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, but sexually transmitted diseases provoke the development and aggravate the course bacterial vaginosis 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 occurs without access to oxygen, but unlike other anaerobes, gardnerellas can also tolerate aerobic conditions.

Externally, gardnerellas look like small rods with oval ends; their size rarely exceeds 1.5 microns. Previously, pathogenic microorganisms Gardnerella were considered members of the genus Haemophilus (they were called Haemophilus vaginalis).

However, in the mid-1980s, their belonging to the Bifidobacteriaceae family was proven. The vast majority of Gardnerella cases are Gram-negative, although a positive Gram stain is occasionally possible.

Lactobacilli that “inhabit” 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 proliferation of various microorganisms. In addition, lactobacilli have an enzymatic effect, so their level serves as a kind of indicator of the condition of the woman’s genital organs. Bakvaginosis develops against the background of replacement of microorganisms of the genus Lactobacillus by an association of pathogenic or conditionally pathogenic 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, affect the overlying parts of the genital tract, and spread to the urinary tract. In addition, the development of gardnerella promotes the proliferation of other flora (staphylococci, streptococci, klebsiella, coli, Klebsiella, etc.).

Bacterial vaginosis caused by gardnerella is the most common infectious disease among sexually active women aged 18–45 years. According to different authors, the frequency of occurrence 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 the numbers is due to the fact that in a third of women gardnerellosis is asymptomatic.

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

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

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

• promiscuity, 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 unjustified, colposcopy, etc.);
• abortions;
• taking medications that impair the functioning 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 condition immune system;
• improper diet with a predominance of too sweet foods and a deficiency fermented milk products;
• use of topical spermicides;
• application in for hygienic purposes pads, tampons, intimate means with too high content synthetic perfume fragrances and allergens;
• wearing tight underwear with a synthetic gusset;
• hormonal disorders caused by natural causes (pregnancy, childbirth, period breastfeeding), diseases or taking appropriate medications;
• chronic fatigue, emotional stress and exhaustion;
• diseases and conditions accompanied by disruption of the microflora of the digestive and genitourinary tract;
• developmental defects and anatomical features vaginal structure;
• insufficient personal hygiene;
• foreign bodies in the vagina and uterus (spirals, caps, etc.).

Gardnerella vaginalis infection does not occur through sexual contact. However, the development of this disease is closely related to the characteristics of sexual relationships. The risk of bacterial vaginosis increases with early start sexual life, availability large quantity sexual partners, high frequency of urogenital, rectogenital sexual intercourse, etc.

Gardnerella infection: symptoms in women, diagnostic methods, possible complications

Symptoms of bacterial vaginosis caused by Gardnerella are nonspecific. Many sexually transmitted diseases (for example, chlamydia, trichomoniasis) can occur under the guise of gardnerellosis. Incubation period infection lasts from 3 to 10 days, but on average - a week.

Symptoms characteristic of the pathology are:

• Quite abundant, sometimes foamy vaginal discharge, initial stages diseases they are homogeneous, gray-white in color, but later 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 occurrence of an unpleasant “fishy” odor from the vagina in combination with heavy discharge is a reason to contact a gynecologist.

Diagnostic criteria for gardnerellosis are:

• plaque evenly covering the mucous membrane of the vagina and external genitalia, while pathophysiological signs of the inflammatory process occur extremely rarely;
• pH values ​​above 4.5 after pH measurements of vaginal epithelium discharge;
• positive amino test result, this is one of the express diagnostic methods, which is carried out by mixing a vaginal smear with a 10% solution of potassium hydroxide for 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 for identifying the disease complement the patient’s medical history and complaints. Gardnerella infection requires treatment differential diagnosis with other urogenital pathologies caused by gonococcus, trichomonas, chlamydia, opportunistic microorganisms. For this purpose tests are prescribed PCR method to detect bacterial DNA.

Without appropriate treatment (and sometimes against the background drug therapy) gardnerellosis is prone to a chronic relapsing course. So, six months after the first episode, symptoms of bacterial vaginosis reappear in a third of patients, and within a year - in 50-70% of women. Such disturbances in 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

Bacterial vaginosis, caused by bacteria of the genus Gardnerella, often occurs during pregnancy. This is usually due to accompanying changes in hormonal balance. For early detection pathology, regular gynecological examination is required, especially in women at risk (with previous or concomitant sexually transmitted infections, chronic inflammatory lesions genitourinary system etc.)

