About white blood cells in a smear

“White blood cells in a smear” is another of my headaches and the heartache of my patients. Many women for years “treat white blood cells”, experiencing the full range of antibiotics, and they all do not go away, and begins an endless search for “hidden infections”. So, explain. White blood cells can be compared with the police, the increase in their number is in two cases: when the crime has already happened (inflammation) or when it is necessary to prevent the crime, that is, to strengthen the protection at the risk of crime.

Normally, the number of white blood cells in the smear depends on the phase of the cycle: a little after menstruation, it becomes even less to ovulation, and after their number increases. With an irregular cycle or taking hormonal drugs, there is no such pattern, and white blood cells can be elevated as a result of these reasons. In addition, the number of white blood cells is influenced by many other factors: sexual intercourse, the use of different detergents, lubricants, the state of the gastrointestinal tract, etc. Thus, in these situations, white blood cells come for “protection”, and not to fight inflammation. There is an individual feature-just a lot of white blood cells. I hope everyone has long understood that “treat tests” is not necessary, and even more so “white blood cells”, especially if you have no complaints.

It is important not a simple increase in leukocytes, and their ratio to the epithelial cells of the vagina: normally, this ratio should be <1:1, with inflammation, this ratio is shifted in the opposite direction.

How to be? To assess the state of flora and the presence of inflammation in the vagina, it is best to use the services of independent laboratories that provide an opportunity to qualitatively examine the smear, that is, to describe in detail all the changes, as well as to indicate the ratio of leukocytes to epithelial cells. The smear should always be supplemented with a quantitative analysis of the components of the vaginal flora. Such analyses are also called “floricans” or “familar”. As a result, you will not just have a description of the flora: sticks, cocci – and a picture of the ratio of different representatives of flora, indicating their species. This is important for making an accurate diagnosis, which affects the correct choice of treatment.

Femoflor-analysis on the ratio of various microorganisms in the vagina.

Once again I want to remind you that the doctor, interpreting your tests, can not say: “you have inflammation there or flora is disturbed, here are candles and pills.” The doctor must make a diagnosis based on a limited list of possible pathologies: candidiasis vulvovaginitis, bacterial vaginosis or aerobic vaginitis, as well as a combination of these pathologies. When there is a correct diagnosis, treatment will be targeted and accurate.


In conclusion, the Chapter devoted to infections, I would like to give some advice on the interpretation of the tests, which are almost always taken by a gynecologist, no matter what problem you address.

First, it is the so-called ” General or gynecological smear on the flora.” The essence of it in a very superficial assessment of the vaginal microflora. The analysis indicates the number of leukocytes, epithelium, and flora is described only by the form of bacteria: sticks or cocci, also note the presence or absence of fungi, Trichomonas and gonococci. Often, such an analysis is given on a piece of paper, where, because of the obscure handwriting, nothing is further clear. As a rule, doctors focus on white blood cells in such a smear and immediately indicate the presence of inflammation, while you may not have any complaints.

A smear on the flora is a superficial representation of the state of the vagina.

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