Gardnerellosis in women: causes, symptoms and treatment, can men get gardnerellosis?

Gardnerella or gardnerellosis is a female disease. The causative agent of the disease is considered to be the microorganism Gardnerella vaginalis. Essentially, this is an imbalance of microflora in the vagina. Bacterial vaginosis is also called gardnerellosis.

The normal state of the vagina is characterized by a predominance of lactobacilli. They help form lactic acid and hydrogen peroxide. This does not provide conditions for the proliferation of opportunistic microorganisms. The causative agent is opportunistic, which is always present in the vagina. Normally there is little of it, it is in a dormant state.

The causes of vaginal dysbiosis are:

• douching;
• some vaginal contraceptives;
• change of sexual partner.

During the disease, other opportunistic microflora are also activated - mycoplasma and anaerobic infection.

People consult a doctor about gardnerella as often as about thrush. According to the old classification, this is an STI, but according to ICD 10, Gardnerella is not classified as an STI. The most common lesions are the vagina, cervix and urethra.

The disease in women is characterized by the presence of scanty or copious discharge from the vagina and urethral canal. Characterized by discomfort in the genitals, itching and burning. Coitus can be painful. The discharge has a characteristic “fishy” odor.

But sometimes the disease for certain women with good immunity proceeds unnoticed. They pose a risk of infecting their sexual partners.

For men, damage to the urethra and the occurrence of sluggish urethritis are also possible. It is even possible to develop chronic prostatitis or inflammation of the foreskin.

The bacterium was discovered and described in 1955. The name of one of the scientists who discovered the bacterium, G. Gardner, became the basis for the name of the pathogen.

The incubation period usually corresponds to a week - one and a half, sometimes up to five weeks.

General description of gardnerellosis

This is a phenomenon in which an imbalance of the vaginal microflora occurs. It does not belong to the group of sexually transmitted infections.

The disease is associated with the accelerated reproduction in the vagina of opportunistic microorganisms, among which gardnerella predominates.

Gardnerella vaginalis is a type of microorganism that, under normal conditions, is present in the vaginal microflora. This bacterium develops in the absence of air. Under favorable conditions, it develops quickly and displaces the bacteria that make up the normal microflora of the urethra and vagina. Under such conditions, the level of lactobacilli that produce lactic acid is significantly reduced.

During the process of reproduction, Gardnerella secretes amino acids, from which amines are formed - compounds that give vaginal discharge a specific unpleasant odor.

These pathogenic microorganisms create conditions for the development of diseases of the genital area, so gardnerellosis must be treated.

Prevention

Women who periodically encounter diseases such as bacterial vaginosis should pay attention to the state of the immune system. Indeed, in most cases, it is the decrease in immunity that becomes the main cause of disruption of the vaginal microflora and leads to frequent hormonal disruptions in women.

Among the most important methods for preventing gardnerellosis are the following:

• active lifestyle;
• proper nutrition;
• healthy sleep about 8 hours a day;
• maintaining intimate hygiene;
• timely visit to the gynecologist;
• having a permanent sexual partner;
• positive attitude.

Thus, in order to prevent the development of a large number of Gardnerella vaginalis in the vaginal microflora, you should try to eat a large amount of fresh vegetables and fruits, drink a lot of water, and include daily walks in the fresh air in your daily schedule. To strengthen the immune system, it is also important to engage in some kind of sport, to toughen up, to have a good mood and a positive attitude. It is also important to wear loose underwear made of natural fabric and prevent hypothermia.

If you have casual sex, you should not forget about condoms. In addition, it is advisable to treat the external genitalia with antiseptic drugs within two hours after intercourse.

Experts do not recommend that women douche during treatment for the disease. The fact is that in this way the natural lubricant is washed out of the vagina and the acidity changes. It is also not advisable to use soap. All this leads to drying out of the mucous membrane and gives impetus to the development of pathogenic microorganisms. Therefore, it is better to use a regular shower and special products for intimate hygiene as hygiene procedures.

To maintain the health of the female genital organs, it is imperative to monitor the state of the intestinal microflora. In case of any gastrointestinal disorders, it is necessary not to delay treatment. The fact is that opportunistic microorganisms living in the intestines can easily penetrate directly into the vagina through a thin wall. Some experts agree that treatment of gardnerellosis is most difficult in patients with intestinal dysbiosis.

Causes

Violation of vaginal dysbiosis and the development of genitourinary diseases against its background occurs due to factors such as:

• unbalanced diet, lack of fermented milk products in the diet;
• promiscuity in sexual relations;
• wearing underwear made of synthetic materials that fits tightly to the body;
• taking antibacterial drugs;
• prolonged use of intrauterine contraception;
• the presence of sexually transmitted diseases (trichomoniasis, chlamydia);
• use of hygiene products containing chemicals, fragrances, fragrances;
• vaginal douching using antiseptics;
• immune system disorders;
• diabetes mellitus and other pathologies of the endocrine system;
• stress, emotional tension;
• hormonal disorders;
• frequent use of barrier contraception. Lubrication of condoms can cause the proliferation of fungi and gardnerella in the vaginal microflora;
• the presence of chronic diseases that reduce the body's defenses.

The listed reasons cause a disruption in the composition of the microflora and the appearance of characteristic symptoms.

Description of the disease

Gardnerellosis, or bacterial vaginosis, is one of the most common gynecological pathologies. According to statistics, every fifth woman develops it at least once.

This is interesting. The disease was named after the American scientist Herman Gardner, who discovered its causative agent - a bacterium of the species Gardnerella vaginalis - in 1950.

The pathogenesis of infection is based on vaginal dysbiosis. At the same time, the proportion of normal microflora represented by lactobacilli (Dederlein's bacilli) quickly decreases, and active reproduction of UPM (bacteria that are commonly called conditionally pathogenic), including Gardnerella, occurs.

These microorganisms actively attach to epithelial structures, increasing their granularity and promoting destruction. In microbiology, such altered cells are called key cells.

Photo c shows the main microscopic sign of the disease.

