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Bacterial vaginosis (BV) is the most common cause of vaginal infection (vaginitis). For grammatical reasons, some people prefer to call it vaginal bacteriosis. It is NOT generally considered to be a sexually transmitted infection . BV is caused by an imbalance of naturally occurring bacterial flora, and should not be confused with yeast infection (candidiasis), or infection with Trichomonas vaginalis (trichomoniasis) which are not caused by bacteria.
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The most common symptom of BV is an abnormal vaginal discharge (especially after sex) with an unpleasant fishy smell. There is rarely itching.Nearly half of all women with BV don’t notice any symptoms. By contrast, a ‘normal’ discharge will be odourless and will vary in consistency and amount with your menstrual cycle – a normal discharge is at its clearest about 2 weeks before your period starts.
When you go to your healthcare provider with questions about vaginal discharge, he or she will have several diagnoses in mind to account for it. These may include:
1.The discharge is normal for you
2.Candidiasis (thrush, or a yeast infection)
3.Trichomonas vaginalis (trichomoniasis)
To find out which of these is the case, a few simple tests are done. The provider will carry out a speculum examination and take some swabs from high in the vagina. These swabs will be tested for:
1.A characteristic smellâ€”this is called the whiff test. A small amount of an alkali is added to a microscope slide that has been swabbed with the dischargeâ€”a ‘fishy’ odour is a positive result for bacterial vaginosis.
2.Loss of acidityâ€”the vagina is normally slightly acidic (with a pH of 3.8â€“4.2), which helps to control bacteria. A swab of the discharge is put onto litmus paper to check the acidity.A positive result for bacterial vaginosis would be a pH of over 4.5.
3.’Clue cells’â€”so called because they give a clue to the reason behind the discharge. These are epithelial cells (like skin) that are coated with bacteria. They can be seen under microscopic examination of your discharge.
Two positive results in addition to the discharge itself are enough to diagnose BV. If there is no discharge, then all 3 criteria are needed.
What might be done?
Your doctor may be able to diagnose bacterial vaginosis from your symptoms. swabs of any discharge may be taken and tested to confirm the diagnosis.
Bacterial vaginosis is caused by excess growth of some of the bacteria that normally live in the vagina, particularly gardnerella vaginalis and mycoplasma hominis. as a result, the natural balance of organisms, in the vagina is altered. the reason for this excess growth is unknown, but the condition is more common in sexually active women and often, but notalways, occurs in association with sexually transmitted diseases. vaginal infections can also be caused by an overgrowth of the candida fungus and the protozoan trichomonas vaginalis. Bacterial vaginosis often causes no symptoms. however, some women have a grayish white vaginal discharge with a fishy or musty odor and vaginal or vulval itching. rarely, the disorder leads to pelvic inflammatory disease, in which some of thereproductive organs become inflamed.
A healthy vagina normally contains many microorganisms, some of the common ones are Lactobacillus crispatus and Lactobacillus jensenii. Lactobacillus, particularly hydrogen peroxide-producing species, appears to help prevent other vaginal microorganisms from multiplying to a level where they cause symptoms. (Note: Lactobacillus acidophilus is not one of the species of Lactobacillus identified as playing a protective role in vaginal flora.) The microorganisms involved in BV are very diverse, but include Gardnerella vaginalis, Mobiluncus, Bacteroides, and Mycoplasma. A change in normal bacterial flora including the reduction of lactobacillus, which may be due to the use of antibiotics or pH imbalance, allows more resistant bacteria to gain a foothold and multiply. In turn these produce toxins which affect the body’s natural defenses and make re-colonization of healthy bacteria more difficult.
Most cases of bacterial vaginosis occur in sexually active women between the ages of 15 and 44, especially after contact with a new partner. Condoms may provide some protection and there is no evidence that spermicide increases BV risk. Although BV appears to be associated with sexual activity, there is no clear evidence of sexual transmission.Rather, BV is a disordering of the chemical and biological balance of the normal flora. Recent research is exploring the link between sexual partner treatment and eradication of recurrent cases of BV. Pregnant women and women with sexually transmitted infections are especially at risk for getting this infection. Bacterial vaginosis does not usually affect women after menopause. A 2005 study by researchers at Ghent University in Belgium showed that subclinical iron deficiency (anemia) was a strong predictor of bacterial vaginosis in pregnant women. A longitudinal study published in February 2006 in the American Journal of Obstetrics and Gynecology showed a link between psychosocial stress and bacterial vaginosis independent of other risk factors.
Although previously considered a mere nuisance infection, untreated bacterial vaginosis may cause serious complications, suchas increased succeptibility to sexually transmitted infections including HIV, and may present other complications for pregnant women. It has also been associated with an increase in the development of Pelvic inflammatory disease (PID) following surgical procedures such as a hysterectomy or an abortion.
Bacterial vaginosis can be cured by antibiotics such as metronidazole and clindamycin. However, there is a high rate of recurrence. Currently, there are very few over the counter products that address bacterial vaginosis. A vaginal gel product called
RepHresh claims to regulate the pH level. Boric acid capsules inserted vaginally is considered a home treatment.
Lactobacillus supplements may also be used; Fem-dophilus (Jarrow Formulas) is a lactobacillus product which specifically claims to help maintain healthy vaginal flora.
It should be noted that seeking medical attention is often necessary, because none of the over the counter products can claim to treat an active infection. More importantly, patients often inaccurately diagnose BV as a yeast infection, and delay proper treatment which may lead to complications.
In a randomized controlled trial, researchers found the efficacy of 0.75% metronidazole vaginal gel in treating bacterial vaginosis (cure rate 70.7%) was equivalent to that of standard oral metronidazole treatment (cure rate 71%). Treatment with vaginal metronidazole gel was associated with fewer gastrointestinal complaints.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.