Treatment of ureaplasmosis in women: symptoms, where it comes from and whether therapy is needed

Recently, there has been a negative trend towards an increase in the incidence of sexually transmitted infections among people of all ages. One of the most common diseases among them is ureaplasmosis. This pathology can be asymptomatic or have a blurred clinical picture, which is why patients often seek medical help when complications arise. However, visiting a doctor at the MedArt clinic in the early stages allows you to completely recover from this pathology and prevent infection of others. Therefore, it is extremely important to know the main symptoms and treatment of ureaplasmosis, since this knowledge will help to suspect the presence of a problem at an early stage.

What is this?

This disease has a bacterial etiology. It develops as a result of the entry and active reproduction in the body of an intracellular parasite - ureaplasma. The following types of this microorganism are dangerous to humans: Ureaplasma urealyticum and Ureaplasma parvum. Due to its small size, this bacterium easily overcomes the cellular barrier, penetrating inside. It readily colonizes the mucous membranes of the genital organs, causing the development of a local pathological focus.

It is important to know how ureaplasmosis is transmitted, as this information will help prevent infection and protect your loved ones. There are several possible mechanisms of transmission of this disease:

• Unprotected sexual contact. This is the most common method of infection. As official statistics show, about 20-40% of the total number of infected people do not experience any problems with their health. Therefore, they are carriers capable of infecting other people. But in the event of unfavorable internal environmental conditions or a decline in immune defense, the risk of clinical symptoms increases significantly. It should be noted that infection with ureaplasma is possible not only through sexual contact, but also through oral, genital and kissing;
• Vertical mechanism (from mother to fetus). This method of infection is closely related to the favorite habitat of this parasite - the mucous membranes of the genital organs. During natural delivery, the child passes through the woman’s genital tract, becoming contaminated with ureaplasma;
• Contact and household path. At the moment, there is no convincing evidence base that allows us to unequivocally state about this method of infection. However, you should carefully handle household items, toilet lids and other objects that a potentially sick person comes into contact with.

Causes

There are several risk factors, the presence of which significantly increases the likelihood of contracting this pathology. This:

• Promiscuous sexual life and refusal to use barrier contraceptives (especially with strangers or unfamiliar people);
• Failure to comply with basic rules of personal hygiene;
• Using someone else's hygiene items (towel, bed linen, toilet rim, etc.);
• Decreased immunity (recent illness, stress, poor diet, taking certain medications, and much more).

The causes of ureaplasmosis are directly related to the routes of transmission of this infection. It is important to note that the incubation period: if infected: can range from 7 to 20 days. However, with strong immune defense, this parasite can remain dormant in the human body for years. Its activation is possible in the following situations:

• Exacerbation of chronic diseases with a history;
• The recovery period after surgery or after an illness;
• Injury to the genitourinary organs;
• Taking certain medications (especially when taken without a doctor’s prescription);
• Constantly being in a stressful environment;
• Poor nutrition or fasting (the daily diet should consist of foods with sufficient amounts of proteins, fats, carbohydrates, vitamins, minerals and trace elements);
• Hormonal changes caused by pregnancy, abortion and other conditions.

Symptoms

As mentioned above, ureaplasma can remain in a vegetative state in the body for several years without showing any symptoms. However, carriage cannot protect the health of the infected person, since when unfavorable internal factors occur, the parasite begins to become active. Increasingly, patients are experiencing simultaneous infection with several sexually transmitted infections. Because of this, the clinical picture may be blurry and not typical for a classic case. The manifestation of the disease varies depending on individual characteristics, concomitant disorders, severity of the condition and gender differences.

How is ureaplasma transmitted?

Ureaplasma is transmitted sexually. Infection does not occur in everyday life. There is no evidence that you can get sick by using the same towel, spending time in the same bed, or while visiting a sauna or swimming pool.

Children can be infected from a sick woman during childbirth. There is evidence that in childhood ureaplasma goes away without any treatment. In adults, infection can lead to acute or chronic inflammation of the genitourinary system.

