If the leukocytes in the smear are 80 90. A smear for flora: interpretation of the results of the analysis, the norm of indicators and pathology

The cells that are in the human immune system are leukocytes. They are designed to protect the body from various infections. A large number of leukocytes in a smear (more than 15 units) indicates the presence of inflammatory processes in a woman.

What are leukocytes in a smear

Leukocytes are capable of destroying pathogenic microorganisms that penetrate the vaginal microflora. The level of increase in such cells reflects the severity of the inflammatory process. The more of them, the more severe the disease. The presence of such protection only helps to identify inflammation, while it does not make it possible to determine which infection is the cause of the disease.

Microscopic examination of a smear is a standard procedure performed by a gynecologist at every visit of a woman. Such an examination can also be done in men, a sample for analysis is taken from their urethra. Women are advised to conduct a study several times a year. The analysis will reveal elevated white blood cells in a smear, which signal the presence of diseases on early stage when their treatment would be most effective.

Symptoms of leukocytosis

A condition characterized by an excess of white blood cells (leukocytes) in the blood is called leukocytosis. Cells protect a person from the invasion of viruses and do not allow their reproduction. A permanent elevated level of leukocytes is the result of an inflammatory process of various etiologies, which is often accompanied by the following symptoms:

• burning sensation and unpleasant odor from the vagina;
• pain when urinating;
• white curdled discharge from the vagina;
• painful intercourse;
• failure menstrual cycle;
• itching of the genitals;
• unsuccessful attempts to get pregnant;
• temperature rise;
• dizziness.

Why are there a lot of leukocytes in the smear

Elevated levels of white blood cells may indicate the onset of an inflammatory process. Taurus concentrate in an infected place, after which they begin to fight dangerous viruses or bacteria. The more microbes accumulate, the greater the number of protective cells. The causes of an increase in leukocytes in a smear are allergic reaction, infections, poor exposure to polymorphonuclear pathogens. In addition, the following factors can provoke an increase in cells:

• coli;
• vaginal dysbacteriosis;
• STDs - diseases that are sexually transmitted (gonorrhea, trichomoniasis, ureaplasmosis);
• hormonal imbalance;
• staphylococcus;
• inflammation of the vagina;
• stress;
• taking medications;
• oncology.

What diseases cause increased leukocytes

In women, elevated leukocytes in a smear indicate various diseases internal organs and reproductive system. The body instantly reacts to the disease, so with the help of research it is possible to determine the presence of an infection at an early stage. Even if there are no visible symptoms of the disease and the woman is not worried about anything, a laboratory analysis may show a different picture. Usually, increased amount cells cause the following diseases:

• endometritis - inflammation that can occur in the uterus;
• cervicitis - increased leukocytes in the cervical canal;
• adnexitis - a disease of the appendages;
• colpitis - an inflammatory process in the vagina;
• intestinal dysbacteriosis;
• cervical erosion;
• urethritis - inflammation of the urethra;
• sexual infections (chlamydia, syphilis, gonorrhea).

The norm of a smear in women

The number of protective blood white cells in women in a smear should be up to 15 units - this is the norm. In the urethra, the number of such cells should not exceed 5 units, in the cervix - 15 units, in the vagina - 10 units. If the level of protective bodies goes beyond the norm and shows from 20 or more units, then this indicates that there are infectious and inflammatory processes.

An increase in a small number of leukocytes (up to 30) can be observed before menstruation - this is a natural phenomenon. In addition, cell growth after the first analysis is sometimes unreliable, because. material may be incorrect. For example, a "thick" smear is practically not visible, since the entire field is covered with clusters of cells that overlap each other. To eliminate all risks, a woman needs to be tested again.

Increased white blood cells in a smear during pregnancy

While waiting for the baby, a pregnant woman undergoes a series of tests and examinations. One of them is a gynecological smear showing the number of leukocytes. As a rule, the number of cells during pregnancy can be high, which is considered normal and will not require intervention by a gynecologist. In this case, a woman must constantly be observed by a doctor to exclude the occurrence of inflammatory processes. If then the therapy is not carried out in time, complications may appear (termination of pregnancy and a negative effect on the fetus).

Normally, leukocytes during pregnancy range from 15 to 30 units. If their content exceeds, then there is an infection in the body. In many cases, pregnant women simply exacerbate chronic diseases. Although often an increase in white blood cells can indicate fungal (candidiasis) and sexual infections: genital herpes, gonorrhea, syphilis. If the protective bodies of a pregnant woman exceed the norm, additional studies are carried out: bacteriological cultures, PCR diagnostics, immunological examination.

