurs in combination with other sexually transmitted infections.

The first signs of gardnerellosis

In women, the development of gardnerellosis is initial stages characterized by the absence clinical signs. Then, as the number of opportunistic microorganisms on the vaginal mucosa increases, they appear from the vagina, having bad smell. In men, against the background of gardnerellosis, an inflammatory process develops in the mucous membrane of the structures of the urogenital tract. In this case, toxic products can accumulate in the tissues, which are then absorbed into the systemic bloodstream and lead to the development of general intoxication and the appearance of the corresponding first signs:

Increase in body temperature to subfebrile levels, usually no more than +37.5 ° C.
General weakness varying degrees severity, which depends on individual characteristics man's body.
Deterioration of appetite up to its complete absence.
Headache without clear localization.
Body aches, which are localized mainly in the lumbar region and large joints.
Nausea, periodic, which may appear if other infectious processes are associated.

The severity of the first signs of gardnerellosis in men depends on the severity of the disease. inflammatory process. Against the background of general intoxication, the first local signs appear, which include sensations of discomfort in the area of the external opening of the urethra. The appearance of the first signs of the development of a pathological process in men is the basis for consultation with a urologist.

Symptoms of gardnerellosis

The development of gardnerellosis in women is accompanied by minimal clinical symptoms. Vaginal discharge appears, which is characterized by the following specific features:

Small volume.
Lack of connection with the menstrual cycle. Rarely, there is a slight increase in the volume of discharge during ovulation (ovulation is the phase of the menstrual cycle characterized by the maturation and release of the egg).
Slimy character, gray color.
Characteristic unpleasant “fishy” odor.
No inflammatory signs.

The appearance of signs of the development of an inflammatory reaction (pain, burning, itching in the vulva, redness and swelling of the vaginal mucosa) indicates the addition of another infectious process, provoked by the weakening protective properties vaginal mucosa.

In men, gardnerellosis occurs with the development of an inflammatory reaction and the appearance of several clinical manifestations:

General intoxication of varying severity, often with minimal changes general condition.
The appearance of unpleasant subjective sensations of discomfort in the area of the external opening of the urethra, which includes burning, pain of varying severity. It may become worse after urination.
Redness (hyperemia) of the mucous membrane of the glans penis, as well as the area of the external opening of the urethra.
The appearance of bulky mucous discharge from the external opening of the urethra, which has an unpleasant odor.

Deterioration of the general condition of men, changes in local manifestations (increased pain, appearance purulent discharge) indicate more severe course infectious process, as well as the addition of other pathogens.

Reliable diagnosis and treatment of gardnerelosis in women is carried out by a gynecologist, in men - by a urologist.

Causes and prevention of gardnerellosis

Gardnerellosis in women is a polyetiological pathological condition, the development of which is provoked by a number of factors:

Congenital decrease in immune activity.
Prolonged, uncontrolled use of antibiotics, leading to disruption of the normal microflora of the vagina.
Violation metabolic processes in a woman’s body, accompanied by an increase in glucose levels and the appearance of favorable conditions for the proliferation of opportunistic microorganisms.
Local or general hypothermia of the body.
Insufficient intimate hygiene, which contributes to the accumulation of microorganisms in the area of the labia majora and minora.
Promiscuous sex life without using condoms.

In men, the development of gardnerellosis is provoked by unprotected sex with a woman who has a violation of the normal microflora of the vagina. This is facilitated by promiscuous sex life with frequent changes partners, decreased functional activity of the immune system.

Prevention of gardnerellosis in men and women includes taking measures aimed at eliminating the effects of provoking factors. It is very important to keep track reproductive health, keep orderly sex life, and when the first signs of the development of a pathological process appear, contact a medical specialist in a timely manner.

Treatment of gardnerellosis

Treatment of gardnerellosis in men and women is complex. It is carried out in 2 stages and involves the destruction of the causative agent of the infectious process with the subsequent normalization of the microflora of the mucous membranes, as well as the functional state immune system. The first stage of treatment includes the use of antibacterial agents that are active against gardnerella. Usually prescribed antibacterial agents groups of semisynthetic penicillins () or cephalosporins (). The duration of antibiotic therapy is determined by the severity of the infectious process; it should not be less than 5 days. Together with antibiotics, antiseptics are prescribed for local use in the form of rinsing or douching in women (solution).

