First of all, let’s understand what is the normal state of the vagina.
Like all open cavities of the body, it is inhabited by a variety of microbes. Some of them that fall on the mucous membranes, can not stay there for a long time – they are expelled by the flow of mucus or urine, and those microorganisms that are able to stay and multiply under these conditions constitute the normal microflora of the vagina.
If the process of attachment and the formation of new microbes is not accompanied by inflammation, it is called colonization, if at the time of the appearance of bacteria the tissue is damaged, then it is about the development of infection.
Normal microflora protects the vagina from harmful microorganisms. It contains a lot of bacteria (108–1010 microbial cells / 1 g of secretions). First of all, the composition of microflora depends on whether a woman has problems with the monthly cycle and hormone production.
If everything is in order with both of them, the lactobacilli, which form hydrogen peroxide and protect their “home” from harmful bacteria, will settle in the vagina. In addition, they produce lactic acid, lacticidin, acidophilin and lactocin B – these substances also help to fight “uninvited guests.
Other bacteria live in the vagina: staphylococcus, streptococcus, intestinal or anaerobic bacteria. And sometimes they are made up of mycoplasmas, ureaplasmas, and gardnerella. However, having learned about it, you should not worry: the main thing is that these microorganisms are in the right proportion with each other.
As long as the balance between them is not broken, they will not create problems. If for some reason the living conditions in the vagina change, for example, during pregnancy, this may result in the appearance of the disease.
The composition of the microflora of our secluded places varies depending on the age and hormonal changes in the woman’s body. During the one-month cycle, young women who are ready to conceive a child change both the quantity and quality of the germs in the vagina.
So, at the time of menstruation and after love contacts, the number of lactobacilli decreases, and the intestinal bacteria, enterococci and streptococci become larger.
Due to irregularities in the vaginal microflora, such trouble as bacterial vaginosis can occur. This disease does not apply to sexually transmitted infections.
It usually begins when the normal microflora of the vagina, consisting mainly of lactobacilli, is supplanted by those types of bacteria that should be present here in small quantities.
How does bacterial vaginosis manifest? As a rule, he declares himself an abundant liquid discharge with an unpleasant smell, reminiscent of spoiled fish. To cure the disease, the doctor will need to find and eliminate the cause of its occurrence; In addition, the doctor will prescribe drugs to the patient to combat harmful bacteria and means that will help restore the normal vaginal microflora.
As for the prevention of bacterial vaginosis, experts advise women to be less nervous, not to wear too tight clothes between the legs (for example, jeans), synthetic underwear and pantyhose without cotton crotch. In addition, you should not get involved in a thorough and deep toilet of the vagina, because attempts to flush it from the inside, for example, with the help of a syringe, can lead to the fact that normal bacteria will just be washed out of their shelter.
Do not forget that the appearance of imbalance in the vagina can lead to treatment with antibiotics.
And what happens if representatives of the normal microflora of the vagina fail to cope with the appearance of harmful bacteria? In this case, a woman can get into trouble: thrush (another name is vulvovaginal candidiasis, candidiasis, mycosis), trichomonas or nonspecific colpitis.
Let’s talk about each of them in more detail.
1) According to statistics, about 70% of women at least once in their life were treated for thrush. At the same time, 40–50% of the fair sex had repeated outbreaks of the disease, and 5% had an unpleasant chronic form of candidiasis. The disease occurs due to hormonal disruptions in the body, as a result of weakened immunity, after treatment with antibiotics. Usually, fungi that live in the body, for example in the intestines, act as the causative agent of thrush.
However, sometimes candidates are transferred from partner to partner. While there are few yeast-like fungi in the vagina, they do not cause problems.
If for some reason they begin to multiply, the woman appears “cheesy” (thick and with flakes) discharge of white color, severe itching in the genital area, and sometimes even a burning sensation at the moment of going to the toilet “in a small way”. In men, Candida causes inflammation of the glans penis, foreskin and urinary organs.
2) Nonspecific (bacterial) vaginitis, or colpitis, begins due to the multiplication of harmful microorganisms – staphylococci, streptococci, intestinal bacteria, mycoplasmas. As a result, the woman has an unusual vaginal discharge: yellow, with pus.
In addition, the patient may complain that she often has to run to the toilet “in a small way”, and during sexual intercourse there is pain.
3) Trichomoniasis (experts also call it Trichomonas vaginitis, or colpitis) refers to diseases that are transmitted sexually. It is caused by the simplest parasites – Trichomonas, which can be found on wet towels, swimsuits or toilets in public places. The onset of the disease is characterized by itching, burning in the vaginal area, pain at the time of visiting the toilet “in a small way”.
Plus, the woman appears abundant white, sometimes frothy discharge with an unpleasant smell.
During pregnancy, the microflora of the vagina of the expectant mother becomes more homogeneous, it is represented mainly by lactic acid bacteria (their number increases 10 times). It would seem that with the increase in the number of microbes defenders, a woman and her child should not be threatened.
But, alas, simultaneously with the predominance of lactobacilli, the acidic environment of the vagina is changing, which, coupled with the suppression of the immune system during pregnancy, creates conditions for the growth and reproduction of other microorganisms from among its inhabitants.
Frequent manifestation of this process – thrush, or vulvovaginal candidiasis. It happens that thrush pursues the future mother during the entire pregnancy and is difficult to treat. Despite the seeming harmlessness, it should always be treated.
In addition to discomfort, it causes inflammation of the mucous membrane of the labia and vagina. As a result, the mucous membrane becomes more vulnerable and can easily be injured during childbirth.
In addition, there is a risk that the pathogen from the genital organs of the expectant mother will get to the child during the birth. Therefore, at the 36th week of pregnancy, all women take a smear from the vagina for flora and, if necessary, prescribe treatment.
Sometimes it is possible to cope with the situation by local means (candles), but pills are also often prescribed.
Another problem that can occur during pregnancy is bacterial vaginosis, when the number of lactobacilli decreases, unsafe bacteria colonize the vagina (leptotriks, gardnerella, mobilunks, peptostreptokokki, etc.) and so-called “key cells” appear (particles of the vaginal surface, sticked sticks. microbes). With the detection of bacterial vaginosis, even if the expectant mother has no complaints and the diagnosis is made based on the smear results, she is prescribed a treatment.
And finally, another condition that is characterized by the “rebellion” of its own microflora during pregnancy is nonspecific vaginitis, when representatives of the dangerous vaginal microflora begin to grow and multiply (streptococci and staphylococci of various varieties, mycoplasmas, etc.). Since in some cases the problem may not bother the future mother, the diagnostic test, based on which the decision on the need for treatment is made, will be the method of seeding microorganisms with the determination of their sensitivity to antibiotics.
Nonspecific vaginitis, like all the problems listed above, must be treated at any stage of pregnancy, and here’s why. During pregnancy, a smear on the vaginal flora is taken three times – in I, II and III trimesters.
Very important will be his results closer to the date of birth. The fact is that this process provokes the spread of an infection in the body, because the birth is accompanied by blood loss, leaving behind wound surfaces; Plus, the normally sterile uterine cavity during movement of the child through the birth canal communicates with the non-sterile vagina, and all this creates conditions for the spread of dangerous germs from the vagina up into the uterus and to the child.
That is why by the time of the onset of labor, the infection needs to be managed, and if the doctor prescribes antibiotics to the expectant mother, do not be afraid to take them, because the presence of disease-causing agents can cause much more harm than a properly chosen drug.