Is it possible to take a pap smear? Tests for genital infections: why, when and how to take. How to prepare for the analysis

In this article, we will look at how a swab is taken on the flora in women, we will conduct a detailed decoding of the results of the analysis and get acquainted with the norms of indicators and possible diseases if they are rejected.

A smear on the flora in women - what does it show

In gynecology, one of the most informative diagnostic methods is the study of a smear for flora. Material for analysis is taken from the mucous membrane of three areas: the urethra, vagina, cervix. Such diagnostics gives doctors the opportunity to determine the quantitative and qualitative composition of the microflora of the urogenital area, the presence of an inflammatory process and the presence of atypical cells. With the help of a smear on the flora in women, the causative agents of various sexually transmitted infectious diseases are easily detected.

In what cases is a smear analysis for flora performed?

This study is always performed when a woman complains of some symptoms associated with gynecological diseases (pain in the lower abdomen, itching and discomfort in the vagina, a change in the nature of the discharge). Also, a smear analysis should be carried out as part of preventive examinations. In addition, a smear is taken when planning pregnancy and after the end of antibiotic therapy.

How many days is a smear analysis prepared for flora

For women, the question arises: how long does a smear analysis for flora take? It will be ready within 1 day.

How long are smear tests for flora valid

The analysis result is valid for 10 days.

How to take a swab for flora

Preparing to take a smear for flora

Special preparation for a smear on the flora in women is not required. There are only a few points to pay attention to. For two days before the test, a woman should not use any vaginal remedies, including suppositories and lubricants. Also, within 3 days, you should refrain from sexual contact, taking a bath, douching. Remember that the procedure cannot be performed during menstruation.

How a swab is taken for flora in women

On the day of taking the material for analysis for vaginal hygiene, you can not use anything other than the usual washing with warm water without soap. Two hours before the procedure, urination is undesirable. The gynecologist first examines the walls of the vagina and the cervix using mirrors, then, using a special spatula or cotton swab, takes material from 2 areas - the vagina and cervix, and then from the urethra. The resulting material is applied to 3 sterile glass slides marked: V (vaginal swab), C (cervical swab), U (urethral swab). The gynecologist dries the glass and sends it to the laboratory for examination, where the smears are stained and determine which microflora is present.

This procedure for taking a smear on the flora is completely painless, passes quickly and does not entail any complications. The only thing that may be unpleasant is when a smear is taken from the inflamed opening of the urethra.

Swab sampling from a virgin

A smear on the flora of virgins is taken in the same way, through a hole in the hymen. The girl does not experience any pain, and the hymen is not injured or torn. A swab for flora can be taken even from little girls, if there is an indication for this.

Smear on flora - norm and pathology

In women who do not have gynecological problems, the content of lactobacilli in a smear should reach 95%. Lactobacilli produce lactic acid, which helps maintain sufficient acidity. This protects the woman's genitals from the penetration of pathogenic microorganisms.

It is known that during pregnancy, the number of lactobacilli can become less. Therefore, the natural defense mechanism is disrupted, which leads to the risk of infection. That is why the analysis of a smear for flora during pregnancy is very important for expectant mothers.

Lactobacilli are not the only variety of microorganisms that make up the microflora of a healthy woman. Normally, candida and gardnerella may also be present. But their number should be quite small. Under the influence of certain factors (prolonged stress, overwork, pregnancy, diseases), the body's immune defenses weaken. Under such conditions, these organisms multiply rapidly, and vaginal dysbacteriosis (bacterial vaginosis), candidiasis (thrush), gonorrhea, chlamydia, ureaplasmosis, mycoplasmosis and gardenrellosis develop.

Smear on flora (table of norms)

You are presented with a table of smear norms for flora, in which it is very easy to find the desired indicator.

Smear on flora: decoding of indicators

In order to save time in medical practice, abbreviations are used to denote smear analysis indicators. In Latin letters V, C, U, it is customary to designate the areas from where the material for analysis is taken.

V - vagina (in Latin vagina).
C - cervical canal (cervix).
U - urethra (uretra).

In addition, the following designations are used to decipher the analysis of a gynecological smear:

L - leukocytes. These cells are present in both healthy women and patients. If there is a disease, the number of leukocytes increases.

Ep - epithelium. Also found the designation "pl. ep." It means "squamous epithelium".

Trich - Trichomonas. This is the organism that causes a disease called trichomoniasis.

Gn - gonococcus which is the causative agent of gonorrhea.

