Vaginosis, colpitis and thrush: the signs are similar - the diseases are different. Bacterial candidiasis: symptoms and treatment

Bacterial candidiasis, or gardnerellosis, is vaginal dysbiosis. This is a fairly common female problem that causes serious discomfort for ladies. Contrary to popular belief, this disease is not venereal. Gardnerella vaginalis, the infection that causes bacterial vaginosis, is transmitted through sexual contact. However, the entry of this virus into the body does not necessarily indicate the development of the disease. In small quantities, microbes make up the normal microflora of the vagina of every woman.

You can only become infected with this virus through unprotected sex. For this reason, you should be checked regularly after each change of partner. This will help to timely determine whether the virus has entered the body, so that appropriate drug treatment can be prescribed. Women who have already encountered bacterial vaginosis need to carefully monitor their health and do everything possible to strengthen the body's immune abilities.

Causes

The vaginal microflora consists of a huge number of different bacteria. Among them, milk and lactobacilli predominate. They are necessary for the complete processing of glycogen. The breakdown products are synthesized, resulting in the formation of lactic acid. It is this that creates an acidic environment in which pathogenic microbes and bacteria cannot multiply. As long as there is an acidic environment in the vagina, the development of bacterial candidiasis and thrush will be impossible.

It should be noted that the cause of bacterial candidiasis is not the accelerated reproduction of any pathogenic organism, but the body’s reaction to these microbes. The most dangerous are Mobilincus, Mycoplasma and Gardnerella. When they appear in the microflora, the number of anaerobic bacteria increases. Because of this, the acidic environment can no longer cope with its responsibilities so effectively. Among the most popular causes of bacterial thrush are:

1. Intestinal dysbiosis and diseases of the endocrine system;
2. Consequences of abortions and miscarriages, pregnancy;
3. Hormonal changes or imbalance;
4. Menopause or decreased immune abilities of the body;
5. Long-term use of antibiotics, cytostatics, antifungal drugs;
6. Consequences of radiation therapy and foreign body in the vagina;
7. Constant use of tampons, intrauterine devices, menstrual caps;
8. Unprotected sex and excessive sexual activity;
9. Excessive desire for cleanliness;
10. Surgeries on the vagina, diseases of the reproductive system;
11. Use of non-hormonal contraceptives.

It must be remembered that bacterial candidiasis is not a sexually transmitted disease. Of course, the causative agents of the disease are transmitted sexually, but sex with a carrier alone is not the cause of the disease. Try to monitor the condition of your body, treat any diseases in a timely manner and regularly take vitamin complexes to boost your immunity.

What antibiotics should be used for thrush?

Symptoms

The first sign of bacterial candidiasis, for which your doctor will prescribe treatment, is a strong, unpleasant odor from the vagina. Over time, moderate or heavy discharge of a cloudy color is added to it. They can also be greyish, usually uniform, have no lumps, but are endowed with an unpleasant fishy odor. This smell is constantly present, but increases significantly during sexual intercourse and during menstruation.

Because bacterial candidiasis rarely causes serious discomfort, such symptoms may persist for a very long time. After a few months, you may notice that the discharge has become darker, thicker, somewhat reminiscent of a cheesy mass that can easily foam. It is also sticky and viscous, spreading along the inner walls of the vagina. After contact with it, your hands emit an unpleasant odor for a long time.

More serious symptoms of bacterial thrush may not be present at all. It is extremely rare for women to experience itching and burning in the mucous membrane and urinary disorders. Most often, this occurs from time to time, and the woman does not pay much attention to this problem.

This problem can be recognized by the accompanying complications in the form of heavy periods, pain in the lower abdomen. Unlike thrush or trichomoniasis, bacterial thrush rarely causes severe itching.

Complications

Bacterial vaginosis itself is not spread through sexual contact, but sex is the only possible way for the causative agent of this disease to enter the body. Most often, people with this disease develop serious infections of the genital tract. This type of thrush poses the greatest danger to pregnant women, whose risk of HIV infection increases significantly.

The presence of this disease significantly increases the likelihood of serious inflammatory processes in the pelvis. It should be noted that bacterial candidiasis often occurs in women who have terminated pregnancy and have encountered endometritis damage and other serious disorders in the reproductive system.

The presence of Gardnerella vaginalis in the body of a pregnant woman significantly increases the likelihood of spontaneous abortions at 3-5 months. It can also lead to premature birth, rupture of the placenta and membranes during pregnancy. If the mother has genital herpes in her blood, this pathogen increases the risk of infection to 90%.