How to treat leukocytes in a smear

If an increase in white blood cells is detected in women, the doctor may prescribe treatment, but only after the cause of such growth has been accurately established. In some cases, it is not possible to find the etiology of the increase, and the specialist resorts to observation - the patient will need to undergo regular examinations. The main task of therapy is not a treatment to reduce white blood cells, but the fight against the disease that caused their growth. Treatment methods:

• With thrush, the doctor prescribes antifungal agents (Nystatin, Sertaconazole, pimafucin, vaginal suppositories Terzhinan).
• If the increase in leukocytes is caused by chlamydia, then antibiotics should be drunk (levofloxacin, amoxicillin, doxycycline, azithromycin, erythromycin). In this case, the patient's sexual partner should undergo treatment.
• For the treatment of gonorrhea, women and men are prescribed ceftriaxone, azithromycin, doxycycline.
• An increase in white blood cells in syphilis is treated with drugs containing penicillin (ceftriaxone, ampicillin).
• Sanitation of the genital organs.
• With elevated leukocytes in a smear, douching with a solution of chlorophyllipt and warm baths help well.
• Using special tampons with aloe juice and honey.
• Rarely - treatment folk remedies: douching with tincture of chamomile, decoction of oak bark or St. John's wort.

Video: smear indicators for flora

In women, a smear is taken on the flora, as a rule, when visiting any gynecologist. It is according to the results of such an analysis that leukocytes can be detected. In a healthy woman, they can normally have fifteen to twenty in the field of view. If the number of leukocytes is overestimated, then an inflammatory process that occurs in the genital area can be suspected.

Inflammation can be triggered by vaginitis, infections, colpitis, and other diseases that are sexually transmitted. It is believed that the higher the leukocyte level, the more pronounced the inflammatory process is already occurring in a woman. Of course, to clarify this pathogen, the doctor must conduct special additional studies: PCR, bacteriological cultures, immunological studies.

The norm of the number of leukocytes in a smear

In a smear, in the field of view of leukocytes, normally more than fifteen should not be. In the urethra - no more than five, in the cervix - up to fifteen, and in the vagina up to ten are allowed. Only doctors consider this the norm.

Increased number of leukocytes in a smear

With any inflammatory processes in female body, the quantitative composition of leukocytes increases quite sharply. For example, inflammation of the vagina provokes precisely a sharp increase in the composition of leukocytes in a smear. It is necessary to know that the more the analysis of leukocytes showed, the more acute is the condition of the present disease. If a woman's body has acute inflammation, in this case, there may be up to a hundred leukocytes in the field of view, or in medical language it can be said that "leukocytes cover the entire field of view."

Of course, the identified infections could appear in the body of a woman for a long time, they just could “sit out”. And only with a decrease in immunity, they made themselves felt. Quite often this happens precisely against the background of pregnancy, when a serious hormonal restructuring of the female body, the entire immune system of a pregnant woman takes place. It is at this very moment that the “dormant” pathogens begin to manifest themselves.

The causes of inflammation processes can be hidden in STDs, which include genital herpes, gonorrhea, mycoplasmosis, syphilis, ureaplasmosis and other serious diseases. Another very common cause of an increased composition in a leukocyte smear is thrush. Of course, in pregnant women, such a disease is more often diagnosed than in other women, and this disease requires adequate treatment.

When determining an increased leukocyte count and a pathogen in a smear, the attending physician immediately prescribes treatment. All pregnant women are carefully selected drugs, taking into account the duration of pregnancy, the individual characteristics of their body, as well as the sensitivity of the pathogen to certain drugs. If the pathogen has not been identified, or local treatment completely ineffective, then the doctor, as a rule, raises the question of the use of antibiotic therapy.

Quite a few patients believe that an elevated leukocyte level, in the absence of pronounced symptoms, is a trifle. Only an untreated infection, in fact, can cause dangerous chronic diseases in the pelvic area, miscarriages and lead to weakness in labor in the future. Therefore, it is simply necessary for a pregnant woman to start treatment, and this should be done as early as possible.

In a modern medical center, every woman can receive qualified assistance from experienced specialists, pass necessary analyzes, receive a treatment regimen in order to gain women's health and a successful pregnancy.

With an increased leukocyte composition, a gynecologist can identify one of the diseases:

• inflammation of the vaginal walls - colpitis disease;
• dysbacteriosis of the vagina or intestines;
• diseases of the genital organs of a cancerous form;
• inflammation of the uterine walls - endometritis disease;
• cervicitis, which is a special inflammatory process in the cervical canal;
• disease adnexitis in the form of inflammation of the ovaries;
• urethritis, which is inflammation of the urethra (the urination channel).

If the gynecologist detects an increased number of leukocytes, then you just need to pass the mandatory PCR tests. They are needed for additional testing. Only on the basis of these analyzes is it possible to detect the cause of the increase in white cells, that is, to learn about the disease. After determining the disease caused by an increase in white blood cells, your gynecologist will be able to prescribe the right treatment for you or send you to a consultation with doctors who can continue to investigate the disease.