In addition, smears often contain mucus. This suggests that the pH of the vagina is within the normal range.

A small amount of.
++ - moderate.
+++ - increased.
++++ - big.

If any organism is not found at all, make a mark "abs", which means "absent".

Doderlein sticks in a smear

This is the second name for lactobacilli, organisms that form the natural flora of the vagina. These bacteria secrete lactic acid, which retains the acidity necessary to neutralize disease-causing microbes.

A decrease in the number of lactobacilli indicates that the pH of the vagina shifts to alkaline values ​​and becomes less than 4.5. This often happens during an active sexual life. It should be noted that the pH of the vagina largely depends on the presence of opportunistic as well as pathogenic organisms. Moreover, the presence in the vagina of a certain number of opportunistic forms is considered normal.

Cocci are spherical microorganisms. These bacteria are found in both healthy women and those who suffer from inflammatory diseases. The presence of a few cocci in the smear is considered the norm. When immunity weakens, the number of cocci begins to rise sharply. They can be gram positive or gram negative.

What is the difference between gr+ and gr- cocci?

To describe microorganisms in detail, experts do not only indicate their size and shape. Gram staining is required for complete characterization. Part of the microorganisms will be colored after washing the material. These are the gram-positive forms. Other organisms are discolored as a result of washing, that is, they are gram-negative bacteria.

Gram-positive include staphylococci, streptococci, enterococci. Gram-negative cocci include Escherichia coli, gonococci, and Proteus.

A culture smear may be required to confirm the diagnosis.

Epithelium in a smear for flora

Epithelial cells can normally be present in a smear for flora. These cells represent the outer layer of the vaginal wall and cervix. Their number may vary depending on the phase of the menstrual cycle, hormone intake, during pregnancy. If the body has a lot of sex hormones - estrogens, then there will be a lot of epithelial cells. If the epithelium is absent, this indicates atrophy of the epithelium, a lack of estrogen or an excess of male sex hormones.

Key cells in a smear in women

Key cells are epithelial cells surrounded by small rods. Normally, they should not be. And in case of pathology, they are found in a smear, which indicates that aerobic lactobacilli were replaced by anaerobic microorganisms, including small sticks. This condition is called bacterial vaginosis.

Mushrooms in a smear

Fungi may be present in small numbers and cause no symptoms of the disease. This is the case if fungal spores are found under a microscope, if hyphae, fungal mycelium are found, then there will be a common candidiasis with vivid symptoms.

Trichomonas are large unicellular with flagella. Under the microscope can be found
whole or destroyed microorganisms. This indicates a trichomoniasis infection.

Trichomonas are shown by arrows

The norm of leukocytes in a smear for flora

Normally, the number of leukocytes in a smear for flora in the first phase of the menstrual cycle is up to 10 per field of view, in the second phase - 10-15 per field of view. If the leukocytes in the smear are elevated, then this indicates an inflammatory process, but does not reveal the pathogen.
And therefore, if nothing else is found other than an increase in leukocytes, then a more sensitive study of seeding or PCR diagnostics may be required to detect smaller pathogens: viruses, mycoplasmas and chlamydia.

Table of norms for the content of microorganisms in a smear

Smear on flora during pregnancy

The body of pregnant women begins to produce a lot of progesterone, which is why the number of lactobacilli increases several times. This is necessary to protect the developing fetus from pathogenic microbes. Therefore, it is desirable to undergo an analysis for the degree of purity of the vagina even at the stage of pregnancy planning.

In pregnant women, a smear on the flora is taken repeatedly. The first time a woman is registered, then at 30 and 38 weeks. Thus, the vaginal microflora is monitored for the entire period of pregnancy. Pregnant women often have vaginal candidiasis due to hormonal imbalance. If "strange" discharge appears during pregnancy, you should definitely contact your gynecologist.

Degrees of purity of the vagina

To assess the state of the microflora, the concept of "the degree of purity of the vagina" is used.

The first degree of purity of the vagina - this indicator indicates that the woman is completely healthy. The content of lactobacilli in the smear in this case reaches the norm of 95%. Single squamous cells may be present, vaginal pH is acidic. Pathogenic microorganisms and leukocytes are absent.

At the second degree of purity of the vagina, a smear reveals 80-95% of lactobacilli and a small number of opportunistic microorganisms, as well as single epithelial cells (no more than 5) and leukocytes (no more than 10) and epithelial cells, the pH of the vagina is acidic. The second degree is typical for most healthy women and, like the first, is also considered the norm.

