Ungaba ne-BV kanye nomngcongololo ngesikhathi esisodwa? Yebo, kodwa akuyona leyo mbuzo ebalulekile

Yebo. Ungaba ne-BV kanye nomngcongololo ngesikhathi esisodwa, kodwa ukuvamise kancane kakhulu ukuba kube khona izifo ezimbili ngesikhathi esisodwa: ocwaningweni olunzulu lwe-16,484 ezigulini ezivakashele isigameko esiphuthumayo lapho kwenziwa khona ukuhlolwa kwamanzi esitho sangasese sowesifazane, zombili izifo zatholakala ndawonye ku-0.8% wezigameko. Inkinga enkulu ukuthi izimpawu zazo ziyafana kakhulu kangangokuthi awukwazi ukuhlukanisa kalula zodwa.

Ngamafuphi kakhulu: Izinto ezibalulekile

• Ukuba khona kwezifo ezimbili ngesikhathi esisodwa kuyinto eqinile kodwa ayivamile. Ezigulini ezihloliwe emtholampilo wezimo eziphuthumayo, i-BV kanye nomngcongololo kwatholakala ndawonye ku-0.8% wezigameko, kuyilapho i-BV yodwa yaba ngu-25.0%.
• Izimpawu azisizi nhlobo ukukusiza uhlukanise lezi zifo. Ocwaningweni olwenziwa ngo-2001, abesifazane abangu-11% kuphela ababeqonda izimpawu ezijwayelekile zomngcongololo.
• Ukuba khona kwezifo ezimbili kusho imiphumela emihle yezivivinyo ezimbili ngesikhathi esisodwa, hhayi isithombe esisodwa sezimpawu ezididayo.
• Akuwona umuthi owodwa ophatha zombili izifo. I-BV idinga i-antibiotic, umngcongololo udinga i-antifungal, kanti omunye akwenzeli lutho omunye.
• Uma zombili izifo seziqinisekisiwe, ukuphatha zombili ngesikhathi esisodwa kuyinto evamile. Ukukhulelwa yisimo lapho i-BV ibaluleke kakhulu khona.

Yebo, i-BV nomngcongololo kungenzeka ngesikhathi esisodwa, kodwa kuyivelakancane kunalokho okushiwo yi-internet

Yebo, ungaba ne-BV nomngcongololo ngesikhathi esisodwa. Phakathi kwabantu abangu-16,484 abavakashele izigameko eziphuthumayo lapho kwenziwa khona ukuhlolwa kwamanzi esitho sangasese sowesifazane, i-bacterial vaginosis kanye nomngcongololo kwatholakala ndawonye ku-0.8% wezigameko, noma abantu abangu-136. I-BV yodwa yaba ngu-25.0% kanti umngcongololo wedwa waba ngu-3.8%. Izifo ezingezona ezihlangene ziningi kakhulu kunezifo ezihlangene, ngakho-ke i-BV nomngcongololo ndawonye kungenzeka kodwa akuyona incazelo ephezulu yezimpawu ezididayo.

Funda leyo 0.8% ngokucophelela. Ichaza abantu abanezimpawu abavakashele isigameko esiphuthumayo futhi benziwa ukuhlolwa kwamanzi, hhayi abesifazane ngokujwayelekile. Akuyona "0.8% yezinye izifo ezihlanganayo," futhi noma ngubani oyitsheni kanjalo uyishintshile i-denominator.

Ukuququda kungenzeka ngoba izimo zombili zihlala esisekelweni esifanayo: imvelo eyonakele yesitho sangasese sowesifazane esinezinga eliphansi lezinhlobo ze-Lactobacillus ezivikelayo, okuvula umnyango ukwanda kwamagciwane kanye ne-Candida ngokufanayo.