Symptoms of the disease

Discharge from bacterial vaginosis
Gardnerellosis in women is expressed in nonspecific symptoms, which are similar to the manifestation of most sexually transmitted diseases. Signs of dysbiosis include:

• burning and itching sensations in the vaginal area;
• an unpleasant odor reminiscent of rotten fish, which cannot be eliminated even if hygiene standards are observed;
• pain when emptying the bladder and during sexual intercourse;
• pain in the lower abdomen;
• vaginal discharge. They are not abundant and have a homogeneous creamy consistency. The color of the discharge may be grey, yellowish or greenish.

The symptoms of the disease worsen after sexual intercourse: when seminal fluid enters the vagina, bacteria receive additional conditions for development in its alkaline environment.

Gardnerella in women - what is it?

Very often, bacterial vaginosis is caused by gardnerella (gram-variable or gram-negative rods). This bacterium belongs to the facultative anaerobes; it does not form capsules and spores, and exhibits good adhesion on the surface of the mature vaginal epithelium. Actively multiplying in the vaginal environment, gardnerella secretes its metabolic products - amino acids. From these amino acids, volatile amines arise - compounds that give vaginal discharge an unpleasant fishy odor.

The main sign of this pathology is considered to be “key cells”. This is the name of mature epithelial cells, on the surface of which a huge number of coccobacilli or gram-variable rods are attached: Gardnerella vaginalis, Mobiluncus spp., obligate anaerobic bacteria.

Gardnerella in a smear

Diagnostics

Excess of lactobacilli
Vaginal dysbiosis is diagnosed using the following methods:

• vaginal smear;
• study of the vaginal pH level;
• PCR;
• isonitrile test.

Also, if gardnerellosis is suspected, an external examination of the genital organs plays an important role in terms of diagnosis.

Incubation period

The incubation period of the disease lasts about 10 days. Approximately 1.5 weeks after the onset of the pathological process, the woman shows the first signs of vaginal dysbiosis.

Gardnerella in women: symptoms

Gardnerellosis can occur in chronic or acute form. In a chronic course, symptoms may not be present or may be very scarce. The symptoms are not specific, they are typical for many STDs. In the acute form of gardnerellosis the following is noted:

- itching and burning in the genitals;

- pain during sexual intercourse;

- copious discharge;

— an unpleasant fishy smell is perhaps the only difference from other infections.

We have a detailed differential diagnosis of bacterial vaginosis with trichomoniasis, ureaplasmosis, and thrush in women on our website.

Symptoms of the disease become obvious when the leukocyte response is reduced. Scientists have suggested that gardnerella is capable of producing a leukotoxic factor. Under its influence, functional and even structural changes in leukocytes occur. Changes in vaginal flora associated with gardnerellosis can lead to serious consequences. Endometritis or salpingoophoritis may develop. Pregnant women face a difficult birth and a high risk of spontaneous abortion.

Gardnerella in women: photo

Treatment approaches

The goal of therapy for gardnerellosis is to suppress pathogens of the pathological process, normalize the composition of the microflora and increase local immunity.

For gardnerellosis, antibacterial drugs must be prescribed. These include:

1. Metronidazole. This drug is recommended to be taken twice a day, the daily dose is 1 g (one tablet contains 0.25 active substance);
2. Trichopolum. The dosage is determined by the doctor, the tablets are taken twice a day. The course of treatment does not exceed a week;
3. Azithromycin. The medicine is taken for 5 days. This drug should be used very carefully, following your doctor's instructions;
4. Unidox Solutab. Treatment of gardnerellosis with this drug can be continued for 7-14 days. You need to take the tablets once a day. The daily dose will be 100 mg in case of acute disease. If the pathological process is complicated, the specialist increases the dosage.

In addition to antibacterial therapy, gardnerellosis requires measures to restore the normal composition of the vaginal microflora. For this, the following medications are prescribed:

• Bifidumbacterin in the form of suppositories or solution for insertion into the vagina;
• Vagilak – capsules for vaginal administration;
• Terzhinan in the form of vaginal suppositories;
• Acylak suppositories.

Sexual partners should also undergo treatment: although men do not show symptoms of gardnerellosis in most cases, they still act as carriers of this bacterium and therefore re-infect the woman.

Preventive measures do not completely protect against the development of gardnerellosis, but significantly reduce the risk of developing the pathological process. These include the following:

• the use of barrier contraceptives during sexual intercourse with unverified partners;
• avoidance of casual sex;
• compliance with personal hygiene standards;
• wearing underwear made from natural materials, which should not be tight;
• timely treatment of diseases of any organs and systems of the body;
• maintaining a healthy lifestyle.

Gardnerellosis not only worsens a woman’s quality of life, but also reduces local immunity, promoting the development of serious inflammatory processes in the genitourinary system. That is why the disease cannot be started.

Drugs for treatment

At the first stage of treatment, antibacterial drugs are used to combat Gardnerella vaginalis.

First, a test is required to determine the sensitivity of the pathogen to various drugs. It is also necessary to treat the sexual partner if PCR shows the presence of the pathogen. Treated with tetracyclines, lincosamides and fluoroquinolones.

Therapy has proven itself positively:

• metronidazole (trichopolum);
• tinidazole;
• doxycycline;
• clindamycin (dalacin);
• levofloxacin.

Metronidazole is treated with tablets for internal use and vaginal tablets.

Treatment takes about ten days.

The antibacterial and antiprotozoal agent tinidazole is treated according to the course of treatment individually prescribed by the attending physician. Doxycycline (a tetracycline group of antibiotics) and levofloxacin (a fluoroquinolone) are often treated for gardnerellosis in men.

Read also Balanoposthitis - types and methods of treatment

Tablets for internal use - clindamycin (an antibiotic of the lincosamide group) are very good at suppressing Gardnerella vaginalis. But the prescription of drugs is made only by the attending physician.

Self-medication is unacceptable.

Miramistin solution, Metronidazole gel or Betadine vaginal suppositories are used locally.

To prevent gardnerella, you should not get carried away with douching.

Give preference to loose underwear made of good natural fiber, strictly observe intimate hygiene, and strengthen the immune system. And be sure to get treatment and consult a doctor. Only the doctor decides whether to continue treatment or not.

The danger of gardnerellosis in pregnant women

What is the danger of gardnerellosis in pregnant women?
In pregnant women, gardnerellosis can be caused by hormonal changes occurring in the body.