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

Therefore, when discharge of a characteristic consistency and with a specific odor appears, it is necessary to urgently begin therapy. Most medications intended 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 (Dalacin, Clindacin) in the form of cream or suppositories, 5 g or one piece, respectively, at night for 3 - 5 days;
• Metronidazole (Metrogil, Metrovagin, Trichopol, Trichosept, Flagyl) cream (0.75%), suppositories - 2 times a day intravaginally or tablets 0.5 g twice a day, course of therapy - 5 - 7 days.

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

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

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), and macrolides. Tetracycline antibiotics (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 unjustified.

Therefore, first-line drugs are:

• Nitroimidazoles(Metronidazole, Ornidazole, Tinidazole). They are used orally, intravaginally in women and topically in men. The dosage and duration of treatment is determined individually. As a rule, Metronidazole (or its analogues under other names) is taken trade names) 2.0 g once or 0.5 g twice a day for a week. Ornidazole is taken 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 medications in this class, Clindamycin is the most effective. It is used 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 abstain from drinking alcoholic beverages for the entire duration of treatment and for 24 hours after its completion. 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 activity (sex with gardnerellosis without a condom can aggravate the course of the disease).

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

• Pour 3 tbsp. dry celandine herb with a liter of boiling water, squeeze out a few cloves of garlic, leave 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 pulp, moisten a regular tampon in it and insert it into the vagina overnight. To increase the effectiveness of treatment, alternate with gauze or cotton swabs soaked in a mixture of onion and horseradish juice. The course of therapy lasts 12 days.
• Mix 10 g each of lavender herb, bird cherry and Chernobyl flowers, 20 g each of calendula herb, sage and cudweed, oak bark, birch leaves, 30 g chamomile flowers. Pour two tablespoons of the mixture into a liter of hot water, wrap the dishes in a towel, leave for 2 - 3 hours, strain and douche overnight for 2 weeks.
• Buy tinctures of yarrow and eucalyptus at the pharmacy, mix and drink 25 drops in 50 ml of water three times a day on an empty stomach.
• Mix mistletoe and yarrow herb in equal proportions. Brew a couple of spoons with half a liter of boiling water, leave overnight and strain. Can be used for douching or taken orally 1 tbsp. three times a day.
• Grind the Trichopolum tablet into powder, add a teaspoon of honey and the same amount of onion pulp. Apply the resulting mass onto a tampon and insert into the vagina at night. Alternate with tampons with calendula ointment (can be purchased at the pharmacy).
• Pour a tablespoon of tansy baskets into 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 black poplar buds, calendula and chamomile flowers, eucalyptus and bird cherry leaves in equal proportions. Take 2 - 3 tbsp, pour a liter of boiling water, leave overnight and strain. First, douche with this solution, then insert a tampon with lanolin-based propolis ointment into the vagina (if it is not available in the pharmacy, you need to mix 10 g of crushed propolis and melted lanolin). The duration of treatment is 2 weeks. At the same time, you can drink a decoction of wormwood.
• Pour 300 ml of boiling water over a tablespoon of bird cherry fruit, simmer over low heat for 20 minutes, cool and strain. Drink 1/3 three times a day half an hour before meals. This solution can also be used for douching.
• For men, the following composition is recommended for penile hygiene: half a liter of chamomile decoction, 1 tbsp. soda, 5 drops of potassium permanganate and 2 drops of iodine.

However, treatment does not guarantee re-infection. Its likelihood increases if provoking risk factors are not excluded. The activity of local immunity can be increased 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 tablet form.

In order not to face the problem of how to treat gardnerella, it is better to prevent infection in a timely manner. It is necessary to minimize wearing tight synthetic underwear and clothing, especially in the hot season. Panty liners and sanitary pads should be changed at least once every three hours. You should also avoid douching too often and unnecessaryly. In addition, it is necessary to adhere to the rules of safe sex and use condoms.

Gardnerellosis has widespread among gynecological diseases in women. It received its second name “bacterial vaginosis” due to the development of the bacteria Gardnerella vaginalis in the vagina.

In normal conditions, the microflora of a healthy woman always contains these bacteria in small quantities.

But to the appearance severe symptoms gardnerella leads to an increase in the concentration of gardnerella and their imbalance with lactobacilli. Treatment of this disease with drugs should begin when the first signs are detected.

Reasons

Where does gardnerella come from in women, and what is it? This bacterium is present in the vagina of every woman. A stage may simply come when its quantity increases and it becomes pathogenic.