At the third degree of purity of the vagina, the smear contains more conditionally pathogenic microorganisms than lactobacilli, and this indicates the presence of an inflammatory process, the pH of the vagina is alkaline or neutral. In the smear, leukocytes (10 - 30) and epithelial cells are determined. A woman may be disturbed by pathological discharge, itching and burning in an intimate place.

The fourth degree of purity of the vagina - this means that the analysis revealed a lot of pathogenic bacterial flora, leukocytes (more than 50) and epithelial cells (more than 15 - 20) with a small number of Doderlein sticks, the vaginal environment is strongly shifted to the alkaline side. In some patients, lactobacilli are not detected at all. This condition indicates the development of bacterial vaginosis or another infectious and inflammatory disease. The woman has vivid symptoms of an infectious disease.

With the third and fourth degree of purity of the vagina, drug treatment with broad-spectrum antibiotics is required. Antibacterial therapy is prescribed taking into account the sensitivity of pathogenic microorganisms.

Deciphering the results of a smear on the flora in women

What do the results of the smear test show? The presence of certain components in the smear makes it possible to assume a certain disease, choose methods for further diagnosis and prescribe the correct treatment.

With a high content of leukocytes and epithelium, there is reason to suspect an inflammatory process (acute or chronic). Mucus in healthy women is present only in the vagina. Its detection in the urethra is a sign of inflammation in the urinary system. There should also be no cocci in the urethra. With a "bad" smear analysis, additional urinalysis and ultrasound will be required.

If cocci, small rods and "key" cells are present in the smear, then the gynecologist diagnoses bacterial vaginosis.

When gonococcus is detected, the diagnosis of gonorrhea is made. If gardnerella and trichomonas are found, then the patient has gardnerellosis and trichomoniasis. A large number of Candida fungi indicates a deterioration in the degree of purity and dysbiosis. In this case, the number of Doderlein sticks usually becomes less compared to pathogenic ones, and the doctor makes a diagnosis of vaginal candidiasis.

conclusions

The results of a smear analysis for flora in women during a preventive examination allow us to evaluate the work of the immune and hormonal systems, identify vaginal dysbacteriosis, diagnose chronic inflammatory diseases of the genitourinary organs and sexually transmitted infections. With a "bad" smear on the flora, the gynecologist can prescribe additional examination methods in a timely manner and select the required treatment.
A "good" smear on the flora will give a woman peace of mind and confidence that she is all right in terms of women's health, which is why it is so important to undergo a gynecological examination once every six months.

A mandatory procedure when visiting a gynecologist is to take biological material to assess the state of the microflora and epithelial cells of the vagina, the internal mucous membrane of the uterine body, endometrium, and cervical canal.

A gynecological smear, the study and interpretation of which is carried out in the laboratory, is highly informative.

The analysis allows you to determine the hormonal level of the reproductive system, the amount and composition of vaginal discharge, the bacterial content of the microflora in women, prevent inflammatory processes, identify developmental pathologies, the presence of neoplasms and sexually transmitted infections.

Diseases of the female reproductive system are dealt with by a specialized area in medicine - gynecology.

There are a lot of reasons for patients to apply: passing a medical examination for employment, pregnancy, pain or unpleasant cramping sensations in the lower abdomen, itching or burning, thrush, heavy menstruation or discharge of unknown origin.

A general smear or microscopy is performed during a preventive examination or during pregnancy planning. The result is the study of the cervical and urethra, vagina, in virgins - the rectum.

Papanicolaou analysis for cytology makes it possible to detect the papilloma virus, precancerous conditions of the epithelium, and the cervix in time. It is recommended to undergo a Pap test for all female representatives with hereditary oncological diseases, persons over 21 years of age.

The bacteriological method of research, bacteriological culture in women, is recommended if there is a suspicion of an inflammatory process, a violation of the microflora, which was caused by opportunistic and pathogenic microorganisms.

PCR is carried out in the form of an analysis for infections transmitted mainly by sexual contact. Gives complete information about the bacterial composition of the internal microflora.

The efficiency and reliability of the method is 98%.

Preparing for a smear test

Before prescribing an examination, the gynecologist or laboratory employee is obliged to warn the patient about how to properly take a smear for flora, which can and cannot be done before the procedure.

