Where does gardnerellosis come from? Gardnerella vaginalis: description of the pathogenic microorganism and the diseases caused. Photo gallery: drugs for local therapy for gardnerellosis

In our body there are a huge number of not only harmful, but also beneficial bacteria. They live everywhere: on the surface of the skin, in the intestines, on the mucous membranes and in the vagina. Thus, almost every organ has its own individual microflora, which 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 under normal conditions also lives in the human body along with many others. It is believed that healthy woman In the vagina, acidifying lactobacilli predominate, which create an optimal environment. If this ratio is violated, gardnerellosis occurs with all the accompanying symptoms.

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

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

What number of microorganisms in a smear is considered normal?

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

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

Can gardnerella be in the mouth?

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

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 - predominantly green color of the secretion;
• 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 if normal microflora vagina, even if she did not have unprotected sexual intercourse. However, the leading route of infection remains sexual (oral, anal and vaginal penetration have the same risk of infection). Gardnerellosis can also be transmitted by wearing shared underwear or using insufficiently treated sex toys.

Length of incubation period

On average, clinical symptoms of the disease 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 a viral infection (ARI, cold), 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 bad smell, which can be felt several meters away, as well as a yellow, brown or green color. The discharge is quite difficult to wash off from clothes and can overfill your panty liner.
3. Swelling of soft tissues. The labia minora and clitoris swell, become extremely sensitive and sharply painful. After some time, in the absence of wiping and the use of absorbent wipes, 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 in the later stages of the development of the disease.

Gardnerellosis and childbearing

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

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

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

How is the disease diagnosed?

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

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

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

Methods to confirm the diagnosis:

Leading methods of treating gardnerellosis in women

Treatment of bacterial vaginosis is based on normalizing the vaginal microflora. For this, doctors use not only pharmaceuticals, but also a special diet. And also during the 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 young patients).

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 general medications. 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. Candles containing large number lactobacilli help normalize the internal environment of the 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 of the disease:

1. Antibiotics in tablets and capsules are used when local therapy does 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, the use of traditional medicine is acceptable. Various douches and tampons will help get rid of the main manifestations of the disease and make the wait easier. Remember that such treatment will not completely solve the problem, since pharmaceuticals are required to restore normal microflora.

I happened to encounter a patient who completely abandoned traditional therapy, preferring to use herbs and plants to eliminate bacterial vaginosis. Regular douching with high-dose solutions led to the fact that the patient not only did not cure gardnerella, but also acquired a serious chemical burn of the vaginal mucosa. The victim was taken by ambulance to the gynecology department, where she underwent reconstructive 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 most 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:

• consume only fresh and natural products without chemical additives (you can buy them at 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 complete 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, lie for a long time in a 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, the temperature in the room was high, as a result of which the woman was constantly sweating. Excessive formation of sebum contributed to the appearance of itching and burning, and all the therapy for gardnerellosis was useless. Only after the patient managed to take a vacation for two months and go to a sanatorium did the treatment become effective. sea ​​water and warm air, combined with pharmaceuticals and good hygiene, helped the woman forget about her illness.

What complications and negative consequences occur in patients with gardnerellosis:

• problems with conception - altered microflora causes the death of sperm when they do not have time to reach the egg;
• 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 for individual prevention of the disease.

While studying in my fourth year of 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 during the winter season, had encountered Garnerellosis and its unpleasant consequences. More than half of them had problems with immunity (they often got sick or caught colds). Throughout the fall, doctors recommended that they take certain pills with high content Latobacteria, and women also added dairy products (cheese, sour cream, sourdough) to the diet, which they consumed several times every day. As cold weather approached, doctors took from patients necessary tests- vaginal smears. In 95% of the studied patients, practically no gardnerella was observed in the material. Another 5% admitted that they did not always strictly follow doctors’ recommendations and drank alcoholic beverages. Thanks to this technique, most of the victims were able to forget about their illness forever.