Fungal disease Candidiasis of the gastrointestinal tract

Treatment

Vaginal thrush requires mandatory consultation with a qualified physician. Until now, experts have not determined an unambiguous scheme for influencing this disease - in each individual case it is prescribed individually. It is very important for a specialist to determine the nature of the disease, as well as accompanying disorders in the functioning of the body. Typically, the cause of such candidiasis is diabetes mellitus, hypofunction of the thyroid gland, and inflammation of the genital organs. First of all, you will have to carry out therapy aimed at these diseases. The most commonly prescribed antifungal drugs are Fluconazole or Itraconazole. They are taken for a long period of time - about 1-2 months.

You should not end therapy when all signs of the disease disappear. It is necessary to complete the treatment course completely.

When bacterial vaginosis occurs simultaneously with other diseases of the reproductive system, it is necessary to take complex medications. They must act on both mycosis and bacteria. The most optimal such option is Metrogyl Plus. It must be inserted into the vagina twice a day for 5 days. You can also use Clotrimazole or Metranidazole. This therapy is highly effective; it helps restore normal microflora. Apply a small amount of ointment to the tampon and insert it as deep into the vagina as possible.

Disease prevention

Like any other disease, bacterial thrush is much easier to prevent than to treat. First of all, you must take a responsible approach to the issue of personal hygiene. Don’t forget to wash your face every day, change your underwear, and use special cosmetics. Also engage in the prevention of sexually transmitted diseases. To do this, you need to avoid promiscuity and always use condoms and antibacterial vaginal suppositories.

With comprehensive prevention, you will be able to reduce the risk of this type of thrush to 7%.

Try to monitor the state of your immune system. Eat right, exercise, give up bad habits. Also take vitamin complexes regularly. This will help restore normal vaginal microflora. Try to dress appropriately for the weather, do not get too cold or overheat. Treat in a timely manner any viral and infectious diseases that have an extremely negative impact on the state of a person’s immune abilities. Use special gentle soap for genital hygiene.

The phrase “bacterial candidiasis” does not sound entirely correct for a gynecologist and venereologist, but nevertheless, about 50% of women have encountered symptoms of this disease at least once in their lives. Sometimes, instead bacterial candidiasis , they also use the phrase “bacterial vaginosis or vaginal dysbiosis.”

It seems clear that candidiasis is an infection of the vagina by yeast fungi of the genus Candida. Where did this word come from then? In fact, this is due to the addition of a secondary infection caused by the activity of bacteria. One of the most common pathogenic bacteria is Escherichia coli. Its population occupies 80% of the entire intestinal microflora.

Development factors

You should not think that only people leading an immoral lifestyle are susceptible to the development of this disease; no one is immune from its occurrence. The penetration of pathogenic microorganisms into the vagina is possible for the following reasons:

• failure to comply with basic hygiene rules;
• wearing tight synthetic underwear;
• excessive use of absorbent pads or tampons disrupts the normal balance of a woman’s microflora;
• if the rules of intimate hygiene are not observed, opportunistic intestinal flora enters the vagina through an ascending route; viral infections can penetrate through the blood; this route is called “hematogenous”;
• A descending route of transmission of infection is also possible, in this case pathogenic microbes descend from the uterus, for example, during inflammatory processes due to an abortion, an installed and forgotten intrauterine device, or an advanced uterine tumor.
• With contact transmission, infection occurs through sexual intercourse with an unhealthy partner.
• the development of bacterial vaginosis (candidiasis) can be provoked by taking hormonal contraceptives and corticosteroids.

Predisposing factors include pregnancy and menopause. The presence of severe pathology on the part of the immune system, for example, with AIDS, in almost 99% of cases will lead to the development of bacterial thrush.

Bacterial vaginosis (candidiasis), in the absence of sexually transmitted infections, will naturally not be considered a sexually transmitted disease, but frequent changes of sexual partners can provoke the development of this disease.

In addition, the causes of combined pathology include uncontrolled use of antibacterial drugs; local use of antibiotics is of particular importance, i.e. direct frequent contact of an antibacterial drug into a woman’s vagina (with a condom treated with an antibacterial agent, in the form of irrigations, creams, ointments).

Inappropriate use of antibiotics can cause dysbiosis, which will lead to a reduction in the population of bifidobacteria and lactobacilli. At this stage, there is one step before the development of bacterial thrush. The fact is that the wall of the vagina borders the wall of the rectum, and it is easy for pathogenic bacteria to move from the rectum to the vagina. In some cases, thrush can be practically asymptomatic; they are described mainly in asocial women.

Symptoms of bacterial candidiasis

The disease has nonspecific symptoms and can easily be confused with the classic form of thrush.