Inkinga yangempela akusona ukuthi zombili zingenzeka yini. Kuyinto yokuthi izimpawu azikwazi ukukutshela ukuthi yini onayo

Izimpawu ze-BV vs umngcongololo zibukeka zingahlukaniseki kalula ephepheni. Nansi indlela okufanele ibukeke ngayo umehluko wetexthbook.

Manje buka ukuthi iyahluleka kanjani. Ocwaningweni olwenziwa ngemibuzo lwabesifazane abangu-634 olwashicilelwa ku-American Family Physician ngo-2001, kuphela abayi-11% abaqaphela kahle izimpawu ezijwayelekile zomngcongololo. Kwisibuyekezo esifanayo sango-2001, phakathi kwabesifazane abanezimpawu ezingapheli zesitho sangasese sowesifazane asebephathise ngemithi ye-antifungal ethengiswa esitolo, kwatholakala ukuthi kuphela abayi-28% ababenomngcongololo ophindaphindayo lapho kuhlolwa isazi sezokwelapha. Lezi zibalo sezidala, futhi kusengazo izinombolo eziningi kakhulu esizizo mayelana nokucisheka kokuzisiza.

Odokotela abakwazi ukwenza kangcono ngendaba kuphela. Iziqondiso ze-CDC zango-2021 zokuphuma esithweni sangasese sowesifazane zisho ukuthi ukuthatha umlando wedwa kuye kwabikwa kunganele ukuthola ukwelashwa okunembayo. Futhi i-CDC ithi ocwaningweni oluhlalise umphakathi lonke, iningi labesifazane abane-BV babengenazo nhlobo izimpawu, ngakho-ke "akukho mphunga wokubola inhlanzi" akukukhiphi i-BV.

Ngakho ingozi ayilona lokhu kuba nezifo ezimbili ngesikhathi esisodwa. Ingozi yizimpawu ezifana kakhulu kanye nomuthi ongalungile, okukunika isonto lokungakhululeki futhi akukho mphango.

Ukuba khona kwezifo ezimbili ngesikhathi esisodwa yinto oyikhomba ngokuhlolwa, hhayi into oyibonayo

Ukuba khona kwezifo ezimbili nge-BV nomngcongololo kuyisiphetho sezobunhlalakahle, hhayi umbono owufika eshawini. I-CDC ididiskhiphela i-BV ngokusekelwe ezicashuneni eziyi-Amsel, ezidinga izici ezintathu kwezingu-ezingene ezizathandayo: ukuphuma okuncane okuyingxube, amaklayi eseli emaphepheni, i-pH yesitho sangasese sowesifazane engaphezu kuka-4.5, nokuhlolwa kwe-amine "whiff" okuhle. Isilinganiso esiyingqayizivele sihlala siyi-Nugent-scored Gram stain.

Umngcongololo unomthetho wawo. Esigulini esinezimpawu, i-CDC idinga umngcongololo noma ama-pseudohyphae kusampula enziwe ngamanzi, noma isivivinyo esihle noma esinye isivivinyo se-Candida. Lokho kubalulekile ngoba cishe abesifazane abayi-10% kuya ku-20% baphethe i-Candida ngaphandle kwezimpawu, ngakho-ke umphumela omuhle womngcongololo ongahambisani nesi khaleleki akubashwa njalo.

Okubalulekile okusebenzayo: ukuba khona kwezifo ezimbili ngesikhathi esisodwa kusho imiphumela emihle emibili ehlukene kusuka ekuvakasheni okukodwa. Isithombe sezimpawu ezididayo akusona ukuba khona kwezifo ezimbili, kuyisiqalo esingenasivivinyo.

Ngaphambi kwalowo mphakathi, uhlelo lokusebenza lomngane wezempilo njenge-August AI lungakusiza ukuthi ubhale lapho ukuphuma, iphunga, nokulunywa kwaqala khona nokuthi kube njani, ukuze umhlinzeki athole umlando ocacile esikhundleni sokuthi "izinsuku ezimbalwa." Kuyisithasiselo senhlanzeko, akusona isiphetho.