Preparation for microscopic examination provides for the rejection of potent antibiotics 2 weeks before the proposed analysis, visiting the bathroom the day before. You should try not to go to the toilet 2 hours before the analysis.

Diagnosis is best done not before, but during menstruation and in the first two days after.

To increase the sensitivity of the test, bakposev on the microflora is carried out in the absence of treatment with antibacterial drugs and douching. Be sure to follow a special diet 2-3 days before bacteriological analysis: limit foods that provoke fermentation or intestinal upset.

Refrain from sexual intercourse with a partner and do not wash yourself 24 hours before data collection.

3-5 days before the appointed PCR diagnosis, it is forbidden to take any antibacterial and contraceptives. For 36 hours it is necessary to exclude sexual contact. It is advisable not to take a shower the day before the PCR and on the eve of taking the analysis. The material is taken during menstruation and for 1-2 days after it ends.

How to take a swab from women

The material sampling technique is usually carried out in the morning in the gynecology department or directly in the laboratory itself. Taking vaginal discharge and sites for research is prescribed only for women who are sexually active. In girls, it is taken more carefully from the lateral fornix of the vagina to exclude damage to the hymen, and from the intestines, secretion.

All manipulations take place on the gynecological chair. At this time, the specialist introduces a special mirror, depending on the age and physiological characteristics of the patient. If the organs are not yet formed, size XS is used, girls will need a mirror S. After labor, examination instruments with a diameter of 25-30 mm, sizes M, L are used.

The collection of material is carried out with a spatula or spatula, brush, applied to a glass slide or placed in a test tube for further transfer of the results to the laboratory.

Smear on microflora: transcript

It is impossible to independently draw a conclusion about how good or bad a smear turned out without the appropriate knowledge. With the help of special symbols, it is very easy to decipher the microscopic examination of a smear. Depending on the localization of the taken biological material, they are distinguished: the vagina - "V", the cervix - "C" and the urethra - "U".

Gram-positive rods, "Gr.+" and the absence of coccal flora. The result is "++++". It is observed quite rarely, most often it is a consequence of intensive antibiotic therapy. Norm: "++", "+++" sticks, the number of cocci does not exceed "++".

Gram-negative bacteria gonococci - "Gn", Trichomonas vaginalis - "Trich", yeast of the genus "Candida". Correspond to diseases like gonorrhea, trichomoniasis and candidiasis.

The presence of key cells and Escherichia coli, if they are listed in the composition of the microflora, indicates that the patient has bacterial vaginosis.

Smear on flora: the norm in women

All patients, without exception, from the age of 14 until the onset of menopause, correspond to the same norm, obtained as a result of laboratory microscopic examination.

Leukocytes. Providing protection of the body from penetrating viruses, bacteria and infections, they can be in sight, but should not exceed the indicator in the vagina - 10, in the cervix - 30, urethra - 5.

Epithelium. A moderate amount of epithelial tissue is normal. A high number indicates possible inflammation, while a too low indicates insufficient production of the hormone estrogen.

Slime. Little or no amount is allowed. The maximum daily rate of excretion of the secretion of the glands of the cervical canal is 5 ml.

Gram-positive rods, "Gr.+". Lactobacilli and Doderlein sticks must be present in large numbers. They are responsible for the body's immune response to foreign bodies. They should not be in the cervix and urethra.

"Gr.-", gram-negative, anaerobic rods are not determined.

Gonococci with the symbol "gn", trichomonas, chlamydia, key and atypical cells, fungi, yeast, Candida are absent. If they are found in the results, the patient is assigned an additional examination for gonorrhea, trichomoniasis, chlamydia, bacterial vaginosis, thrush.

Smear for purity

To avoid complications during the period of gestation, pregnant women are advised to determine the degree of purity of the gynecological smear. Normally, in a healthy woman, the vaginal microflora is 95-98% Bacillus vaginalis or Doderlein's lactobacilli. They produce lactic acid, which helps maintain acid levels.

Pathogenic and opportunistic microorganisms are not able to survive in such conditions. But under the influence of various factors, such as sexual activity, menopause, the menstrual cycle and a decrease in immunity, microflora indicators can change.