There are simply paradoxical cases when a woman has been treated, and the leukocytes in the smear are not normal. These special situations, most often, occur due to vaginal dysbacteriosis. Then you should repeat the courses using special antibacterial suppositories.

Leukocytes in the female body perform a protective function. Their presence indicates that local immunity is normal.

But sometimes tests reveal a large number of leukocytes in a smear. This clearly indicates the presence of certain diseases, which can be identified with a more thorough examination.

As a rule, a lot of these cells are formed when an inflammatory process occurs in the body. They rush to the affected area and there they begin to fight dangerous microbes. The more microbes, the more leukocytes are formed.

The reasons for the increased leukocytes in a smear may be different. It's possible it's an infection. Many polymorphonuclear pathogens can have a harmful effect on the body. Allergic exposures are another factor.

The norm of leukocytes in a smear

Leukocytes play an important role in a woman's health:

• contribute to the fight against various viral and infectious pathogens;
• contribute to the development of common pathological diseases.

The number of leukocytes in a smear should be up to 15 units in the field of view. This is considered the norm. The number of leukocytes in the urethra should not exceed 5 units, in the vagina - 10 units and in the cervix - 15 units.

If the level of leukocytes exceeds the norm and shows 20, 30, 40 or 50, then this indicates that there are inflammatory and infectious processes in the urethra.

Why white blood cells in a smear are increased: reasons

In women, the causes of elevated white blood cells in a smear can indicate various kinds of diseases, both internal organs and pathologies of the reproductive system.

With any inflammatory processes in the female body, the quantitative composition of leukocytes increases quite sharply. For example, inflammation of the vagina provokes precisely a sharp increase in the composition of leukocytes in a smear.

It is necessary to know that the more the analysis of leukocytes showed, the more acute is the condition of the present disease. If there is acute inflammation in the woman's body, in this case, up to a hundred leukocytes can be in sight.

So what does this mean? Most often, the situation when a woman's leukocytes in a smear are increased is caused by the following reasons:

• - inflammation of the cervical (cervical) canal;
• - the presence of an inflammatory process in the appendages (fallopian tubes or ovaries);
• - inflammation of the mucous membrane of the vagina;
• endometritis - inflammation of the uterine mucosa;
• - inflammation in the urethra;
• oncological pathologies of the genital area;
• genital infections (,).

Usually, elevated leukocytes in a smear do not manifest themselves in any way for a long time. A woman may not even be aware that an inflammatory process is actively developing in her body until she passes tests during a routine examination.

Nevertheless, sometimes you can find these symptoms:

• problems with emptying the intestines and bladder;
• soreness in the anus and pelvic organs;
• copious with an unpleasant odor;
• disruptions in the menstrual cycle;
• futile attempts to get pregnant.

If there are a lot of leukocytes in the smear, the specialist chooses a method of treatment based on the results of the patient's examination. In some cases, it is not possible to identify the cause of the increase in the level of leukocytes, and the doctor resorts to observation tactics - the patient is recommended to regularly go for examinations and carefully monitor her well-being.

Analysis methodology

In non-pregnant women, a smear test is recommended in the first days after the cessation of menstruation or shortly before its onset.

Violation of the technique of taking a smear can lead to the so-called. false positive results - elevated leukocytes in a smear in the absence of objective pathology. To avoid this, a woman must follow the rules for preparing for taking a smear.

These rules provide:

• discontinuation of medications - both general and local action a week before taking a smear;
• exclusion of intimate contacts 2-3 days before the analysis;
• do not urinate 2-3 hours before sampling.

An intimate toilet is carried out the night before only with warm water, without douching and any hygiene products, which are also excluded 2-3 days before taking a smear.

Why is an increase in leukocytes dangerous?

The lack of adequate treatment and a prolonged inflammatory process leads to the following consequences:

1. Chronic diseases of the genital organs.
2. Damage to the urinary system and kidneys.
3. Benign and malignant tumors of the reproductive organs.
4. Ovarian dysfunction.
5. Cervical erosion.
6. Infertility.
7. miscarriages.
8. Fading pregnancy.
9. Mastopathy, fibroadenoma.

Every woman, when visiting a gynecologist, takes a smear, which reflects the presence of not only bacteria, but also leukocytes. With an increased concentration of leukocytes, an inflammatory process of the pelvic organs can be assumed, an examination and timely treatment can be prescribed.

In contact with

What are leukocytes

Leukocytes are white blood cells, they are produced immune system organism to destroy pathogenic microflora.

White cells are concentrated in places of inflammation, absorbing infectious agents, they are able to penetrate through the walls of blood vessels and enter all places of the human body.