Akuwona umuthi owodwa ophatha zombili. Ziyizinhlobo ezihlukene zemithi

Ungaphatha i-BV nomngcongololo ngomuthi ofanayo? Cha, futhi isizathu siyezi-pharmacological, hhayi esiphakamisayo. Iziqondiso zokuphatha i-BV yi-CDC yizidakamizwa ze-antibiotic: i-metronidazole ezingama-500 mg kabili ngosuku izinsuku eziyi-7, i-metronidazole ye-0.75% ye-gel yesitho sangasese sowesifazane kanye ngosuku izinsuku eziyi-5, noma i-clindamycin 2% ye-cream yesitho sangasese sowesifazane ngaphambi kokulala izinsuku eziyi-7. Umngcongololo ongakhelene kakhulu uthatha i-antifungal: umthamo owodwa we-150 mg we-fluconazole womlomo, noma i-azole ye-topical njenge-clotrimazole, miconazole, noma terconazole izinsuku eziyi-1 kuya kweziyi-14 kuye ngemithi. Ama-antifungal akwenzi lutho ku-BV. Ama-antibiotic e-BV akwenzi lutho ku-Candida.

Nansi into amakhasi amaningi angakutshela yona: uma usezinsukwini ezintathu ku-Monistat ngaphandle kokuvela okukhulu, i-cream ingase ibe isisuse ukuguga kwamavulva ngokuba nje ngokudambisa. Lolo kunciphisa okungelona ukwelashwa yilokho okubambezela ukuhlolwa okunembayo ngenkathi i-BV engaphathisiwe iqhubeka. Ukufanisa umuthi nomhlophe kuyanakekelwa ukulungisa ukunquma ukuthi iyiphi i-antibiotic elungile ku-urinary tract infection.

Uma zombili sezitsinisekisiwe, ukuphatha zombili ngesikhathi esisodwa kuyinto evamile, hhayi engozi

Ukuphatha zombili ngesikhathi esisodwa yinto evamile lapho izivivinyo sezitsinisekise zombili. Umthamo owodwa we-150 mg we-fluconazole kanye nesikhathi se-metronidazole (noma i-clindamycin ye-topical) kuvame ukunikezwa ngesikhathi esisodwa, futhi ngalamazinga ayikho ingxubevange ebalulekile ngokwezokwelapha kubantu abaningi.

Impendulo eqotho ngokulandelana: akukho siqondiso esisemthethweni esichaza ukuthi yini eza kuqala. Umthetho wokusebenza ulula. Izifo eziqinisekisiwe ziphathwa, futhi azizishintshi ukuba ziqaphele.

I-BV igxuma phambili emgqeni ezimeni ezimbili: ukukhulelwa, nokulungiselela inqubo ye-gynecologic ehlelelwe. I-BV engaphathisiwe ixhumene nengozi yokubeletha ngaphambi kwesikhathi nokwanda kokuthambekela ekuthelelweni kwesibeletho, okuyenza kube yiyo okufanele ingalindi.

Amaphuzu amabili okuthobela anquma ukuthi lokhu kuyaphumelela yini. Qedela isikhathi esiphelele sezinsuku ezi-5 kuye kwezi-7 ze-BV ngisho nangemuva kokuba iphunga nokuphuma kuye kunciphe, ngoba ukwelashwa okungewona okokukhulula izimpawu kungukuphulukiswa. Futhi landela izeluleko zotshwala ezikunikezwa nge-metronidazole.

Ezinye izimpawu zisho ukuthi akuyona i-BV elula noma umngcongololo nhlobo

Shayela i-911 noma uye esigamekweni esiphuthumayo manje uma:

• Unezibonakaliso zokuphendula okukhulu kakhulu komuthi onikezwe ngudokotela: ukuqubuka komzimba wonke, ukuvuvukala kobuso noma komphimbo, ubunzima bokuphefumula.
• Une-fever nezingaba kanye nobuhlungu obukhulu besisu esingezansi noma esesiswini.
• Une ukuphuma kwegazi okukhulu noma okungalindelekile esithweni sangasese sowesifazane.

