About 4 favorite gynecologist infections: Gardnerella, Ureaplasma, Mycoplasma and HPV

How many megatons of antibiotics, immunomodulators and other pharmaceutical products were pumped into the bodies of Russians in order to cure them of these four “formidable enemies”, and the victory is not visible. And they continue to attack the formidable red seals “discovered” in the forms of tests, only occasionally giving ground, giving months or years of apparent prosperity. The global “mission” of these infections is to draw a line between doctors who profess the principles of evidence-based medicine, and those for whom medicine has remained at the level of quackery. But it doesn’t make people feel better. I will try once again to clarify this issue, although I understand that this topic will be raised constantly.

If the doctor persistently treats Ureaplasma or HPV-it is necessary to change the doctor.

About HPV there is a separate paragraph, so here I will touch on this topic briefly: HPV is not treatable, since there is no drug that has a direct effect on it. HPV wins our immune system, which should not be prevented from doing so. And it often interferes with the actualization of patients, that is, the creation of constant stress from the horror of the consequences of infection, which leads to a decrease in the activity of the immune system. Artificial attempts to stimulate the immune system (the main drugs used in our country) are not used in any civilized country, since this type of treatment has not shown proper safety, and most importantly, effectiveness. All facts “cure” these drugs are linked with natural decline in activity virus.

Around the world, HPV and its consequences are fought by an active vaccination campaign and a call for regular cytological smear. Once again, the fact of HPV – not a reason for the duty of panic. With regular cytological examination of the cervix and colposcopy, the probability of missing a bad disease is close to zero. Small warts, as a rule, pass themselves, for especially impatient there is a very effective drug-aldara (for topical use) or removal of these formations by laser or radio wave.

The human papilloma virus is not as dangerous as it is told. But most importantly, the risks of infection can be reduced by passing a special vaccination.

No matter how hard the scientist Gardner to write in the history of medicine his name, calling the disease “gardnerellosis”, nothing happened. It turned out that the bacteria he discovered was not the most important, and even not the only reason for the development of such a disease as “bacterial vaginosis”, so his fame did not last long, but not in our country. And how here not to remember the beautiful creation “group” (as the artists themselves call themselves) “Leningrad” – that “he loves our people…”, so accustomed we have all long forgotten the name “gardnerellosis”, which is infinitely treat men and women, prescribing long lists of antibiotics.

Now to the point: there is a violation of the flora of the vagina, which is called ” bacterial vaginosis – – grayish discharge with a rotten fish smell. In this case, the vagina increases the number of bacteria that can live without oxygen, and in addition to Gardnerella such tenacious bacteria recruited a dozen more, and they all “muddy discharge and produce an unpleasant smell”, that is, one Gardnerella can not cope. Moreover, Gardnerella normally lives in the vagina, pretending to be a “civilian”, and it can be safely called a weak character, since for rebellious manifestations she needs accomplices and, Yes, she herself needs to increase in number a thousand times. Thus, if the analysis in front of “Gardnerella” is printed “discovered” is nothing, hear nothing. Analysis caught a couple of disturbing Gardnerella with registration in the vagina that you’re jumping at shadows, not that there is to rebel. So this analysis isn’t necessary? No. What about “bacterial vaginosis”? It’s simple: donate blood “florianus” or “familar” (quantitative evaluation of vaginal flora) plus the usual smear on flora to identify the “key cells”. Once again for the most hypochondriacal: the disease “gardnerellosis” does not exist, “tests do not treat.”

Well, the sweet – Ureaplasma/Mycoplasma, where the same without them. Seems to take away these beloved of microorganisms of the Russian gynecologists – and talk to patients there is nothing, so you see this picture: Cabinet, doctor’s office: “Doctor, what tests?”- “Tests are good…” – and silence. Not that now when in tens of thousands of offices doctors paint the plans of military operations consisting of tens of drugs, droppers and candles, actively being at war with these “ineradicable enemies of mankind”. Assaults, temporary victories followed by defeats, the patient in desperation, changing generals and the composition of offensive weapons – and fight again. Some finally, as in the famous song BG [2], understand that “according to new intelligence, we fought with ourselves”, and stop treatment, realizing that they have caused more harm than good, and “who is now there.”

Mycoplasma and Ureaplasma are favorite “commercial” infections.

