The aim of the study was to evaluate the clinical efficacy of an integrated approach to therapy and prevention of relapse of bacterial vaginosis in women of reproductive age with overweight and obesity. We examined 60 women of reproductive age (19–39 years) with overweight and obesity (BMI+30±4.2) and a verified diagnosis of recurrent bacterial vaginosis (real-time PCR, diagnostic system Femoflor–16). The effectiveness of treatment of bacterial vaginosis in overweight and obese women was 94.0% due to the rapid elimination of the pathogen by a single dose of 2 g of the drug group 5-nitroimidazoles Secnidox and macrolide 16-membered antibiotic with bactericidal mechanism Doramycin (World Medicine, United Kingdom). Combination prolonged therapy with the multi-strain probiotic Brevelac and the natural drug Reitoil increased the remission period of bacterial vaginosis to 6 months in 91.0% of this group of patients. Keywords: bacterial vaginosis, overweight, obesity, therapy, remission.

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The aim of our work was to study the intestinal microbiome in obese women and further develop differentiated patterns of exposure to the intestinal microbiota to improve metabolism and reduce excess weight. Materials and methods: Surveyed 120 overweight and obese women. For comparison, 60 women without overweight and obesity were examined. Group I – women with vulvovaginal candidiasis and overweight and obesity (60 women); group II – women with vulvovaginal candidiasis without overweight and obesity (30 women); group III – women with bacterial vaginosis and overweight and obesity (60 women); ІV – women with bacterial vaginosis without overweight and obesity (30 women). The study of the intestinal microbiocenosis included the determination of the species and quantitative composition of the microflora. Quantitative indicators of intestinal microflora were studied by seeding 1 ml from each dilution on differential diagnostic media: Endo, Ploskireva, ICA (bismuth – agar sulfide) to detect pathogenic enterobacteria; ZhSA (yellow – salt agar) for determination of staphylococci. To study the hemolytic activity of bacteria was used agar with 5% erythrocyte content of sheep. The presence of bifidobacteria in the test material was studied on Blaurok medium, and lactobacilli – on MRS medium. Statistical analysis of the obtained research results was performed using standard computer packages “Data Analysis” Microsoft Excel for Windows 2002. Results: Based on the results of studies, we can summarize the nature of changes in the intestinal microbiome on the background of vulvovaginal candidiasis and bacterial vaginosis in women with overweight and obesity. In all women with excess body weight and obesity, intestinal microflora disorders have been registered, which are characterized by the replacing the lactobacilli and bifidum bacteria to opportunistic pathogens. A significant increase in Firmicutes phylum microorganisms and a significant decrease in Bacteroidetes phylum were found. The obtained data prove that changes in the species composition of the intestinal microbiota play an important role in the pathogenesis of obesity. Conclusions: The results indicate the feasibility of monitoring the intestinal microbiota in women with vulvovaginal candidiasis and bacterial vaginosis, especially in the presence of excess body weight and obesity to determine the degree of violations of its components, and timely correction of the detected changes.