• 1 degree the purity of the vagina is normally pH 3.8-4.5. Wednesday is sour. Leukocytes and epithelial cells - no more than 10.
• 2 degree. Slightly acidic medium: pH=4.5-5. There is a slight increase in gram-positive cocci, Candida fungi.
• 3 degree. Pathogenic microorganisms are activated, mucus appears, epithelium indicators exceed the norm. Neutral acidity level, pH=5-7. There are more than 10 leukocytes. Mucus, key cells are present, gram-negative and gram-positive microorganisms multiply in favorable microflora conditions.
• On the last 4 degrees, low purity. The pH values ​​reach 7.5. Doderlein's sticks are either absent at all, or are in a single quantity. The vagina is filled with pathogens.

Bacteriological research

The diversity of the composition, in addition to the lactobacillus Doderlein sticks, which are an integral part of the microflora of the vagina of the examined woman, does not begin to be studied immediately. Sowing on a specially created favorable environment of the collected biological material for its subsequent growth, development and reproduction takes time.

It is possible to evaluate bacteriological seeding for flora through a microscope, provided that the number of representatives of microorganisms increases.

• 0 class. observed during antibiotic treatment. The causative agent is missing.
• I class. The number of bacteria does not increase or moderate growth.
• II class. Mixed nature of microflora. Up to 10 colonies of bacteria Gardnerella vaginalis or Mobiluncus, causative agents of gardnerellosis, are determined.
• III class. There are about 100 colonies. Gardnerella and Mobiluncus live mainly in the microflora. Symptoms of bacterial vaginosis appear.
• IV class. Lactobacilli are absent, immunity is weakened. Diagnosis of an acquired infectious disease - aerobic vaginitis.

Cytological examination

The probability of detecting areas of altered epithelium, papillomavirus and oncological neoplasms is quite high after 30 years, the onset of sexual activity.

The correct interpretation of the Pap test depends on the presence or absence of cancerous, atypical cells.

• NILM. Clinical picture without features, CBO. Leukocytes and bacteria are isolated in small quantities. Possible primary candidiasis or bacterial vaginosis. The epithelial layer is normal.
• ASC US. Found atypical areas in the epithelial tissue of unknown origin. A re-analysis is carried out after 6 months to search for chlamydia, dysplasia, human papillomavirus.
• LSIL. To confirm a precancerous condition caused by atypical cells, a biopsy, colposcopy is prescribed. Mild signs of changes in the epithelium.
• ASC-H. A pronounced lesion of the squamous epithelium. In 1% of patients, the initial stage of cervical cancer is diagnosed, the remaining 98-99% have grade 2-3 dysplasia.
• HSIL. Concomitant symptoms preceding cancer of the squamous epithelium, cervix, were detected in more than 7% of the examined women. 2% have cancer.
• AGC. Atypical condition of the glandular epithelium. Diagnosis: cervical or endometrial cancer, an advanced form of dysplasia.
• AIS. Squamous cell carcinoma, cervical cancer.

PCR analysis

The molecular biological method of PCR diagnostics is characterized by high sensitivity and reliability of the obtained data. Due to the creation of earlier samples of the selected and copied DNA segment, a comparison with the obtained biological material takes place.

Analysis for infections using PCR makes it possible in a short time to find the causative agent of the disease of the female genital organs by obtaining a positive or negative result.

Polymerase chain reaction facilitates the determination of chlamydia, ureaplasmosis, thrush, trichomoniasis, HPV, HIV, the search for the causes of severe pregnancy and hormonal disorders.

The disadvantages of PCR are cases of false data with incorrectly performed tests, possible mutation of the pathogen's DNA.

It is best to take a smear for flora 2-3 days after the end of menstruation, i.e. on day 7-10 of the cycle. But it can be taken on another day, and during menstruation.

In some cases, a doctor may ask a woman to take a bacteriological smear, which is also called a "smear on the flora." It is necessary in order to determine how many microbes are in the genital tract of women. With it, you can find out exactly which microbes are in the vagina, their number. Usually, such tests are not carried out during menstruation, unless the doctor insists on this.

A swab for flora is taken at almost every examination of a woman by a gynecologist, for preventive purposes. It is no secret that many diseases can occur without symptoms, at least at the very beginning. But in some cases, the doctor specifically prescribes this examination. We list the main reasons for which they are asked to take tests:

