It is no exaggeration to call the vaginal microflora the most sensitive of the microflora. Even the skin community of microorganisms does not respond so sensitively to the slightest changes in the conditions of existence, despite the fact that skin microbes live outside, “on the seven winds and on the seven rains”.
There are many myths concerning the inhabitants of the vagina. At the end of the last century, such an allegedly sexually transmitted infectious disease as gardnerellosis was widespread. This disease was caused by the insidious bacterium Gardnerella vaginalis (translated as “Gardnerella vaginalis”), hence the name. The main symptom of gardnerellosis was abundant discharge from the vagina, which has an unpleasant smell similar to the smell of not very fresh fish.
Doctors treated gardnerellosis and, I must say, sometimes they succeeded…
Women counted among their partners the one who infected them with gardnerellosis…
Men did not suffer from this unpleasant disease, but they could easily act as a carrier-distributor…
Some doctors diagnose gardnerellosis to this day…
But in fact, such a disease does not exist! Not in the sense that humanity has managed to” defeat “gardnerellosis in the same way as it” defeated ” smallpox, but in the sense that this disease is nothing more than a violation of the normal balance of the vaginal microflora – vaginal dysbacteriosis or, if quite scientifically, bacterial vaginosis.
Vaginosis can be compared to a revolution. Suddenly, the power changes. Those who used to rule the ball die or run away in panic. They are replaced by oppressed folk, that is, bacterial masses. Who was nothing becomes everything.
“All” in the literal sense of the word. Lactobacilli, also known as lactobacilli, also known as lactic acid bacteria [35], normally make up about ninety – five percent of the vaginal microbial population. In bacterial vaginosis, lactobacilli give way and power to Gardnerella and their “henchmen”, whose number normally does not exceed five percent of the total number of microorganisms.
It would seem-what is the difference between gardnerellosis and vaginosis? As they say: “what’s in the forehead, what’s on the forehead.” The essence is the same-active reproduction of Gardnerella.
The same, but not very much. A clear understanding of what is happening allows you to successfully treat diseases. If in the treatment of gardnerellosis you need to focus on the suppression of harmful Gardnerella, then in the treatment of vaginosis, the emphasis is on restoring the normal balance of microflora, on supporting lactic acid bacteria, these “sentinels of love” that make a woman’s sex life pleasant and hassle-free.
“What the hell kind of’ love sentinels ‘ are they if they cause thrush?! – some readers will say angrily now. “They are pests, not sentries!”»
This is the next myth – the myth that thrush is caused by lactic, that is, lactic acid bacteria. How could it be otherwise? The title is clear…
From the name, you might think that a hydrogen bomb is filled with hydrogen gas. A “grasshopper” is not an insect, but the son of a blacksmith. Do not confuse the cause with the effect, vaginal candidiasis received the household name “thrush” because of the white curd secretions observed in this disease. Lactic acid bacteria have nothing to do with it.
Lactobacilli do not just make up the vast majority of normal vaginal microflora. Nothing happens “just like that” in nature. Lactobacilli in the vagina to the place and to the point. They protect their habitat from outsiders who strive to settle in this wonderful place.
The vagina from the microbial point of view is a Paradise on earth (let’s do without vulgarities and smirks, and talk to the point). True Paradise – it is warm, humid and, in General, safe. This is not something you can live on, under the constant threat of”flooding”.
The more attractive the habitat, the more willing it will be to colonize and the stronger its protection from possible invaders should be.
Nature did not accidentally pick up lactobacilli to populate the vagina. Lactobacilli produce lactic acid, making the vaginal environment acidic, unfavorable for most microorganisms. In addition to acid, they also produce lysozyme, an antibacterial enzyme that destroys the cell walls of bacteria and protozoa. The same lysozyme that is contained in our saliva, giving it a bactericidal property, although not very large, as well as in breast milk.
Lactic acid in combination with lysozyme – it’s like the infantry, reinforced by tanks. The one who pokes his nose, definitely will not be well.
But in addition to “infantry” and ” tanks “there is also” artillery ” – hydrogen peroxide, produced by lactobacilli along with lactic acid and lysozyme.
Hydrogen peroxide H2O2 is not only a means for hair bleaching, but also a very active chemical that readily enters into various kinds of reactions. As a result of these reactions, monatomic oxygen O is split off from the hydrogen peroxide molecule, and the peroxide turns into water H2O.
Monatomic oxygen can be compared to a projectile fired from a cannon. It “flies” in space and looks for a place to get to, something to enter into a chemical reaction with. If monatomic oxygen comes across the membrane of a microorganism, it will react with some of its component, that is, in fact, it will punch a hole in the membrane. One or two “holes” can be closed, but if the membrane turns into a kind of sieve, the cell will die.
But this is not all… If the enemy managed to overcome all the barriers put up in front of him, lactobacilli rush into hand – to-hand combat-stick to “foreign” microorganisms, thereby causing their death. These are the universal defenders.