Rules for individual prevention of gardnerellosis in women:

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 to stop using them altogether.
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 harmful microorganisms multiply in the skin folds, which subsequently penetrate the vagina, causing disruption of the microflora.
4. Do not take antibacterial drugs without a doctor's prescription. Antimicrobial agents not only help 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. When following a vegan or vegetarian diet for a long time, the reserves of nutrients in the body are depleted, as a result of which regeneration processes suffer.
   Dairy products are necessary to maintain optimal microflora

The cause is an insufficient number of lactobacilli, which are the main components of the normal flora of the female vagina.

Gardnerellosis or bacterial vaginosis is very common. When gardnerella were first identified, they were declared a new type of disease, only sexually transmitted. But a little later it turned out that a minimal amount of these pathogenic bacteria was initially present in the female microflora.

Formation of the disease

Normally, any healthy woman has gardnerella. But the proliferation of this bacterium is actively prevented by lactobacilli, which maintain the acidic internal environment of the vagina thanks to the lactic acid they produce. It is the lactoflora that takes on local immune and protective functions, suppressing the growth of bacteria such as gardnerella in women.

The causes of the disease lie in the fact that, due to certain circumstances, the number of lactobacilli is significantly reduced, and at this moment there is a sharp increase in anaerobic bacteria. The vaginal environment becomes alkaline, and this facilitates the penetration of new infections. That is why gardnerellosis is usually complicated by inflammatory diseases of the genitourinary system in women.

Signs of gardnerella in women

This disease is practically asymptomatic. The only clear sign of the presence of this infection is very strong vaginal discharge, usually

grayish white or yellow, having a very pungent smell of spoiled fish.

Quite often gardnerellosis is complicated by vaginitis. Then, in addition to heavy discharge, the woman experiences a burning sensation and unpleasant itching in the vagina, which intensifies with urination and sexual intercourse.

A change in sexual partner can cause an increase in the natural number of a microorganism such as gardnerella in women. The reasons for the growth of these bacteria are sometimes hidden in the use of contraceptives that include 9-nonoxynol. All this can provoke a decrease in the number of lactobacilli and, accordingly, an increase in opportunistic flora.

Treatment of the disease

If, after the tests, a pathogenic growth of the gardnerella bacterium in women was revealed, how to treat it is a completely natural question. Modern therapy methods used in gynecology make it possible to achieve a complete recovery. But, unfortunately, there is no guarantee of the absence of potential relapses of the present disease.

The treatment takes place in two stages. At the first stage, the patient receives medications designed to eliminate the manifestations and causes of the disease. The following drugs are usually prescribed: Dalatsin (capsules or cream) intravaginally and Metronidazole tablets. To prevent the development of thrush, Clotrimazole cream is prescribed in parallel.

At the second stage of treatment, it is necessary to restore the natural microflora. To do this, you should take the drug “Bifidumbacterin”, Acylak” and immunostimulating drugs.

The main reasons for the development of the disease

The main reasons for the formation of bacterial vaginosis include:

• frequent change of sexual partners;
• insufficient intimate hygiene during menstruation;
• hormonal disruptions of the body during puberty and/or during pregnancy;
• wearing underwear made of non-breathable synthetic materials;
• long-term use of antibacterial agents;
• intestinal dysbiosis;
• decreased immunity.

Leading a healthy lifestyle, using a condom during unplanned sexual contact, having a regular sexual partner - all this can prevent the occurrence of such an unpleasant gardnerella in women. The causes of this disease can simply be excluded if the appropriate rules are followed.

Gardnerella (bacterial vaginosis) is a very common infection these days. According to statistics, more than 20% of sexually active women suffer from this disease.

The thing is that gardnerella is always present in the microflora of the female genital organ.

But with a sharp increase in the number of these bacteria, the vaginal microflora is disrupted, which leads to the development of infection.

The question of whether this type of vaginosis is a disease that, like many, is sexually transmitted, still does not have a clear answer from doctors. However, bacterial vaginosis requires immediate treatment and is not even discussed.

Gardnerella itself is not pathogenic, but it gives rise to other pathogens that are more dangerous to women's health. Gardnerella performs the function of preparing the soil for harmful microorganisms. When these microorganisms begin to multiply at an accelerated pace, the products of their metabolism have a detrimental effect not only on the vagina, but also penetrate the urethra.