1. Be sure to take a smear on the flora from women who are in an interesting position, and more than once. During pregnancy, it is necessary to constantly monitor the state of the reproductive system of women, because. during this period, bacterial infections, inflammatory diseases may appear, due to which the pregnancy may be interrupted, or there will be disturbances in the development of the fetus.
2. You can and should take a smear on the flora if a woman is planning a pregnancy. If inflammations and infections are detected in advance, they can be cured even before the child is conceived. It is no secret that during pregnancy, many drugs can not be used.
3. A woman complains of unusual discharge. They may be of a strange color, such as green or yellow, even brown. Too thick discharges, or curdled ones, often with a pungent odor, may also alert.
4. Women who complain that they have the following symptoms may be asked to take a smear: pain in the perineum, burning, or severe itching.
5. It is possible and necessary to take tests or visit a gynecologist, even if a woman is healthy, for preventive purposes, especially if she has changed her sexual partner or has recently had more than one man, but several.
6. A smear on the flora is taken from women who have been taking drugs for a long time. Antibiotics or oral contraceptives can change the microflora of the vagina. After the course of treatment is completed, you can take a smear on the flora in order to detect all deviations in time and bring everything back to normal.
7. She doesn't have her period. In this case, a full examination of women is prescribed to find out the cause. If this is not pregnancy, but a sign of some disease, it must be detected and treated.

Learn more about analysis

Where are these tests usually done? In the gynecologist's office. Where exactly is a smear taken for analysis? The doctor takes a smear on the flora from 3 points: the vagina, cervix, and urethra. It is collected using a special sterile swab. It doesn't hurt at all and doesn't cause any discomfort. When exactly can these tests be taken? Is it possible to take a smear during menstruation? We will answer these and other questions.

It's no secret that girls are carefully preparing for a visit to the gynecological office. Knowing that the doctor will take a smear from her, the patient finds out hygiene requirements in advance. Women stop taking antibacterial drugs, painkillers. The specialist does not advise a woman to go to him for examination on “special” days if there are no ailments. But sometimes menstrual flow is not an obstacle to the study of the microflora of the vagina. It will not hurt you to figure out in which cases the trip to the doctor should be postponed "until better times."

Why is cell sampling from intimate areas so important?

When you get to an appointment with a women's doctor, you know that the examination will end with a smear. A scraping taken from the mucous membranes of the patient allows the gynecologist to obtain accurate information about the state of the microflora in her "inner corners". The procedure for taking a smear is simple. The doctor inserts a miniature mirror into the patient's vagina. Not all ladies and young ladies know if a gynecologist can take a smear during menstruation. Using a special spatula, the gynecologist collects cells from the cervix and vagina. In some cases, it becomes necessary to take a scraping from the urethra. This material is placed on special laboratory glasses. Cells will be studied by specialists in a laboratory.

Some patients feel slight discomfort during the procedure. Most often, pain in delicate areas indicates an inflammatory process.

A smear is necessary if the following events have occurred in a woman's life:

• pregnancy;
• the emergence of a new sexual partner;
• long-term antibiotic treatment;
• delay of menstruation;
• discomfort and burning sensation in the perineum.

Any deviations are a reason for diagnosis

A woman may suspect that her genitourinary system is not in order if she has a discharge of an unusual color. Itching and soreness "there" can also alert the patient. If possible, schedule an appointment with your doctor the day after your period ends. This is a good time for research. The immune forces of the body have almost no effect on the composition of the microflora of your vagina.

A gynecological smear will help you find out what diseases are preventing you from living in peace. If the doctor detects increased acidity in the vaginal environment, most likely, you are annoyed by thrush. The presence of chlamydia in a smear will “tell” the gynecologist that you are developing chlamydia. The sooner you recover from this infectious disease, the less problems you will have in the future.

Girls often ask if it is possible to take smears during menstruation. Experts advise to postpone the sampling of biological material if there are no “female” ailments. Scheduled inspection is best done two to three days after the end of menstrual flow.

Menstruation "confuses the cards" ...

Experts explain in detail to young ladies the nuances of preparing for the examination. You should stop taking strong medications five days before your "date" with the gynecologist. Two days before the medical examination, you need to refrain from intimate contact.

Doctors advise girls to wash themselves six to seven hours before visiting the gynecological office. Ideally, all hygiene procedures must be performed in the evening, on the eve of the sampling of biological material. It is desirable to wash without the use of gel, using only water.

During the period of menstrual flow, a visit to the gynecological office is undesirable.

Recall what interferes with menstrual blood:

• it is more difficult for the patient to follow the rules of preparation. It will be difficult for a woman who has begun to have critical days not to wash herself for a long time;
• the gynecologist does not see well where the smear is taken from;
• the presence of blood can distort the results of studies.

In what cases is menstruation not a hindrance for examination?