1. Redness and itching in the genital area.
2. Unpleasant specific smell of rotten fish.
3. Quite profuse vaginal discharge, depending on the flora, variations are possible. If the fungal flora predominates, the presence of cheesy, white discharge is noted. If bacterial flora occurs, the discharge is yellowish-white and foamy.
4. General weakness. Due to the fact that all these fungi and bacteria described above carry out their “dark” business, the remains of their waste products, which are quite toxic, accumulate in the body. Against this background, a state of general weakness and apathy develops.

It is worth noting that when having sex or urinating, a woman may feel discomfort and, in some cases, pain. This can lead to a decrease in the patient’s quality of life and a complete cessation of sexual activity.

Bacterial vaginosis during pregnancy

Bacterial vaginosis during pregnancy poses a danger to the life of the mother and fetus. When passing through the birth canal, a newborn can become infected with thrush. Infection with a “bouquet” of amniotic fluid pathogens will lead to delayed intrauterine development of the fetus, low birth weight, and congenital pathology of the immune system.

Intrauterine malformations in the fetus are possible. In the early stages of pregnancy, infection of the amniotic fluid can lead to a frozen pregnancy or spontaneous abortion. However, a woman who does not miss an appearance at the antenatal clinic is not particularly threatened by these troubles.

Diagnosis and treatment of bacterial candidiasis

When examined, representatives of sexually transmitted diseases can be found in a smear. These include chlamydia, trichomonas, ureaplasma, mycoplasma, gardnerella. These protozoa can be identified, in addition to the existing Candida fungi, both individually and in various combinations, or even as a whole “bouquet”. Bacterial vaginosis is treated by a gynecologist.

If necessary and if there is an STD, the therapy prescribed by the gynecologist is monitored by a dermatovenerologist.

When sowing vaginal discharge, in most cases, E. coli is sown in large quantities (high titer), but there may also be other types of opportunistic bacteria. Normally, the growth of pathogenic flora is restrained by the activity of beneficial bacteria that inhabit the intestines of a healthy person.

Ureaplasma, mycoplasma, chlamydia, gardnerella, if there are no accompanying microorganisms and predisposing factors, in itself does not cause an inflammatory process in the vagina, but when there are several pathogens at the same time that enhance the effect of each other, and with a background contamination with fungi of the genus Candida, massive inflammatory the process in the vagina can no longer be avoided.

Doctors have enough antifungal and antibacterial drugs in their arsenal; individual treatment is selected depending on the stage of pregnancy, and the risk of adverse consequences for the unborn child is minimized.

To summarize, it should be noted that the described pathology of a woman’s vagina really exists. Bacterial infection against the background of thrush is always secondary. There are many ways to avoid the occurrence of such diseases, such as - bacterial candidiasis . At the first manifestations of ill health in the female genital area, an examination by a gynecologist is necessary. During pregnancy, untreated bacterial vaginosis or candidiasis can be fatal.

Women make this diagnosis for themselves when they are bothered by discharge. And gynecologists understand thrush as a strictly defined disease caused by a known pathogen - a fungus of the genus Candida. But discharge, itching and burning are caused not only by fungi.

T What are the symptoms of vaginal inflammation? (colpitis) are possible with gonorrhea, trichomoniasis, bacterial vaginosis (gardnerellosis), genital herpes, chlamydia, mycoplasmosis, ureaplasmosis and other infections. Therefore, when the described complaints bother you, you need to go to the doctor for examination and find out the causative agent, and not self-medicate, because advertised drugs are effective only against real thrush - candidiasis.

The set of studies for complaints of discharge is standard and is carried out in a certain sequence:

1. Smear (bacterioscopy).

2. If necessary, culture (bacteriological examination)

3. PCR (DNA diagnostics).

Following this sequence will allow you to save money by starting with a simpler and cheaper study. The most common causative agents of colpitis (fungi, trichomonas, gonococci, gardnerella) are detected in a regular smear if it is made in a qualified laboratory and do not require PCR. Conversely, pathogens detected by PCR (chlamydia, ureaplasma, mycoplasma, herpes, papillomavirus) are less likely to cause symptoms of colpitis, and their detection and specific treatment does not always lead to the disappearance of complaints, because The vaginal flora remains disturbed. Moreover, if there is a large discharge with a large number of white blood cells (pus), the PCR reagents are inactivated, and the result may be false negative (i.e. the result will be negative despite the presence of infection). Therefore, it is first necessary to identify and treat disorders of the vaginal flora, and only then, if indicated, do PCR.

Normal vaginal microflora:

Daderlein bacilli (lactic bacteria). They should be detected in a smear along with epithelial cells (the superficial exfoliating layer of the vaginal walls) and a small number of leukocytes (up to 20 in the field of view of the microscope).

Other microorganisms that normally live in the vagina (fungi, gardnerella) are present in small quantities that do not allow them to be seen in a smear.

