Vaginal pathological discharge is the most common symptom that occurs in about 1/3 gynaecological patients. Among women with complaints of copious discharge from the genital tract, diseases such as bacterial vaginosis, trichomonas vulvovaginitis, vaginal candidiasis, cervicitis due to chlamydial infection, herpes simplex virus, gonorrheal infection, and increased cervical secretion are most often encountered. The marked growth of vaginal infections, bacterial vaginosis, which occupies a leading place in the structure of obstetric-gynaecological morbidity, is largely due to economic, environmental causes, immunological disorders, changes in hormonal homeostasis, massive and irrational use of various drugs, especially antibiotics.
To the factors leading to the development of bacterial vaginosis, it should be attributed primarily to long-term, sometimes uncontrolled use of antibiotics, which leads to dysbiosis not only of the vagina but also of the gastrointestinal tract. According to the data of some authors, almost every second patient with bacterial vaginosis has violations of the microecology of the intestine. Thus, we can assume the presence of a single dysbiotic process in the body with a pronounced manifestation of it either in the reproductive or in the digestive system. Also, as our studies have shown, bacterial vaginosis often occurs against the background of menstrual irregularities mainly in the form of oligomenorrhea or inferior luteal phase and in women who have been using the IUD for a long time (more than five years). The emergence of bacterial vaginosis can also be caused by advanced or concomitant inflammatory diseases of female genital organs. According to our data, vaginitis is most common among patients with bacterial vaginosis among the transferred gynaecological diseases (63.9%). Also, there is a high incidence of benign cervical disease.
At present, obstetrician-gynaecologists have in their arsenal a wide range of different drugs for the treatment of bacterial vaginosis, which has an antianaerobic effect. It should be noted that many clinicians today prefer the vaginal route of administration of drugs in the treatment of bacterial vaginosis, which is not inferior to the effectiveness of oral therapy. It is more preferable since the drugs of local action are injected directly into the source, with less chance of developing adverse reactions. Local drugs can be prescribed for pregnant women and women in the lactation period, as well as for extragenital pathology when systemic drugs are contraindicated.