Gardnerella cannot cross the placental barrier, but in the case of an advanced process, the risk of developing inflammatory processes in the vagina increases. This can provoke uterine bleeding, early discharge of amniotic fluid, and diseases of the genitourinary system. This often causes infection of the fetus, and in the most difficult cases, miscarriage.

Treatment of gardnerellosis during pregnancy

Treatment of gardnerellosis during pregnancy has its own nuances. Everyone knows that during pregnancy, taking almost all medications is contraindicated.

• It is impossible to completely destroy Gardnerella while carrying a child, since this requires taking antibiotics, which are prohibited for the expectant mother. Treatment consists of using local antibacterial drugs that help reduce the manifestations of the disease and reduce the pathological activity of gardnerella. A woman can undergo full treatment after childbirth.
• The main task of the gynecologist during pregnancy is to monitor the number of gardnerella in order to prevent the development of concomitant diseases of the genitourinary system. In order to control the condition of the vaginal mucosa with gardnerellosis, a woman should be examined once a month in a gynecological chair. During this examination, the doctor takes smears for microscopic examination. If symptoms of a concomitant infection are detected, local procedures (douching, genital irrigation, sitz baths, etc.) are urgently prescribed. If you have inflammation of the pelvic organs, vaginal suppositories cannot be used.

Just as in the treatment of the disease in non-pregnant women, therapy for gardnerellosis in pregnant women is carried out in two stages: reducing the amount of pathogenic microflora and normalizing lacto and bifidobacteria in the vagina. A positive effect from treatment is observed only if the woman consults a gynecologist in a timely manner and the disease does not become chronic.

Treatment at home

Gardnerellosis can be treated at home only after consulting a doctor. In this case, you can use various suppositories, as well as douching procedures.

To suppress the number of pathogenic microorganisms in the vagina, vaginal suppositories such as Terzhinan and Metronidazole are used. It is recommended to administer the suppositories before bedtime so that they melt and remain in the vagina and have the desired effect.

Douching can be done in the following ways:

1. using hydrogen peroxide. You need to take 100 ml of hydrogen peroxide (3%) with 300 ml of warm water. Pour the resulting solution into a syringe, insert the tip into the vagina, and pour in the liquid in a stream. Continue manipulation for 10-15 minutes. It should be done in the bathroom or in bed, with your legs apart;
2. using herbal and plant infusions. For preparation, take chamomile, violet, oak bark, and wormwood in equal parts. A tablespoon of the resulting mixture is poured into a liter of water and left for 12 hours. After this, the composition is filtered, douching is carried out in the morning and evening.

Methods for diagnosing gardnerella in women

Diagnostic criteria for this pathology are:

■ Presence of so-called “key cells” in smears. Lactobacilli, as well as polymorphonuclear leukocytes, are absent.

■ Homogeneous creamy consistency of the discharge.

■ Positive result on amino test. (A sample of the secretions is placed on a glass and a little potassium hydroxide solution is added. When gardella is present, the smell of rotting fish appears).

■ The pH value in the vagina is greater than or equal to 4.5.

If at least three of the four specified criteria are present, the diagnosis can be considered confirmed.

Normal indicators in a smear

Additional diagnostic methods include:

— Gas chromatography of vaginal discharge, mass spectrometry (trimethylamine is detected).

— High-voltage electrophoresis, allowing the detection of volatile amines.

— Microbiological tests (detection of Gardnerella vaginalis). The norm in tests is less than 10 to 5 degrees CFU or no more than 103 - 105 CFU/ml.

— LSC (laser correlation spectroscopy) method.

Principles of therapy

How to treat gardnerellosis in women? First of all, the factors that provoke the development of the disease should be eliminated.

Standard instructions for patients include:

1. Refusal of unreasonable and uncontrolled use of antimicrobial drugs.
2. Sex with a regular sexual partner, excluding casual relationships.
3. Using condoms.
4. Taking oral contraceptives and other hormonal drugs only after consulting a doctor.
5. Avoid douching.
6. Healthy and varied diet: avoiding fatty, fried, overly salty and spicy foods. Eating enough fruits, vegetables and dairy products (help restore the lactobacilli population).

Frequent douching washes away beneficial flora and is harmful to health.

After eliminating the external causes, the specialist begins to destroy the infectious agent. Antibiotic therapy is carried out. Since the selection of the drug is carried out individually, based on many factors, it is important that it is prescribed by a doctor. How is gardnerellosis usually treated in women?

Standard therapeutic regimens involve the use of one of the powerful antimicrobial agents:

• Metronidazole – 0.5 g × 2 times / day (7 days) or 2 g once;
• Ornizadol – 0.5 g × 2 times a day (5 days);
• Clindamycin –0.3 g × 2 times a day (3 days);
• Vilprafen – 0.5 × 3 times a day (7 days).

The medication must be taken according to the schedule prescribed by the doctor

In addition to taking tablet forms of antibiotics, local therapy is possible. Most often, vaginal creams, gels and suppositories are prescribed for gardnerellosis in women.

Among the drugs of choice:

• Clindamycin (cream, 2%);
• Metronidazole (gel, 0.75%);
• Dalacin (cream, 2%);
• Flagyl (vaginal suppositories).

The advantage of local dosage forms is that they practically do not enter the general bloodstream

In rare cases, specialists settle on exclusively local treatment, but its effectiveness is significantly lower compared to systemic antibiotic therapy.

For several decades, Metronidazole for gardnerellosis in women remains one of the most popular medications. This antibiotic has a broad profile of action and is active against most bacteria, Trichomonas, and protozoa. Contraindicated in case of individual intolerance, leukopenia, central nervous system diseases, liver damage, pregnancy.

Trichopolum is one of the trade names of Metronidazole

Ornidazole is also often prescribed to patients: for gardnerellosis in women, it quickly destroys pathogenic microorganisms and has virtually no side effects. It is not advisable to take it during the first trimester of pregnancy, with decompensated liver and kidney diseases, or individual intolerance.

Ornidazole is effective not only against gardnerella, but also against other pathogens of genitourinary infections

The modern macrolide antibiotic Vilprafen has proven itself well: for gardnerellosis in women, it is usually prescribed in advanced cases, as well as in cases of other infections.