By the number of leukocytes, one can judge the state of health of a woman: if there are a lot of them in a smear, then an inflammatory process of the pelvic organs is possible.

Having absorbed a large number of bacteria, white cells are destroyed, causing a local increase in temperature and swelling of the tissues. The presence of leukocytes in biological material indicates that the immune system is fighting infectious agents or allergens.

What does a smear show

A smear on the flora in women is taken not only for diagnostic purposes, but also after drug therapy during pregnancy and after childbirth. If a woman is pregnant, the analysis is taken several times. For maximum accuracy of the analysis result, it is necessary to prepare:

• two days to give up sexual intercourse;
• do not douche;
• do not use candles vaginal tablets and other means;
• do not empty bladder two hours before the test;
• at night, before the day of the smear, you should wash yourself without using detergents.

On the days of menstruation, a smear is not taken: the microflora changes, and the result may be unreliable.

A smear is taken with special disposable instruments on a gynecological chair using a mirror. Material is collected from three different locations:

• U - from the urethra;
• C - from the cervical canal (cervix);
• V - from the posterior fornix of the vagina.

The taken material is examined microscopically in the laboratory, the result is indicated in the direction. Depending on what the smear shows, the doctor confirms the diagnosis or order additional testing. With the help of microflora analysis, the following can be established:

• inflammatory processes, vagina and urethra;
• fungal diseases;
• sexually transmitted infections;
• precancerous pathologies;
• oncological processes.

When deciphering the result, it is necessary to indicate where the material was taken from.

Normal indicators also differ depending on the place of material sampling.

Norm in women:

• urethra - 0-5-10;
• cervical canal - 0-30;
• vagina - 0-10-15.

Attention! White blood cells in a smear during pregnancy can be increased to 20 units per field of view in the vagina. This indicator is considered normal.

Causes of elevated leukocytes

If the leukocytes in the smear are elevated, it may be both the inflammatory process and the infectious disease.

The higher the level of white blood cells, the more acute the process, their concentration can rise to 100 units. Such indicators occur with the following pathologies:

• cervicitis - inflammation of the cervix;
• colpitis;
• adnexitis;
• urethritis;
• inflammation of the endometrium of the uterus;
• violation of the microflora of the vagina;
• intestinal dysbacteriosis;
• oncology of the pelvic organs;
• hormonal disorders during puberty, endocrine changes;
• injuries of the mucous membrane of the vagina;
• abuse of hygiene products;
• use of tampons;
• an allergic reaction to the biological fluid of a partner, medications, douching;
• absence intimate hygiene, wearing synthetic underwear;
• venereal diseases;
• sexually transmitted infections.

Inflammatory process does not always have pronounced symptoms, often the disease is detected after a routine examination and a smear on the microflora.

Important! If leukocytes are elevated in the cervical canal, the cause may be a serious pathology of the cervix or body of the uterus, up to malignant neoplasms.

But if there are mucous secretions and a bad smear during pregnancy, you must follow all the doctor's recommendations and undergo a course of treatment.

This will allow eliminate the risk of infection of the baby during childbirth with a bacterial or viral infection.

Elevated white blood cells in a smear during pregnancy are for the following reasons:

• a change in the general hormonal background of the body, increased production of hormones - and estrogen, which contribute to an increase in the acidity of the vaginal microflora and an increase in the concentration of leukocytes;
• a decrease in immunity to maintain pregnancy contributes to the activation of latent infections, which causes an increase in white cells;
• thrush, which begins to progress during pregnancy.

The cause must be eliminated otherwise the inflammatory process will spread further, and elevated white blood cells in the cervical canal can cause uterine disease or infection of the fetus, which will provoke a miscarriage or premature birth.

Smear grades

To determine the degree of purity of a gynecological smear, material is taken for a separate analysis, the fence is made from the walls and placed on a special glass, which is then studied under a microscope. There are 4 degrees in total, but only the first two are normal:

• 1 - 0-5 leukocytes, a smear of perfect purity, white cells are normal, the microflora is inhabited by lactic acid bacteria, a small number of epithelial cells, there are no inflammatory processes.
• 2 - 5-10 leukocytes, the norm in women, opportunistic microflora may be present in the smear, but at the same time a sufficient number of beneficial bacteria, a minimum of mucus and epithelial cells.
• 3 - 10-50 increased level of white cells, mucus in large quantities, a lot of epithelium, the level of lactobacilli is lowered, opportunistic flora is increased, an obvious inflammatory process is diagnosed.
• 4 - a lot of leukocytes, they cannot be counted, there are bacterial or viral infectious agents: Trichomonas, gonococci, chlamydia. Dederlein sticks are absent, mucus and epithelium are abundant. With such indicators, one can assume not only inflammation, but also an infectious disease.

