Dysbiosis and vaginal infections: treating vaginosis, candida, cystitis

Heat, humidity, the use of tight swimwear, contact with the sand, swimming in the sea, frequenting swimming pools and crowded places: these are all summer factors that increase the chances of developing avaginal infection. “The vulva, that is the set of female external genital organs, hosts a resident bacterial flora that operates in close relationship with the innermost one, present in the vagina, and can be influenced by multiple factors”, explains Dr. Filippo Murina, Head of the Lower Genital Tract Pathology Service and Menopause Center at the V. Buzzi Hospital – University of Milan. «In fact, a very delicate balance reigns among the various microorganisms, which can be altered by hormonal imbalances, broad spectrum antibiotics, overly aggressive intimate hygiene products, prolonged use of panty liners, drop in immune defenses and much more. The result is a condition of dysbiosis, more or less pronounced, or an excessive growth of “bad” bacteria at the expense of the good ones ».

The most common vaginal infections

Less known than intestinal dysbiosis, which can involve the vaginal tract is likely to lead to various consequences, including bacterial vaginosis, a very common infection characterized by intimate itching, burning when urinating, foul-smelling discharge and an increased chance of developing other urogenital tract infections, such as cystitis. Other quite common outcomes are the vulvovaginal candidiasisan infection fungal caused by yeasts belonging to the genus Candida, and aerobic vaginitis, due to the increase of aerobic bacteria (which live in the presence of oxygen) generally of intestinal origin, such as Escherichia coli, but sometimes also “local”, such as Streptococci.

What are the causes

“We mentioned that vaginal dysbiosis has various causes, including hormonal imbalances,” specifies Dr. Murina. “For example, the prepubescent girls and therefore in the phase preceding the first menstruation they have a lower quantity of hormones and this facilitates the proliferation of some pathogenic bacteria strains. The same happens in the pregnant womenbut in this case due to an increase in estrogen, while in post-menopause the sex hormones decrease and with them the amount of good bacteria, the Lactobacilli ».

Even some diseases can affect the bacterial flora (such as diabetes, Crohn’s disease or ulcerative colitis), on a par with many bad hygienic-behavioral habits that can favor an imbalance in the vulvo-vestibular region, the point of entry to the vagina: inadequate detergents and soaps, synthetic underwear that does not promote perspiration, continuous use of panty liners, full hair removal. “Even the antibiotic treatmentstaken for other health reasons, can disturb the bacterial flora, because these drugs often act with a broad spectrum of microbial coverage and can therefore damage the microbiota, without sparing the good bacteria ».

How is the diagnosis made

To find the right solution, you need to first arrive at a precise diagnosis to identify the triggering cause: “This is achieved with an in-depth medical history, which takes into account symptoms and clinical signs, to be” crossed “with some laboratory data, obtained through a bacteriological examination and vaginal culture and other secretion evaluation techniques, such as swabs. One of these elements is not enough to establish the origin of the problem, there is always a need for integration “, explains Dr. Murina. Instead, self-diagnosis tools are often used (such as tampons sold in pharmacies or supermarkets) and generic over-the-counter solutions, which in most cases do not offer the right solution or, even worse, open the way to relapses. “Many forms are acute and sporadic, that is they arise once or twice a year or perhaps throughout the life span: here the treatment can be based on antifungal or antibacterial agents, to be administered orally or perhaps topically, in the form of creams or eggs. Other patients, on the other hand, may face recurrent forms, which occur at least three or four times a year, so it becomes important to rebalance the vaginal bacterial flora through the use of probiotics and prebiotics “.

Natural novelties

Today there are also natural products that, in addition to carrying out an action antifungal And antibacterial, regenerate the tissues by forming a protective film on the vaginal mucosa which helps to recreate conditions favorable to the restoration of the local microenvironment. “But the correct strategy must always be customized based on the type of infection, the number of episodes and some characteristics of the individual patient”, concludes the expert.

On the other hand, there are no really effective “grandmother’s remedies”, such as external irrigations with water and bicarbonate: on the contrary, these methods risk negatively modifying the vulvar microenvironment ». By following the right path, however, it takes an average of 24-48 hours to get relief from candidiasis, while vaginosis with foul-smelling leukorrhea can see a significant remission of symptoms within three or four days.