Ureaplasmosis in men

1. Urethritis. It is characterized by severe discomfort, pain and burning in the urethral area. The pain becomes more pronounced when urinating and becomes almost unbearable (patients note pronounced pain). During sex, pain also occurs, which intensifies after ejaculation. There are also signs of general intoxication: general weakness, malaise, low-grade body temperature, fever;
2. Presence of discharge from the urethra. In most cases, they are mucous in nature, liquid in consistency, and are released in large quantities;
3. Inflammation of the epididymis. In the absence of timely treatment, the symptoms of ureaplasmosis in men can be complemented by heaviness and pain in the testicles. The pain increases greatly with palpation and any tactile contact;
4. Signs of prostatitis. In most cases, they occur in late stages and indicate the active progression of the pathological process. Patients suffer from intense pain in the perineum, which gets worse when sitting. A drop in libido and erectile dysfunction are also possible, and discomfort and pain appear during sex;
5. Infertility. The prolonged course of the inflammatory process in the prostate gland and orchitis causes significant harm to sperm production and sperm quality, which can lead to the development of male infertility.

Among women

1. Urethritis. Manifests itself as a burning sensation in the urethra. Upon visual examination, the doctor detects signs of an inflammatory process on the mucous membranes of the external pharynx;
2. Discharge from the genitourinary tract. As a rule, they are mucous in nature and are secreted in large quantities;
3. Pain during sex. This sign is associated with additional mechanical contact with the mucous membrane, where active inflammation is localized;
4. Discharge of blood after sexual intercourse. Due to the presence of inflammation on the mucous membrane and mechanical impact on it, the integrity of the mucous membrane may be impaired, which leads to the appearance of small local bleeding;
5. Frequent pain and discomfort in the lower third of the abdomen. These symptoms of ureaplasmosis may signal the progression of the infection and the involvement of other organs of the reproductive system (uterus, fallopian tubes) in the pathological process;
6. Infertility. Lack of timely treatment and ignoring this problem can lead to damage to the uterus. As a result, a woman cannot become pregnant and carry a child. Even with successful conception, she may experience frequent early miscarriages or premature births.

In pregnant women

The clinical picture of ureaplasmosis during pregnancy is not specific. The most common symptoms of the disease during pregnancy are:

Severe itching and burning in the genitourinary area: aggravated by urination.

• Vaginitis: intense pain, increased body temperature, scanty discharge, general malaise;
• Inflammation of the mucous layer of the cervical canal.

Despite the minimal differences in the symptoms of this disease in pregnant and non-pregnant women, there are a number of features that must be taken into account during pregnancy. This:

1. During pregnancy, there is a physiological decline in immune defense. Therefore, if previously the patient was a carrier, then after the formation of the fetus she may become sick;
2. In the first trimester, it is prohibited to prescribe antibacterial drugs. Antibiotics have a large number of unwanted and dangerous side effects that can have a detrimental effect on the growth and development of the child in the womb;
3. Due to the decline in immune defense, ureaplasma contributes to the addition of other sexually transmitted infections.

There are various consequences of ureaplasmosis during pregnancy. If the disease is diagnosed in the first trimester, then fetal development disorders (congenital anomalies), frozen pregnancy and miscarriage are possible. In later stages, the risk of developing fetoplacental insufficiency and intrauterine hypoxia increases significantly. Premature birth is also possible; the baby may be born weak and underweight. With prolonged fetal hypoxia, the appearance of not only physical, but also mental disorders is allowed. There is also evidence that ureaplasma has a destructive effect on the nervous system. Therefore, earlier women were shown termination of pregnancy. However, today this is not an indication for abortion, so if you contact the specialists of the MedArt clinic in a timely manner, you can carry and give birth to a healthy baby.

Classification of ureaplasma

There are two types of ureaplasma that can exist in the female body. These are Ureaplasma parvum and Ureaplasma urealiticum.

If a woman is diagnosed with ureaplasma parvum, then she does not require treatment, since this microorganism is a representative of the normal flora that populates the genitourinary organs.

A woman who is diagnosed with ureaplasma urealiticum should undergo mandatory therapy, since these bacteria can lead to the development of inflammation.