Treatment should be prescribed by a doctor, most often prescribed suppositories for elevated leukocytes in a smear; if an infection is detected, then antimicrobial or antibacterial drugs are used.

If the degree of purity of the smear is less than two, an appeal to a specialist and specific treatment is not required. Such an increase can be observed in the norm.

Diagnosis and treatment

The most common cause of elevated leukocytes in the female microflora are diseases of the genitourinary system, which are accompanied by characteristic symptoms:

• cramps and pain when urinating, frequent urges - all these are signs of urethritis or;
• diarrhea and discomfort in the anus - a violation of the microflora of the vagina and intestines;
• vaginal discharge with a pungent odor, itching and burning in the vagina - bacterial vaginitis, cervicitis, endometritis, inflammation of the appendages;
• discharge of a purulent nature with foam or in the form of cottage cheese - a fungal or venereal infection;
• pain syndrome during intercourse - a pathological process in the uterus, cervix or appendages, there may be a tumor;
• if the menstrual cycle is disturbed and white bodies are elevated - problems with the ovaries or appendages.

If the smear is bad, the doctor prescribes a more detailed examination, and having found out what it means, he prescribes treatment.

Depending on the etiology of the inflammatory process, treatment is prescribed:

• Miramistin, potassium permanganate, chlorhexidine are used for vaginal douching. This allows you to reduce the reproduction of pathogenic microflora.
• Candles with elevated leukocytes in a smear are used twice a day for 10 days, the most popular are the following drugs: Terzhinan, Genferon, Viferon, Hexicon.
• Fungal infection is treated with Flucostat or Fluconazole. The course of treatment is determined by the doctor.
• Candles with elevated leukocytes in the smear are used and to treat a bacterial infection, but antibiotics and antimicrobial agents are prescribed in parallel - Metronidazole, Tsiprinol.
• To normalize the microflora of the vagina, eubiotics are prescribed - Lactobacterin, Bifidumbacterin, Vagilak.

Advice! Do not self-medicate: uncontrolled use of antibiotics can cause bacterial resistance, and the disease will take a chronic form.

In contact with

At each visit to the gynecologist during the examination, tests are necessarily taken from the urogenital tract, regardless of whether the woman has complaints or not. A smear on the flora displays not only beneficial, opportunistic and pathogenic bacteria, but also leukocytes.

Often, it is the elevated leukocytes in a smear in women that indicate some kind of malfunction in the body, it requires finding out the cause of this condition, and, of course, treatment. It is important to remember that no self-treatment will help to cope with the problem, and sometimes it can lead to negative consequences.

Briefly about leukocytes

Leukocytes are white blood cells that protect the body from all types of harmful agents (bacteria, viruses, etc.). That is, the main function of leukocytes is the implementation of the protection of the body, both specific, for example, from a certain type of microorganisms, and nonspecific or general.

The concentration of leukocytes increases in areas of inflammation, where they capture and digest foreign agents. In the case of a large accumulation of pathogenic agents, white blood cells increase significantly in size and begin to break down. The process of destruction of leukocytes is accompanied by a local inflammatory reaction: edema and hyperemia of the damaged area, an increase in local temperature.

smear on flora

A swab for flora, as already mentioned, is taken from a woman at each visit. antenatal clinic, that is, every six months, if the patient has complaints, as well as after a long course of antibiotics, when planning a pregnancy, during the period of gestation and after childbirth. During pregnancy, a smear for microflora (in the absence of complaints) is examined three times: upon registration, before maternity leave (30 weeks) and at 36 weeks.

Preparation for the delivery of the analysis

In order for the results of a smear on the flora to be reliable, it is necessary to prepare in advance for the test:

• for 1 - 2 days to exclude sexual contact;
• douching is not allowed 2 days before the visit to the doctor;
• it is forbidden to use candles, tablets and creams at least a day in advance;
• a smear is not taken during menstruation, since menstruation changes the composition of the smear;
• 2-3 hours before visiting the gynecologist, refrain from urinating;
• should be washed on the eve of the reception, with warm water without soap.

If a woman is preparing for a preventive examination, then it is advisable to schedule a visit to the gynecologist in the first days after menstruation or before they begin.

Sampling and testing procedure

IN gynecological smear determine the composition of the microflora of the contents of the urethra, vagina and cervix.

The material is taken with sterile disposable instruments. A swab is taken from the urethra with a bacteriological loop or a Volkmann spoon, from the vagina (posterior fornix) with a sterile gauze swab, and from the cervix with an Eyre spatula.

Symbols are indicated on the slides:

• U - smear taken from the urethra;
• C - smear from the cervix;
• V - smear from the vagina.