If you planned to take a smear during a routine examination, critical days will not please you. But you are unlikely to get upset. The girls, who find themselves in a delicate situation, postpone the visit to the female doctor for another day. But when a lady is worried about sharp pains in the vagina, it is unreasonable to wait for a “good moment”.

Recall what ailments become the reason for an urgent smear from a woman:

• the appearance of fetid secretions;
• prolonged menstrual bleeding;
• increased body temperature;
• highlighting an alarming color. Yellow or green mucus indicates the development of a pathological process in the urogenital area;
• a strong burning sensation, cramps in delicate areas.

As you already understood, in some cases, menstruation is not an obstacle to taking cells from intimate places. If you are going to an appointment with a female doctor, take a diaper with you. She will need to be put on a gynecological chair. Before the procedure, try not to urinate for an hour and a half. If this condition is met, the doctor will be able to obtain more reliable information about your microflora.

How to pass a smear for PCR

PCR analysis is designed to reveal hidden infections of the genitourinary system. The method is based on the polymer chain reaction. Pathogenic microorganisms are often the main cause of infertility. Research on infection can be carried out on critical days.

Medicine goes to the trick: the doctor advises the patient on the eve of the study to dine with salty dishes or smoked meats. You can eat some pickled vegetables, drink a glass of wine. Spicy and smoked dishes will act as a "bait" for bacteria. Yielding to provocation, microorganisms will demonstrate increased activity. This means that the study of the vaginal microflora can easily determine the type of bacteria. Having received information about the causative agent of the infection, the gynecologist will select drugs for you to eliminate it.

Compromise option

If you are going to take a smear during your period, you should be prepared that the examination procedure will take longer than it used to take. If your test reveals an infection, your doctor will recommend antibiotics. To clarify the diagnosis, the doctor may prescribe an ultrasound of the uterus and ovaries.

If the “menstrual” smear seems to the doctor not informative enough, the gynecologist will advise you to come for an examination after the end of the discharge.

A swab for flora - biological purity or microflora - is one of the main research methods practiced in gynecology. Material for such a study is taken from the mucous membranes of the vagina, cervix and urethra. The main task of the gynecologist taking the analysis is to obtain information about the state of the microflora and the presence of pathogens of genitourinary diseases.

There are many microorganisms in the female genital organs, some of them are dangerous, others are harmless to the body, while they are few, others are completely necessary for women's health, as they help fight pathogenic bacteria that cause inflammation. smear on flora(smear on the cleanliness of the vagina) helps to determine the composition of the flora and the quality of the environment in which it lives.

What can be found in a smear for the purity of the vagina?

A smear on the purity of the vaginal flora can reveal the following elements:

• Epithelium. These are dead epithelial cells of tissues covering organs, in particular the vagina and cervix. Normally, it should be a little. If there is a lot of biomaterial in the studied sample, it means that an inflammatory process occurs in the body. The absence of epithelium is observed in women with disruptions in the hormonal background, with an excess of testosterone and a lack of estrogen. This is a no less dangerous symptom, leading to early aging of the body and a decrease in sexual function.
• Leukocytes. These are special cells - defenders against infections, produced by the immune system. Leukocyte cells are white in color, which is why they are called white blood cells. Normally, there should be a small amount of them in order to withstand the attacks of pathogenic bacteria. A sign of inflammation is an increase in the number of leukocytes.
• red blood cells. Red blood cells are part of the blood - they give it a red color. Their concentration in the smear depends on the phase of the menstrual cycle. However, if there are a lot of them, erosion, inflammation, or damage to the vaginal mucosa can be assumed.
• Slime.This viscous substance is secreted by the glands of the vagina. Thanks to her, the genital tract is self-cleansing. And this means that mucus must necessarily be part of the smear for the purity of the vagina. If mucus is found in the urethra, then this is the first sign of urinary tract infection.
• atypical cells. These are cells that differ in structure from normal cells. Normally, they should not be at all - they are a sign of a precancerous condition.
• Gardnerella. These microorganisms belong to the conditionally pathogenic flora, which means that they are harmless up to a certain point. It is conditional pathogenicity that allows them to be in the body without causing attacks by the immune system. Under certain circumstances, for example, when immunity is weakened or infection with other pathogens, the number of gardnerella increases, which leads to gardnerellosis, which rarely occurs alone. The detection of these microorganisms in a smear in a small amount is the norm. But an increase in the number of gardnerella indicates vaginal dysbacteriosis and bacterial vaginosis.
• key cells.So called epithelial cells that stick together with microbes and viruses. They appear with gardnerellosis and weak immunity.
• Cocci.Bacteria of spherical shape, having a pathogenic (gonococcus) or conditionally pathogenic (staphylococcus) character. In case of detection of cocci pathogens, very serious treatment is necessary.
• Candida. This fungus can be found in small numbers even in healthy women. If there are more candida than lactobacilli, then candidiasis begins, or, as this disease is called, “thrush”. This happens when taking antibiotics, pregnancy and reduced immunity.
• Trichomonas. This bacterium, the causative agent of the dangerous disease of trichomoniasis, can not always be detected when examining a smear for the purity of the vagina because of its ability to change shape. To confirm its presence, an additional analysis is carried out - bacterial culture (bakposev). But if it is found, treatment cannot be avoided.
• Dondraine sticks - lactobacilli. The main female microorganisms that support the health of the reproductive system. Their presence in the smear for the purity of the vagina is strictly necessary.