Leukocytes are protective cells that fight infectious agents. Their number increases in inflammatory diseases; they are a sign of the presence of infection, but do not allow identification of a specific pathogen.

I. INFECTIONS DETECTED BY BACTERIOSCOPE:

1. Candidiasis- true thrush. Caused by fungi of the genus Candida. These fungi normally live in the vagina of a healthy woman without requiring treatment.

Treatment is required when complaints appear: white discharge, often cheesy, in lumps, with a sour odor; itching that increases after sexual intercourse, water procedures, at night, during a certain phase of the menstrual cycle.

These complaints occur periodically and are provoked by poor diet, fasting, hypothermia, stress, illness, a certain period of the menstrual cycle, or taking hormonal medications (birth control pills). Sometimes the symptoms go away on their own or with self-medication (various suppositories), but after a while they resume.

Candidiasis is not a classic sexually transmitted disease (STD); it is an internal condition caused by decreased immunity. Therefore, with long-term, recurrent, difficult-to-treat candidiasis, it is necessary to look for pathology in the body that can cause immunodeficiency, manifested, in particular, by candidiasis.

Causes of persistent candidiasis:

The presence of a chronic infection of the reproductive system or any other system of the body.

The immune system is exhausted in the fight against chronic inflammation, and this also manifests itself in candidiasis.

Chronic diseases, for example, kidneys, liver, for the same reason.

Hormonal disorders: ovarian dysfunction, decreased thyroid function, diabetes mellitus, obesity.

Taking hormonal medications: birth control pills, prednisolone (for the treatment of immune diseases).

Genital herpes.

Taking antibiotics that cause intestinal dysbiosis. The reservoir of candidiasis in the body is the intestines, from there the fungi spread to other habitats.

Poor nutrition, in particular, excess sweets, can also lead to the development of dysbiosis and the proliferation of fungi.

Chronic intestinal diseases - colitis.

Incorrect use of eubiotics: after (or instead of) treatment of disorders of the vaginal flora, for example, bacterial vaginosis, drugs containing lactic bacteria (lactobacterin, acylact) are often prescribed. These bacteria should normally live in the vagina, maintaining an acidic environment in it, and if there are sufficient numbers of them, alkali-loving bacteria that cause bacterial vaginosis cannot settle. But fungi coexist perfectly with lactic bacteria in an acidic environment and multiply under these conditions. Therefore, it is possible to prescribe eubiotics only if the absence of fungi is confirmed (by smear, or better yet by culture).

Thus, candidiasis is a marker of trouble in the body, and in addition to specific treatment with antifungal drugs, it requires a full examination and elimination of the root cause of immunodeficiency.

Occurring as an internal condition, candidiasis can be transmitted sexually. Therefore, both partners undergo treatment at the same time.

2 Bacterial vaginosis ( gardnerellosis). These terms are not complete synonyms.

Bacterial vaginosis is vaginal dysbiosis, i.e. a condition in which the ratio of microorganisms normally living in the vagina is disrupted. Those that should be more numerous (lactic bacteria) become smaller, and vice versa, those that should normally be few in number multiply. Gardnerella is one of those that should be fewer in number, but not the only one. Thus, vaginosis is not an infection (not only not an STD, but not an infection at all); the bacteria do not come from outside, but only regroup their own. Features of the bacterioscopic picture in vaginosis is a small number of leukocytes, because no infectious agents. Therefore, bacterial vaginosis (gardnerellosis) is not contracted, and this is the only condition that does not require treatment of the partner.

Normally, the vagina maintains an acidic, oxygen-rich environment, favorable for the proliferation of lactic bacteria. When environmental conditions change—the absence of oxygen and alkalization—lactic bacteria are replaced by those for whom these conditions are favorable: gardnerella and other bacteria that live in an alkaline environment and do not use oxygen.

Reasons The development of bacterial vaginosis can be:

Wearing tight-fitting synthetic underwear, tight-fitting synthetic trousers, i.e. creating barriers to oxygen penetration.

Abuse of daily pads and tampons is for the same reason.

Long-term use of antibiotics, which also kill lactic bacteria.

Poor nutrition is a lack of fermented milk products in the diet, which are a source of lactic bacteria for the body.

Chronic intestinal diseases and other conditions that cause dysbiosis - lactic bacteria come with food and live in the intestines.

Symptoms of bacterial vaginosis: discharge is whitish-gray, homogeneous, sticky, with a strong unpleasant odor.

The diagnosis of bacterial vaginosis is made only on the basis of complaints and bacterioscopy. PCR for gardnerella should not be carried out: firstly, gardnerella is not the only bacterium that multiplies during vaginosis, i.e. the absence of gardnerellosis does not mean the absence of bacterial vaginosis; and secondly, gardnerella can normally be present in the vagina, and a positive result of such a highly sensitive method as PCR indicates only its presence, and not its predominance.