After the glasses are dry, they are sent to the laboratory for analysis. Laboratory assistants stain smears with special dyes (according to Gram), then examine them under a microscope. During the analysis, leukocytes and various opportunistic and pathogenic bacteria are counted, which are stained in different colors.

Deciphering smear analysis

The data that is indicated in the smear analysis:

Leukocytes

The rate of leukocytes depends on the place from which the smear was taken. Their content is normally small. In the urethra, the number of leukocytes is 0 - 5 - 10, in the vagina their concentration corresponds to 0 - 10 - 15, and in the cervical canal from 0 to 30.

During pregnancy, the content of leukocytes increases slightly and can range from 15 to 20 (in the vagina) in the field of view.

squamous epithelium

The squamous epithelium lines the vagina, urethra and cervical canal. In normal smears, the number of epithelial cells ranges from 5 to 10. With the disappearance of the epithelium (0 cells in the field of view), they speak of atrophy of the mucous membrane, and in the case of an increase in epithelial cells, inflammation.

Slime

Lactobacilli or Doderlein sticks

Normal smears are characterized by a large content of them in the vagina, while they are absent in the cervix and urethra. With a decrease in the number of lactic acid bacteria, they speak of.

Yeast

Mushrooms of the genus Candida are normally absent at all three points of swab sampling, but their single presence in the vagina is allowed. An increase in yeast-like fungi indicates thrush.

"Key" cells

They are conglomerates of squamous epithelial cells and bacteria - gardnerella. Normally absent, the presence of such cells is a sign of gardnerellosis or bacterial vaginosis.

Leptothrix

Refers to anaerobic (living without air) gram-negative bacteria, often found in mixed infections, such as thrush and bacterial vaginosis or trichomoniasis and chlamydia. If these bacteria are detected in a smear, an extended analysis for sexual infections is indicated.

Other

• Mobilunkus - also refers to anaerobic microorganisms and is present in candidiasis or bacterial vaginosis.
• Trichomonas - refers to the simplest, normally they are absent in the smear.
• Gonococci - cause a sexually transmitted disease - gonorrhea, respectively, are normally absent.
• coli- normally observed in a single number in a smear from the vagina. With an increase in the concentration of bacteria, bacterial vaginosis and neglect of personal hygiene are possible.
• Cocci - in gynecological smears are divided into gram-positive - stained blue and gram-negative - do not stain and remain pink. Gram-positive cocci include opportunistic bacteria: streptococci, staphylococci and enterococci, which are normally contained in smears in single quantities. With an increase in their concentration, they speak of nonspecific vaginitis (colpitis).

Degrees of purity of the vaginal smear

When talking about gynecological smears, they mean not only smears taken from the cervical canal, urethra and vagina, but also a separate type of smear that determines the degree of cleanliness of the vagina. The material is taken from the walls of the vagina and dried on a separate glass. There are 4 degrees of purity, but only degrees 1 and 2 are normal:

• 1 degree - leukocytes 0 - 5

Considered ideal. The number of leukocytes is small, the microflora is mainly (up to 95%) represented by lactic acid bacteria, epithelial cells are few.

• 2 degree - leukocytes 5 - 10

It also refers to the norm, but in a smear opportunistic microorganisms (cocci or single yeast fungi) are determined in a small amount. Lactobacilli prevail, leukocytes and mucus are moderate, epithelial cells are normal.

• 3 degree - more than 10 (up to 50)

The content of leukocytes increases, a lot of mucus and epithelium is determined. The concentration of Doderlein sticks decreases due to an increase in opportunistic flora.

• 4 degree - leukocytes completely (not countable)

Against the background of a huge number of leukocytes (the term “completely” is indicated in the description of the smear), pathogenic microorganisms (gonococci, Trichomonas) are determined. Doderlein's sticks are not determined, there are a lot of mucus and epithelial cells (a consequence of the inflammatory process).

When identifying 3 and 4 degrees of purity of the vaginal smear, it is necessary to establish the cause of the inflammation and treat it.

Causes of an increase in the content of leukocytes in a smear

If the leukocytes in a smear in women are increased, then the causes can be both diseases of the reproductive sphere, and malfunctions in the work of other internal organs and systems. Inflammation comes first among the causes of an increase in leukocytes in urogenital smears:

• inflammatory process in the cervical canal or;
• development of inflammation in the appendages (tubes and ovaries) or salpingo-oophoritis;
• inflammation of the uterine mucosa - endometritis;
• inflammatory process in the vagina - colpitis or vaginitis;
• the development of inflammation in the urethra - urethritis;
• malignant tumors of the genital organs (destruction of healthy tissues is accompanied by inflammation);
• intestinal and/or vaginal dysbacteriosis;
• infections that are sexually transmitted (both sexually transmitted diseases and latent sexual infections).