At the second stage of therapeutic measures in women, preparations for local use based on lactic acid (probiotics) are used, which makes it possible to increase the activity of lactobacilli. If necessary, immunomodulatory drugs are prescribed for plant based(ginseng, lemongrass). The duration of the second stage of treatment for gardnerellosis is at least 2 weeks (in women, it may take several months to restore normal vaginal microflora).

The prognosis for gardnerellosis in men and women is generally favorable. Lack of treatment leads to the development of complications, which include various inflammatory processes in internal organs reproductive system, which is the result of a decrease in the protective properties of the mucous membranes.

Gardnerella is detected in a smear when the normal microflora is disrupted genitourinary organs. This is an opportunistic bacterium, which is present in small quantities in the vagina and does not cause disruption of the microflora. If exceeded established standards leads to copious discharge with an unpleasant odor, itching and burning in the genitals.

To determine deviations from the norm, it is carried out laboratory test biological material taken from the patient's genitals.

Indications for the purpose of analysis

To identify gardnerella in men, you can use a urogenital smear or morning urine; in women, a vaginal smear is taken.

Gynecologists at public and private clinics (Invitro and others) recommend getting tested for Gardnerella if a woman has:

vaginal microflora is disrupted;
there is excessively abundant vaginal discharge, which is accompanied by an unpleasant odor;
During a routine examination, pathogenic microorganisms were found in a genital smear;
if you plan to become pregnant, such an analysis will allow you to timely identify the infection and prevent the development of complications that it provokes;
during pregnancy is accompanied by complications.

For a man, a test to check Gardnerella is extremely rarely prescribed, since after entering the body, its activity is suppressed within 48-72 hours. Less commonly, a man can be a carrier of pathogenic flora.

Necessity timely diagnosis due to the asymptomatic course of the pathology and possible complications. In women, gardnerella can cause:

Vaginosis – pathological condition, which is characterized by a violation of the vaginal microflora.
Inflammatory diseases of the pelvic organs (cervicitis, endometritis, bartholinitis), which are accompanied by painful sensations and discomfort in the lower abdomen, copious discharge of white, gray, greenish, yellow tint.
Inflammation membranes or the membranes of the uterus during pregnancy.
Miscarriage in the second trimester of pregnancy.
Premature delivery.
Low birth weight children.

Preparation

Regardless of the indications for which a woman is sent for analysis to identify gardnerella vaginalis, it is necessary to properly prepare for it, which will allow obtaining reliable results and, if necessary, prescribing the correct therapy.

For this purpose, Invitro and other clinics specializing in such studies recommend:

abstain from sexual intercourse at least 24 hours before the test;
one day, eliminate douching, use medications, especially with an antibacterial effect, which are administered vaginally;
exclude urination 3 hours before the test, this is especially true for men, since urine has antiseptic properties and may significantly influence the results of the study;
schedule a study before the onset of menstruation or immediately after it; the optimal day is considered to be 7-10 days of the cycle;
On the day of the study, wash without using soap.

Reasons for the appearance of gardnerella in the analysis and its symptoms

Gardnerella vaginalis is diagnosed in more than 20% of women of childbearing age. The main reason for the growth of bacteria is a violation of the vaginal microflora, which is often associated with the use of birth control pills, vaginal suppositories and pills, douching, as well as sexual activity with frequent changes of partners without the use of barrier contraceptives.

Contributing factors to the proliferation of Gardnerella in women are:

decreased local and general immunity;
endocrine disorders, hormonal imbalance;
disturbance of intestinal microflora;
long course antibacterial therapy general and local action;
inflammatory pathologies of the pelvic organs;
taking hormonal medications and antidepressants;
alcohol abuse, smoking;
frequent stress.

Possible symptoms

In most cases, gardnerellosis is asymptomatic and occurs without significant clinical picture. Microorganisms are discovered during clinical trial smear during a preventive examination.