Bhuka ukuvakashela kungakapheli isonto elilandelayo uma:

• Izimpawu zingakayithuthuki emuva kwezinsuku ezimbalwa ngemuva kokuphothula umthamo ogcwele wokwelashwa.
• Izimpawu zibuyela emavikini ambalwa ngemuva kokuhlanjululwa.
• Ukhulelwe ukuphuma okusha noma okubi kakhulu esithweni sangasese sowesifazane noma iphunga, okudinga ukuhlolwa okusheshayo ngudokotela wakho wezinhlanzi kunokuziphathisa nge-OTC futhi ulinde ubone.

Khuluma nodokotela wakho ngaphambi kokuba uqale uma:

• Uke wasebenzisa i-antifungal ye-OTC ngaphandle kokuphumula.
• Ukhulelwe noma uzama ukukhulelwa.
• Uke waba nezikhathi eziphindaphindiwe.
• Unezinsizwa ezintsha noma ukukhathazeka nge-STI.

Izimpawu ezingacacile ngokuvamile ziyisiphetho esingalungile noma esishiyiwe, hhayi umthamo okufanele uphindwe. Uma ufuna ukuhlolwa ngokushesha, ukuvakashela ku-urgent care online nge- $39 kubeka isazi sezokwelapha esine-US ilayisensi phambi kwezimpawu zakho, futhi siyanquma ukuthi umuthi kadokotela ufanele yini. Qaphela umkhawulo: ukuvakashela kwevidiyo akukwazi ukuhlola i-pH strip, i-whiff test noma i-wet-mount microscopy, ngakho-ke isazi sezokwelapha singakuthumela ukuhlolwa ngokomuntu.

Izifo eziphindaphindayo ze-BV nomngcongololo ngokuvamile kusho ukuhlola okushiyiwe, hhayi inhlanhla embi

Izifo eziphindaphindayo ze-BV nomngcongololo ngokuvamile kusho ukuthi isiphetho sokuqala sasingalungile noma singaphelele kunokuthi ukwelashwa kuhlulekile. Ukulungisa ukuhlola kabusha ngenkathi unezimpawu, hhayi ukuphatha kabusha ngaphandle kokuhlolwa. Lena yiyo ingozi efanayo neye-izifo ezintwalazayo zesikhumba ezivame ukuphuma, lapho izikhathi zokuphinda ziphonswa kwinto eyayingakaze iqinisekiswe.

Lokho okusiza ngempela, ngokulandelana: qedela imithamo egcwele ye-antibiotic ne-antifungal; yeka ukudouching kanye nokusebenzisa izinsipho, amashidi, neziyalezo ezinephunga unomphela; futhi uma ufuna ukuzama ukwesekwa kwe-Lactobacillus, qala emva kokuba izimithamo zombili seziqediwe esikhundleni sokuzibeka ngesikhathi esisodwa. Ubufakazi be-probiotics ekugcineni ukubuyela esimweni buyashintshashintsha, futhi akuyona indawo yokwelashwa.

Ukuze uthole iphethini ongayidlulisela kusazi sezokwelapha, uhlelo lokusebenza lomngane wezempilo njenge-August AI lungakusiza ukuthi ubhale izinsuku zezigameko, izimpawu, nokuthi yini oyiphuzile isikhathi ngasinye.

Imibuzo evame ukubuzwa

Ingabe ama-antibiotic asetshenziselwa ukuphatha i-BV angabangela umngcongololo?

Yebo. I-metronidazole ne-clindamycin zibopha amagciwane esitho sangasese sowesifazane ngokubanzi, futhi i-Candida ingakhula esikhundleni esingashiwo. Kungakho ukulunywa kwesinye isikhathi kubonakala ngendlela uma usugcwalisa umthamo we-BV. Kuyimlandelelwano, hhayi ukuba ne-BV nomngcongololo ngesikhathi esisodwa, futhi iphathwa nge-antifungal uma ukulunywa sekubone.