When should you take a smear for flora?

It is recommended to take a smear for flora for any. Unfortunately, many women's diseases are hidden, so this analysis is simply irreplaceable. In addition, there are direct indications for the delivery of a gynecological smear for the purity of the vagina:

• Inflammation of the pelvic organs;
• Planning for pregnancy;
• Pain in the lower abdomen;
• Itching, burning and unnatural vaginal discharge;
• Pregnancy;
• Taking antibiotics or hormones;
• Change of sexual partner.

In these cases, a smear on the purity of the vagina will help identify violations of the flora.

How to properly prepare for taking a smear for vaginal cleanliness?

Before visiting a doctor, you should follow some recommendations:

• Do not use vaginal preparations and douching;
• Refrain from sexual intercourse for a couple of days;
• Immediately before taking a smear, try not to urinate for 2-3 hours.

It is best to go for an examination after the completion of menstruation, in 5-6 days. A direct sampling of biomaterial from a woman is carried out by a gynecologist using a disposable spatula. The procedure is absolutely painless.

How to decipher the analysis - a swab for the purity of the vagina

Only a specialist with the appropriate qualifications can decipher the analysis. It is desirable that this is done by the same doctor who took the smear for analysis. Doctors designate all indicators with several letters for brevity. It looks like this:

V - vagina;

C - cervical canal of the cervix;

U - urethra;

L - leukocytes;

Ep - epithelium;

GN-gonokokkovoi;

Trich - Trichomonas.

A healthy smear contains mucus, which indicates a normal pH level, and lactobacilli (Doderlein sticks), which make up 95% of the total microflora.

The “abs” sign on the form of the analysis result indicates the absence of one or another component, and the “+” sign indicates its presence.

Normal smear indicators for the purity of the flora

What is the degree of purity of the vagina

According to the result of a smear on the purity of the vagina, the degree of purity of the vagina is determined. There are only 4 of them:

• 1 degreecharacterized by a normal number of leukocytes in the test sample. Lactobacilli make up the bulk of the total microflora. Epithelium and mucus - in moderation. If, after studying the biomaterial, 1 degree of vaginal purity is assigned, this means that the body's immunity is strong, the microflora is in perfect order and there is no threat of inflammation or infection.
• 2 degreealso determined by the leukocyte count is normal. In the microflora of the vagina there are cocci and fungi along with lactobacilli. Mucus and epithelium - within the permissible concentration. These indicators are considered the norm, but the microflora is not ideal. This can cause inflammation due to reduced immunity.
• 3 degree: the number of leukocytes is increased. Most of the microflora consists of pathogenic and pathogenic microorganisms: fungi, cocci. There are very few lactobacilli, and a lot of mucus and epithelium. All of these are signs of an infection or serious inflammation that requires immediate treatment.
• 4 degree: a large number of leukocytes and pathogens. Lactobacilli are not observed. A lot of mucus and epithelium, which indicates a pronounced inflammatory process. An urgent medical examination and treatment is required.

If the first two degrees are considered the norm and do not require special attention, then the third and fourth degrees indicate an infection of the internal genital organs. Various gynecological procedures for such indications cannot be performed without prior treatment and re-examination.

The analysis of a smear for the purity of the vagina is of great importance for studying the work of the immune system and determining infections and inflammations, especially chronic ones. If necessary, the doctor can conduct an extended examination of the discharge using special methods of analysis: cytomorphological and bacterial.