The milkwoman (vaginal candidiasis) – fungal damage of a mucous membrane of a vagina. As manifestations of the milkwoman serve the itch and burning in a vulva, plentiful curdled allocations, pain at an urination and sexual intercourse. Spread of a fungal infection in an organism and transition to a generalized form, violations of a normal course of pregnancy and childbirth, infection of a fruit is possible. The milkwoman is diagnosed according to gynecologic survey, a kolposkopiya, a microscopic and bacteriological research of dab. Treatment of the milkwoman is carried out by local and system antifungal medicines.
The milkwoman — the inflammatory damage of a mucous membrane of a vagina caused by sort Candida mushrooms. It is characterized by burning and an itch in a vagina, white curdled allocations. The milkwoman is also called the candidiasis of newborns most of which often is shown as oral cavity candidiasis. Diagnostics of the milkwoman is carried out by detection of a mushroom at microscopy and a cultural research of dabs from a vagina. For an exception of the accompanying STD IFA, RIF and PTsR researches are conducted. The chronic recidivous milkwoman is the indication for full inspection of the patient for the purpose of identification of those violations in an organism which could serve as the reason of such current of the milkwoman. Treatment is performed by local and general use of antimikotichesky medicines.
The Drozhzhepodobny mushrooms of Candida provoking development of the milkwoman are opportunistic flora of a vagina of most of women and at the same time do not cause any pathological symptoms. Therefore, unlike classical STD, the milkwoman cannot be carried for 100% to diseases from sexually transfer though mushrooms of Candida and can be transferred from sexual partners. The clinical venereology, along with gynecology, is engaged in diagnostics and treatment of the milkwoman in a type of similarity of her clinical picture to sexually transmitted infections and frequent cases of a combination of these diseases.
Causes of the milkwoman
Lead various factors breaking healthy microflora of a vagina to development of the milkwoman. Decrease in number of the useful bacteria normal containing growth of fungal flora, and intensive reproduction of fungi is as a result observed. Active growth of fungi leads to manifestation of their pathogenic properties with the advent of inflammatory changes mucous vaginas as a colpitis or a vaginit.
Violation of a normal ratio of microorganisms in a vagina with development of the milkwoman can be caused by treatment by cytostatics and other immunosupressor, application of hormonal contraception, decrease in immunity in connection with somatic diseases (HIV, chronic bronchitis, tonsillitis, chronic pyelonephritis, cirrhosis and so forth), hormonal deviations (diabetes, dysfunction of ovaries, a climax, a hypothyroidism, obesity), anorexia, pregnancy, stressful situations, sharp change of climate.
Long or frequent antibiotic treatment, use of antibacterial medicines without additional purpose of probiotics first of all cause an intestinal dysbiosis. As intestines are the tank of mushrooms Candida, his disease (dysbacteriosis, colitis, etc.) lead to distribution of Candida to other bodies and first of all in a vagina with development of the milkwoman.
With the advent of the milkwoman various local factors can exert adverse impact on a vagina biocenosis: non-compliance with personal hygiene, irregular change of laying and vaginal tampons, application of local contraceptives, use of the deodorized laying and the flavored color toilet paper, wearing synthetic underwear. Frequent use in the hygienic purposes of means with antibacterial action (antibacterial soap, intimate gel, vaginal spray) often leads to decrease in local natural immunity and can provoke emergence of the milkwoman.
At some women appearance of the milkwoman is observed after wearing wet linen, visit of the pool or swimming in open reservoirs. It is connected with beneficial influence of the damp environment on activity of mushrooms of Candida. Improper feeding with the excess use of sweets can also promote development of the milkwoman.
The newborns born from patients with the milkwoman of mothers can get sick with the milkwoman as a result of infection during the pre-natal period or passing in patrimonial ways. Development of the milkwoman in such cases is promoted by the weakened condition of an organism of the child in connection with the got patrimonial trauma, premature birth, a hemolytic disease, the pre-natal hypoxia postponed asphyxia of the newborn.
The milkwoman is shown by the expressed burning and an itch in genitalia and a vagina. These symptoms are followed by emergence of the allocations having white color, characteristic of candidiasis. The non-uniform consistence of allocations with the small lumps reminding cottage cheese particles is typical for the milkwoman. Allocations can have a sourish smell. Many women suffering from the milkwoman note increase in number of allocations after the sexual intercourse, water procedures, at night. Reddening of small vulvar lips, sometimes — puffiness of small and big vulvar lips which can reach an anus is often observed. Puffiness and inflammatory changes mucous lead vaginas at the milkwoman to the fact that during sexual intercourse the woman has pains. Morbidity of urinations can be noted.
Quite often the erased current of the milkwoman when her clinical manifestations are poorly expressed meets or there is only one of the specified symptoms. Symptoms of the milkwoman can spontaneously pass with the advent of menstrual allocations as during this period the vaginal environment is displaced in the alkaline party less favorable for fungi. However the milkwoman can get and a chronic current. Its recurrence, as a rule, takes place at least 4 times a year and arises usually in a week prior to the beginning of periods. The chronic milkwoman will much worse respond to treatment and can lead to emergence of complications. The milkwoman's combination to other infectious damages of a vagina is possible (ureaplasmosis, clamidiosis, genital herpes, etc.).
The most frequent manifestation of the milkwoman at newborns is kandidozny damage of gums (gingivit), a soft palate, mucous cheeks and language (glossit) (stomatitis). It is shown by emergence on a mucous membrane of the sites or spots covered with a white raid. At removal of a raid under it the red and inflamed mucous is bared. The newborn suffering from the milkwoman is uneasy, often shouts, badly sucks and can refuse a breast. Less often the milkwoman of newborns is shown in the form of kandidozny conjunctivitis. The pneumonia caused by fungi can become a consequence of pre-natal infection.
