Bacterial vaginosis: causes, tests and treatment in Tashkent

Other names: Дисбиоз влагалища, гарднереллёз, нарушение микрофлоры влагалища

Bacterial vaginosis is not an infection in the usual sense, but an imbalance of the vagina’s own microflora: beneficial lactobacilli are replaced by other microorganisms. Hence the characteristic grayish-white discharge with the smell of stale fish, which intensifies after sexual intercourse. This is the most common cause of pathological discharge in women, and the main difficulty here is not the treatment, but the tendency to return.

🧾 МКБ-10: N76 🏥 Where it is treated: 2 Not an STI, partner does not need to be treatedThe smell of fish is a characteristic signRecurs often

👨‍⚕️ Which doctor

Gynecologist

🔬 Diagnostics

Smear, pH, Femoflor

💊 Treatment

Antibacterial agents + restoration of flora

📈 Prognosis

Good, but prone to relapse

⚠️ At risk

Douching, partner change, IUD

⏱ When to see a doctor

Planned; during pregnancy - do not delay

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Бактериальный вагиноз при беременности
Боль внизу живота и температура
Выделения с примесью крови
Симптомы сохраняются после нескольких курсов лечения
Появление зуда и жжения — возможна сопутствующая инфекция

What happens to the microflora

Normally, the basis of the vaginal microflora is lactobacilli. They produce lactic acid, maintaining an acidic environment, and hydrogen peroxide, which inhibits the growth of other microorganisms. This is a natural defense.

With bacterial vaginosis, the number of lactobacilli decreases sharply, and their place is taken by anaerobic bacteria, including gardnerella. The environment becomes alkaline, and a characteristic odor appears - it is formed from amines released by these bacteria.

Key difference from vaginitis: with vaginosis there is no inflammation as such. The mucous membrane does not redden, there is no swelling, there are few leukocytes in the smear. Therefore, itching and burning are uncharacteristic for it - their appearance usually means the addition of another problem, such as candidiasis.

Symptoms

Copious homogeneous grayish-white discharge
An unpleasant odor, often described as fishy
Increased odor after sexual intercourse and during menstruation
Discharge evenly covers the vaginal walls
No significant itching or burning
No redness or swelling of the mucous membrane
Discomfort during sexual intercourse
About half of women have no symptoms at all

Усиление запаха после полового акта имеет простое объяснение: сперма имеет щелочную реакцию, и при контакте с ней амины высвобождаются активнее. Это настолько характерный признак, что он входит в диагностические критерии.

What upsets the balance

Douching is one of the main reasons; they flush out lactobacilli and have no proven benefit
Aggressive intimate hygiene products, perfumed soaps, antiseptics
Change of sexual partner and new partner
Unprotected contacts - sperm changes pH
A course of antibiotics for any reason
Intrauterine device
Hormonal changes, pregnancy, menopause
Wearing synthetic tight underwear, panty liners without changing
Smoking
Stress and decreased immunity
Diabetes mellitus

Pay attention to the first point. Douching is a practice that seems hygienic, but in fact is one of the main factors in the development and recurrence of vaginosis. The vagina cleans itself, and washing it from the inside does not help, but harms it.

Why is it dangerous?

Increased risk of pelvic inflammatory disease
Easier transmission of sexually transmitted infections, including HIV
Complications after gynecological operations and intrauterine interventions
During pregnancy: premature birth, premature rupture of water, infectious complications
Postpartum and post-abortion inflammatory complications
Chronic discomfort and impact on the quality of intimate life

Именно из-за акушерских рисков бактериальный вагиноз при беременности лечат обязательно, даже если он не вызывает жалоб. Вне беременности бессимптомный вагиноз обычно лечат при подготовке к операциям и внутриматочным процедурам.

Diagnostics

Examination in the mirror - characteristic discharge without signs of inflammation
Smear microscopy - detection of “key cells”, few lactobacilli, few leukocytes
Determination of pH of vaginal discharge - with vaginosis above normal
Amine test with alkali solution - increased fishy smell
Femoflor - quantitative PCR assessment of the composition of microflora; especially useful for relapses
Examination for sexually transmitted infections - to exclude combined pathology
Culture for suspected candidiasis
Blood glucose in recurrent course

The diagnosis is made by a combination of symptoms, and not by the detection of gardnerella. This bacterium is also present in small quantities in healthy women, so the fact of its detection does not require treatment.