Diagnostics

To make a diagnosis, you will need to carefully collect complaints and anamnestic data. However, the symptoms described above are not enough to diagnose ureaplasmosis. Despite the fact that they are indirect signs of the disease, they do not appear in all patients and can have varying degrees of severity. Therefore, the next stage of diagnosis is inspection. Men are examined by a urologist or dermatovenerologist, and women are examined by a gynecologist in a gynecological chair. During a medical examination, an inflammatory process on the mucous membranes and the presence of copious mucous discharge can be detected. However, in order to obtain the most reliable diagnostic data, before the examination it is recommended to adhere to the following preparatory measures:

• Two days before the doctor’s appointment, refrain from any sexual relations;
• 3 days before the examination, stop using vaginal suppositories, gels and tampons;
• Before the procedure (if the appointment is scheduled for the morning, then in the evening) take a shower or bath, but without using intimate hygiene products;
• Stop douching.

The most reliable way to confirm this diagnosis is laboratory diagnostics. Analysis for ureaplasmosis can be carried out with different types of biological material from the patient (blood and scrapings from the mucous membrane). Possible purpose:

1. PCR diagnostics. To identify this parasite, PCR tests are used, based on the detection of specific sections of the microorganism’s DNA. In most cases, urine is collected for this test. The sensitivity and specificity of this diagnostic method reaches 95%, due to which the possibility of obtaining a false answer is minimized. Sensitivity with other vaginal swabs is slightly lower, at 86%. PCR is the main way to detect ureaplasma infection.
2. ELISA and PIF. With their help, you can find antibodies to ureaplasma. The results obtained are quite difficult to interpret, since there is no stable immune protection against ureaplasmosis, and the number of carriers significantly exceeds the number of patients with active symptoms.

Today, these are the only laboratory diagnostic methods that are advisable to prescribe. Other methods are used only for scientific purposes. Microscopy, for example, is not used due to the small size of the parasite. It simply cannot be seen under a microscope, using even the most modern technical devices. In addition, this microorganism does not have cell walls, making Gram staining impossible. The purpose of microscopy is allowed exclusively to assess the state of the vaginal microflora and the degree of leukocytosis.

The diagnostic methods described above, in most cases, are sufficient to establish a diagnosis. It is important to note that not only the sick person needs to be examined, but also his sexual partner. This is an important component of successful treatment, since by hiding the fact of infection, one can become infected again during further sexual contacts.

Treatment

Regardless of the clinical case, treatment of ureaplasmosis is carried out in accordance with the following rules:

• Not only the patient, but also his sexual partner should be treated. Having a regular sexual partner, it is necessary to come for examination and receive therapy together. This helps prevent re-infection and spread of the disease;
• If concomitant infections are detected, therapy is selected according to an individual scheme. The attending physician at the MedArt clinic selects the most appropriate medications and their dosage;
• During the period of receiving therapy, you will need to abstain from any sexual relations (even using condoms);
• To consolidate the therapeutic result and prevent relapse, a follow-up examination is carried out.

Treatment of ureaplasmosis in men and women is carried out according to the same scheme. It involves an integrated approach that simultaneously affects different systems of the body. For this purpose they prescribe:

1. A course of antibacterial drugs. Antibiotics can be taken either in tablet form or as vaginal suppositories. It is possible to administer medications using douching. To prevent disruption of the intestinal microflora, patients are prescribed probiotics to prevent disruption of the digestive tract;
2. Immunostimulants. They strengthen immune defense, as a result of which the body intensively fights infection and its consequences;
3. Temporary refusal of sex. This is a necessary measure that makes it possible to prevent the disease from becoming chronic or carrier. It also helps prevent reinfection and infecting other people;
4. Diet. Since ureaplasmosis must be treated comprehensively, it is worth paying special attention to the diet. You will need to limit your consumption of fried, smoked and salty foods. It is also recommended to avoid alcoholic beverages (especially while taking antibiotics).

As mentioned above, to eliminate ureaplasma, it is necessary to examine and treat not only the patient, but also his sexual partners. After completing the therapeutic course, you will need to monitor the presence of the parasite for the first 3-4 months, so it is important to regularly visit the doctor on the appointed days.

