Hormonal changes during pregnancy affect both the mental and physical state of a woman. This period is characterized by an increase in the levels of female sex hormones secreted by the ovaries – estrogens and progesterone. Pregnant women become more sensitive to changes in their body, which causes anxiety and worry. One of the characteristic manifestations of pregnancy is more abundant vaginal discharge and the discomfort it causes. 1. How do vaginal contents change during pregnancy? The mucous membrane of the vagina is covered by a multilayered flat neuroprotective epithelium, the cells of which are of several types: basal, parabasal, deep intermediate, superficial intermediate, superficial. These cells undergo cyclic changes that are controlled by estrogens. Sex hormones stimulate their maturation, and when estrogen levels increase, there is a predominant amount of acidophilic cells that are located on the surface of the mucous membrane. Estrogens stimulate the formation of glycogen in these cells. The lactobacilli in the vagina, the so-called Döderlein bacteria, have 2 main functions: cytolysis of surface cells, from which glycogen is released, which is subsequently broken down into dextrose (D-glucose, the biologically active form of glucose) and the conversion of glucose into milk acid and other organic acids that lead to low pH values, between 3.8 and 4.2. The mucous membrane of the vagina lacks glands, and humidity is maintained by transudate from the blood vessels located in the vaginal wall, as well as by the secretion secreted by the cervical glands, the so-called cervical mucus. The cervix is ​​a major target organ for sex hormones during pregnancy, as it is part of the soft birth canal and undergoes major changes during this period. It changes its consistency, hypertrophies and the glands begin to secrete more secretion. Normally, vaginal discharge is clear to white, odorless, and highly viscous. Cervical mucus has a highly alkaline reaction, which can temporarily disrupt the acidic nature of the vaginal contents and, combined with the release of a large amount of glycogen in most pregnant women, provides an optimal environment for the development and change in the status of conditionally pathogenic microorganisms as the most – the dimorphic yeast Candida albicans is often isolated (70%). Another reason for the reproduction of candida during pregnancy is the fact that estrogens reduce the levels of IgG and IgA – part of the body’s local immune defense, which facilitates the development of a vaginal infection. Pregnancy is one of the main predisposing factors for the development of candidal vulvovaginitis. Studies show that more than a third of pregnant women are affected at some point. NEWS_MORE_BOX Candida yeasts have two vegetative forms: spore and hypha. In a saprophytic (inactive) state, candida exists in the form of a spore.It is part of the normal vaginal microflora and does not pose a problem in healthy women. Its isolation does not necessarily indicate the presence of an infection. In a favorable environment for development, it transforms into its active form – a fungus and becomes pathogenic. On a native preparation it is visualized as a hypha (thread). In this state, Candida albicans begins to secrete formic acid, which causes the characteristic symptoms of candidiasis, which are the following: abundant, white (resembling curdled milk) vaginal discharge, itching, redness. Candidiasis in itself usually does not pose a danger to both the mother and the fetus. The problem is that the inflammation caused by Candida albicans in the vaginal mucosa additionally lowers the local immunity and breaks the biological barrier of the vaginal wall, which is a prerequisite for the reproduction of pathogenic bacteria and the development of bacterial vaginosis. This condition poses a risk of premature rupture of the amniotic sac and preterm delivery. In all cases, when a pregnant woman feels discomfort and a change in her usual state, it is necessary to consult a specialist obstetrician-gynecologist, who will assess what the behavior will be in the given case.