Ungathatha i-fluconazole somngcongololo ngesikhathi ukhulelwe?

Ngokuvamile cha. I-fluconazole yomlomo ngokuvamile iyagwenywa ekukhulelweni, bese kusetshenziswa ama-azole e-topical esikhundleni. I-metronidazole isetshenziselwa i-BV ekukhulelweni. Ngoba i-BV ekukhulelweni ixhumene nokubeletha ngaphambi kwesikhathi, ukuphuma okusha noma iphunga ngenkathi ukhulelwe kudinga ukuhlolwa okusheshayo ngudokotela wakho wezinhlanzi esikhundleni sokuthenga imithi yomngcongololo esitolo bese ulinda ubone.

Izimpawu ze-BV nomngcongololo kufanele zicacise ngesikhathi esisodwa?

Cha. Ukulunywa komngcongololo kuvame ukuncipha ngosuku olulodwa kuye kwezintathu emva komthamo we-fluconazole, ngenkathi iphunga nokuphuma kwe-BV kungathatha umthamo ophelele kanye nezinye izinsuku ezimbalwa ukuba kunciphe. Abantu abahlola i-antibiotic ngesivinini somngcongololo banquma ukuthi "ayisebenzi" futhi bayeke ngaphambi kwesikhathi, okuyindlela ejwayelekile kakhulu yokuphinda ibuyele esimweni.

Ingabe kuphephile ukuzala ngenkathi uphathwa ngezigulo zombili?

Cha. Odokotela ngokuvamile bayeluleka ukuba balinde kuze kube yilapho ukwelashwa sekuqediwe. Ama-creams angamafutha asekelwe ku-antifungal kanye ne-suppositories angabuthakazelisa amakhondomu elateksi nama-diaphragm, futhi ukugudleka kwandisa izicubu ezivele zinomlilo. Isizathu esifanayo siyasebenza ku-ukuzala ngenkathi une-UTI: izinsuku ezimbalwa zokuvinjelwa zibiza kancane kunesikhathi sokuphinda umthamo.

Ingabe i-BV noma umngcongololo ingazicacisa yona ngaphandle kokuphathwa?

Ngezinye izikhathi. I-BV ingayihoxisa ngokwayo, futhi ingabuyela esimweni ngaphandle kokuphathwa. Umngcongololo onobunzima ngesikhathi esisodwa uhlala engaphathelwe kahle. Ukukulinda yilokho okwenza kube khona ukuba kube nezifo ezimbili ngesikhathi esisodwa kuphathwe kancane: omunye umzimba uyanyamalala, omunye uhlala, futhi ngenkathi uhlolwa, isithombe siyadida kunesosiku lokuqala.

Okubalulekile

Ungaba ne-BV nomngcongololo ngesikhathi esisodwa? Yebo, cishe ku-0.8% wezigameko ezihloliwe esigamekweni esiphuthumayo. Kodwa izimpawu azikwazi ukukutshela ukuthi yini onayo, ezimbili zidinga izinhlobo ezihlukene zemithi, futhi ukuba khona kwezifo ezimbili ngesikhathi esisodwa kusho izivivinyo ezimbili ezinhle. Hlola ngenkathi unezimpawu, bese uphatha lokho empeleni okukhona.

Isitatimende: Lesi sihloko senzelwe ulwazi kuphela futhi asinayo imithombo yezokwelapha. Njalo thintana nomhlinzeki wezempilo oqeqeshiwe ukuze uthole ukuhlola kanye nezinqumo zokuphathwa. Uma ubhekene nesimo esiphuthumayo sezokwelapha, shayela i-911 noma uye esigamekweni esiphuthumayo esiseduzane ngokushesha.