Factors promoting development gardnerella:

1. Taking antibiotics, hormones and other medications that affect normal microflora body.
2. Very frequent change sexual partner. This leads to the fact that infection with one of the sexually transmitted diseases can occur, and only then a disruption of the microflora and the growth of gardnerella bacteria.
3. Overwork, hypothermia, stress.
4. . In women, hormonal imbalances occur quite often, and they are the cause of the development of this or that disease, as well as the cause of an increase in the number of bacteria.
5. Common systemic diseases.
6. Sexual infections and sexually transmitted diseases in women.
7. Local procedures that disrupt the balance in the vagina: douching, the use of suppositories, tampons and vaginal capsules with active substances.

Under the influence of these factors, vaginal dysbiosis, gardnerellosis, candidiasis and other nonspecific inflammatory diseases occur.

Symptoms of gardnerellosis in women

Symptoms indicating the development of gardnerellosis in women are very few and similar to the signs of other gynecological diseases.

The main, and in most cases the only symptom of gardnerellosis is thin, uniform consistency, gray-white or yellowish vaginal discharge with an unpleasant odor (the smell of “rotten fish”).

The appearance of such symptoms, discomfort and pain during sexual intercourse, indicates the development of inflammatory processes in the vagina and other pelvic organs in women.

Danger of disease during pregnancy

Having this disease can lead to:

1. Infection of the fetus.
2. Endometritis.
3. Low weight for someone who has just given birth to a child.
4. Development of complications after a cesarean section.
5. Pneumonia in a newborn.
6. The development of uterine bleeding, which poses a huge danger.
7. Rupture of the amniotic membrane, and at a very early stage.

That is why you should not ignore the symptoms of gardnerellosis and start treatment, especially if the woman is in an “interesting” position, as this can lead to unpleasant consequences.

More about douching

When douching, the normal microflora of the vagina is washed away, which is replaced by opportunistic bacteria (for example, Gardnerella vaginalis).

Often, women, when symptoms of gardnerellosis (unpleasant odor of vaginal discharge) occur, resort to douching on their own, associating the unpleasant odor with insufficient hygiene. At the same time, douching causes an even greater exacerbation of gardnerellosis.

According to modern ideas, douching has neither hygienic, nor preventive, nor therapeutic effect. Moreover, it is a risk factor for gardnerellosis, inflammation of the appendages, and ectopic pregnancy.

Treatment of gardnerellosis in women

When the first symptoms of gardnerellosis are detected in women, treatment should begin as soon as possible. Therapy for the disease includes several medications used in the form of vaginal gels and creams, as well as tablets for oral administration. Typically the duration of treatment is 7 days and includes the medications described below.

The treatment regimen for gardnerella is complex and consists of two parts:

1. Reducing the number of gardnerella, living on the vaginal mucosa. This is achieved by ingesting antibiotics. systemic action(in tablet form): clindamycin and metronidazole. In combination with them, local forms are used - clindamycin cream and metronidazole gel.
2. Restoration of normal vaginal microflora. Achieved by ingesting probiotics containing lactobacilli (Lactobacterin, Laktonorm), as well as local treatment in the form of suppositories (Acilact, Lactonorm).

For successful treatment it is also important to observe dietary recommendations which consist of avoiding fatty, fried, spicy foods and drinking alcohol. It will be useful to take fermented milk products and yoghurts containing lactic acid bacteria.

All actions in the treatment of gardnerellosis in women are aimed at restoring healthy vaginal microflora. The effectiveness of treatment can be judged by the disappearance of symptoms of gardnerellosis (decreased burning sensation, pain, dryness; no discharge and unpleasant odor from the vagina).

A control bacterioscopy is prescribed a week after completion of the course of treatment, and a repeat bacterioscopy is scheduled after 1-1.5 months.

Prevention

First of all, it is necessary to limit promiscuity, which contributes to the spread of STIs, to promptly approach the treatment of various diseases of the body, primarily related to its hormonal levels and sexual sphere, to eat properly, pay attention to great value rest, avoid stress that affects the immune system.

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

Definition of gardnerellosis in women

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

The predominance of Gardnerella in the vaginal microflora is called bacterial vaginosis

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

What number of microorganisms in a smear is considered normal?

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

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

Can gardnerella be in the mouth?