If bacterial vaginosis is combined with candidiasis (thrush), the use of combined antimicrobial and antifungal drugs is indicated:

• Terzhinan;
• Klion-D;
• Neo-Penotran.

Repeated inspection is carried out after 10-15 days

The treatment regimen for bacterial vaginosis necessarily includes the administration of probiotics. These products help restore normal microflora and fight opportunistic bacteria. Popular drugs for the treatment of gardnerellosis in women are presented in the table below.

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 predominant yellow tint of the discharge;
• 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.

Treatment of Gardnerella vaginalis during pregnancy

In general, the treatment of vaginosis during pregnancy has its own characteristics associated with restrictions on antimicrobial therapy. During this period, the woman’s body undergoes hormonal changes. They activate many hidden pathologies, against the background of which the growth of Gardnerella is revealed. Gardnerella poses no direct danger to the fetus - the fetus is reliably protected from its influence by the placenta. And even if the bacteria gets on the baby’s skin during birth, no inflammatory reaction will occur. This does not mean at all that the disease can be started during pregnancy. If gardnerella is relatively safe for the embryo, then the vaginal walls may become inflamed, and in particularly advanced cases, complications such as uterine bleeding, postpartum endometritis, other diseases of the genitourinary system, etc. may occur. If gardnerella is not detected and treated in time, during pregnancy, there is a risk of miscarriage.

Basically, treatment during pregnancy is similar: a course of antimicrobial drugs, a restorative course using lactobacilli, taking drugs that inhibit the growth of Gardnerella. From about the 20th week until the end of the first trimester of pregnancy, only vaginal suppositories are prescribed - they will not have a significant effect on the embryo. In the following months, internal medications may be prescribed. First of all, it is important to reduce the number of bacteria and eliminate the resulting inflammation. If the inflammatory processes cannot be eliminated, childbirth may require special preparation.

Summing up

So, how do doctors treat gardnerellosis today?

The general treatment regimen can be described by the following algorithm:

1. Elimination of excessive amounts of gardnerella in the genital tract. First-line antibiotics - Metronidazole and Clindamycin (during pregnancy - Ampicillin and Metronidazole). Both oral and local use are possible.
2. Restoration of normal vaginal microflora. The most commonly used are vaginal suppositories containing beneficial lactobacilli (Lactonorm, Acylact). In addition, a diet excluding spicy and fatty foods, alcohol and sweets is recommended. It is advisable to eat a large amount of fermented milk products (kefir, yogurt).
3. According to indications - taking immunomodulators (adjusting echinacea, Immunal, Immunorm).

Table: Popular antibiotics for the treatment of gardnerella infection:

Diagnosis of the disease

When diagnosing a disease, an external examination is first done. Then tests are taken to determine the presence (or absence) of all sexually transmitted diseases, and PCR diagnostics are performed. The discharge is analyzed and recorded if prevotella is found in it.

Symptoms of gardnerella in men are noted, the condition of the prostate gland is checked, and an ultrasound examination is performed. The secretion of the prostate gland is examined under a microscope. If there is a suspicion of prostatitis, then drugs for its treatment (for example, doxycycline) are included in the general regimen.

Clinical forms of gardnerellosis

To describe the clinical signs of urogenital pathologies provoked by anaerobic microorganisms, scientists have developed a special classification, including the following forms of gardnerellosis:

1. Bacterial vaginosis;
2. Bacterial infection of the upper genital tract;
3. Gardnerellosis of the female urinary tract;
4. Gardnerellosis of the male urinary tract;
5. Gardnerellosis in pregnant women.

Bacterial vaginosis

This, according to experts, is the most common clinical form of the disease. As a rule, during a diagnostic study, in the discharge from the genital organs, along with gardnerella, other representatives of anaerobic microflora (leptostreptococci, mobiluncus, bacteroides, etc.) are found, but at the same time, there are no sexually transmitted pathogens in it. In 50% of patients with bacterial vaginosis, the main symptoms are discharge with an unpleasant smell of rotten fish. In the other half of patients with this form of pathology, objective and subjective symptoms are not detected.

The unpleasant odor, according to experts, occurs due to the formation of biogenic amines during the metabolism of Gardnerella and other non-sporogenous anaerobes. Putrescine and cadaverine (pathological amines), presented in the form of non-volatile salts, become rapidly evaporating substances during the alkalization process, emitting a strong fishy odor.

Gardnerellosis of the upper genital tract

With this form of pathology, infection can occur directly through the periuterine tissue, as well as lymphogenously or hematogenously. There are cases when this form of gardnerellosis became the cause of the development of endometritis and salpingo-oophoritis, and some authors describe cases of blood infection with gardnerella (gardnerella septicemia), leading to severe endotoxic shock and postoperative complications in gynecological patients.

Note: This is why all women preparing for surgery should be screened for bacterial vaginosis.

Gardnerellosis of the urinary tract in women

The development of this pathology is explained by the anatomical proximity of the vagina and urethra, as a result of which the pathogen is transferred from the genital organs to the urinary tract.

There is evidence that gardnerella is very often isolated from the urine of practically healthy women. However, Garnerellosis can be diagnosed only if there are more than 1000 CFU of bacteria in one milliliter of urine taken by a catheter.

Gardnerellosis of the male urinary tract

In men, this disease does not occur as often as in women. Often, when Gardnerella is detected in combination with other bacteroids, the anterior urethra becomes inflamed in representatives of the stronger sex. In this case, a sluggish course of urethritis is noted, with mild clinical symptoms. Patients complain of scanty mucous-serous discharge, without pain or discomfort. Complications of gardnerellosis in men are very rare in clinical practice. There are isolated reports of the development of gardnerella prostatitis, cystitis, epididymitis and pyelonephritis. In manifest forms of the disease, the features of the clinical course, as a rule, are determined by precisely those pathogenic microorganisms with which the causative agent of gardnerellosis enters into association.

Note: men who suffer from an asymptomatic (or low-symptomatic) form of the disease are often sources of infection to their sexual partners.