Disturbed microflora for Gardnerella is the number 1 cause. Bacteria that grow in such a “favorable” environment cause inflammation.

Is bacterial vaginosis contagious?

Certainly. It is patients who are very sexually active who most often encounter this disease. You can avoid the transmission of vaginosis by using contraceptives, especially if you are starting a relationship with a new partner. This statement does not mean at all that a man is “contagious.” It is possible that a man’s microflora will be alien to your body. This will lead to dysbacteriosis, and then to gardnerellosis.

Treatment for this disease is no different from other sexually transmitted infections. Regardless of confirmation of the disease, both partners must undergo a full course of treatment with drugs prescribed by the doctor for one of them.

You can get sick with gardnerellosis, even if there has been no infection as such. The disease can develop due to taking antibiotics or topical contraceptives. Many cases of the development of gardnerella have been recorded after taking the following drugs: Terzhinan, Betadine, Polygynax.

The vaginal microflora can be disrupted by prolonged stress, dieting, or intense physical and emotional stress.

Symptoms of gardnerellosis

Every woman should know the first signs of the onset of the disease, because treatment should begin and special medications should be taken as early as possible.

Symptoms of gardnerellosis in women appear much more noticeably than in representatives of the stronger sex. Vaginal discharge may be yellow, green, white, clear, or white-gray. They have a uniform consistency, creamy or watery, and often foam.

The labia become swollen, red, and itching and burning occur when urinating or during sexual intercourse. The main sign of the disease is the smell of spoiled fish.

In addition to discharge, gardnerella in women causes an internal inflammatory process, which also entails itching, pain and burning in the vagina.

In men (90%), gardnerella does not cause any discomfort. In rare cases, the presence of the disease can be judged by painful urination. Even less common are copious discharge from the penis, burning and itching.

If any minor symptoms of gardnerellosis appear in women, it is recommended to immediately consult a doctor. Experts say that the disease can be cured the first time only at an early stage of development.

Complications and consequences of the disease are varied.

Urethritis, prostatitis, infertility threaten men. And women often develop inflammatory diseases of the pelvic organs. The external genitalia, vagina, cervix - everything is at risk. The consequence is endometritis and adnexitis, which will bother you for the rest of your life.

If we talk about the consequences that appear immediately, then this is a sharp decrease in immunity and a high risk of diseases of the genitourinary system.

Gardnerellosis often occurs in pregnant women. Often, a woman becomes infected before conceiving a child, and during pregnancy, pathogenic microbes worsen. The reasons are as follows: during pregnancy, the body’s immune defense drops sharply and hormonal changes occur. These factors affect the microflora of the female vagina, and if a girl has a minimal risk of getting gardnerellosis, the body does not act to the benefit of the owner.

Diagnosis of the disease

Nowadays, gardnerella in women can be detected in the initial stages, fortunately, this is possible for every specialist. At the first suspicion, women should immediately contact a gynecologist, and men should immediately contact a venereologist or urologist.

First, the patient is examined and symptoms are assessed. The most common complaint is discharge with a strong unpleasant odor. If the symptoms of Gardnerella are not so well expressed, then a laboratory analysis is carried out to identify the pathogen.

The analysis is general smear with microscopy. Examining the cells of a sick person under a microscope, you can notice a thick layer of microbes, which indicates the fact of the disease. Another test to confirm the disease is measuring the pH of the vaginal environment. A definitive diagnosis can be made after a reaction to isontril (precisely the substance that emits a terribly unpleasant odor).

If the diagnosis is confirmed, ask your doctor to conduct an examination for the presence of inflammatory processes in the vagina (culture of vaginal discharge, dysbiosis analysis, PCR).

Gardnerellosis in women during pregnancy is the most common disease, but do not despair, the main thing is to cope with the disease in a timely manner. Treatment medications must be prescribed by a doctor, since many medications are prohibited, including antibiotics.