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

Gardnerellosis of the oral cavity is accompanied by the formation of plaque on the mucous membrane

Table: difference between gardnerellosis and thrush

Comparative feature	Gardnerellosis	Thrush
The type of microorganism that causes the disease	Bacterium
What does discharge look like?	Greenish-brown, cloudy	White, yellowish
Existing specific odor	Spoiled fish or rotten meat, pungent	Sourish, curdish, barely perceptible
Number of allocations	Up to 250 milliliters per day	50–200 milliliters
Increased symptoms after sexual intercourse	Expressed	Virtually absent
Damage to other organs and systems	Very rare	Oral cavity, gastrointestinal tract

Existing varieties of the disease

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

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

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

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

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

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

Why does gardnerellosis occur?

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

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

Ways of transmission of the disease

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

Length of incubation period

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

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

Video: the doctor talks about the peculiarities of the disease

Main symptomatic signs of pathology

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

Main symptoms of the disease:

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

Gardnerellosis and childbearing

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

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

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

How is the disease diagnosed?

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

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

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

Methods to confirm the diagnosis:

Leading methods of treatment of gardnerellosis in women

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

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

Video: doctor’s opinion on the need for therapy

Treatment of illness with pharmaceuticals

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

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

Local medications used to combat the disease:

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

Photo gallery: drugs for local therapy for gardnerellosis

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

Systemic drugs

Medicines for systemic treatment diseases:

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

Photo gallery: drugs for systemic therapy of gardnerellosis

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

Traditional medicine as an aid

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

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

The most popular folk recipes:

Table: physiotherapy in the treatment of the disease

Name of the technique	How is the procedure performed?	Main effects
Radon baths	Immersion of the patient waist-deep in water enriched with this chemical element	Causes the death of the majority pathogenic microorganisms, without causing damage to normal microflora
	Targeted impact of tiny impulses on specific areas of the body	Helps accelerate recovery and regeneration processes in the human body
Medicinal electrophoresis with anti-inflammatory drugs	Introduction to the body medications using current	Faster and more effective administration of the substance and its distribution in soft tissues
Inductothermy	Application of magnetic fields of different intensities	Reducing discomfort, preventing the formation of adhesions

Photo gallery: physiotherapy in gynecology

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

Changes in diet and lifestyle for gardnerellosis

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

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

What foods should you include in your diet:

Rules for women during the treatment period

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

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

Treatment prognosis and possible unpleasant consequences

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

• diabetes mellitus;
• hypertension;
• varicose veins.

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

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

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

What complications and negative consequences found in patients with gardnerellosis:

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

Photo gallery: complications of the disease

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

How to protect yourself from developing the disease

Treatment of gardnerellosis requires the expenditure of a large amount of effort and money. That is why it is much easier to protect your body from the development of such a disease than to undergo a course of therapy. For this purpose, doctors have developed rules individual prevention illness.

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

Rules for individual prevention of gardnerellosis in women:

1. Don't forget to constantly change hygiene products. Panty liners are the source of most harmful microbes that penetrate the vaginal mucosa and begin to actively multiply there. Doctors strongly do not recommend wearing them for more than two to three hours. Absorbent pads should be changed every four hours during menstruation as they cause irritation. Special cups and tampons are also a source of bacteria. That is why they need to be replaced or emptied every two hours, and women prone to thrush are advised not to use them at all.
2. Use personal protective equipment with new sexual partners. Condoms are best suited for this purpose: currently they produce both male and female variations. They are made of latex, which not only lubricates and does not injure the vaginal mucosa, but also does not allow various microorganisms to pass through it.
   Male and female condoms protect against the transmission of bacteria
3. Wear underwear that fits properly and only from natural fabrics. Synthetic tight briefs with seams in awkward places can rub the crotch, resulting in the formation of tiny wounds and cracks. During the hot season, this area often sweats, and in skin folds Harmful microorganisms multiply, which subsequently penetrate the vagina, causing disruption of the microflora.
4. Do not take antibacterial drugs without a doctor's prescription. Antimicrobials They help not only fight pathogens, but also kill beneficial flora. It takes weeks and even months to restore it, so doctors often try to choose more gentle antibiotics with minimal traumatic effect.
5. Rinse the vagina only when necessary. Many women believe that douching is an integral part of daily hygiene. However, the flow of water washes out all beneficial microorganisms, leaving the mucous membrane completely defenseless. Also, such procedures lead to vaginal dryness due to the removal of natural lubrication. Under such conditions, cracks or tiny tears are more likely to appear during sexual intercourse.
6. Don't give up animal products. Meat, fish, eggs, milk, cottage cheese, kefir and various yoghurts are a source of healthy lactobacilli and protein products. Prolonged adherence to a vegan or vegetarian diet will deplete your reserves. useful substances in the body, as a result of which regeneration processes suffer.
   Dairy products are necessary to maintain optimal microflora