Gardnerellosis in pregnant women

In gynecological practice, this form of pathology occurs in almost 20% of pregnant women. But fortunately, intrauterine infection develops very rarely, since during this period active protective mechanisms increase. However, some authors note the possibility of moderate suppression of cellular immunity. Very often, bacterial vaginosis causes various disorders during pregnancy, and the disease can also provoke the development of postpartum complications.

Women diagnosed with gardnerellosis are twice as likely to experience premature birth, and in a tenth of women in labor, gardnerella and other microorganisms are found in the amniotic fluid, although normally it should be sterile.

There is also evidence that bacterial vaginosis may be associated with chorioamnionitis (a purulent-septic complication that also leads to premature birth), and, according to some experts, gardnerella can provoke postpartum or post-abortion sepsis.

Gardnerella and normal vaginal flora

In a healthy woman, the vagina is sterile only at birth.

During life, it is gradually enriched with saprophytic and opportunistic flora, ensuring its normal functional state.

In girls, an alkaline vaginal environment is maintained until puberty (pH about 7.0).

After menarche, this indicator decreases to an average of 4.4, that is, the environment becomes acidic.

Accordingly, the composition also changes.

In childhood, the vagina is inseminated with gram-positive bacteria (staphylococcus, streptococcus, diphtheroids).

In an adult woman, Doderlein's bacillus (lactobacillus) predominates, and only 10% is the share of all other normal microorganisms of the female external genital tract.

Among them, half, that is, 5% of the total number of normal microorganisms, is occupied by Gardnerella vaginalis.

Also, 70% of women normally have ureaplasma and mycoplasma.

E. coli, some staphylococci and streptococci, anaerobic microbes, fungi of the genus Candida, and bifidumbacteria are normally found in the vagina.

In postmenopause, the vaginal flora also becomes impoverished: there are fewer microorganisms, mainly gram-positive bacteria, rods and diplococci.

For the health of a woman and her partner, the % content of a particular microorganism is of particular importance, and gardnerella is a good example of this.

A decrease in the number of Doderlein bacilli (lactobacillus) leads to a compensatory increase in the proportion of Gardnerella.

What drugs are used to treat gardnerella?

Nitroimidazoles remain the most effective drugs in treatment. The main representative of this group of drugs is metronidazole (Trichopol). It is effective against most anaerobic microorganisms. The drug acts by destroying DNA and suppressing the synthesis of nucleic acids.

It can be used in different doses. A regimen of 500 mg of metronidazole per day for a course of 7 to 10 days is often used. If necessary, the dose can be increased.

Metronidazole is incompatible with alcohol. Therefore, if the issue of drinking alcohol is very acute for patients, it is worth treating gardnerellosis with ornidazole. It is just as effective, but does not cause disulfiram-like reactions when combined with alcohol.

Nitrofurans (MacMirror) also affect anaerobic flora. Sometimes balanoposthitis in men is caused by associations of microorganisms.

Gardnerella is often combined not only with opportunistic bacteria, but also with pathogens of sexually transmitted infections. In this case, other antibiotics such as doxycycline or levofloxacin may be used.

Topical clindamycin can be used. This is an antifungal ointment. But it is also effective against anaerobic bacteria.

Sometimes antibiotics in men are used in parenteral forms. This is required in case of severe anaerobic balanoposthitis.

Intravenous drip administration of metronidazole is also indicated in case of systemic manifestations of infection or the formation of abscesses of any location.

Enzymes may be prescribed to increase the effectiveness of antibiotics.

For severe pain, ointments with local anesthetics are used. They may be required if ulcers or erosions form on the head of the penis.

For severe inflammation and swelling, NSAIDs are prescribed. If symptoms appear in men, please contact our clinic. We employ highly qualified specialists.

The venereologist will prescribe the necessary tests to confirm the diagnosis. You will be examined to identify possible concomitant infections. Treatment of gardnerellosis in men, if you seek help in time, will not take much time. Usually 1 week is enough to get rid of urethritis or balanoposthitis caused by anaerobic flora.

Antibiotics used to treat gardnerellosis can be divided into local and systemic drugs.

The following are prescribed as local remedies:

• Metronidazole (available as a 0.75% gel),
• Fluomizin (a tablet inserted into the vagina every night),
• Clindamycin (2% cream).

System tools include:

• Metronidazole and its analogues (Klion, Metrogyl);
• Tinidazole;
• Clindamycin.

All of the above drugs should not be taken together with alcohol.

Otherwise, the following complications may arise:

• dizziness;
• headache;
• drop in blood pressure;
• collapse;
• dysfunction of the urinary tract.

The cost of funds is about 200-300 rubles. The course of treatment is usually 12-15 days.

Gel for penis enlargement for only 147 rubles!

"Titan Gel" - guaranteed penis enlargement. With Titan Gel you will always be in full combat readiness mode!

Read more…

Possible complications

The most common consequence of the disease is the development of inflammation of the urogenital tract:

• Balanoposthitis - lesions of the head of the penis and foreskin.
• Chronic urethritis is a disorder of the mucous membrane of the urinary canal.
• Chronic prostatitis – damage to prostate tissue.
• Vesiculitis – inflammation of the seminal vesicles.

Such an outcome is possible only with a long course of the pathological process, its chronicity or severe immunodeficiency states.

The frequent combination of gardnerellosis with other sexually transmitted infections leads to a decrease in the reproductive function of men, a decrease in sperm motility and, as a result, infertility.

The most common complication is inflammation of the prostate gland.

An effective drug for the treatment of chronic forms of prostatitis is Prostatilen AC. Its formula contains active natural ingredients that have a positive effect on prostate tissue. Prostatilen AC also increases the level of free testosterone in the blood and improves sperm quality by increasing the number of morphologically correct forms of germ cells. This has a positive effect on male fertility. Being a medicine, the medicine has passed all the necessary laboratory tests. The effectiveness of its use has been proven in clinical studies.

Pathology therapy

For gardnerellosis, the patient should follow the following recommendations for a quick and successful recovery:

1. Compliance with diet. During the course of treatment and after its completion, the patient is shown a nutritious diet with a high protein content. The patient should include a sufficient amount of poultry meat, milk and dairy products, vegetables and fruits in the diet. It is necessary to exclude fatty and smoked foods from the menu; it is recommended to avoid drinking strong drinks and smoking.