Less commonly, vaginosis can have pronounced symptoms:

pathologically abundant viscous discharge from the genital tract of a white, yellow or gray hue with an unpleasant aroma (smell of rotten fish);
swelling and redness of the vaginal mucous membranes against the background copious discharge secretion and its accumulation on the walls;
discomfort, itching, burning in the perineum;
disruptions of the menstrual cycle;
pain during sexual intercourse and urination;
deterioration of general condition;
inflammatory diseases of the lower organs of the urinary system (cystitis, urethritis) due to the close location of the genital organs.

Types of tests for gardnerellosis

For diagnosis, a woman must contact a gynecologist, a man a urologist, a dermatovenerologist in a dermatovenerological clinic or in any private clinic, for example Invitro.

To diagnose gardnerella vaginalis, a scraping is taken from the mucous membranes of the genital organs. Afterwards, the smear is sent to the laboratory for examination, which is carried out in one of the following ways:

Microscopic analysis is carried out after drying and staining the biological material using a special method, which makes it possible to detect Gardnerella and other pathogenic microorganisms in the smear. During the study, cells in the field of view are taken into account. The duration ranges from 1 to 3 days.
Bacteriological culture is highly accurate and is carried out in relation to a specific microorganism. To obtain results, biological material is placed in a special specially created environment in which Gardnerella vaginalis will grow and reproduce. The container with the material being studied is placed in a thermostat, which allows you to maintain the required temperature and humidity for growing flora. To determine the resistance of bacteria to medications, a test with antibacterial drugs is performed. The duration of the study is from 7 to 10 days.
PCR or polymerase chain reaction allows you to detect DNA, which carries all the genetic data of the bacterium. It is highly accurate and allows you to identify gardnerella in a smear even if its quantity is small. Disadvantage this method It is impossible to determine the number of bacteria, which are opportunistic and, in small quantities, are not dangerous.
Cytological examination is necessary for timely diagnosis of cervical cancer. Thanks to it, inflammatory lesions of the tissues of the genital organs and vaginosis are also detected.
KACH (Hay-Ison smear analysis) allows you to confirm the pathogenic flora that led to disruption of the vaginal flora.

Decoding the results

A PCR test can only contain two results: positive or negative. In the first case, bacterial vaginosis is confirmed and additional, more informative studies are carried out to identify the amount of the pathogenic microorganism and prescribe therapy, for example, bacteriological culture vaginal microflora.

An important test for gardenellosis is bacterial culture, which allows you to determine not only quantitative indicator pathogenic flora, but also its sensitivity to antibacterial drugs. During this analysis, the norm of Gardnerella is 10 to the 5th power.

During microscopic examination of a smear for flora in Invitro, other private and public medical institutions In addition to gardnerella, the following indicators are taken into account:

Flat epithelium is normally present in no more than 10 units per field of view. With an increase in its quantity, one can assume the development of inflammatory processes in the genital organs. The absence of epithelium in the smear indirectly indicates hormonal disbalance or degeneration of vaginal tissue.
Leukocytes normally in the vagina do not exceed 10 units in the field of view, and in cervical canal 30, when white bodies are detected in an amount of more than 10, there is reason to assume the development of infectious and inflammatory processes in the genitals.
Staphylococcus and streptococcus are normally absent or do not exceed 10 to 4 degrees and 10 to 5 degrees CFU, respectively. If the indicators are exceeded, a diagnosis is made purulent inflammation genitals. More research is required.
Doderlein bacilli and lactobacilli normally make up 95-98% of the total vaginal microflora. A decrease in their number and an increase in atypical cells and cocci indicates vaginal dysbiosis, inflammatory pathologies and other pathogenic processes in the genital organs.
Atypical or key cells are epithelial cells glued together or vaginal gardnerella, which are normally absent or do not exceed 10 to the 5th power. When their level increases, a diagnosis of vaginosis is made, and a decrease in lactobacilli is noted.
Candida is a yeast fungal infection that healthy woman not detected or does not exceed 10 to 4 degrees CFU. Exceeding the level is a sign of candidiasis or thrush.
Trichomonas is normally absent. If the tests determine a small number of pathogenic cells, a diagnosis of trichomoniasis is made.
Gonococci are normally absent. When they are detected, a diagnosis of gonorrhea is made.
Escherichia coli is normally absent or visible in the field of view in an amount of no more than 10 to 4 degrees. When the indicator increases together with a high level of leukocytes, coli considered to be the causative agent of inflammatory quantity.