Gardnerella is one of the causes of bacterial vaginosis in women. However, it is not the most well-known bacteria that is sexually transmitted. Its pathogenic properties were recognized quite recently - in 1980. In the same year, the bacterium received its name in honor of one of the discoverers, G. Gardner. Currently, the study of gardnerella and the causes of gardnerellosis in women continues.

Are gardnerella and bacterial vaginosis transmitted sexually or are there other methods of infection? The article will answer the most important issues about female gardnerella: where gardnerella comes from in women and how it is transmitted, what are the causes and symptoms of infection, as well as what bacterial vaginosis is and how it differs from other diseases.

How can you get infected with gardnerella?

Sexual transmission of gardnerellosis is the most common

To protect yourself from infection, of course, it is important to know how gardnerellosis (or “gardenellosis” - as it is sometimes mistakenly written on the Internet) is transmitted.

Exists 3 main ways of infection with gardnerella:

• intimate contact;
• household way;
• and from the mother in labor to the child through the birth canal.

The probability of transmission for each route of infection with gardnerellosis is different.

The most common route of infection with gardnerella is entry of bacteria into the genital tract from an infected genital area to a healthy one. People who frequently change sexual partners and neglect condoms are at risk.

Vaginal microflora - typical area Gardnerella habitats. This type of bacteria does not survive in the mouth, but the oral cavity during oral sex is an intermediate source of infection. For example, similar situation occurs if both sexual partners are women.

In analyzes on bacteriological culture gardnerella(Gardnerella vaginalis) detected in 21-33% of women reproductive age . Increased quantity Gardnerella vaginalis becomes common cause problems with conception and pregnancy.

When pregnancy occurs, it is very difficult to cure a woman from gardnerellosis, because expectant mothers have contraindications to taking antibacterial agents. In addition, a pregnant woman’s immunity is lowered, which complicates the course of the disease.

That's why infection of a child during childbirth- a frequent occurrence. However, in the baby, gardnerella is present in small quantities and does not cause symptoms. The onset of the disease can only occur when certain factors. Therefore, the route of transmission of infection from mother to child is the cause of gardnerellosis in virgins.

Household route of infection- the most controversial. Gardnerella is an anaerobic microorganism. This means that areas where there is little air are optimal for bacteria. Studies have shown that the general use of towels, washcloths and bed linen, gardnerellosis is transmitted, but this happens extremely rarely.

An increased amount of Gardnerella vaginalis in the vaginal microflora becomes a common cause of problems with conception and pregnancy.

Gardnerellosis in women: causes of the disease

Normally, gardnerella reproduces poorly in the female body, because its activity is restrained by other inhabitants of the genital tract - beneficial lactobacilli and other microorganisms. But if something happens to these inhabitants - for example, they die due to antibiotics or for other reasons - then gardnerella begins to multiply quickly.

Reasons that activate gardnerella in women, are divided into 2 groups: external and internal.

External factors include:

• frequent sexual relations with different people;
• absence barrier protection- condoms;
• stress;
• taking antibiotics;
• reception oral contraceptives, other hormonal drugs;
• treatment with cytostatics;
• radiation therapy.

Normally, gardnerella reproduces poorly in the female body, because its activity is inhibited by beneficial lactobacilli and other microorganisms

TO internal reasons that cause gardnerellosis in women include:

weakened immune system;

hormonal imbalances in adolescence, during pregnancy, during menopause;

decreased immunity in the autumn-winter period, after colds;

accompanying or previous diseases genitourinary organs;

Intestinal dysbiosis almost 100% accompanies the clinical picture of gardnerellosis;

diseases of the immune system ( HIV, cancer, leukemia).

The mechanism of development of gardnerellosis

Normally, in women, the vaginal microflora consists of almost 90% lactobacilli. These representatives of beneficial flora protect the body from the activation of pathogenic bacteria, including gardnerella. The “work” of lactobacilli is as follows:

Infection with gardnerella (pictured) is the cause of gardnerellosis

oxidation of the environment - in acidic environment harmful microorganisms reproduce poorly;

increasing local immunity;

synthesis of hydrogen peroxide - a natural antiseptic.