Pathogenic microorganisms - the culprits of inflammation

Why do leukocytes increase in a smear? Pathogenic microorganisms are involved in the development of the inflammatory process, which are difficult to detect in the usual way - by examining a urogenital smear, or activated representatives of the opportunistic flora. To detect pathogens of latent sexual infections, they resort to a more complex examination - the PCR method (examination of blood, urine, secretions from the genital organs).

With a detailed study in smears or blood, the following can be detected:

• mycoplasma and ureaplasma;
• gonococci (see);
• Koch's stick (the causative agent of tuberculosis);
• pale treponema (pathogen);
• Donovan bodies (causative agents of inguinal granuloma);
• trichomonas (see);
• amoeba;
• human papillomavirus (cause);
• immunodeficiency virus;
• viruses;
• mushrooms of the genus Candida ();
• actinomycete fungi.

Other causes of an increase in white blood cells

Bacterial vaginosis or vaginal dysbiosis

Under certain conditions, conditionally pathogenic flora is activated and the growth of lactic acid bacteria is suppressed:

• disruptions in hormonal status (puberty or decline in reproductive function - pre- and menopause, pregnancy and spontaneous abortion, endocrine diseases);
• weakening of local and general immunity (hypothermia, antibiotic therapy);
• severe stress and overwork;
• microtrauma of the vagina due to intense sex;
• radiotherapy, chemotherapy;
• the use of spermicides in the form of ointments and suppositories;
• oral sex;
• a large number of sexual partners;
• excessive adherence to the rules of intimate hygiene, passion for douching;
• the entrance to the vagina deformed by scars (anatomical features, pathological childbirth, surgical interventions);
• imbalance of the intestinal microflora (dysbacteriosis);
• foreign bodies in the vagina (tampons).

Allergy

• allergies to drugs and herbs;
• intolerance to lubricants (gels, ointments);
• partner's sperm intolerance.

Irritation of the vulva and vagina

• neglect of intimate hygiene;
• temperature changes (hypothermia and overheating);
• mechanical injury (tight, synthetic underwear, thongs, rough sex, etc.);
• chemical burns (douching with acids and other drugs);
• common diseases (diabetes mellitus, pathology of the urinary system and others).

In addition, elevated leukocytes in urogenital smears can be observed within 24 hours after intercourse or for 7 to 10 days after the installation of an intrauterine device. If the cause of the increase in the content of leukocytes in smears cannot be established, a more thorough and detailed examination should be carried out, including for the detection of malignant tumors of the reproductive system.

Causes of an increase in leukocytes in pregnant women

Some increase in the level of leukocytes in a smear during pregnancy is considered normal. The normal content of white blood cells in vaginal smears corresponds to 15 - 20 per field of view.

Elevated leukocytes in pregnant women in a smear are explained by physiological factors:

• Firstly, during the period of gestation, the hormonal balance is restructured, progesterone and estrogens are produced in large quantities. Under the influence of estrogens, Doderlein sticks begin to actively multiply, which create an acidic environment in the vagina and prevent the reproduction of opportunistic and pathogenic flora, but contribute to the accumulation of leukocytes.
• Secondly, expectant mothers have reduced immunity, which prevents the rejection of the embryo as a foreign body. Due to weakened immunity, pathogenic bacteria easily penetrate the vagina or a latent infection is activated, which explains the increase in leukocytes in gynecological smears (a protective reaction during inflammation).

Often a very high concentration of white blood cells in smears (50 - 100 or leukocytes entirely in the field of view) is detected, which, as a rule, is noted with thrush (urogenital candidiasis). In such cases, in addition to a large number of leukocytes, fungi of the genus Candida and mycelium in the form of white threads are found in the smear.

An excess of white blood cells in expectant mothers requires a thorough examination and appropriate treatment. The infectious process from the vagina can go to the cervix and cervical canal, penetrate the uterine cavity, which will lead to infection of the amniotic fluid and the fetus and end in miscarriage or premature birth.

Clinical manifestations

An increased level of leukocytes in secretions from the cervical and urethra and vagina often accompanies diseases of the urinary and reproductive organs of a woman:

• frequent and painful urination - a sign or;
• false urge to defecate indicate intestinal dysbacteriosis;
• discharge with an unpleasant odor, accompanied by itching and burning, may indicate vaginitis, cervicitis, or inflammation of the uterus and;
• purulent, foamy discharge or cheesy discharge are observed with vaginitis of a specific etiology (thrush, gonorrhea, trichomoniasis);
• possible with pathology of the cervix, uterus or appendages;
• in combination with an increase in leukocytes, it makes one think of inflammation of the appendages.

Diagnosis that determines the direction of treatment

Before you begin to deal with an increased level of white blood cells in smears, it is necessary to establish the cause of this phenomenon. It often happens that the content of leukocytes in a gynecological smear is high, although there is no activation and growth of opportunistic flora and, moreover, specific pathogens. What to do in such a case?