Now to the point. Everything in question is called genital Mycoplasma. Of all their diversity, we are interested in only four: Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealiticum and Ureaplasma parvum. Immediately weed out Mycoplasma hominis, as it is one of the participants of the “bacterial riot” in “bacterial vaginosis”, that is, does not require treatment, and disappears in the course of therapy of the underlying disease. And there were three of them. Let’s start with the fact that 40 to 80% of healthy, sexually active people are infected with these microorganisms, in 5-10% of children and adults who have never lived a sexual life, these microorganisms are also detected. Further, the world is divided into countries where doctors often do not even know about the existence of such microorganisms (America), countries where some doctors attach importance to them, and some also ignore (Western Europe), and countries where without our “Trinity” can not live – Russia, China, Eastern Europe, part of Asia.

In America, tests for Mycoplasma and Ureaplasma routinely do not take.

Actually, it is clear that where evidence-based medicine in honor-there Ureaplasma / Mycoplasma is not treated, and accordingly, Vice versa. Yes, in America, of course, they know that ureaplasama and Mycoplasma can be responsible for non-gonococcal urethritis, urethral syndrome in women, cystitis and pyelonephritis, cause inflammation of the placenta and fetal membranes with corresponding complications after and during pregnancy, premature birth and fetal complications (lung damage, inflammation of the meninges), affect the joints and cause the formation of kidney stones, lead to male and female infertility. And now correlate a few facts: 40-80 % are infected, that is, half of the healthy population should suffer from diseases with quite vivid manifestations, and the number of complications of pregnancy and childbirth – off scale. But the examination for these microorganisms is not included in the recommendations for preparing couples for pregnancy in Europe and America.

Mycoplasma and Ureaplasma alone do not cause all the terrible complications attributed to them. Usually they act as a part of microbial ensemble and then are dangerous.

Articles on these pests in the American scientific literature less than a dozen in the world – less than a hundred, and most of them – from Eastern Europe and China. Why, with such a well-established legal system of control over the work of doctors there are no claims that would prove that the doctor did not cure ureaplasm in time, and the pregnancy, for example, ended unsuccessfully (if such a practice existed, such a survey would have been introduced into the routine long ago). The fact that according to evidence-based medicine the fact of infection with Ureaplasma and Mycoplasma in itself does not mean anything. These microorganisms often act as part of microbial ensembles on the background of serious immunodeficiency States, that is, they are not the leading and only cause of the disease. Thus, for example, in a situation with pregnancy, the preventive removal of these microorganisms does not affect the incidence of complications. With regard to other diseases (urethritis, cystitis, inflammation of the appendages, etc.) – Ureaplasma and Mycoplasma are considered as the last cause after the exclusion of all others. Here is a good example: in the store there was a robbery, detained all: two thieves-recidivists, George, undergoing treatment for kleptomania, and a first-year student of the faculty of Philology of MSU Innokenty Frolov. It is obvious that in result of circumstances, the theft could make the innocent who dared to take this step, starved for a second month amid a chronic lack of money, that is to mean we will, but to suspect – at least, until they prove the innocence of others. This is how evidence-based medicine relates to this problem. At us in any unclear situation begin to press Innokenty, and we live.

Analysis on Gardnerella by PCR should not be done separately. It will be uninformative.

Since after reading each article there are many clarifying questions, immediately answer the main ones.

  1. Yes, the analysis is only to Gardnerella by PCR not need to take. It has significance only in the analysis of the type of familar or florianus, which assesses the proportion of all microorganisms.
  2. No, it does not matter in what titer you have ureaplasm and what type it is (parvum or urealiticum), if you do not have any clinical manifestations of the disease. If there are symptoms – first exclude all the most likely causes.
  3. Before pregnancy, as during pregnancy, examination for Ureaplasma / Mycoplasma does not make sense, since its asymptomatic carrier does not require treatment. But in our country would still will force (on orders Ministry of health Russia) and if reveal, will insist on treatment. Treatment, of course, will not make any sense, but it’s up to you to decide who to trust more – the Ministry of health of Russia or medical science.
  4. Ureaplasma / Mycoplasma will be one of the last causes in the diagnosis of infertility and miscarriage, as in unsuccessful IVF attempts.
  5. Examination for Ureaplasma and Mycoplasma should not be routine, but used only as the last diagnostic test on the list when searching for the cause of the disease.

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