Doctors usually prescribe the following drugs for treatment: Metronidazole, Clindamycin. Both drugs are available both in the form of a gel for external use and in the form of tablets. Treatment and dosage of the drug is prescribed by the attending physician. It should be remembered that these drugs are incompatible with alcohol. After completing the course of treatment, get tested again, and then monitor your health and prevent relapses.

Prevention of the disease is quite simple:

• Take care of your health.
• Strengthen your immune system.
• Lead healthy image life (don't overwork, eat right).
• Avoid casual sex.
• Use condoms.
• Use antiseptics within 2 hours after “suspicious” sexual intercourse.
• Avoid douching and medications containing 9-nonoxynol (contraceptives).

Constantly monitor your genitals, keep them perfectly clean. At the first appearance of any symptoms, consult a doctor, do not self-medicate!

The vaginal microflora is in a state of fragile equilibrium. Changes in lifestyle and illness can upset the balance. Sometimes the result is an inflammatory reaction. But dysbiosis may begin, which is not accompanied by signs of inflammation. In gynecology it is called bacterial vaginosis (gardnerellosis) or this infection is also mistakenly called gardinella, gardenellosis or gardanella.

What prevents pathogens from multiplying...

Several factors play a role in protecting the internal environment of the vagina.

• Clear separation. The genital organs are strictly divided into upper and lower sections so that any infectious process can be limited. Also, the vagina is disconnected from the external environment. The labia majora are tightly closed, which prevents the penetration of pathogens.
• Features of the epithelium. The mucous membrane is dependent on the concentration of estrogen. Under their influence, a large amount of glycogen accumulates in cells. Cells are constantly renewed, and dead ones become a breeding ground for lactic acid bacteria.
• Biological protection. Glycogen metabolism ends with the formation of lactic acid. It acidifies the environment and makes it unsuitable for the life of most microorganisms. Hydrogen peroxide is also formed, which can damage pathogenic cells. Glucose is completely used by lacto and bifidobacteria, so there is no nutrient medium left for pathogens.

The described processes, at a normal level of health, help maintain the internal environment of the vagina. They are called the “self-cleaning ability of the vagina.” This property is typical for women reproductive age, since it is directly related to the state of hormonal levels.

... and why the protection fails

The causes of gardnerella in women lie in factors that lead to an imbalance of microflora. Mechanisms are launched that lead to a decrease in the number of beneficial microorganisms. Nature does not tolerate emptiness - the vacant spaces are occupied by opportunistic flora. In some cases, it can become a trigger for the emergence of pathogens. Formation can be caused by the following conditions.

• Hormonal changes. Pregnancy, frequent stress, pathologies of the reproductive organs, menopause are accompanied by a relative or absolute imbalance of hormones. The vaginal mucosa is sensitive to the concentration of estrogen. When they decrease, glycogen storage decreases, which means there is less nutrient medium for lactobacilli.
• Infections. Sexually transmitted diseases destroy normal flora. Even after recovery, time is needed to restore the microbiocenosis. And chronic infections do not allow normalcy to be restored for a long time.
• Medicines. A course of antibiotic treatment does not go away without leaving a trace. Most of them have a wide spectrum of action, so not only the causative agent of the disease dies, but also the normal flora of the intestines and vagina. Gardnerella vaginalis takes its place. Treatment with cytostatics and hormones has a negative effect on the flora.
• Contraception. Intrauterine devices, despite their compatibility with biological tissues, cause minor chronic inflammation, which is part of the contraceptive mechanism. But such a reaction in some women leads to dysbiosis. Sometimes the use of certain spermicides may be to blame.
• Interventions. An abortion that is performed in later with the help of curettage, operations also expose the microflora to a negative influence, and a failure occurs.
• Decreased immunity. Under the influence of chronic diseases, endocrine pathologies, stress and excessive physical activity, the immune system malfunctions. Weakening of protection can also be observed in the form of a local reaction, which gives scope for the development of opportunistic flora.
• Allergies and toxic substances. Allergic reaction accompanied by increased immune tension. This can be either a systemic reaction of the whole organism or a local manifestation. In women, this is often caused by sanitary pads with fragrances and the use of soap for intimate hygiene.