A bacterioscopic examination of a smear allows one to detect changes in the flora: the predominance of small rods over normal lactic acid bacteria, and the presence of “key” cells - a picture that occurs only in bacterial vaginosis: these are epithelial cells. “covered” with a small stick.

More accurately, bacterial vaginal vaginosis is determined using bacteriological examination. At the same time, the quantitative ratio of lactic bacteria, gardnerella and other bacteria is determined. This method is especially useful for monitoring the effectiveness of treatment.

3. Trichomoniasis. Refers to STDs. Caused by flagellated protozoa - Trichomonas.

Symptoms: copious, liquid, foamy discharge, accompanied by itching, pain during sexual intercourse. As a rule, the appearance of symptoms is associated with a change in sexual partner.

The diagnosis is made based on complaints and detection of trichomonas in a smear.

Treated with antibacterial drugs together with partners. During treatment you must use a condom.

4. Gonorrhea. It still remains the most common cause of inflammatory diseases of the female genital organs. It often occurs asymptomatically, without exacerbations.

Symptoms: yellow discharge accompanied by itching; itching and pain during urination. The appearance of symptoms may be associated with a change of partner.

The diagnosis is made on the basis of complaints and the detection of diplococci in the smear - bacteria that resemble double balls in appearance, located inside or extracellularly.

Treated with antibiotics at the same time as your partner. For acute gonorrhea, a single dose of antibiotics is sufficient; for chronic gonorrhea, a course is sufficient. Until the fact of cure is established, a condom must be used.

The effectiveness of treatment is assessed 7-10 days after cessation of treatment using bacterioscopy and culture. Smears are taken after 24, 48 and 72 hours, and cultures are taken 72 hours after provocation. Provocation of an exacerbation is carried out with a gonovaccine, a chemical method (lubricating the urethra with Lugol's solution in glycerin), a nutritional (food) method (eating smoked, spicy, salty foods, alcohol), and a thermal method (hot bath). The criterion for cure is the absence of gonococci three times (with an interval of 10 days) in the smear and culture after provocation. Then observation is continued for another 3 months with examination once a month.

II. WHEN A LARGE IS DETECTED IN A smear

white blood cell count without an obvious pathogen; cocci and bacilli that do not form a clear picture of the infections described above are subject to bacteriological examination (culture) to determine sensitivity to antibiotics.

The second indication for conducting a bacteriological study is to establish a criterion for the cure of gonorrhea, bacterial vaginosis and candidiasis. Under the influence of treatment, these pathogens find themselves in unfavorable conditions, their number sharply decreases, and they stop reproducing, so a smear can show their absence, while they only quieted down for a while. Sowing is done on a nutrient medium, in which they again “come to life” and begin to multiply. Therefore, this is a more reliable method of determining the fact of cure.

III. IF AFTER DETERMINATION

causative agents of colpitis and treatment of inflammation, the symptoms remain, and the smear shows the normal state of the vaginal flora with an increased number of leukocytes; the PCR method is used to determine the causative agent.

It allows you to detect microorganisms living inside epithelial cells, therefore not getting into the secretions. In addition, these organisms are very small (smaller than a normal cell), so they are not visible when examined under a microscope. PCR makes it possible to determine the DNA of these microbes in the material, the main molecule that ensures the vital functions of any organism, and on this basis to judge their presence.

To obtain a reliable result, many conditions must be met, in particular, obtaining cell scrapings rather than secretions for research, because The studied microorganisms are intracellular; the use of high-quality reagents, etc. For the diagnosis of the infections listed below, this method is the most sensitive and specific.

However, the PCR method is unsuitable for determining the effectiveness of treatment. Viral diseases are incurable; treatment only makes exacerbations less frequent and complaints less pronounced. Therefore, treatment control is not carried out. And after treatment of chlamydia, myco- and ureaplasmas, their DNA remains in the genital tract for quite a long time (at least a month, but maybe more), which does not indicate the presence of living pathogens. Therefore, to assess the effectiveness of treatment of these diseases, a cultural method (seeding) is used. It allows you to detect only living, reproducing microorganisms, which is a sign of undertreatment. Or they take a PCR test a month later or after the next menstruation.

The definition of the following infections is the last in line when complaining about discharge, because these microorganisms live in higher parts of the reproductive system: in the tubes, uterus, cervix, and do not cause colpitis (inflammation of the vagina). Therefore, first, the most common causes of colpitis are searched for and treated (see above), and only then, if complaints persist, can we say that the discharge is caused not by colpitis (or not only), but by salpingo-oophoritis (inflammation of the uterine appendages), endometritis (inflammation of the uterine mucosa ) or cervicitis (inflammation of the cervical canal).