In the absence of timely medical intervention, this disease can become chronic. In this case, the treatment regimen for ureaplasmosis changes. The patient is prescribed a long course of antibacterial drugs. In the absence of the desired therapeutic effect, it is possible to change the antibiotic group. Immunomodulators are also used to improve immunity. To improve the prognosis and well-being, patients are advised to undergo physiotherapy.

Therapy with a modern antiviral agent

Recently, given the great importance of the immune system in the development of the disease, as well as the negative impact of antibiotic therapy itself on the body as a whole, it is recommended to include immune therapy agents in the therapeutic complex, which increase the activity of immune reactions against infection and enhance the effect of antibiotic therapy. Thus, in the complex therapy of ureaplasmosis, the drug Viferon Suppositories may be recommended. The drug is a recombinant alpha-2 interferon in combination with antioxidants (vitamins E and C). Prescribing VIFERON® rectal suppositories in the complex treatment of ureaplasmosis can significantly reduce course doses and duration of antibiotic therapy, as well as significantly reduce the immunosuppressive and toxic effects associated with the use of antibacterial drugs. Reducing the course dose of antibiotics in women, in turn, can significantly reduce the risk of developing vaginal candidiasis (thrush).

Where to treat

It is necessary to understand that it is almost impossible to cope with ureaplasmosis on your own. Moreover, self-medication can cause significant harm to health and only aggravates the course of the disease. Purchasing and taking antibacterial drugs without a medical prescription can lead to disruption of the intestinal microflora, as well as obtaining the status of a carrier of ureaplasma. In this case, the patient will not suffer from symptoms of the pathology (up to a certain point), but will be able to infect other people.

Therefore, it is strongly recommended to make an appointment with a doctor at the MedArt clinic if you identify the first signs of ureaplasmosis. An early visit to the doctor will help stop the progression of the pathological process and prevent the development of severe complications (including male and female infertility). The MedArt medical center has a diagnostic laboratory equipped with modern technical equipment. Thanks to this, specialists can make the correct diagnosis in the shortest possible time. Treatment is prescribed on an individual basis, depending on the characteristics of the body and associated factors.

Probiotics

To prevent candidiasis, simultaneously with antibacterial drugs, it is necessary to take probiotics - drugs containing “beneficial” microorganisms that are part of the normal microflora or contribute to its restoration.

The most effective modern probiotics include:

• Lactovit.
• Bifidumbacterin.
• Lactobacterin.
• Linux.
• Narine.
• Biovestin.

In the acute form of the disease, the administration of systemic antibiotics along with probiotics is often sufficient for successful treatment. In the subacute form, it is advisable to supplement such treatment with local antibiotics (vaginal tablets, douching).

Prevention

Ureaplasmosis is a preventable disease. To do this, just follow simple rules, including:

• Compliance with personal hygiene rules. It is necessary to shower daily and use high-quality intimate hygiene products. It is also important to keep clothes, especially underwear, clean;
• Do not use other people’s hygiene items, have your own towel and bed linen;
• Avoid casual sex. During sexual contacts (especially with strangers or unfamiliar people), use barrier contraception (condoms);
• Monitor the condition of the mucous membranes of the genital organs and oral cavity. When wounds appear, they must be treated with antiseptic agents and the healing process closely monitored;
• See a doctor in a timely manner and undergo preventive examinations. If you notice the symptoms described above, you must immediately make an appointment with a doctor and get diagnosed;
• Do not self-medicate and adhere to medical prescriptions. It is strictly forbidden to prescribe and buy medications for yourself, especially antibiotics. You also cannot change the dosage and duration of the therapeutic course yourself.

On a note

During treatment, it is necessary to abstain from sexual intercourse, follow a diet that excludes the consumption of spicy, salty, fried, spicy and other irritating foods, as well as alcohol. After completion of treatment, a mandatory follow-up examination is required to assess the effectiveness of therapy. Preventive measures to avoid infection with ureaplasmosis are identical to those for other STIs: avoid casual sex, use protective equipment during sexual contact, and, if possible, monitor the health of your partner.

Reference and information material

Author of the article

Khaldin Alexey Anatolievich

Dermatovenerologist, clinical immunologist, MD, professor

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