   If you have gardnerellosis, you should avoid fatty and smoked foods.

2. During treatment, the patient must use barrier contraception during sex. At the same time, the man’s sexual partner should also undergo diagnostic tests, since the probability of her having a pathology is more than 92%.
3. To destroy the causative agent of infections, including secondary ones, antibacterial agents should be taken. To quickly relieve the symptoms of the disease, local drugs are used: Metrogyl, Mikospor, Miconazole, Trichopolum. The use of general antibiotics allows you to completely eliminate the pathogen: Doxycycline, Amoxicillin, Ampicillin , etc. For severe infections, complex antimicrobial therapy, including several types of antibiotics, is possible.
4. Careful observance of personal hygiene rules. The patient needs to wash himself daily and treat the genitals with anti-skin irritation products. During the period of therapy, you should avoid wearing synthetic underwear.
5. To normalize the functioning of the immune system, the patient is advised to take multivitamin complexes and, if prescribed by a specialist, immunostimulants.

   Treatment of gardnerellosis in all sexes

6. During therapy, you should avoid visiting steam rooms and baths and reduce the amount of physical activity. It is also not recommended to swim in the pool, as the high chlorine content in the water leads to irritation of the skin in the groin area.
7. Along with antibacterial therapy, it is also necessary to treat with probiotics. These are drugs whose action is aimed at normalizing the patient’s intestinal microflora. These drugs will minimize the side effects of taking antimicrobial drugs. Most often, patients with gardnerellosis are prescribed Hilak, Hilak Forte, Linex , etc.

The full therapeutic course for gardenelosis is about 21-25 days. After completion of treatment, the patient must undergo a repeat PCR test, which will reveal how effective the therapy was.

Antibacterial drugs used for gardenelosis

Attention! Over the next six months after the relief of gardnerellosis, the patient is advised to undergo regular preventive examinations and tests to identify the pathogen. These measures are aimed at preventing relapse of the disease and preventing complications.

Video - Gardnerellosis in men

Gardnerellosis: etiology and clinic

The causes of gardnerellosis are the development of vaginal dysbiosis as a result of:

• violations of intimate hygiene rules: too frequent douching;
• systematic use of chlorine-containing antimicrobial drugs (chlorhexidine, miramistin);
• taking contraceptive medications with 9-nonoxynol: Patentex Oval, Nonoxynol;
• change of sexual partner;
• combined diseases from the group of sexually transmitted infections;
• use of spermicides;
• pregnancy, abortion, onset of menopause;
• sometimes – disturbances of the normal intestinal microflora;
• other reasons for decreased vaginal acidity;
• uncontrolled use of antibiotics.

A man becomes infected with Gardnerella from a woman.

Sometimes this causes urethritis, that is, inflammation of the walls of the mucous membrane of the urethra:

• pain and burning when trying to urinate;
• unpleasant odorous discharge;
• decreased urine stream;
• pain during sex.

Also, defeat by Gardnerella leads to anaerobic balanoposthitis (inflammation of the glans penis and foreskin (inner leaf)):

• hyperemia of the glans penis;
• pain during urination and sexual activity;
• swelling of the head of the penis;
• excess smegma.

Complications: dysuric syndrome, urethritis, prostatitis, bartholinitis, infertility.

Asymptomatic infection is possible, when a man does not suffer from clinical manifestations, but is a source of infection for his partner.

The development of gardnerellosis itself contributes to the alkalization of the vaginal environment with the formation of amines, which leads to the growth of anaerobic flora and the progression of dysbiosis.

Recovery after treatment

To relieve discomfort and recreate the optimal biocenosis of the vagina, the following is used:

• Lactobacterin.
• Bifidumbacterin lyophilisate.
• Acylacta suppositories.

The duration of this course is about 2, sometimes 4 weeks. During this time, it is possible to increase the number of beneficial microbes and improve immunity.

To combat pathogenic bacteria in the future, immunomodulators, for example, Interferon, are used. They are taken in a course of 10-14 days. To consolidate success, repetition is possible.

Treatment regimen for gardnerellosis in men

Antibiotic therapy is the basis for the treatment of gardnerellosis. Typically these are tetracycline drugs or mincosalides. In addition, the doctor may prescribe immunomodulators (Immunal), bifidobacteria (Linex, Hilak Forte) and multivitamins. Gel and ointment for external use are the final link in the complex of treatment of gardnerellosis.

During therapy, a man should:

• refuse sexual intercourse;
• exclude smoked and spicy foods;
• exclude alcohol;
• limit physical activity;
• strive for emotional peace.

Both the man and his sexual partner must undergo therapy, otherwise it will not bring the desired result. This is due to the fact that stable immunity to the causative agent of gardnerellosis is not formed. Infection with Gardnerella can occur immediately after the end of therapy.

The following tablets are also used for treatment:

• trichopolum;
• tiberal;
• metronidazole;
• doxycycline;
• tinidazole;
• vilprafen;
• polygynax;
• tavanik;
• amoxicillin;
• clindamycin;
• McMiror;
• fluconazole.

Ornidazole vero for gardnerellosis is a very effective drug. The best antibiotic against Gardnerella for treating women is Terzhinan vaginal suppositories.

The course of treatment for gardnerellosis is about three weeks. At the end of therapy, the man and woman must undergo control tests.

Causes

When Gardnerella vaginalis enters the body of a healthy person, it cannot actively multiply due to the pH level of the mucous membranes, and remains in acceptable quantities. This bacterium is dangerous only if the body is weakened.

Factors predisposing to the development of the disease are:

• decreased immunity regardless of the cause;
• pathologies of the gastrointestinal tract, development of intestinal dysbiosis;
• urogenital infections;
• inflammatory processes in the genitourinary tract;
• long-term antibiotic therapy;
• hormonal imbalances;
• exposure to external factors - hypothermia, overheating, stress, etc.

How is gardenellosis transmitted?

The most common belief is that this disease is transmitted through unprotected sexual contact with a woman affected by bacterial vaginosis. However, some scientists do not agree with this statement, since a small amount of the pathogen may be present in the male genital microflora.