Treatment

Antibacterial drugs acting on anaerobic flora - in tablets or topically, as prescribed by a doctor
Local forms: suppositories, gels, vaginal tablets
The second stage is the restoration of microflora with lactobacilli preparations; fundamentally important for preventing relapse
Products that normalize vaginal pH
Complete refusal of douching
Refusal of aggressive intimate hygiene products
Treatment of concomitant candidiasis when it appears
Special regimens during pregnancy - medications are selected by the doctor taking into account the period
For frequent relapses, long-term maintenance regimens

Treatment полового партнёра при бактериальном вагинозе не требуется: это не инфекция, передающаяся половым путём, и обследования показали, что лечение мужчины не снижает частоту рецидивов у женщины.

Why it comes back and what to do

Не проведён второй этап — восстановление лактофлоры после антибактериального курса
Продолжаются спринцевания и использование агрессивных средств гигиены
Сохраняется провоцирующий фактор: курение, ВМС, частая смена партнёров
Есть сопутствующий кандидоз, который лечится отдельно
Не компенсирован сахарный диабет
Курс был прерван при исчезновении запаха
При частых рецидивах врач подбирает длительную поддерживающую схему — это нормальная практика, а не признак неудачи

Where is treatment in Tashkent

An examination by a gynecologist, smear microscopy and, in case of relapses, a quantitative assessment of the microflora are needed.

In Tashkent, examination and treatment of bacterial vaginosis is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.

The simplest thing you can do today is to stop douching and switch to soft, fragrance-free hygiene products. For some women, this alone significantly reduces the frequency of exacerbations. Clinic contacts are below.

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Первичный приём гинекологаfrom 200 000 Осмотр в зеркалахfrom 60 000 Фемофлор Скринfrom 625 000 Фемофлор 16from 465 000

💊 Treatment

Санация влагалища (с медикаментами)from 150 000 Санация влагалища (сложные случаи)from 275 000

Frequently asked questions: Bacterial vaginosis

Is it sexually transmitted?+

No. Bacterial vaginosis is an imbalance of one’s own microflora, and not an infection acquired from the outside. Therefore, treatment of the sexual partner is not required and does not reduce the frequency of relapses. At the same time, changing partners and unprotected contacts are indeed factors contributing to imbalance.

Why does the smell intensify after intimacy?+

Sperm has an alkaline reaction, and when it comes into contact with vaginal contents, amines produced by anaerobic bacteria are released more actively. This sign is so characteristic that it is included in the diagnostic criteria for the disease.

Does douching help?+

No, on the contrary, it is one of the main factors in the development and recurrence of vaginosis. Douching washes out lactobacilli, which constitute a natural defense, and disrupts acidity. The vagina cleans itself and does not require rinsing from the inside.

Why does vaginosis keep coming back?+

Most often, because after the antibacterial course the second stage is not carried out - restoration of lactoflora, or the provoking factor remains: douching, aggressive hygiene, smoking, uncompensated diabetes. With frequent relapses, the doctor selects a long-term maintenance regimen, and this is normal practice.

Do I need treatment if nothing bothers me?+

Outside of pregnancy, asymptomatic vaginosis is usually treated in preparation for gynecological operations and intrauterine interventions to avoid infectious complications. During pregnancy, treatment is mandatory, since vaginosis is associated with the risk of premature birth.

How is it different from thrush?+

With candidiasis, the discharge is white, thick, cheesy, and the main complaints are severe itching and burning. With bacterial vaginosis, the discharge is thin, grayish, with a fishy odor, and there is usually no itching. These are fundamentally different conditions with different treatments, and they are often combined, which is why a smear is needed.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated bacterial vaginosis в Ташкенте

При рецидивирующем вагинозе важно не просто пролечить обострение, а восстановить микрофлору и устранить провоцирующие факторы. В Ташкенте обследование, включая расширенный анализ микрофлоры, и лечение проводят в медицинском центре UROLOGIC COMPLEX и в clinicsе Tashkent Medical Park.