It begs the question-why with such protectors as lactobacilli, nature needed to populate the vagina with Gardnerella, streptococci, thrush-causing fungi of the genus Candida and about three hundred other types of microorganisms? Is it really based on the “fly in the ointment” rule, according to which this spoon must necessarily be present in every barrel of honey?
After all, how good it would be if only useful lactobacilli lived in the vagina. Women would not know what vaginosis and thrush are… by the Way, maybe we should preventatively treat all women, achieving one hundred percent representation of lactobacilli in the vaginal microflora? So to speak, for preventive purposes?
Why do definitely useful lactobacilli need neighbors that can cause diseases? Wouldn’t it be better to do without them?
Try to answer this question yourself. After all, you already know about Microbiology, have read this book almost to the end (there is only one Chapter left to read), so you can easily find the right answer.
Five minutes to think. Or ten. In short, think as much as you need…
Here’s a hint: “that’s why the pike is in the sea, so that the carp does not sleep.” Turn this hint inside out and get what you need.
Why is the carp in the sea, so that the pike does not sleep?
Yes! Exactly! Conditional “carp”, the same three hundred species of microorganisms that make up five percent of the total number, are needed in order to constantly maintain the “pike” – lactobacilli in combat condition. To ensure that the production of lactic acid, lysozyme and peroxide would not stop either day or night. It is well known that the presence of competitors is the best incentive for business development. Neighbors do not allow lactobacilli to relax, and sometimes they can almost completely replace them.
Yes-replace! And this is not a myth or a joke. About five (and according to some data – ten) percent of healthy women in the vaginal microflora is not dominated by lactobacilli, and their neighbors (but not Gardnerella and fungi of the genus Candida). So the presence of neighbors in lactobacilli can be considered as a kind of safety measure, a natural reserve.
But let’s go back to the myths.
Here is the next myth – a woman can get gardnerellosis from her sexual partner, but it is impossible to get thrush.
In fact, Gardnerella, the carrier of which can be a partner (only the carrier-men do not suffer from gardnerellosis or something similar), can not provoke the development of vaginosis in a woman, that is, a rapid reproduction of Gardnerella, and then other bacteria. For the development of vaginosis, internal causes are needed, and factors that cause a violation of the balance of microflora are needed. If this violation is not present, the gardnerells received from the man will not change anything. If there is a violation, then they… will not change anything either – their gardnerells will “take over” without outside help.
But with fungi of the genus Candida, the situation is different. A woman can get an active strain of “candidates” from a partner, which will begin to multiply intensively in the vagina, suppressing all other microorganisms. As a result, candidiasis will develop.
But for all that, candidiasis is not considered a sexually transmitted infection. Doctors have their own formalities and problems – according to the accepted rules, the causative agent of sexually transmitted infection can not be a natural inhabitant of the human body. And fungi of the genus Candida (even if not all types) are a component of the normal vaginal microflora.
Regarding the treatment of candidiasis, there are many similar myths in their spirit, which can be conditionally combined into the myth that candidiasis, that is, thrush, does not require specialized antifungal treatment, but can be treated with “General strengthening”, “stimulating the immune system” and still do not understand what means. The quotation marks are not accidental, because the means used have nothing in common with Immunostimulants, and General tonic means, if you want to know, do not exist in nature at all. The doctors jokingly say they know of only one fortifying agent is a bullet – proof vest. Jokes are jokes, but there is a lot of truth in this joke. All right, let’s have not only a bulletproof vest, but also armor with chain mail. But not drugs, because each of them has a specific effect, and does not” strengthen the body ” at all. Where is the logic? Where is the mind? And anywhere else!
The range of products used to treat thrush is incredibly wide, starting with the wearing of copper bracelets on the wrist (well, what can be the connection?) and ending with injections of various vitamins. What’s wrong with that? Don’t vitamins have a tonic effect? So let them strengthen the entire body, including the vagina…
By the way – about vitamins, since they are remembered.
Vitamins in our time are considered something like the elixir of life in the middle Ages. Vitamins are necessary, vitamins are important, without vitamins nowhere, and, of course, vitamins have the proverbial tonic effect (with the same success, that is, with the same share of logic, you can say that vitamins allow a person to fly).
But do you know what vitamins are?
The great Google will tell you that these are organic substances of various chemical nature and relatively simple structure, which are vital to our body, but are not produced in it, and therefore we must get them from outside. Normally – with food, in diseases-in tablets or injections.
Each vitamin has its own action – its own role, its own purpose, its own place in the metabolism. For example, group d vitamins provide absorption of calcium and phosphorus from food masses in the small intestine, and vitamin PP, aka nicotinic acid or vitamin B3, participates in a number of metabolic reactions. But not a single vitamin may not provide an antifungal effect. However, this effect can be achieved logically – vitamins are involved in metabolic processes, therefore their presence contributes to normal metabolism and energy, and this, in turn, is the key to a good functioning of the immune system… and so on. But you can logically go a lot of places. For example, you can prove that the moon has its own special form of life. In fact, there is no life on the moon.