Gardnerella can be called a "hidden predator." This bacterium is present in the vagina, but is in the status of a conditional pathogen- i.e. coexists with lactobacilli and does not cause inflammatory phenomena. Its pathogenic properties are as follows:

with an increase in the amount of pathogenic microflora and a decrease in lactobacilli, gardnerella begins to actively destroy beneficial bacteria ;

gardnerella alkalizes the environment, from the level pH 4.5 to 7.5. An alkaline environment is ideal for the propagation of infection and at the same time, inhibits the restoration of the number of lactobacilli;

• Gardnerellosis and bacterial vaginosis - what is the difference?

  
  The course of gardnerella infection together with other microbes is defined as bacterial vaginosis

  It is worth saying that gardnerellosis starts separately in women very rarely. Most doctors generally consider this term obsolete, because in practice this disease almost never occurs. Why is this so? The point is that gardnerella is almost never the only pathogen. Most often, these bacteria are found in combination with mycoplasma, ureaplasma, chlamydia and some anaerobic bacteria. The course of gardnerella infection together with other microbes is defined as a separate disease - bacterial vaginosis. But this condition is very widespread among women.

  Vaginal bacteriosis is also sexually transmitted; you can also infect a child during childbirth. Bacterial vaginosis complicates pregnancy and is difficult to treat, so the best defense in this case is prevention.

  The difference between bacterial vaginosis and gardnerellosis is that after childbirth the likelihood of complications with bacterial vaginosis is much higher. It is possible to develop life-threatening conditions - for example, blood poisoning, postpartum fever and others.

  Gardnerellosis is easily transmitted through sexual contact. If you experience an unpleasant odor from the genital tract, itching and burning, or changes in discharge, you should not look for a diagnosis on the Internet. Even if you are not mistaken, and the cause of the symptoms is gardnerellosis, The infection should only be treated by a specialist. In women, this problem is dealt with by a gynecologist and a dermatovenerologist. With a competent approach to treatment, getting rid of the problem will not be difficult. Self-treatment of gardnerellosis and bacterial vaginosis is unacceptable.

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Gardnerellosis in women: symptoms and treatment, causes, medications, regimen

In women it is a fairly common disease. At one time it was believed that infection occurs through intimacy. But in modern world Women's health is influenced by many factors. And although most people for some reason associate the appearance of many female diseases more with intimacy with a new man, at the same time, the problem may be associated with exposure to aggressive external factors on bacteria of female microflora. For example, weakened immunity, taking antibiotics, dysbacteriosis in gastrointestinal tract, changes in hormonal background etc. In this article, we will look at this disease in more detail, find out where it comes from and tell you how gardnerellosis is treated in women.

Causes: where does the infection come from?

As already mentioned, the disease can appear during unprotected sexual intercourse, however, in addition to this, the method of contraception plays an important role. When using contraceptives, the normal microflora is disrupted, which facilitates the penetration of various infections. Douching is also not beneficial for the female body, since favorable microflora is washed away. Here are the main causes of women's health problems:

1. Menstrual irregularities;
2. Inflammatory processes in the genitourinary system, infectious diseases;
3. Disturbance of microflora due to taking certain medications;
4. Long-term use of intrauterine contraception;
5. Weakening of the immune system;
6. Dysbacteriosis in the gastrointestinal tract;
7. Tense atmosphere at work, in the family, constant psycho-emotional stress.

It can be said with a high degree of probability that the appearance of gardnerella will be associated with a lack of the required amount of bacteria that provide a comfortable microflora in the vagina. However, healthy microflora also contains pathogenic bacteria, but not in such quantities that they can cause some discomfort in women.

The presence of gardnerella bacteria in a woman’s body is completely common. Healthy microflora prevents these bacteria from multiplying by producing the required amount of lactic acid, which neutralizes harmful microorganisms.

The reason for the appearance of gardnerella is the numerical superiority of harmful gardnerella bacteria over bacteria that support healthy microflora vagina. The result of this process is that the microflora becomes alkaline, which in turn contributes to the penetration of various infections into the vagina, this provokes the development of inflammatory processes.

Symptoms and treatment of gardnerella

Of course, before starting treatment for a detected disease, it is necessary to consult with a specialist in the field who will help determine the cause of this disease.

