After laboratory diagnosis of a smear, the gynecologist often informs the patient that she has mixed microflora in the smear. What it is? During a laboratory test, a physician identifies the presence and concentration of harmful microorganisms, the presence of an inflammatory process, and fungus in the biomaterial.
Such diagnostics makes it possible to detect dangerous diseases at a very early stage of development, even before the first alarming symptoms appear. Even a preventive visit to a gynecologist involves taking a smear to analyze the microflora of the cervix and vagina.
In a healthy woman, the ratio of beneficial to harmful bacteria in the genitals is 95:5. If this balance is disturbed, a mixed microflora is diagnosed. It is especially dangerous for girls who are pregnant.
Definition
What is mixed flora in a smear in women? The answer to this question worries many patients who have heard such a diagnosis for the first time. It means that in a woman’s genitals the balance between beneficial and harmful microorganisms is disturbed.
During a laboratory examination of a smear, a physician can detect in the sample squamous epithelial cells, lactobacilli, leukocytes, cocci and other bacteria that are dangerous to the reproductive system. If there are too many of them, the patient may develop a gynecological disease.
The proliferation of staphylococci, coccobacilli and gonococci is especially dangerous for pregnant women. If such a patient has a mixed microflora, the doctor recommends comprehensive treatment.
Flora mixed in a smear in women can signal the onset of menopause, menstruation, the presence of sexually transmitted diseases, and ovarian hyperfunction. This condition is also observed in patients during puberty.
In a healthy patient, lactobacilli predominate in a sample of the vaginal or uterine mucosa. Also in a normal analysis, epithelial cells, leukocytes, and mucus may be detected. All these elements indicate the absence of an inflammatory process and strong immune defense.
If an increase in the number of fungi and cocci is detected in the smear, the patient’s risk of developing inflammation increases. A high concentration of leukocytes, epithelium and mucus also indicates gynecological pathologies. When the leukocyte norm is significantly exceeded, the smear contains very few lactobacilli and pathogenic microorganisms predominate. This patient’s condition requires immediate treatment to prevent the progression of the disease.
Mixed flora abundant in a smear can occur for various reasons. Typically, this diagnosis occurs against the background of:
- Long-term use of potent antibacterial drugs, which leads to slight suppression of the functions of the immune system and dysbacteriosis.
- Use of vaginal contraceptives. Such drugs can upset the balance of beneficial and harmful microorganisms in the genitals.
- Use of a contraceptive intrauterine device. This method of contraception also disrupts the balance of microflora and promotes the proliferation of coccobacilli.
If harmful microorganisms actively multiply, dysbacteriosis begins in the genitals. This can contribute to the development of inflammation, sexually transmitted diseases, etc. In addition, the patient experiences unpleasant symptoms in the form of itching, burning, and copious vaginal discharge. If you are concerned about such signs of microflora imbalance, be sure to make an appointment with a gynecologist and take a smear.
Microflora in the vagina
A smear on the flora in women is an analysis that allows you to assess the likelihood of pathological processes occurring in the reproductive system. The analysis can detect squamous epithelial cells, cocci, Dederlein's lactobacilli, leukocytes and other microorganisms. Microflora can be scanty, medium, mixed or abundant. If the microflora in the vagina is poor, then only Dederlein's rods are detected, these are beneficial lactobacilli.
With an average number, large colonies of rods and 7-10 leukocytes will fall into the field of view of the laboratory technician. If we are talking about mixed microflora, women’s smears reveal 15-30 leukocytes, a small number of Dederlein bacilli, and cocci - spherical pathological bacteria. The result “abundant microflora” means that the inner walls of the vagina are covered with leukocytes in the absence of lactobacilli. This provokes an unpleasant odor and the release of a significant amount of mucus.
Causes
Mixed flora in a smear can occur both in adult women who are sexually active and in young teenage girls. There may be several reasons for the development of such a deviation from the norm - these include inflammatory processes in the genital organs and infectious venereal diseases.
Severe itching, burning, and vaginal discharge with an unpleasant odor may indicate the development of colpitis or bacterial vaginosis. The main causative agents of such ailments are harmful microorganisms. Some pathologies develop with an increase in the number of leukocytes, but for other diseases this condition is not necessary. However, in any case, an increased concentration of harmful pathogenic bacteria is observed in the smear.
Some diseases cannot be completely cured without antibiotics. However, such medications often destroy not only harmful, but also beneficial bacteria, which is why a woman begins to have an imbalance of vaginal microflora. Antibiotics also reduce immune defense, which provokes the proliferation of pathogens.
Another reason for mixed microflora can be douching too often. The solution washes out the microflora in the vagina and provokes the growth of harmful bacteria. If you want to maintain flora balance, it is better to give up intrauterine devices and hormonal contraceptives.