In fact, candidiasis is treated with antifungal agents. You can take any number of measures to restore the normal balance of the vaginal microflora as soon as possible, using probiotic drugs in the form of candles, etc., but this will not be of any use. First, you need to “curb” candidiasis. Until the population of propagated fungi is destroyed (reduced to a natural minimum), no other microorganism can reproduce normally in the vagina – the fungi will crush it with their number. And when this is done, the normal microflora will “rise from the ashes” – it will recover by itself, without any help. Therefore, the need for probiotics in the treatment of candidiasis is another myth that we have just debunked. The introduction of Lactobacillus strains from outside after the cure of candidiasis is necessary in rare cases, that is, this is an exception to the rule, and not the rule.
And the “preventive” use of probiotics, in order to suddenly not develop candidiasis – is also nonsense, a myth born by the manufacturers of these drugs. What works well does not require repair, and the normal balance of microflora does not need such “preventive” measures.
Do you think that probiotics still do not hurt? Or do you use the well-known demagogic argument “there will be no harm from them”? Yes, from useless there is no harm, but do not forget that this useless you get for living blood money, from the sky it does not fall into your hands. So the harm from a useless drug is there-damage to the wallet.
And in order to visualize the mechanism of such “prevention”, you can make a simple experiment. Put a glass on the table and fill it to the brim with water. Then try adding a little more water to a full glass. Evaluate the result, then wipe the puddle, pour the water out of the glass, and never again engage in nonsense, no matter how much you might be tempted to do so by advertising.
The same can be said about the use of probiotics in bacterial vaginosis. But prebiotics, that is, drugs that stimulate the growth of lactobacilli, in some cases are used and give a good effect. But they should be applied to the place, not indiscriminately to everyone, but according to a doctor’s prescription, in cases when they are actually needed.
It is possible that now one of the readers will remember that she or her friend’s candidiasis was cured with the help of some fufloimmunoactivator or labudoimmunostimulator. Here is really-took and disappeared. For a while, then come back. But he was gone, gone! I haven’t bothered you for three months, so that’s a recovery, right?
This “recovery” is another myth – the myth that an infectious disease can be cured without direct action on its pathogen. The fact is that periods of activity in colonies of microorganisms are accompanied by periods of relative rest. Untreated candidiasis has passed from an acute form to a chronic one and from time to time it will remind you of itself. But the interval between the attenuation of the acute process and the first outbreak of the chronic, as well as the intervals between further exacerbations of the “chronicle”, can be optimistically regarded as a recovery. “Why does this damned fungus (microbe) love me so much that it keeps coming back to me?!”- people complain. No, in fact, there is no return, since the return involves a preliminary departure, parting. And the infectious agent did not leave you anywhere, it just lay down to rest for a while.
The undulating course of chronic infectious diseases, that is, alternating periods of exacerbation with periods of relative calm, gives charlatans an excellent opportunity to shout about the effectiveness of their “miracle” medicines. Has your condition improved? So the medicine helps! But in fact, the body’s immune system has repelled another microbial attack and now the microbes are gaining strength before the next one.
Let’s also debunk another myth that is not directly related to microbiological myths, but is a General medical one. According to this myth, the patient’s well-being is the main and main criterion for curing the disease. There is a certain logic in this – if I feel good, it means that I am all right. But it is not always possible to rely on your well-being without the risk of being deceived. The painful process (any – from infectious to oncological) may not disappear, but subside, decrease to imperceptible limits. But the time will come when it will “raise its head” again, just as a new fire may be kindled from a single remaining ember. Therefore, the cure of the disease (or elimination of exacerbation) can only be stated by a doctor. Doctors have a whole set of criteria for each case. For example, you should complete the treatment of candidiasis or vaginosis after a vaginal smear confirms the fact of restoring the normal balance of microflora, and not immediately after the disappearance of secretions and unpleasant sensations like itching.
In the case of infectious diseases, premature termination of treatment is fraught with rapid emergence of resistance to the used antibiotics or, say, antifungal drugs. The last to die are the most resistant microorganisms to the action of the antibiotic, a kind of “guard”, the percentage of which in the colony as a whole is small. But if the antimicrobial treatment is stopped early, the restored colony will consist entirely of “guards”. Like this. Remember this.
PostScript. “Sentinels of love” are different from lactobacilli that live in the colon. The genus is the same-Lactobacillus, but the species are different. And they also differ from Lactobacillus acidophilus, which turns milk into kefir in cooperation with other microorganisms. So an unconventional method of treating vaginosis with a tampon soaked in kefir, in addition to direct harm in the form of local irritation, will no longer have any effect and will not bring any benefit. The use of kefir to treat bacterial vaginosis is not just a myth, but a stupid “pest” myth.