Using the indicators described above, the degree of vaginal cleanliness is determined:

A zero level indicates the absence of infectious agents in the vaginal microflora.
The first level – the environment of the genital organs is within normal limits. There is a small amount of gardnerella or other bacteria.
The second level is the number of pathogenic microorganisms within normal limits, but there is a decrease in the level of lactobacilli.
The third level - the concentration of gardnerella slightly exceeds the permissible level, the Doderlein bacillus is absent or present in insignificant quantities.
The fourth level – the concentration of lactobacilli in the vaginal microflora is less than 6%, a high level of pathogenic microorganisms.

Gardnerella vaginalis is a conditionally pathogenic microorganism that, in small quantities, does not disrupt the microflora of the genital organs and is not dangerous. However, when exceeding permissible norm(10 to 5 CFU) against the background of predisposing factors can cause inflammatory pathologies and lead to other complications. For diagnosis, it is necessary to take a smear to determine the vaginal microflora. For this purpose, bacterial culture, PCR, microscopic and cytological examination are prescribed, qualitative analysis biological material.

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 the natural microflora of 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 hormonal imbalance.

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 of childbearing age has this disease. 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 acid-base balance 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, smear readings will normalize, discharge will 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 that can cause increased activity gardnerella, found in small quantities in the body of every woman. A woman's hormonal levels change and decrease protective functions body, thereby provoking the 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.

Gardnerellosis is called inflammatory disease, caused by the active reproduction of gardnerella in the genitals. Women often face this problem. Normally, these microorganisms are present in the natural microflora of the vagina in minimum concentration. Under the influence of negative factors, their number begins to increase rapidly, which is why gardnerellosis develops in women.

The disease can appear at any age. Therefore, it is important for every representative of the fair sex to understand where Gardnerella comes from in women, to know the symptoms and rules of therapy.

Features of the disease and its causative agent

IN natural microflora The vagina contains a huge number of microorganisms. Most of them are beneficial lactobacilli. They allow you to maintain normal acidity of the environment, which prevents the proliferation of pathogenic bacteria. There are about 95% of them. The rest is occupied by opportunistic microorganisms: Candida fungi, enterobacteria, cocci and others. The presence of Gardnerella in a woman on the walls of the vagina in a minimal amount is also considered normal. Its concentration is so low that it does not pose any threat.

Under the influence of some negative factors, dysbiosis may appear. It is accompanied by the rapid death of lactobacilli. As a result, the acidity of the environment decreases. This allows pathogens to actively multiply.

What is gardnerella modern science well known. In photographs taken using a microscope, it looks like a stick, the size of which does not exceed 1.5 microns. Only its species is known, Gardnerella vaginalis. Bacteria belong to the group of anaerobic bacteria, that is, the presence of air is not necessary for their vital activity. Under favorable conditions, they quickly multiply on the mucous surfaces of the genitourinary system.

Gardnerella vaginalis in the process of its life throws out into environment ketabolites. These substances depress local immunity and promote the death of leukocytes. Due to this, microorganisms can penetrate into the deep layers of mucous surfaces.

Recent studies have shown that the development of gardnerellosis is influenced by mycoplasmas, peptostreptococci and other anaerobes. Therefore, the disease is considered a mixed infection and is more often called bacterial vaginosis.