Only a qualified physician can determine the exact cause of the development of the pathological condition after a comprehensive examination of the patient’s body. Modern diagnostics will allow you to establish an accurate diagnosis and prescribe effective treatment.
What can be found in a smear
To diagnose pathological conditions, the doctor will most likely take a smear not only from the vagina, but also from the cervical canal and urethra. Technically, these are completely different procedures, but the material is usually collected only once. During microscopic diagnostics, a laboratory technician can detect flat epithelium, mucus, Doderlein bacilli, and leukocytes in the smear.
The inner surface of the vagina and cervical canal consists of squamous epithelium. The presence of a large number of cells of this type indicates the possible development of urethritis or vaginitis. A lack of squamous cells indicates insufficient secretion of progesterone, a hormone necessary for successful conception and pregnancy.
White blood cells are necessary for the body to cope with pathogenic microorganisms. Normally, the number of cells in the vagina does not exceed 10, in the cervix - 30. A high concentration of leukocytes most often indicates the presence of an inflammatory process of the reproductive system (vaginitis, cervicitis), accompanied by phagocytosis.
Mucus is produced by the vaginal glands and cervix. The amount of mucus in the smear should be moderate. Heavy discharge (the doctor will also assess this visually during the examination) may indicate vaginal dysbiosis. Doderlein rods constitute normal microflora; these are gram-positive cells. A lack of rods in most cases indicates the development of bacterial vaginosis.
Analysis
Mixed flora in a smear in women can be scanty, abundant or normal. The accuracy of the test result largely depends on proper preparation for laboratory analysis.
A gynecologist should be visited for preventive purposes at least once a year. During the examination, the doctor must take a smear of the vaginal flora. If the patient is pregnant or has any gynecological diseases, such diagnostics will have to be carried out much more often.
To pass the test successfully, be sure to use the recommendations below from medical specialists.
- A few hours before your appointment with the gynecologist, be sure to visit the toilet, since urination later is prohibited.
- For daily intimate hygiene, use warm water. It is recommended to avoid soap or intimate hygiene gels for at least a day.
- Avoid sexual intercourse for several days.
- Avoid douching, vaginal suppositories, or tampons.
During menstruation, taking a smear for flora is not recommended, since heavy discharge can distort the picture, and the doctor will not be able to make an accurate diagnosis. Despite the fact that deciphering a smear should only be trusted to an experienced medical specialist, every woman should know which microorganisms should not be detected in a normal analysis. The category of infectious pathogens includes streptococcus, staphylococcus, gonococcus, Candida fungus, and gram-negative bacteria.
Streptococci are especially dangerous in large quantities for pregnant women, since their reproduction leads to the appearance of an inflammatory process in the genitals, damage to the ureter, and can contribute to spontaneous miscarriage.
If the correct ratio of lactobacilli and red blood cells is violated, we can say with complete confidence that the production of estrogen in the patient’s body is significantly reduced. Imbalance of the vaginal microflora is one of the main reasons for the development of cervical erosion and inflammatory diseases of the genitourinary system.
Vaginal microflora
After examination, a smear in women usually reveals the presence of leukocytes, Dederlein's lactobacilli, squamous epithelial cells, cocci and some other microorganisms. It is the content of the smear that allows you to determine the type of microflora and assess the risk of certain pathologies. It is recommended to take a smear for flora approximately every six months.
Gynecologists divide the vaginal microflora, depending on its composition, into several types:
- Scarce. The study identifies the presence of almost only beneficial lactobacilli - Dederlein bacilli.
- Average. The researcher observes quite large lactobacilli colonies and up to ten leukocytes.
- Flora mixed. In addition to the not very large volume of lactobacilli, up to thirty leukocytes and the presence of cocci are detected.
- Abundant mixed flora. As a rule, it is coccobacillary and has an unpleasant, rather pungent aroma. Lactobacilli are completely absent, and there is a clear excess of leukocytes. During the examination, excessive mucus secretion is observed.
The study of microflora is carried out to diagnose the presence of pathogenic flora, which makes it possible to determine gynecological inflammatory processes. A smear on the flora is usually prescribed if a woman experiences pain in the lower abdomen, her discharge has changed in color or aroma, or there is a burning or itching sensation in the vagina.
In addition, it is recommended to check the microflora with the onset of menopause, pregnancy, or any suspicion of a gynecological disease. Gynecologists insist on checking the microflora after a course of treatment with hormonal drugs that can affect intrauterine acidity.
