Factors influencing vaginal eumicrobia
Authors:
R. Krajčovičová; R. Hudeček
Published in:
Prakt Gyn 2008; 12(4): 202-211
Overview
Vaginal ecosystem is complex and intricately regulated system, which sensitively re acts to minimal changes of endogenic or exogenic conditi ons. Basic components are vaginal epitel, mucosal imunite system, hormonal levels of menstru al cycle, endogenic vaginal flora and acid vaginal pH. The studi es are focusing principally on investigati on of factors, which are disturbing vaginal ecosystem and alone or in combinati on are le ading to vaginal infecti ons. Negative factors are bad state of he alth, systematic or local aplicati on of vari o us pharmace uticals, hormonal disbalance of menstru al cycle and incorrect hygi enic behavi o ur. Disturbance of vaginal microecology independently relates to smoking, sexu al promiscuity, frequent vaginal interco urse, vaginal interco urse after anal interco urse, sexu al practice with uncircumcisi on man, lack of H2O2 producting lactobacil and presence of HSV- 2 serum antibodi es (p = 0.001). Hormonal oral contracepti on and condoms use significantly decre ase incidence of bacteri al vaginosis. IUD aplicati on in contrast incre ases bacteri al vaginosis [16]. Disturbance of vaginal balance le ads to prevalence of pathogenic micro organisms. Outcome is colpitis, which is most frequent dise ase of sexu al active women. Basic problems of gyne acology are staying in recidival and complicated vaginal infecti ons. They have seri o us he alth after effects with impact on fertility and qu ality of life. Patomechanism of these problems is in crash of vaginal ecosystem functi oning. Resoluti on of a problem is necessary complex vi ew on functi oning of vaginal ecosystém, consistent di agnostic and after tre atment of acute infecti on propositi on of optimal long term therapy to restituti on vaginal mikroecology. Long term aplicati on of low levels of estrogen in combinati on with local aplicati on of live probi otic lactobacil strains be ars first results [5]. Investigati on of vaginal ecosystem with purpose of clinical estimati on of optimal combinati on of probi otic strains sho uld le ad to cre ating of optimal probi otic preparati on. This probi otic medicine sho uld serve to regenerati on and stabilisati on of vaginal mili e u. We can expect from this preparati on decre ase of morbidity and incre ase qu ality of life women’s in reproductive age.
Key words:
vaginal ecosystem – vaginal micromilieu – endogenic vaginal flora – estrogen – lactobacillus acidophilus – acid pH – vaginal discomfort – bacterial vaginosis – vulvovaginal candidosis – probiotics
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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Practical Gynecology
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