BACTERIAL VAGINOSIS
Bacterial vaginosis is a vaginal infection caused by the overgrowth of bacteria naturally found in the vagina.
- Naturally, the vagina has an environment containing both good and bad bacteria.
- In bacterial vaginosis, the normal healthy bacteria are replaced by an excess of bad bacteria. This upsets and throws the vagina environment out of balance.
- Bacterial vaginosis is a common condition of the vagina, it is harmless and easily treated.
- The condition can affect women of any age, but women in their reproductive year are most likely affected.
- Most of the time, the condition doesn’t cause any health problems. Sometimes, having bacterial vaginosis can lead to issues while trying to get pregnant, increase the risk of early delivery among pregnant women, result in pelvic inflammatory disease, and make women susceptible to sexually transmitted infections such HIV, gonorrhea, or herpes simplex virus.
- It has been shown that HIV infected women with bacterial vaginosis are more likely to transmit HIV to their sexual partners than those without bacterial vaginosis.
CAUSES
The vaginal environment contains a type of bacteria called lactobacillus. This bacteria keeps the vagina slightly acidic so bad types of bacteria don’t grow well. A decline in the number of lactobacilli, causes more bad bacteria to thrive, resulting in bacterial vaginosis.
Risk factors for bacterial vaginosis include:
- Douching, the practice of washing or cleaning out the inside of the vagina with water or other cleansing agents alters the natural balance of the vagina and predisposes women to develop the condition. The vagina is self-cleaning, so douching is often not required.
- Having a female partner, this increases the risk by 60%.
- Having multiple sex partner or a new partner.
- Smoking
- Using an intrauterine device
- Certain antibiotics
SYMPTOMS
- Burning during urination
- Vaginal itching
- Thin white, gray, or green vaginal discharge
- Fishy smell that gets stronger after sex
Occasionally, there may be no symptoms
DIAGNOSIS AND TREATMENT
Diagnosis is suspected based on symptoms and may be verified by:
- Asking about any prior vaginal infections or sexually transmitted infections.
- Taking a swab from inside the vagina to check for overgrowth of bad bacteria or the presence of clue cells. To test for clue cells, the doctor places a drop of sodium chloride solution on a slide containing vaginal discharge and examine it under a microscope. Clue cells are vaginal cells coated with bacteria that are a sign of bacterial vaginosis.
- Testing the vaginal for acidity either by placing a pH test strip in the vagina or by putting a swab of vaginal discharge onto a litmus paper. A pH greater than 4.5 or higher is suggestive of bacterial vaginosis.
TREATMENT
Treatment option includes antibiotics which can either be given orally or applied directly inside the vagina). They include
- Metronidazole such as Flagyl, Metrogel-Vaginal which may be taken orally and is also available as a topical gel.
- Clindamycin such as Cleocin, which is available as a cream.
- Tinidazole which is taken orally.
Bacterial vaginosis is not a sexually transmitted infection, and it is generally unnecessary to treat a male sexual partner of an infected woman.
Female partners should seek testing as they may need treatment.
Pregnant women with symptoms should be treated to help decrease the risk of premature delivery. This is highly important.