1. Chlamydia . The second most common disease (after gonorrhea), causing inflammation of the female genital organs. Chlamydia are absolute pathogens, i.e. are not normally present in the genital tract, and their detection, even in the absence of complaints, is an indication for treatment.

Discharge with chlamydia is usually scanty, may be accompanied by itching, and is often combined with pain and itching during urination.

The diagnosis is made using PCR, the effectiveness of treatment is assessed a month after its completion using PCR or culture.

As with all STDs, both partners are treated at the same time, and a condom is used during treatment.

2. Mycoplasmosis . Caused by microorganisms similar to chlamydia, but unlike them, they are non-absolute pathogens, i.e. may be present in the genital tract normally, be detected by PCR and not cause symptoms. Only the presence of symptoms in the confirmed absence of other, more likely infections, and the confirmed presence of mycoplasmas can be an indication for their treatment.

Symptoms and treatment are the same as for chlamydia.

Subtlety: There are several types of mycoplasmas. T.N. genital mycoplasma (mycoplasma genitalium) causes inflammation of the genitourinary system (urethritis, prostatitis) in men and does not cause diseases in women. The causative agent of mycoplasmosis in women is human mycoplasma (mycoplasma hominis). Now it is fashionable to be examined for “everything” using PCR. Do not pay extra money and do not test for genital mycoplasma. Leave it to the men. And it’s even easier to determine not the species, but the genus of mycoplasmas.

3. Ureaplasmosis. Ureaplasma is a close relative of ureaplasma and has the same features.

However, ureaplasma more often than mycoplasma causes inflammation of the genitourinary system. Ureaplasma has 2 biovars, one of which (T960) is often resistant to the traditional antibiotic used for these diseases, doxycycline.

If chlamydia is treated regardless of conditions and complaints, then mycoplasmosis and ureaplasmosis require mandatory treatment only for a planned or ongoing pregnancy. During pregnancy, these organisms become real pathogens and can cause infection of the fetus, miscarriage, and complications of childbirth.

Culture testing for ureaplasmosis and mycoplasmosis is very expensive and is carried out in few laboratories. Therefore, the effectiveness of treatment is assessed by the disappearance of complaints, a favorable course of pregnancy, or, in extreme cases, by the PCR method, carried out no earlier than a month after taking the last pill.

3. Genital herpes. It has specific manifestations, but often occurs atypically, for example, manifesting itself only as periodic itching and pain during sexual intercourse, and minor discharge. Often a herpetic infection is the cause of constantly recurring, incurable candidiasis.

Detection of the genital herpes virus requires periodic monitoring of the condition of the cervix, because it is the second most common cause of the development of its malignant lesions.

Genital herpes needs to be treated if it occurs with frequent exacerbations and complaints, if it is the cause of persistent candidiasis, if pregnancy is planned. Herpes, like any viral infection, is not completely cured, but is suppressed enough to not bother you. The main component of treatment is the specific antiviral drug acyclovir (Zovirax).

4. Human papillomavirus infection . Infection caused by the human papillomavirus. It manifests itself as genital warts on the external genitalia and in the vagina. However, condylomas are not a mandatory sign. Often this infection manifests itself as minor discharge and the development of cervical pathology, even malignant.

There are several types of the virus, the most oncogenic (with the highest frequency of causing malignant diseases of the cervix) are types 16 and 18.

If human papillomavirus is detected, it is necessary to be examined every six months for the presence of cervical pathology, do colposcopy and cytological examination. If pathology is detected, remove it surgically, just like genital warts. Local administration of interferon drugs reduces the likelihood of recurrence of condylomas.

Conclusion:

Thrush is not just a word that means discharge and itching. This is a specific disease caused by fungi .

Discharge and itching (colpitis) can be caused not only by thrush, but also by a number of other infections. Therefore, you cannot diagnose yourself and self-medicate; you need to go to a doctor and determine the specific pathogen. If candidiasis is detected, in addition to prescribing antifungal drugs, you need to examine the body, find the root cause of immunodeficiency, and take measures to increase immunity (vitamins, immunomodulators). Both partners must undergo treatment at the same time, because this disease is sexually transmitted, even if it initially occurs as a sign of immunodeficiency. To be clearer: if you have candidiasis, this does not mean that someone else has infected you, but it does mean that you can infect someone else.

If bacterial vaginosis (gardnerellosis) is detected, in addition to prescribing antibiotics, measures are taken to eliminate the conditions for its occurrence (underwear made from natural fabrics, avoidance of sanitary pads every day, fermented milk diet). The partner is not treated because it's not an infection.

If an STD is detected (gonorrhea, trichomoniasis, chlamydia), treatment is mandatory, regardless of complaints.