Key reasons for the development of the disease

Gardnerellosis is a dangerous disease for women's health. It is not enough to understand what it is; it is important to remember the main reasons for its development. Among them are:

Sudden change hormonal levels. Related to this is the fact that the problem is often troubling young girls at the stage of puberty, as well as women in menopause. Often the disease is diagnosed during pregnancy.
Severe poisoning. Intoxication of the body provokes death beneficial microflora intestines and vagina, which causes dysbiosis. Harmful bacteria then enter an environment that is comfortable for reproduction.
Diabetes. The causes of gardnellosis also lie in increased blood sugar levels. This helps to reduce the acidity of the vagina, which leads to the active proliferation of pathogenic microflora.
Injuries to the reproductive system. This is possible with emergency situations, and surgical intervention or performing an abortion.
Reduced protective properties of the body. Suppression of the immune system often occurs when stressful situations, infectious diseases, change climatic conditions residence, as well as long-term use of certain medications.
Breaking the rules intimate hygiene. Insufficient toilet of the genital organs provokes an increase in the amount of pathogenic microflora. It is especially important to prevent the spread of bacteria into the vagina from the intestines. To do this, washing is carried out after each bowel movement. But excessive hygiene can also lead to the development of pathology. WITH bacterial vaginosis often encountered by women who regularly douche or use aggressive detergents.
Intestinal dysbiosis. Pathogenic microflora from digestive system can easily move into the vagina. Therefore, it is important to promptly treat all gastrointestinal diseases.

Gardnerellosis in women can be caused by wearing tight underwear made from synthetic fabrics. It creates a greenhouse effect around the genitals. Such an environment becomes comfortable for the life of microbes.

Theoretically, bacteria can live for some time on the surface of towels, washcloths, bed linen and other personal items. But such infection occurs extremely rarely.

Characteristic symptoms

Symptoms of gardnerellosis in women do not always appear. About 50% of patients learn about their illness only after undergoing an examination by a gynecologist. The development of the inflammatory process takes about 20 days. During this time, pathogenic microorganisms manage to multiply to impressive quantities and begin to spread to the organs of the genitourinary system.

At the early stage of the disease, symptoms are mild. The woman feels only mild discomfort in the vagina. Later, other signs of a problem are discovered:

Unnatural discharge appears. At first they may have a slimy consistency. Their color is translucent whitish. As inflammation develops, the color of the vaginal secretion changes to gray. Chronic gardnerellosis is accompanied by discharge of a rich yellow or green hue. After sexual intercourse, their volume increases several times. The main distinguishing feature of this secretion is its repulsive fishy smell.
Due to the accumulation of discharge during gardnerellosis, swelling and redness of the tissue may appear on the walls of the vagina.
There are problems with the urinary system. When going to the toilet, you feel a strong burning or itching sensation.
Sexual intercourse brings painful sensations. Because of this, a woman wants to have sex less and less, and her libido suffers significantly.
Feeling of weakness, exhaustion, decreased performance.

With intensive reproduction of pathogenic microflora, an increase in body temperature is also possible. In such a situation, it is important for women to consult a doctor as soon as possible and begin treatment. Otherwise, serious complications may develop.

Diagnostic methods

Symptoms of gardnerellosis are easily confused with manifestations of other diseases. An accurate diagnosis can only be made after a full medical examination. Doctors use the following diagnostic methods:

Anamnesis collection and examination of the genital organs. The specialist must identify the presence external factors, which could give impetus to the development of the disease, as well as determine the presence of characteristic symptoms.
Examination of a vaginal smear under a microscope. Gardnerella is clearly visible under high magnification.
pH level measurement. For this, special test strips are used. If the acidity of the environment is reduced, we can judge about vaginal dysbiosis.
Study of a smear from the genital organs using the polymerase chain reaction technique. This test allows you to detect the presence of bacteria and determine their concentration.
Identification in biological material presence of isonitrile. It is this substance that is responsible for the appearance of an unpleasant fishy odor from the genitals.

Based on the results of the research, the doctor can develop a plan for how to treat the disease. Testing blood and urine samples can also help determine the severity of the disease. If infection is suspected of spreading to nearby organs, a pelvic ultrasound is prescribed.

Therapy

To maintain health, it is important to recognize symptoms in women in time and begin treatment for gardnerellosis. If the disease is diagnosed on early stage, then the duration of therapy is no more than 7 days. During this time, it is necessary to solve two main problems:

Get rid of excess amounts of harmful bacteria.
Restore the natural microflora of the vagina.