Usually in the first stages the disease does not manifest itself in any way, which is dangerous. If treatment is not started in time, the consequences can be much more frightening. Therefore, you should not neglect annual (preferably more often, for example, once every six months) preventive examinations by a gynecologist. If a woman observes the following symptoms, then most likely she needs to see a specialist in the near future, since there is a high risk of developing a disease such as gardnerellosis:

1. The appearance of unusual discharge of various colors (can be gray, yellow or green, as well as transparent color) homogeneous mass and unpleasant odor;
2. The appearance of itching, burning and other discomfort in the vagina;
3. Swelling of the labia, irritation;
4. Painful sensations during sexual intercourse. Gardnerellosis in women is transmitted to men through sexual contact.

In pregnant women, infection with this disease can manifest itself as follows:

1. Uterine bleeding with subsequent inflammatory processes, infection of the baby;
2. Underweight, pneumonia in a newborn;
3. Chronic inflammation of the genitourinary system;
4. Complications in the mother's body after surgery.

If you find yourself with at least one of the above signs, then you need to seek help from a doctor as soon as possible to get tested for Gardnerella. First of all, this applies to girls who have planned a pregnancy. To diagnose the disease, a gynecologist will take a smear, based on the results of which treatment will be prescribed. In some cases, to determine the disease, girls are asked to donate blood for leukocytes. The results of a smear can provide information about infection or non-infection of the genitourinary system.

Treatment regimen for gardnerellosis in women

The essence of treatment for this disease is to destroy Gardnerella bacteria and subsequently restore normal vaginal microflora. For treatment, the doctor prescribes antibiotics and other medications. Good results in the fight against the disease are shown by such drugs as:

1. Ornidazole;
2. Ampicillin;
3. Clindamycin;
4. Metronidazole.

There are also alternative drugs, fighting gardnerella (including suppositories for gardnerella, antibiotic treatment), however, before making a choice in favor of this or that medicine, it is better to consult with your gynecologist. The regimen for taking the drugs is indicated in the annotation to them. In addition to the instructions themselves, the doctor will write a diagram that you need to follow.

Self-medication is strictly prohibited, since not all drugs may be suitable.

Compatibility of your body and medicine The doctor will determine it using the tests you have previously taken.

After the harmful bacteria are destroyed, it is necessary to restore the normal microflora of the vagina in order to prevent the penetration of various infections and the development of the inflammatory process. Preparations aimed at restoring microflora contain beneficial bacteria that enter the female body kill weakened gardnerella bacteria, thereby bringing the microflora into normal condition. Treatment of pregnant women for gardnerella is carried out under the full supervision of a leading obstetrician-gynecologist, since many drugs are contraindicated for pregnant women.

Particular attention should be paid to your diet during the treatment period. No wonder they say: “We are what we eat.” With gardnerella in women, it is recommended to refrain from eating foods that promote bacterial growth, normalize your diet and add more fermented milk products.

During the course of treatment, it is better to refrain from unprotected sex, as there is a high risk of infecting your partner with your illness. Subsequently, this illness may come back to you.

Folk remedies for the treatment of gardnerellosis

Since this disease is quite common, it could not go unnoticed. Let's consider the treatment of gardnerella with folk remedies. Treatment is aimed at relieving the signs discussed above, as well as restoring the natural microflora of the vagina. Treatment at home involves the use of natural herbs that are found in free access in pharmacies in your city. Below are some folk remedies:

1. For douching, prepare a decoction of chamomile, sage and St. John's wort.
2. For oral administration, you can use a decoction of pine buds;
3. Local application tea tree will also help relieve acute symptoms of the disease.

Disease prevention

1. Maintain personal hygiene, especially during menstruation;
2. Give preference underwear made from natural fabrics and not restricting movement;
3. Choose contraceptive methods only after consultation with a gynecologist;
4. Healthy eating, healthy lifestyle, no snacking, less stress;
5. At least once every six months, it is necessary to see a gynecologist to exclude the development of both bacterial and other diseases (this is especially true for those girls who do not have a regular sexual partner).

So, let's summarize all of the above. Gardnerella in women, although it is a non-serious gynecological disease, is diagnosed in most women who are able to give birth, however, its treatment should not be put off for a long time, because this can trigger the development of other inflammatory processes in the body. Timely detection of the disease can prevent the development of complications and subsequent expensive treatment. Preventive examination a gynecologist is one of the most effective ways prevention and maintaining your health at the proper level.