When ureaplasmosis and mycoplasmosis are detected, treatment is prescribed only if there are complaints, preparation for pregnancy or pregnancy.

If any infection is detected, all partners are treated simultaneously, regardless of test results. A condom is used during treatment.

The effectiveness of treatment is determined after 7-10 days, for chlamydia, mycoplasmosis and ureaplasmosis - after a month using bacteriological (cultural) research.

Viral diseases (herpes, human papillomavirus infection) are not treated, but are controlled.

Symptoms of colpitis can be caused not only by a vaginal infection. but also inflammatory diseases more than other organs of the reproductive system: uterus, appendages. In this case, treatment is more complex.

During whitish and unpleasant-smelling discharge, every woman, confidently shaking her head, independently makes a diagnosis - thrush. What is this disease? In medicine, very often thrush is not an independent disease - it is bacterial candidiasis. In the vast majority of cases, this disease combines two diseases: bacterial vaginosis (gardnerellosis) and vaginal candidiasis (thrush), which, in fact, means very similar clinical manifestations. During the course of these diseases, the vaginal microflora is disrupted; lack of treatment can lead to problems during pregnancy and after childbirth. In order to be prepared for the manifestation of the disease, you should consider in more detail the symptoms and treatment during thrush.

The etiology of both diseases is absolutely different - despite similar symptoms, thrush usually develops against the background of gardnerellosis, and here's why. The cause of a disease such as bacterial vaginosis is the replacement of normal microflora with pathological one - in this case, the qualitative composition of microorganisms may not even change, but their quantitative relationship changes significantly. Against the background of disturbed microflora, Candida fungi begin to actively multiply and appear, which lead to candidiasis. Moreover, while beneficial to the body in all other cases, lactobacilli in thrush contribute to the proliferation of the fungus.

Causes of microflora disturbances and the development of candidiasis

The following factors can change the qualitative and quantitative composition of microflora:

• Antibiotic treatment.
• Weak immunity.
• Douching with aggressive agents.
• Improper use of personal hygiene items (daily bags, tampons, pads should be used for no more than 4 hours).
• Addiction to too tight clothes and synthetic underwear, which block the access of fresh air to the vagina, which leads to the creation of a “greenhouse effect” - ideal conditions for the development of pathogens.
• Intestinal dysbiosis and thrush are inextricable concepts, since Candida fungus also exists in the intestinal microflora. In this case, complex treatment of two diseases is recommended.

If any symptoms appear, you should seek medical advice and refrain from self-medication - even life-saving pills that promise to cure thrush in one day will not give results if the diagnosis is incorrect. In addition, incorrect treatment will lead to a number of side effects, which may later cause difficulties in trying to get pregnant.

For recovery, doctors prescribe step-by-step treatment of the disease for a visible clinical effect and elimination of possible consequences:

• The first stage is the destruction of pathogenic microorganisms that disrupt the imbalance in the vaginal microflora. For this, local treatment with suppositories or tablets containing antibiotics is recommended: Metrogyl, Trichopolum, Metronidazole, Clindamycin. In case of intestinal dysbiosis, the doctor simultaneously prescribes medications that normalize the state of the intestinal microflora.
• The second stage is the restoration of normal vaginal microflora. For this purpose, preparations based on beneficial bacteria (eubiotics) are used: Bifidumbacterin - suppositories for thrush, which effectively restore the normal balance of the vagina.
• The third stage is taking immunomodulatory drugs - prebiotics, based on bifidobacteria, which actively fight the proliferation of pathogenic vaginal microflora.

Additional measures for candidiasis are: avoiding synthetic underwear, maintaining personal hygiene at the proper level, avoiding sexual relations for a while, and following a diet prescribed by a doctor. Treatment of the disease on average lasts at least 2-3 weeks - even if symptoms disappear before this period, you must take medications as prescribed by your doctor for the entire specified time. Only after repeated tests and the doctor’s approval that the microflora has been successfully normalized can you return to your normal rhythm of life.

Bacterial candidiasis is a disease that includes symptoms of two diseases: gardnerellosis and thrush (candidiasis). These two diseases are closely intertwined. Given the impact of pathogenic yeast fungi of the genus Candida, the microflora of a woman’s vagina suffers.

Considering that when immunity decreases and microflora is disrupted, bacterial diseases often arise, one of which is bacterial vaginitis. In turn, bacterial vaginitis provokes the activation of fungi, which leads to the appearance of thrush (candidiasis).