The question of whether Gardnerella is transmitted during sex remains open. It has been noticed that women who constantly change sexual partners and neglect protective measures get sick more often. But at the same time, in cases of observation of adolescents and mature people leading an active sex life, this pattern was not statistically confirmed.

Symptoms of gardnerella in women

Where does garganella come from? vagina and how to treat it? Gardnerella vaginalis are small rods and cocci with a complex cell wall structure. They are immobile and cannot form spores. Carbohydrates are fermented in nutrient media until acetic acid is formed. They are similar in antigenic structure to candida.

The viability of microorganisms is low. In the external environment, death can occur within 24 hours; in semi-liquid media, they can persist for several days.

The source of infection can be a sick or healthy woman. Studies have shown that from 12 to 47% of women are carriers of gardnerella in the absence of symptoms. The pathogen is also detected in girls younger age, as well as in virgins. But with the development of vaginosis, the number of microorganisms increases significantly. In ICD-10, gardnerellosis is encrypted as N 89.8 - other non-inflammatory pathologies.

Gardnerella leaves behind unstable immunity. Therefore, the disease can recur.

How it manifests itself

It is difficult to confuse with another disease the way gardnerella manifests itself in women. Some signs are nonspecific, but there are also very clear ones, characteristic only of this pathology.

• Discharge. Normally, the amount of leucorrhoea is small, almost imperceptible. With gardnerellosis it can increase significantly. The nature of the discharge is homogeneous, gray-white or with a yellowish tint.
• Smell . A characteristic feature of gardnerellosis is the smell of rotten fish. It is observed constantly, but may intensify after sexual intercourse or washing.
• Itching and burning. In the initial stages they may not bother you. Their addition indicates the development of complications of the disease.
• Discomfort when urinating. Dysuric disorders also appear with complications - gardnerella urethritis.
• Pain . Tugging sensations in the lower abdomen or pain during intercourse may be signs of an ascending infection spreading.

Symptoms of intoxication and temperature are not typical for this pathology. Most often, its onset occurs unnoticed by the woman. For men, the disease can manifest itself in the form of epididymitis and urethritis. But long-term existence in the urethral cavity is uncharacteristic; there are no necessary conditions life.

What makes it more difficult?

What is dangerous about gardnerella infection is that it has serious consequences that cannot always be eliminated.

• Increased risk of infections. Against the background of dysbacteriosis, conditions are created for the penetration of pathogenic pathogens.
• Ascending infection. Inflammatory pathologies of the vagina can spread to the overlying sections and lead to the development of salpingitis.
• Complications of pregnancy and childbirth. In advanced cases, it can cause premature birth, premature rupture of membranes, chorioamnionitis and postpartum endometritis.

Long-term consequences of Gardnerella for women can manifest themselves in the form of infertility and problems with pregnancy.

How to identify and treat

Before you begin treatment for gardnerella in women, you need to conduct a thorough diagnosis. Some women start looking for photos of discharge on the Internet to understand whether it is it or not. Most of the symptoms of the disease are nonspecific and only allow one to suspect pathology. Of the clinical and laboratory findings listed below, at least three must be present to make a diagnosis.

• Discharge. Homogeneous, gray-white in color, evenly cover the vaginal mucosa, with an unpleasant odor.
• Smear. Based on the results of the analysis, key cells are detected - the epithelium, which is covered with small cocci.
• Acidity. The pH of vaginal discharge is 4.5, and in some situations even lower.
• Aminotest. A positive result of the study shows that after adding 10% potassium hydroxide to the smears, the “fishy” smell either sharply appears or intensifies.

Bacterial culture for diagnosis is of no value. In healthy women, decoding may show a certain number of microbes that will grow on a nutrient medium.

A smear is taken at every visit to the gynecologist. For bacterial vaginosis, the following characteristic features must be observed:

• massive microflora with key cells;
• single lactobacilli;
• no leukocyte reaction.