The likelihood of infection during intimacy makes it possible to classify this pathology as a sexually transmitted infection, but it cannot be called venereal in the general sense of the word.

Gardnerellosis or bacterial vaginitis in pregnant women

Gardnerella is most dangerous for pregnant women.

Since this pathogen produces a cytotoxin that destroys the membranes.

The disease leads to miscarriage or premature birth, the birth of children with low body weight, and in severe cases, to the development of endometriosis.

Treatment is carried out locally, as tablet drugs pass the placental barrier.

• From 12 weeks - suppositories, vaginal tablets with clindamycin, metronidazole;
• From week 26 - taking metronidazole tablets in combination with local treatment;
• At any time – intake of lactic acid flora, local colonization with saprophytic flora (probiotics in suppositories);
• Strict abstinence from sex for the entire period of treatment;
• Preventive treatment of the sexual partner;
• Sanitation of the vagina before childbirth or delivery by cesarean section.

Diagnosis of gardnerellosis: what tests should be taken before treatment?

• Sowing for flora and sensitivity (cultural method with inoculation on blood agar or corn broth);
• smear for microscopy (an experienced laboratory assistant is required for interpretation due to the ambivalence of Gram staining);
• PCR smear (the most accurate diagnostic method);
• determination of the basic vaginal environment (pH more than 4.5);
• smear for cytological examination (CON test);
• amine test (the same amines that give off an unpleasant odor).

Men donate sperm, scrapings of the urethral tract, and prostate secretions as material.

Women - smear and scraping from the vagina, cervix.

After treatment, PCR can be repeated 1-1.5 months after the end of the course of treatment.

Quantitative real-time PCR is necessary, since Gardnerella DNA will definitely be detected.

Symptoms

Symptoms and treatment of gardnerella in men vary. First, a slippery coating appears on the coronal sulcus and a “fishy” smell. The erythema of the head, as well as the foreskin, is weakly expressed. Inflammation begins in the urethra, and a burning sensation is felt when urinating.

If the patient has vesiculitis or prostatitis, then the symptoms of these pathologies are added to gardnerellosis (there is a photo in this article) after the bacteria begin to spread throughout the genitourinary system. Bacteria pose a threat in that they often provoke complications.

The most serious are abscesses and sepsis. In addition to these, other complications may arise that make gardnerella dangerous. It depends on how fast the bacteria spreads.

In carriers of gardnerella vaginalis, the disease is hidden, and there are almost no signs of the disease. Therefore, the other partner receives a certain “portion” of bacteria during sexual intercourse. If the pathogens cause the disease, the first symptoms will appear 7 days after infection. First of all, the head of the penis, as well as the mucous membrane, will become inflamed.

Gardnerella urethritis in men usually begins to develop due to existing bacteria - mycoplasma, ureaplasma, chlamydia. Their numbers will also increase. If treatment for gardnerella in men is not started on time, then inflammation can also affect other internal organs:

• prostatitis;
• pyelonephritis, which manifests itself as muscle pain and fever;
• Epidymitis is accompanied by pain in the testicular area.

Together with the main causative agent of the disease, ureaplasma and other viruses often appear. Against the background of gardnerellosis, cystitis begins. Symptoms of the inflammatory process intensify significantly. Urination becomes even more painful.

Attention! The severity and duration of gardnerellosis is determined by the structure of the male reproductive system, which is initially able to suppress the proliferation of bacteria and stop further inflammation.

Traditional medicine recipes

As an auxiliary therapy for the disease, products based on medicinal plants and natural adaptogens are widely used. However, remember that treatment of gardnerellosis in women with folk remedies is possible only in the absence of concomitant sexually transmitted infections, as well as signs of inflammation of the uterus, fallopian tubes and ovaries.

Important! Alternative medicine, like any medicine, has its contraindications. Be sure to consult your doctor before starting therapy.

Sitz baths made from oak bark decoction

Ingredients:

• oak bark – 250 g;
• water – 0.75 l.

Oak bark has an astringent, anti-inflammatory and decongestant effect

Pour the prepared raw materials with cool water and leave for 3-4 hours. Then boil the liquid for 15 minutes, cool to a comfortable temperature and strain. Pour into a shallow bowl and use for sitz baths before bed. Duration of treatment is 10-14 days.

Medicinal mixture for preparing sitz baths

Ingredients:

• juniper berries;
• Oak bark;
• chamomile flowers;
• walnut leaves;
• oat straws.

Pour 200 g of the crushed mixture, made up of ingredients taken in equal proportions, with a liter of boiling water. Leave for 45 minutes covered. Strain and pour into a sitz bath basin.

Sitz baths will help relieve itching and irritation

Tampons with aloe juice

Take 5-10 ml of aloe juice (preferably the plant is more than three years old) and soak a small cotton swab with it. Insert the tampon into the vagina and leave for 7-8 hours (preferably overnight). Course – 7 days.

Aloe – a powerful natural adaptogen

Gardnerellosis is one of the common “female” diseases. Discomfort in the vagina and perineum, as well as foul-smelling discharge, are the first to indicate dysbacteriosis of the vaginal microflora and require timely treatment.

Having successfully completed two-stage therapy, a woman will get rid of unpleasant symptoms, feeling comfortable and confident.

Antibiotics

Antibiotics for gardnerellosis are a last resort measure of treatment. Minor strains of Gardnerella vaginalis line the healthy microflora of the vagina and urethra. There is no need to destroy it simply because it exists. Antibacterial drugs have a detrimental effect not only on the condition of the intestines, but also on the bacterial status of the urogenital tract. The doctor prescribes antibiotics only in the following situations:

1. Gardnerella is detected in the largest possible numbers.
2. Treatment with local drugs and antimicrobial agents does not bring results.
3. Gardnerellosis was accompanied by a secondary infection.

Only in the above cases is it advisable to use antibiotics, but in other situations, gardnerellosis can be treated forever. Taking into account the specifics of the pathology, doctors most often prescribe the following drugs:

• Vilprafen;
• Amoxiclav;
• Azithromycin.

Antibiotics are prescribed only after a laboratory test of sensitivity to their spectrum. Gardnerella may not be resistant to a certain group of antibiotics, so treatment “blindly” leads to dangerous consequences.