Classification of disease symptoms

With bacterial vaginosis, the number of lactobacilli decreases, and the number of anaerobes and aerobes increases from 100 to 1000 times. Mycoplasma, gardnerella, bacteroides, peptostreptococci, peptococci and other bacterial flora are also detected. In this case, the pH of the vaginal environment shifts to the alkaline side. The reasons for such violations are the following:

• Endocrine system disorders.
• Taking broad-spectrum antibiotics.
• Diseases of the genital area (infectious and inflammatory).
• Long-term use of various methods of contraception.
• Frequent douching.
• Weakened immunity of the body system and, in particular, vaginal barriers.

Vaginal candidiasis and bacterial vaginosis affect the vaginal mucosa, but it is necessary to distinguish these diseases from each other.

Clinical manifestations of vaginal candidiasis

Symptoms:

• Itching and burning in the genitals. In an acute process, these symptoms are pronounced.
• Discharge. Curdled or creamy, white. The quantity varies.
• The smell of discharge. Characteristic of kefir, mild.
• Pain during urination and sexual intercourse. Characteristic for an acute process.
• Swelling and redness of the vaginal mucosa. Always available. In an acute process they are pronounced. In chronic cases, to a lesser extent.

Clinical manifestations of bacterial vaginosis

Symptoms:

• Itching and burning of the genitals. Not always present.
• Discharge. Viscous, homogeneous and foamy. Color – white or yellowish-green. May have a cheesy appearance.
• The smell of discharge. Unpleasant odor, reminiscent of fish.
• Pain during urination and sexual intercourse. There is no characteristic pain.
• Swelling and redness of the vaginal mucosa. Mucous, without signs of inflammation. There is no redness or swelling.

You need to know that candidiasis is caused by yeast. This type of disease is transmitted sexually. Vaginitis is an inflammatory disease. The source of inflammation is bacterial infections, which are often not sexually transmitted.

Treatment of bacterial candidiasis

Candidiasis, which is accompanied by bacterial vaginitis, arouses patients' interest in the method of treatment. It is necessary to know the pathogenesis of the disease. Existing underlying diseases (underfunction of the thyroid gland, diabetes mellitus, inflammation of the cervix, disease of the genital organs) - all this must be treated, since all of the above diseases can be the cause of the disease. Gynecologists usually recommend Itraconazole, Fluconazole and other antimycotic drugs that affect bacterial candidiasis. Treatment of vaginosis is represented by the following drugs: Ornizadol, Clindamycin, Metronizadol.

Note that the optimal combination of bacterial vaginosis and vaginal candidiasis is the use of drugs that simultaneously affect both the fungus and the opportunistic bacterial flora. Such a remedy is Metrogyl Plus ointment. It is inserted into the vagina in an amount of 5 g twice a day. The course of treatment is 5 days. This drug contains Metronidazole, which attacks bacteria, and Clotrimazole, which kills fungus. Treatment with this drug is 94% effective. To normalize the vaginal microflora, bifidobacteria and lactobacilli are used. They are used both internally and locally - on tampons.

Treatment during pregnancy

First of all, I would like to say that a pregnant woman must undergo all examinations that the doctor prescribes for her. These are examinations for sexually transmitted diseases and inflammatory processes. It is very important to protect the unborn child from infection. Bacterial candidiasis, as a rule, is treated topically during pregnancy, acting directly on pathogenic fungi and microorganisms. After quality treatment, the doctor recommends medications that restore the vaginal microflora. After the course of treatment, laboratory tests are prescribed to make sure that the disease has been cured. If the case is complex (the woman has bacterial candidiasis and the symptoms are pronounced), the woman is recommended to have a caesarean section during childbirth.

Disease prevention

Measures to prevent this disease are of great importance, therefore it is necessary:

• Observe hygiene standards (wash daily, change underwear).
• Remember about the prevention of sexually transmitted diseases (use condoms, use antibacterial suppositories). Especially in cases where sexual partners are casual and change frequently.
• Keep the immune system and microflora of the genital organs under control. These measures include normalization of nutrition, daily routine, as well as hardening and walks in the fresh air.

Folk remedies

1st recipe. Grate two medium-sized carrots on a fine grater and squeeze out the juice. 10 cloves of garlic - crushed. Chop a small head of cabbage, put it in a saucepan, add 2 cups of water and boil for 15 minutes. After this, add carrot juice, garlic, boil for 1 minute and remove from heat. When the product has cooled, strain and take ½ glass before meals twice a day.

2nd recipe. Pour 2 tablespoons of dry rowan with 2 cups of boiling water and simmer for 15 minutes over low heat. Remove from heat, add 2 tablespoons of honey and let steep for 4 hours. After this, grate 2 onions and mix with rowan infusion. Take a tablespoon 3 times a day before meals.

All recommendations that you read in this article are for informational purposes only and not a guide to action. Only a doctor, based on laboratory tests, can establish a diagnosis and prescribe qualified treatment.