The examination is not carried out during menstruation. After the last sex, at least 72 hours must pass before testing. It is also recommended to be tested for other sexually transmitted infections using the PCR method. A positive result will indicate the need for treatment with multiple drugs.

Acceptable treatment regimens

It is possible to cure gardnerella at home; hospitalization is not required. But you need to choose and combine correctly medicines. Therapy will differ depending on the woman's position. Possible treatment regimens are shown in the table.

Table - Treatment regimens for bacterial vaginosis

Treatment of bacterial vaginosis begins with the use of local remedies. In addition to those indicated in the table, there are suppositories with metronidazole, which are more convenient to use than cream. If local treatment is ineffective, switch to tablets.

Pregnancy and illness

Bacterial vaginosis can be triggered by pregnancy or weakened local immunity. But treatment of the pathology is carried out no earlier than the second trimester. This is explained by the fact that antibiotics that act on bacteria are dangerous for the developing fetus. In the first trimester, the formation of all organs and systems occurs, so the negative effect of drugs is more pronounced. Later, the placenta begins to function, which provides protection to the fetus from certain harmful substances. The treatment regimen for Gardnerella during pregnancy includes one of three drugs to choose from.

1. Clindamycin cream (2%). A single dose of 5 g is inserted deep into the vagina once a day before bedtime. The course of treatment is three days.
2. Gel "Metronidazole" (0.75%). Dosage for one time is 5 g, used twice a day for five days.
3. Metronidazole tablets. 500 mg orally twice a day. Course duration - 7 days.

During the treatment period, any douching is contraindicated. They will wash out the normal microflora and worsen the condition even more.

Alternative

Any bacterial infection requires the use of antibiotics. No folk remedies or homeopathy can replace these drugs. They can temporarily muffle the symptoms, and this is fraught with the development of complications. Therefore, after making a diagnosis, you need to listen to the doctor’s recommendations, and traditional medicine use for the period of microflora restoration.

Traditional therapy may include medicinal preparations and decoctions that are taken orally. But such treatment has no scientific evidence of effectiveness.

Recovery period

It is impossible to destroy Gardnerella and leave the mucous membrane without normal microflora. Other microorganisms may take the place of the disappeared microbe, and the situation will repeat itself. Therefore, it is necessary to populate the vagina with beneficial flora. To do this, use vaginal suppositories:

• "Gynoflor-E";
• "Bifidumbacterin";
• "Lactobacterin";
• "Vaginorm";
• "Ecofemin".

The first signs of gardnerellosis in women are easy to notice on their own. This is easiest to do while washing. If after soaping an unpleasant fishy smell appears, then this is gardnerella. Do not delay your visit to the doctor, it is better to initial stage start treatment so as not to wait for complications.

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In the vagina, there are normally a variety of microorganisms: lacto and bifidobacteria, which make up up to 95% of the entire microflora of the genital tract, as well as cocci, enterobacteria, E. coli, fungi of the genus Candida, Klebsiella, mycoplasma and others, including gardnerella.

What is gardnerella?

These are bacteria of the genus Gardnerella, which includes only one species - Gardnerella vaginalis. In small quantities, these microorganisms are present as part of the usual microbial association living in the vagina of a healthy woman. They are facultative anaerobes, which means they can exist in an environment without oxygen.

In favorable conditions, microbes quickly multiply in the urethra and vagina, suppressing and destroying lactic acid bacteria. A disease develops that was previously called gardnerellosis. Scientists have now found that other opportunistic microbes are also actively involved in this process - mycoplasma and obligate anaerobes that can only exist in an oxygen-free environment (fusobacteria, bacteroides, peptostreptococci and others). Thus, gardnerellosis in women, according to modern concepts, is a mixed infection. Currently, they prefer to call this disease "".

This diagnosis is not included in the 10th revision of the International Classification of Diseases, since the term “bacterial vaginosis” itself came into practice after the creation of this classification.