The gynecologist will recommend taking smears again, choosing the most successful day of the menstrual cycle and recommending that you properly prepare for the test (exclude sexual intercourse, taking medication, douching). If, upon re-smearing, leukocytes again have a high rate, an extended examination is performed:

A smear from the cervical canal and vagina on the tank. sowing

When sowing vaginal and cervical secretions on nutrient media, colonies of pathogenic and conditionally pathogenic microorganisms. The pathogen is identified and its sensitivity to certain antibiotics is determined, which is necessary for further treatment.

PCR for latent sexually transmitted infections

The method is highly accurate and almost 100% reveals latent sexual infections, which may not manifest themselves clinically, but lead to irreversible consequences (infertility).

Ultrasound of the pelvic organs

In this case, preference is given to ultrasound performed by a transvaginal sensor. Possible cause elevated leukocytes in the analyzes, in addition to inflammation of the uterus and appendages, there can be various tumor-like formations (ovarian cysts, uterine fibroids or sarcoma, uterine polyps, etc.).

Colposcopy

Examination of the cervix under multiple magnification helps to diagnose diseases that are not visible to the naked eye, but are the cause of elevated leukocytes in the tests (leukoplakia, cervical dysplasia or cancer in the initial stage).

Consultations of related specialists

Appointed after the above examination. For example, consulting an endocrinologist and prescribing appropriate therapy to them will help normalize the level of leukocytes in diabetes, pathology thyroid gland or being overweight. A nephrologist will identify a disease of the urinary system (pyelonephritis, cystitis) and prescribe anti-inflammatory therapy (antibiotics, nitrofurans). The allergist will advise you to exclude irritating factors (synthetic underwear, the use of intimate sprays, deodorants and various lubricants). The neurologist will prescribe sedatives and drugs to eliminate neurosis, which can also cause an increase in leukocytes.

Anti-inflammatory treatment

Anti-inflammatory treatment is prescribed only if an infection is detected. How to treat, the doctor decides, depending on the results of the tests. Anti-inflammatory therapy includes:

• local treatment;
• general treatment;
• restoration of normal microflora of the vagina.

Local treatment consists in the appointment of douching:

• the course is short and lasts no more than 4 - 5 days
• drugs (solutions of potassium permanganate, chlorhexidine, miramistin)
• herbs (chamomile, sage, coltsfoot, calendula, St. John's wort). Cm. .

Candles:

• at the same time, candles with anti-inflammatory action are locally prescribed (hexicon, polygynax, betadine and others, see).
• if a diagnosis of urogenital candidiasis is made, it is recommended to use suppositories with an antifungal effect (clotrimazole, pimafucin, livarol, see). Suppositories are administered one to two times a day for 10 to 14 days.
• with an unstarted inflammatory process, treatment is limited to this.

Treatment of latent genital infections

In case of detection viral infection, sexually transmitted diseases or hidden genital infections, systemic antibiotic therapy or antiviral drugs are prescribed. Choice medicinal product depends on the etiology of colpitis and / or cervicitis.

Restoration of the microflora

The final stage of therapy is the restoration of the normal microflora of the vagina (an increase in the content of lactic acid bacteria). For this purpose, the following are assigned:

• vaginal suppositories or tampons with probiotics (lactobacterin, bifidobacterin, acylact, colibacterin and others).

  A high content of white blood cells in smears during pregnancy is dangerous for premature termination of pregnancy (miscarriage or premature birth), intrauterine infection of the fetus, the development of chorioamnionitis (inflammation of the water and placenta), rupture of the birth canal during childbirth and the development of purulent-septic diseases in the postpartum period. Therefore, expectant mothers should carefully follow the recommendations of the doctor and carry out the prescribed or treatment with an increase in the content of leukocytes in the analyzes.

  Question:
  Is it possible to have sex with elevated leukocytes in smear tests?

  If a specific infection is not detected (gonorrhea, chlamydia, genital herpes and other diseases), then sex is not contraindicated.

  Question:
  Can I get pregnant with elevated leukocytes in smears?

  Yes, it is quite possible to get pregnant, but it is advisable to undergo preliminary treatment, since often a high white blood cell count in the analyzes indicates an inflammatory process in the genitals.

  Question:
  Is it possible to reduce the content of leukocytes in the analyzes using only folk methods treatment?

  You should not engage in self-medication, including treatment only with traditional medicine with a “bad” result of a smear analysis. Only a doctor can identify the cause of "bad smears" and prescribe the appropriate treatment. Reduce leukocytes in analyzes only with the help of traditional medicine is not possible, as it is often necessary to treat with antibiotics or antiviral drugs or treatment of concomitant diseases.