Decoding
The result of a laboratory study of the microflora of the uterus and vagina should be carefully examined by a gynecologist. This information will help him justify the occurrence of unpleasant symptoms in the patient, make an accurate diagnosis and, if necessary, prescribe treatment. It is not recommended to interpret gynecological tests on your own, but you still need to know some details.
During a pelvic exam, the doctor removes a small amount of mucus from the vagina or cervix and sends the sample for laboratory testing. If a woman has normal microflora, beneficial bacteria in the sample will be at least 95%. Such microorganisms protect the genitourinary system from harmful elements, preventing their pathological reproduction.
There are several degrees of purity of the flora in the vagina, namely:
- Degree No. 1. The sample contains a small amount of mucus, leukocytes and epithelial cells are normal. A large number of beneficial lactobacilli have been discovered. This indicates normal microflora and the absence of inflammatory processes in the genital organs.
- Degree No. 2. The sample contains normal levels of leukocytes. Yeast and lactobacilli are slightly higher than normal. In patients with such an analysis, the risk of developing inflammation increases significantly. This smear result may also indicate a recent abortion, curettage, or biopsy.
- Degree No. 3. There are many leukocytes and epithelial cells in the smear.
- Network No. 4. There are too many leukocytes in the microflora sample; lactobacilli are not detected at all. The smear is completely populated with harmful bacteria and microorganisms. At this stage, it is not recommended to carry out any gynecological procedures, as the patient develops inflammation. If necessary, the physician may prescribe a retake of the test.
If mixed pathogenic microflora, cocci or yeast fungi are detected in the patient’s smear, appropriate treatment must be started immediately. Patients with poor tests often experience additional unpleasant symptoms - itching, mucus discharge from the vagina, fever, increased body temperature.
Mixed flora - is it bad?
A gynecological smear is a fairly informative study that clearly indicates the problem, its location and degree of danger. With the help of this analysis, which every woman who comes to see a gynecologist must periodically take, it is possible to identify the source of inflammation and the bacteria that provokes its development in a fairly short time.
Based on the results of the smear, you can not only identify the presence of pathogenic (disease-causing) microorganisms, but also understand what percentage they are in with “beneficial” bacteria. If the alkaline environment of the vagina predominates over the acidic one, this always indicates an imbalance. Normally, lactobacilli predominate in a woman’s vaginal environment—they should be at least 95%. The remaining 5% is occupied by leukocytes, epithelial cells and a mass of microorganisms and “bad” bacteria. Such a small amount of harmful microorganisms does not harm a woman’s health and does not manifest itself as unpleasant symptoms. This percentage ratio of “good” to “bad” bacteria is called the absolute norm, and the woman is gynecologically healthy - there is no inflammation or infection.
The result of a gynecological smear “mixed flora” may indicate that foreign bacteria predominate in the vagina or are present in levels exceeding the permissible norm. Depending on which pathogenic microorganisms predominate in the vagina, therapy should be prescribed. Treatment in each individual case is significantly different, because the body is inhabited by different groups of bacteria and infections, and, accordingly, it is necessary to fight them using different methods.
The smear analysis should be deciphered by an experienced doctor, who will prescribe the medications that will help you get rid of the problems. In the future, I would like to wish you to make it a rule to take a smear test at least once every six months. Then the health of the microflora can be kept under control, and the doctor will be aware of your individual characteristics, selecting the most effective and efficient treatment regimens.
During pregnancy
Each woman's vaginal microflora is unique. When the patient is pregnant, pathogenic microorganisms begin to actively multiply. It is because of this that pregnant women are often diagnosed with thrush or bacterial vaginosis.
This is due to a violation of the acid-base balance. Mixed microflora can arise not only due to the development of infectious or exacerbation of chronic gynecological diseases. Such a disorder is also often a consequence of changes in hormonal levels in the female body.
Gynecologists recommend taking a smear test for flora at the stage of pregnancy planning. Such a diagnosis will prevent the development of inflammation, which often occurs in women in the early stages of pregnancy. It is important that during pregnancy the patient’s flora contains no more than 5% of harmful microorganisms. Changes in pH can occur for various reasons, namely:
- Long-term treatment with antibiotics;
- Reduced immune defense of the body;
- Inflammatory pathologies of the genitourinary system;
- Imbalance of vaginal microflora.
Mixed flora during pregnancy can have an extremely negative impact on the growth and development of the fetus. Timely detection and elimination of deviations will normalize the pH level in the vagina and block the proliferation of harmful microorganisms.
Complex treatment of mixed microflora during pregnancy is aimed at destroying harmful microorganisms - coccobacilli, staphylococcus, gonococcus, etc. Therapy is selected by the physician individually for each patient. While carrying a child, it is strictly forbidden to self-medicate. If you notice any alarming symptoms, immediately inform your gynecologist.