Causes and mechanism of development of the disease

Gardnerellosis is not an inflammatory disease, but an imbalance of the vaginal microflora, that is, vaginal dysbiosis. One third of women develop this condition at least once in their lives. Is he dangerous? Bacterial vaginosis creates favorable conditions for the formation of genital tract infections - colpitis and others. It promotes the formation of a precancerous condition of the cervix -. Gardnerellosis increases the risk of unfavorable outcome of gynecological interventions, abortions and childbirth. It increases the likelihood of contracting HIV infection.

Causes of gardnerellosis in women:

• the use of antibacterial drugs, primarily antibiotics, as well as local antiseptics, for example, during douching;
• uncontrolled use of oral contraceptives and spermicides;
• without proper medical supervision;
• hormonal disorders accompanied by a decrease in the volume of blood released during menstruation, as well as prolongation of the menstrual cycle during puberty or menopause;
• inflammatory diseases of the lower genital organs, uterus, appendages;
• promiscuity;
• immunodeficiency states with diabetes mellitus, taking immunosuppressants and cytostatics, HIV infection;
• malformations, polyps, cysts, foreign bodies of the vagina and uterus.

With excessive growth of opportunistic microbes in the vagina, the acidity of its internal environment changes, the pH rises to 7 or more. Under these conditions, the natural protection of the genital organs weakens, and infectious complications arise. Thus, the causes of gardnerellosis lead not only to the development of bacterial vaginosis, but also contribute to the colonization of the vagina by pathogenic microorganisms.

Gardnerellosis in men is much less common. Typically, these germs are removed from the urethra through the urine stream. Isolated cases of inflammatory lesions of the male genital organs by gardnerella have been described. However, every tenth infected man becomes a carrier of the infection, spreading it through unprotected sexual contact. However, he has no external manifestations of the disease.

Clinical picture and diagnosis

The time from the onset of the disease to the formation of the first signs in most cases is 10 days.

Symptoms of gardnerellosis

Quite profuse vaginal discharge, itching, and burning appear. The discharge is usually white or gray in color, it is sticky, homogeneous, foamy, with a characteristic unpleasant fishy odor. They are observed in half of the patients and irritate the walls of the genital organs, sometimes causing burning and itching. There may be increased discomfort during sexual intercourse or menstrual bleeding.

Such symptoms can persist for a very long time, even for many years. With such a long process, the discharge becomes cheesy in nature and yellow-green in color.

Every fifth patient develops urinary problems: it can be frequent, painful, in small portions, and accompanied by itching. At the same time, gardnerella is isolated from the urine in almost all women with bacterial vaginosis.

A feature of vaginosis is the absence of swelling and redness of the vaginal walls, that is, inflammation. However, almost half of the patients have concomitant cervical diseases: inflammation, cicatricial deformity, ectropion, pseudo-erosion.

Making a diagnosis

With such signs, the doctor can make a preliminary diagnosis using the following methods:

• determination of the reaction of vaginal contents (pH-metry), which determines the alkaline reaction, in contrast to the normal - acidic, created by lactic acid bacteria;
• positive amine reaction: when the secretions are mixed with a solution of potassium hydroxide, a strong unpleasant fishy odor appears.

The diagnosis is confirmed by examining stained smears under a microscope. The following specific signs of gardnerellosis are determined:

• a large number of desquamated cells lining the mucosa;
• “key cells” - epithelial cells with Gardnerella and other microbes fixed on them;
• absence of lactic acid sticks;
• the presence of gardnerella, bacteroid, fusobacteria and other pathogens of vaginosis;
• a small number of leukocytes, indicating mild inflammation.

There are other diagnostic methods: immunofluorescence reaction, polymerase chain reaction, DNA hybridization, and cultivation of microorganisms. They are aimed at identifying gardnerella in vaginal contents. These methods are expensive, often labor-intensive, and cost-ineffective, so they are rarely used.

Features of the course of the disease in pregnant women

Gardnerella occurs less frequently during pregnancy than outside of this condition, which is due to a physiological increase in the number of lactobacilli in expectant mother. They are designed to create an acidic environment in the vagina. Thus, lactobacilli protect the fetus from the penetration of infectious agents through the cervix.