The main method for completely curing gardnerella is the use of medications. At the same time, you need to adjust your lifestyle. It is important to give up bad habits and direct all efforts to stimulate the functioning of the immune system.

In respect of therapeutic measures there must be a diet. The daily menu consists mainly of plant products. Fatty and fried foods, smoked meats, marinades, processed foods and fast food should be completely avoided. The restoration of microflora is positively influenced by the consumption of fermented milk products. Avoiding elevated blood sugar levels will help avoid confectionery and all kinds of baked goods.

A week after completing the course of therapy they give up repeat tests. They will allow you to check how effective it turned out to be. drug treatment. You will have to be examined again in a month to make sure there is no relapse.

During pregnancy, it is extremely difficult to get rid of gardnerellosis. Expectant mothers are prohibited from using antibacterial drugs, and without them it is impossible to defeat bacteria. Therefore, during the delivery process, pathogens can be easily transmitted to the baby. Once they appear in the body, they do not manifest themselves in any way. For the development of the disease, exposure to unfavorable factors is necessary.

Eliminating the pathogen

Treatment of gardnerellosis in women is carried out with the mandatory use of antibacterial drugs. To choose the right medication, a test is performed to determine the sensitivity of bacteria to medications. The most commonly used medications are:

Tinidazole. It helps to cope not only with gardnerella, but also with trichomonas, which, against the background of vaginal dysbiosis, also begin to actively multiply.
Metronidazole. Strong antibiotic wide spectrum of action. Under its influence, the DNA of pathogenic microorganisms is destroyed. This remedy is contraindicated in severe liver pathologies, as well as during pregnancy and breastfeeding.
Clindamycin. Belongs to the group of lincosamides. Available in tablet form. Its use provokes the cessation of protein synthesis in Gardnerella cells, which leads to the death of bacteria. The use of this medicine becomes one of the best ways how to get rid of pathogenic microflora.
McMiror. This drug belongs to the category of nitrofurans. Has a strong antibacterial effect. Has low toxicity and wide range actions.
Metrovagin. Available in the form of candles. In women, treatment with this remedy helps to achieve faster positive result. This preparative form will allow the active substance to be delivered precisely to the site of infection. Vaginal suppository administered once a day.
Terzhinan. A combined drug with antibacterial and antifungal effects. Produced in the form of candles.

The specialist you are seeing should tell you how to treat gardnerellosis. He will select the exact dosage and course duration. You will need to strictly follow all doctor's instructions. Unauthorized replacement of drugs with analogues and interruption of the course is fraught with the development of dangerous complications.

Restoration of microflora

The treatment regimen for gardnerellosis involves taking medications to restore the natural balance of the vaginal microflora. For this purpose, the following drugs are used:

Linux.
Bifidumbacterin.
Acylact.
Lactobacterin.
Duphalac.

Treatment of gardnerellosis with such medications begins as soon as the woman has gotten rid of the causative agent of the disease and continues for at least two weeks. Therapy can also be supplemented with agents that stimulate the immune system. These include Interferon, Wobenzym, Genferon.

Possible complications

Previously, doctors believed that gardnerella in women did not pose a health hazard. Modern medicine thinks otherwise. Experts were able to determine an extensive list of what makes the disease dangerous. It can cause the following complications:

Inflammatory processes in the pelvic organs. The infection quickly spreads throughout the genitourinary system, involving large areas of tissue in the destructive process.
Endometritis.
Urethral syndrome.
Bartholinitis.
Problems with conceiving a child, up to irreversible infertility.

If the disease occurs during pregnancy, the risk of infection of the fetus increases. The baby may be born with significant underweight or have congenital diseases. On early exposure to pathogenic microflora can provoke rupture of the amniotic membrane.

Treatment of gardnerella is an unpleasant process. It should begin at the very first manifestation unpleasant symptoms. The woman will have to take medication and be constantly under the supervision of the attending physician. This will be avoided by following elementary rules prevention: maintaining hygiene, being faithful to a regular sexual partner, strengthening the immune system, giving up bad habits. And remember that after completing a course of therapy, you will not get rid of bacteria forever. A relapse can happen at any time.