Not all thrush that itches: the microflora of the vagina can be disturbed for other reasons. Before you drink or insert something, you need to understand the diagnosis.
Catch the algorithm of actions for any unpleasant discharge – and share it with your friends.
The vaginal microbiota is a whole ecosystem with a complex balance of microorganisms. Normally, 95% of it consists of lactobacilli, and the remaining 5% includes opportunistic microorganisms . As soon as the system falters, a woman is faced with a set of unpleasant symptoms:
How wrong to do
When faced with symptoms in the right column, most women self-diagnose thrush, or vulvovaginal candidiasis. However, calling any unpleasant discharge thrush is a gross oversimplification. In the vagina, in addition to Candida fungi, there are other opportunistic microorganisms, the growth of which can cause similar symptoms.
“Women self-medicate, but the antifungal drugs they choose have nothing to do with the effect on other causes of discharge,” says Olga Anatolyevna Pustotina, MD, obstetrician-gynecologist, professor at the Department of Obstetrics and Gynecology with a course in reproductive medicine at the Academy medical education. F.I. Inozemtseva.
Conclusion: even the most expensive antifungal drugs will not help if the violation of the microflora is not caused by candidiasis.
“Women self-medicate, but the antifungal drugs they choose have nothing to do with the effect on other causes of discharge,” says Olga Anatolyevna Pustotina, MD, obstetrician-gynecologist, professor at the Department of Obstetrics and Gynecology with a course in reproductive medicine at the Academy medical education. F.I. Inozemtseva.
Conclusion: even the most expensive antifungal drugs will not help if the violation of the microflora is not caused by candidiasis.
How to
Sexually Transmitted Infections
Trichomoniasis, mycoplasmosis, chlamydia, gonorrhea – with these sexually transmitted infections (STIs), abnormal discharge is also possible. Calm down: STIs are found in only 9 out of 100 patients who complained of atypical discharge. “Moreover, 90% of STI cases are asymptomatic,” says our expert. But it is still worth making sure that they are absent since these infections must be treated even with asymptomatic treatment and certainly in pairs.
Get a doctor’s order for tests
It is recommended to conduct a gynecological examination and measure the vaginal pH. Without this, it is impossible to diagnose vaginal dysbiosis. If necessary, an additional examination is carried out: microscopy of the vaginal smear is done, if possible, PCR diagnostics.
Get the correct diagnosis
It could be:
Bacterial vaginosis is a non-inflammatory process caused by an increase in the number of opportunistic anaerobic bacteria (Gardnerella vag., Atopobium vag).
Vulvovaginal candidiasis (thrush) is an inflammatory process caused by the growth of a fungus of the genus Candida.
Aerobic vulvovaginitis is an inflammatory process caused by an increase in the number of opportunistic aerobic bacteria.
Among patients with complaints of vaginal discharge, only 22% are diagnosed with thrush. Aerobic vaginitis – in 10%. Bacterial vaginosis – in 38%. A combination of certain microbiome disorders – in 30%.
Start treatment
Each of the three states is different. An antifungal drug for thrush cannot cure bacterial vaginosis or aerobic vulvovaginitis, and vice versa.
There are many other subtleties. For example, bacvaginosis can be combined with candidiasis. Or be caused by a combination of several types of opportunistic microbes . This makes “narrowly targeted” therapy ineffective. “In some cases, it is better to use combined preparations with a wide spectrum of action: against bacteria, fungi, and protozoa at the same time,” the expert adds. And a great advantage of such antimicrobial drugs is that do not disturb the balance of the vaginal microflora and retain lactobacilli.
Today, much attention in professional communities is paid to the concept of “couple therapy”, when not only the woman but also her sexual partner undergoes examination and treatment. And it doesn’t have to be for STDs. The same candidiasis or bacterial vaginosis can provoke inflammation in the sexual partner.
Here it is necessary to turn to specialists who know that there are drug manufacturers with a professional approach to the problem of couple therapy and can offer a ready-made solution in one brand when the line includes different dosage forms: vaginal capsules, tablets, and cream.
And if unpleasant discharge appears again and again?
It happens that the diagnosis is established, but the treatment does not help for long. Then you need to look for the reason why the balance of the vaginal microbiota is disturbed. Several factors can negatively affect it:
- Violation of the intestinal microbiota;
- Promiscuity and a large number of partners;
- Rejection of barrier methods of contraception;
- Infectious and inflammatory diseases of the pelvic organs, including chronic ones;
- Excessive intimate hygiene (unreasonable use of antiseptics, douching);
- Foreign bodies in the vagina (sutures, pessaries);
- The use of medicines (antibiotics, hormonal drugs);
- Decompensation of chronic diseases (diabetes mellitus);
- Violation of the anatomy and/or function of the pelvic organs (pelvic organ prolapse, urinary incontinence).
“Bacterial vaginosis itself is not a disease. This is a symptom of some kind of trouble in the body, says Olga Anatolyevna Pustotina. “The task of the patient and the doctor is to create conditions for normal microflora.”