Vilprafen

Vilprafen for gardnerellosis is a macrolide antibiotic that is effective against gram-negative and gram-positive bacteria, as well as anaerobes, including Gardnerella vaginalis. The drug is used in cases where gardnerellosis occurs against the background of a specific infection (chlamydia, gonorrhea, trichomoniasis) or other inflammatory diseases.

Before use, it is advisable to consult a doctor, since the composition of Vilprofen is relatively toxic. However, in most cases it is well tolerated.

Amoxiclav

Amoxiclav for gardnerellosis is a potent antibiotic from the penicillin group. It is prescribed only in cases where gardnerellosis occurs in conjunction with inflammatory diseases of the urinary tract and pelvic organs. In clinical practice, the drug is also used in very advanced situations when gardnerellosis has become chronic.

The active components of Amoxiclav affect almost all pathogenic bacteria. Gardnerella is no exception, as it is included in the list of infectious strains that the antibiotic copes well with.

Azithromycin

Azithromycin for gardnerellosis, according to its pharmacological group, is an amizolid antibiotic that kills strains of gram-negative bacteria, as well as gardnerella. It is ineffective against certain infectious agents, but gardnerellosis cures quickly.

Side effects are rare, but the drug should not be taken by people suffering from kidney and liver pathologies. During pregnancy and lactation, Azithromycin is not recommended for treatment. The only exceptions are severe cases.

The dosage and regimen of taking antibiotics is determined only by a doctor. The patient's complete medical history and laboratory screening results are taken into account.

Pathogenesis of gardnerellosis

The virulence of this microorganism is relatively low, and only in some strains of Gardnerella the final fermentation product is acetic acid and amino acids. Others produce lactic and formic acid in the course of their life. Therefore, some authors are inclined to believe that this bacterium does not have pathogenic properties, but is a saprophyte of the urogenital tract.

During sexual contact with a woman suffering from gardnerellosis (or a bacteria carrier), the pathogen enters the male urethral epithelium, and subsequently, during the next sexual contact, infects or reinfects the female genital tract.

By attaching to the surface of stratified squamous epithelium, gardnerella are able to form characteristic formations, which in clinical practice are called “key cells”. It is their detection during bacterioscopic examination of genital smears that has important diagnostic significance.

Unfortunately, to this day the pathogenesis of this disease is not completely clear. However, scientists have found that gardnerella damages vaginal epithelial cells and also causes autolysis (dissolution) of phagocytes.

Treatment tactics

Treatment of gardenellosis in men is slightly different from treatment in women. The fact is that the male population, when this infection is detected, is not prescribed local agents, so the time of use of the drugs is longer than in the female sex.

If an infectious pathogen such as gardnerella is detected in a man, then drugs and medicines are prescribed individually, based on the results of the studies obtained. It cannot be said that one drug can be suitable for all men, since everyone’s body is different, and the tolerance of certain components is also different.

Basically, when gardnerella is detected, the specialist prescribes medications to the patient in the form of tablets, but there are cases when treatment is prescribed with other drugs, such as urethral instillations, droppers or injections and physiotherapy.

The treatment regimen is simple. Very often, experts prescribe:

1. Levofloxacin, Clindamycin and Doxcycline. These drugs are very popular; they are prescribed first when this disease is detected, but they are not always effective. If their use does not bring results, the doctor prescribes another treatment.
2. Douching drugs into the urethra. This method is quite effective if a man has an eating disorder and his health worsens due to the use of pills. In this case, the drug enters the infected area, bypassing the digestive system, thanks to which it most effectively begins to affect the infectious agent.

The course of treatment for gardnerellosis in men averages 2-3 weeks, this period is observed in those whose infectious disease is not in an advanced stage. If the disease is detected late, and it has progressed, the man will face longer treatment, which may include the use of various types of drugs, for example, both tablets and douching. If complications develop, antibiotics are prescribed, which primarily destroy bacteria that cause complications in the male body.

When carrying out treatment, it is necessary to adhere to the recommendations, thanks to which the infection can be cured in a short time without receiving any negative consequences:

1. During treatment, refrain from drinking alcoholic beverages, which can weaken the effects of the medicinal components or completely suppress them. Substances may be incompatible, cause discomfort or upset the digestive system, which can lead to various diseases.
2. Refrain from sexual intercourse, since medications can negatively affect the elasticity of the mucous membrane of the genital organs and infect the partner with bacteria.
3. Do not eat spicy, fried, smoked and salty foods - this can cause discomfort in the digestive system, lead to various pain sensations, and contribute to the development of ailments associated with the gastrointestinal tract.

You cannot self-medicate. Self-administering medications can lead to complications that can negatively affect your health. First of all, reproductive function may suffer, since different drugs can have different effects on the condition of the genital organs in a man.

In addition, the treatment regimen for gardnerella in men is prescribed based on an analysis of the pathogen, which can cause not only this disease, but also a number of other infections. Gardnerella in men often does not cause an independent disease, but contributes to the development of other, more serious and dangerous diseases.

After the prescribed treatment, control studies are performed. They are done in order to exclude complications and also to ensure that the disease is cured. To do this, they take a smear for microflora, study it under a microscope, and then make a conclusion.

The main thing is not to forget that treatment should be carried out on both partners, only in this case can you get rid of the infectious disease.

Preventive measures

Prevention of gardnerellosis consists of following simple recommendations:

• during sexual intercourse, the use of contraceptives that can maximally protect the body from infection by various microbes and bacteria;
• find a permanent partner - this leads to a minimal risk of infection.

Experts highlight rules that every representative of the stronger sex must follow:

1. If any gynecological disorders are detected in your partner, you must immediately send her to a specialist and undergo tests. Under no circumstances should she be allowed to self-medicate.
2. If a partner is diagnosed with gardnerellosis, it is better to protect herself with contraceptives during sexual intercourse, but this does not mean that the man will necessarily become infected with this infection. Against the background of this pathogen, other diseases may develop.
3. If this disease is detected, treatment is necessary.
4. After the infection is cured, you can have sexual activity without restrictions.

Simple preventive measures will help avoid the development of the disease and complications. Therefore, it is very important to maintain hygiene and use various means to protect your body.