Chronically proceeding milkwoman can become the reason of a number of complications. First of all they are caused by spread of a fungal infection on structures, close to a vagina: a uterus neck with development of a tservitsit, an urethra with development of an uretrit and a bladder with development of cystitis. The milkwoman's combination to other STD at a long recidivous current can lead to development of infertility in women.
Diagnostics of the milkwoman
As a rule, patients with symptoms of the milkwoman address the gynecologist. The doctor performs inspection on a chair and a kolposkopiya, takes dabs from a mucous neck of a uterus and a vagina. The microscopic research of dabs at the milkwoman reveals existence of a fungal mycelium in medicine. It is a bystry method of a research, but it does not supply with the exact information about what species of mushrooms became a cause of illness. For the answer to this question carry out dab on special nutrient mediums with the subsequent studying of the grown colonies and definition of a susceptibility of the allocated Candida mushrooms to antimikotichesky medicines. At the same time consider the quantitative characteristic of the revealed colonies of Candida as their small amount is normal for healthy microflora of a vagina.
Clinical observations show that the milkwoman quite often proceeds against the background of other sexually transmitted infections and can "mask" their existence. Therefore at identification of the milkwoman it is desirable to consult in addition at the venereologist and to undergo inspection on STD. Complex PTsR-diagnostics which if necessary can be added with IFA and REEF is usually applied.
As development of the milkwoman is usually connected with these or those violations happening in an organism, at her identification full inspection of the woman is necessary. It is especially urgent when the milkwoman badly responds to the carried-out treatment or accepts a chronic current. Often the milkwoman is the first symptom of diabetes. Therefore the woman needs to make blood test on sugar and at identification of its increase to address the endocrinologist. Also inspection at the gastroenterologist is recommended: the analysis on dysbacteriosis, a koprogramma, gastroscopy, a X-ray analysis of a stomach, ultrasonography of an abdominal cavity, an irrigoskopiya, a radiological research of a small intestine.
At development of complications of the milkwoman from urinary tract consultation of the urologist, a research of urine and dab from an urethra, Zimnitsky's test, ultrasonography of a bladder is necessary. The differential diagnosis of the milkwoman should be carried out with a bacterial vaginosis, gonorrhea, genital herpes, trichomoniasis.
Treatment of the milkwoman
Local treatment of the milkwoman can be carried out in case of her primary emergence and an uncomplicated current. It is carried out by the vaginal candles or tablets containing antifungal medicines: , , , . Treatment of the sharp milkwoman is carried out from 1 day to one week depending on the appointed medicine. Its efficiency reaches 80-90%. During treatment it is necessary to observe carefully intimate hygiene and to refrain from sexual contacts.
It is not necessary to apply vaginal medicines of a wide range which part nystatin is in local treatment of the milkwoman. They suppress useful microflora of a vagina and often lead to development of a bacterial vaginosis. At an easy current of the milkwoman local treatment can be replaced with single reception of a flyukonazol. Disappearance of symptoms of the milkwoman not always is an izlechennost sign. After treatment the repeated research of vaginal dab is necessary.
At insufficient efficiency of local therapy, a chronic current of the milkwoman system reception of antimikotichesky medicines inside is shown. Most often it is for this purpose applied . After antifungal therapy restoration of healthy vaginal microflora is necessary. For this purpose appoint eubiotik. However their application is expedient only after laboratory confirmed elimination of candidiasis.
Treatment of the chronic milkwoman can continue several months. It has to include the therapy of associated diseases, correction of intestinal dysbacteriosis all-strengthening means, an exception of provocative factors (reception of antibiotics, oral contraceptives, etc.). In treatment of the recidivous milkwoman physiotherapeutic methods are widely applied: SMT, magnetotherapy, electrophoresis, laser therapy, darsonvalization.
Treatment of the milkwoman of newborns is in most cases carried out by local processing of an oral cavity solution of a hlorgeksidin or hydrocarbonate of sodium. The general antifungal therapy is applied only in the complicated cases.
Treatment of the milkwoman at pregnant women
Emergence of the milkwoman is observed more than at a half of pregnant women. Its treatment demands an integrated approach taking into account the contraindications existing during pregnancy. Detection of diseases and pathological states which can provoke the milkwoman is important. At pregnant women treatment of the milkwoman is carried out by generally local means. Most often it is candles with mikonazoly or klotrimazoly. In need of system antifungal therapy of the milkwoman at pregnant women application of a natamitsin as it has no embriotoksichesky effect is possible.
During pregnancy use of national methods of treatment of the milkwoman is possible. Podmyvaniye broth of bark of an oak, a calendula or soda solution, soda and iodine trays and so forth concern to them. These methods are poorly effective in respect of full treatment of the milkwoman, but can help to remove her symptoms during pregnancy.
Prevention of the milkwoman
The prevention of the milkwoman includes adequate antibiotic treatment against the background of obligatory purpose of probiotics; timely and correct treatment of chronic diseases, STD, hormonal violations; respect for intimate hygiene; wearing cotton linen. It is necessary to avoid use of hygienic and intra vaginal means which can change vaginas about the sour party or cause an imbalance in its microflora. That the milkwoman did not appear from misuse of tampons and laying, women should remember that it is necessary to change them each 3-4 hours. Women at whom appearance of the milkwoman is provoked by the damp environment need to be wiped carefully after bathing, to avoid wearing a wet bathing suit, at rest on a reservoir to use a spare dry bathing set.
Prevention of the milkwoman at newborns is promoted by full inspection of women when planning pregnancy, identification and treatment of the milkwoman at pregnant women earlier.