Bacterial vaginosis
What is Bacterial vaginosis?
The vagina naturally has an environment containing “good” and “bad” bacteria. In cases of bacterial vaginosis, there is an excess of bad bacteria. This throws the vaginal environment out of balance.
Bacterial vaginosis is usually a mild problem that may go away on its own in a few days. But it can lead to more serious problems. So it's a good idea to see your doctor and get treatment.
What are the causes of Bacterial vaginosis?
Bacterial vaginosis also is referred to as nonspecific vaginitis, is a vaginal condition that can produce vaginal discharge and results from an overgrowth of certain kinds of bacteria in the vagina.
Experts are not sure what causes the bacteria in the vagina to get out of balance. But certain things make it more likely to happen. Your risk of getting bacterial vaginosis is higher if you:
Have more than one sex partner or have a new sex partner.
Douche.
You may be able to avoid bacterial vaginosis if you limit your number of sex partners and don't douche or smoke.
What are signs and symptoms of bacterial vaginosis?
About half of all women with bacterial vaginosis will have no symptoms. Bacterial vaginosis may occur at the same time as other infections or sexually transmissible infections (STIs).
Bacterial vaginosis signs and symptoms may include:
Thin, gray, white or green vaginal discharge
Foul-smelling "fishy" vaginal odor
Vaginal itching
Burning during urination
How is bacterial vaginosis diagnosed?
It's important to determine whether you have bacterial vaginosis (BV) or a similar condition, such as trichomoniasis or gonorrhoea. These can both also cause abnormal vaginal discharge.
Diagnosis is made based on signs and symptoms and lab tests. During a medical examination, your doctor may notice.
Medical history. Your doctor may ask about any previous vaginal infections or sexually transmitted infections.
Physical and pelvic exam. During a pelvic exam, your doctor visually examines your vagina for signs of infection, and inserts two fingers into your vagina while pressing on your abdomen with the other hand to check your pelvic organs for signs that may indicate disease.
Take a sample of vaginal secretions. This may be done to check for an overgrowth of anaerobic bacteria in your vaginal flora. Your doctor may examine the vaginal secretions under a microscope, looking for "clue cells," vaginal cells covered with bacteria that are a sign of bacterial vaginosis.
Test your vaginal pH. Your doctor may check the acidity of your vagina by placing a pH test strip in your vagina. A vaginal pH of 4.5 or higher is a sign of bacterial vaginosis
What is the treatment of bacterial vaginosis?
To treat bacterial vaginosis, your doctor may prescribe one of the following medications:
Antibiotics
Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine may be taken as a pill by mouth (orally). Metronidazole is also available as a topical gel that you insert into your vagina. To reduce the risk of stomach upset, abdominal pain or nausea while using this medication, avoid alcohol during treatment and for at least one day after completing treatment — check the instructions on the product.
Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that you insert into your vagina. Clindamycin cream may weaken latex condoms during treatment and for at least three days after you stop using the cream.
Tinidazole (Tindamax). This medication is taken orally. Tinidazole has the same potential for stomach upset and nausea as oral metronidazole does, so avoid alcohol during treatment and for at least one day after completing treatment.
Vaginal pH correction treatments
Vaginal pH correction treatments are a relatively new way of treating BV. These usually involve applying a gel to the inside of your vagina that changes the acid balance, making it a less hospitable environment for harmful bacteria. Most vaginal pH correction treatments are available over the counter from pharmacists.
What are the complications of Bacterial vaginosis?
If BV develops in pregnancy, it may increase the risk of pregnancy-related complications, such as premature birth or miscarriage. However, this risk is small and appears more significant for women who have had these complications in a previous pregnancy. BV causes no problems in the vast majority of pregnancies.
As a precaution, you should contact your doctor if you're pregnant and you begin to have vaginal discharge (although discharge can be a normal part of pregnancy).
Bacterial vaginosis can also increase your risk of getting some STIs.
Is it possible to prevention Bacterial vaginosis?
The causes of BV aren't fully understood, so it's not possible to completely prevent it. However, you may be able to lower your risk of developing the condition if you avoid:
Using scented soaps, perfumed bubble bath and antiseptic bath liquids
Using vaginal deodorant
Vaginal douching
Using strong detergents to wash your underwear
These can upset the natural bacterial balance in your vagina, making it more likely that you'll develop BV.