Diagnosis and treatment of gardnerellosis in pregnant women should be given special attention, since it can cause pregnancy complications (chorioamnionitis, abortion). early stages, doubling the likelihood of premature birth, postpartum endometritis and sepsis). There is usually no direct effect on the fetus, but an increased incidence of preterm birth leads to the birth of premature babies.

Thus, untreated gardnerellosis during pregnancy is not a harmless condition; it is dangerous for a woman and her unborn child. This condition must be treated. Treatment is complicated by the fact that many antibacterial drugs are contraindicated during pregnancy (especially during the first trimester).

Therapy

During the course of therapy for gardnerellosis, a woman is advised to give up fatty and sweet foods, take more fluids and fermented milk products, and normalize stools with plant fiber (vegetables). The patient can take a shower or visit the bathhouse, but not take a steam bath. You should avoid taking baths.

Treatment of a sexual partner is carried out only if he has an inflammation of the urethra - urethritis. In other situations, medications are not prescribed to a man. The use of condoms is advisable to reduce the risk of contracting other infectious diseases from a partner, although some recommendations do not require it. Bacterial vaginosis is not sexually transmitted.

The disease must be treated in all cases, especially before abortion.

Treatment of gardnerellosis is based on the following principles:

• antibacterial therapy;
• normalization of vaginal microbial flora;
• strengthening the immune system and preventing relapses.

For gardnerellosis, tetracyclines, cephalosporins, and aminoglycosides are not used. The basis of treatment is Metronidazole, Ampicillin and Clindamycin are used less frequently.

These drugs can be used either in tablet form or topically. Metronidazole or Clindamycin is prescribed orally for a week. During this time and the next 24 hours, the woman is prohibited from drinking alcoholic beverages.

Terzhinan suppositories have proven themselves well; they should be used within ten days. Metronidazole gel and Kleocin vaginal cream are used. Along with these medications, antifungal drugs are prescribed for prevention, in particular Fluconazole for oral or topical use.

Treatment of gardnerellosis during pregnancy is carried out using local drugs, since systemic drugs can harm the child. In the 2nd and 3rd trimesters, vaginal cream Dalacin containing clindamycin has proven itself well. Additionally, to prevent candidiasis, pregnant women are prescribed Natalsid, Pimafucin, and Gino-pevaril suppositories.

In parallel with the use of antibiotics, you can also use antiseptics for topical use, for example, Betadine (Povidone-iodine), Chlorhexidine. This will speed up your recovery.

3 days after the end of the course of antimicrobial therapy, agents are prescribed that restore the normal fermented milk flora of the vagina - Acylact (tablets, suppositories, powder for preparing a suspension), Lactobacterin. Bifidumbacterin is used to restore bifidobacteria. You can also prescribe combined drugs, for example, Linex, Bifiliz and others. They can be used both internally and locally, given the fact that bacterial vaginosis is very often combined with a disturbance in the composition of the intestinal microflora. At the same time, multivitamin complexes are prescribed.

For the prevention and treatment of recurrent gardnerellosis, the Solcotrichovac vaccine is used. It enhances local immune reactions, promotes the development of lactobacilli, and suppresses the proliferation of opportunistic flora. There are specifics to administering the vaccine, so only a doctor should prescribe and monitor treatment.

Treatment at home should be carried out as prescribed by a doctor. Additionally, after the exacerbation subsides, you can douches with chamomile, oak bark, aloe juice, calendula and other herbs with anti-inflammatory and antiseptic properties. However, you should understand: douching washes out beneficial microorganisms, which can further delay recovery. Only folk remedies It is almost impossible to get rid of gardnerellosis.

Treatment usually takes about 2 months: 10 days of antibacterial therapy followed by restoration of the microflora of the genital tract. The effectiveness of therapy is assessed after the complete disappearance of symptoms.

Prevention includes the following areas:

• achieving normal hormonal levels;
• treatment with antibiotics only as prescribed by a doctor;
• compliance with the usual rules of personal hygiene, without frequent douching;
• refusal of sexual contacts with different partners;
• treatment of intestinal dysbiosis and genitourinary system infections.