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Bacterial Vaginosis

Overview of Bacterial Vaginosis

Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance of naturally occurring bacteria in the vagina. The vagina contains a delicate balance of different types of bacteria, but when the harmful bacteria outnumber the beneficial ones, bacterial vaginosis can happen. The condition is not a sexually transmitted infection, although sexual activity can sometimes trigger it.

Prevalence of Bacterial Vaginosis

Those women with vaginal discharge have an estimated 20-30% prevalence of bacterial vaginosis. In high-risk sexual populations, the prevalence can be as high as 50-60%. 

Signs and Symptoms of Bacterial Vaginosis

Bacterial vaginosis symptoms may vary from person to person, but some of the common symptoms include:

  • A thin, grayish-white vaginal discharge with a strong fishy odor.
  • Vaginal itching or burning sensation
  • Pain during urination
  • A feeling of vaginal dryness or irritation
  • Light bleeding after intercourse

However, it is also possible to have bacterial vaginosis and not experience any symptoms at all.

Types of Bacterial Vaginosis

Causes of Bacterial Vaginosis

The exact cause of bacterial vaginosis (BV) is not fully understood but may be caused by an imbalance of the naturally occurring bacteria in the vagina. Normally, the vagina has a delicate balance of beneficial bacteria (such as Lactobacillus) and harmful bacteria. When the balance gets disrupted, the harmful bacteria can multiply and overtake the beneficial bacteria, leading to bacterial vaginosis.

Some of the factors that can contribute to this imbalance and increase the risk of developing bacterial vaginosis include:

  • Sexual activity: Bacterial vaginosis is more common in sexually active women and can get triggered by new or multiple sexual partners.
  • Douching: Douching can disrupt the natural balance of bacteria in the vagina, increasing the risk of bacterial vaginosis.
  • Antibiotics: Taking antibiotics for another infection can sometimes disrupt the vaginal flora, leading to bacterial vaginosis.
  • Hormonal changes: Hormonal changes during pregnancy or menstruation can alter the vaginal pH and increase the risk of bacterial vaginosis.
  • Contraceptive methods: Birth control methods like intrauterine devices and diaphragms can increase bacterial vaginosis risk.

It's important to note that bacterial vaginosis is not a sexually transmitted infection, although sexual activity can increase the risk of developing it.

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Risk Factors of Bacterial Vaginosis

The exact cause of bacterial vaginosis is unknown. However, several risk factors have been identified. Here are some of the most common risk factors for bacterial vaginosis:

  • Sexual activity: Sexually active Women are at a higher risk for developing bacterial vaginosis.
  • Multiple sexual partners: Having multiple sexual partners increases the risk of bacterial vaginosis, as it can disrupt the natural balance of bacteria in the vagina.
  • Douching: Douching, or washing the inside of the vagina with water or other substances, can disrupt the natural balance of bacteria and increase the risk of bacterial vaginosis.
  • Antibiotic use: Taking antibiotics can kill both good and bad bacteria, leading to an overgrowth of harmful bacteria and an increased risk of bacterial vaginosis.
  • Hormonal changes: Changes in hormone levels occurring during pregnancy can also increase the risk of bacterial vaginosis.
  • Contraceptive methods: Certain contraceptives, such as intrauterine devices (IUDs), have been associated with an increased risk of bacterial vaginosis.
  • Smoking: Smoking is a risk factor for bacterial vaginosis.

It is important to note that not all women with these risk factors will develop bacterial vaginosis, and some women who do not have any of these risk factors may still develop bacterial vaginosis.

Complications

Most cases of bacterial vaginosis are not associated with severe complications, but it can increase the risk of some health problems, including:

  • Increased risk of sexually transmitted infections (STIs): Women with bacterial vaginosis are at higher risk of acquiring sexually transmitted infections, such as chlamydia, gonorrhea, and HIV, as the condition can cause changes in the vaginal environment that make it easier for these infections to take hold.
  • Pelvic inflammatory disease (PID): Bacterial vaginosis has been linked to an increased risk of pelvic inflammatory disease (PID), an infection that can occur when bacteria travel from the vagina to the uterus, fallopian tubes, or ovaries.
  • Preterm birth: Bacterial vaginosis during pregnancy has been associated with an increased risk of preterm birth, which can lead to a range of health problems for the baby.
  • Endometritis: Bacterial vaginosis can cause inflammation of the lining of the uterus (endometritis), which can lead to pelvic pain, fever, and other symptoms.
  • Post-surgical infections: Women with Bacterial vaginosis are at increased risk of developing infections after gynecologic surgery, including hysterectomy and abortion.

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Prevention

While it is not always possible to prevent bacterial vaginosis, there are some measures you can take to reduce your risk of developing it:

  • Practice good hygiene: Keeping the vaginal area clean and dry is important to prevent bacterial growth. Use mild, unscented soap and water to clean the area.
  • Avoid douching: Douching can disrupt the natural balance of bacteria in the vagina and increase the risk of developing bacterial vaginosis.
  • Use condoms: Condoms can help prevent sexually transmitted infections (STIs) that can increase the risk of bacterial vaginosis.
  • Limit sexual partners: Having multiple sexual partners can increase the risk of developing bacterial vaginosis.
  • Avoid Perfumed Products: Perfumed soaps, sprays, and other products can irritate the vagina and disrupt the natural balance of bacteria.
  • Wear breathable clothing: Tight clothing and synthetic fabrics can trap moisture and create an environment conducive to bacterial growth. Wear loose-fitting, breathable clothing to reduce your risk of developing bacterial vaginosis.
  • Eat a healthy diet: Eating a diet high in fruits, vegetables, and whole grains can help support a healthy immune system, which may reduce the risk of developing bacterial vaginosis.

If you experience symptoms of bacterial vaginosis, such as unusual discharge, odor, or itching, it is important to seek medical attention.

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Diagnosis

Bacterial vaginosis diagnosis is typically made based on a combination of clinical symptoms, physical examination, and laboratory tests.

  • Clinical symptoms: Bacterial vaginosis is typically characterized by a thin, white, or gray discharge with a distinct odor (often described as a "fishy" smell), itching, and burning in the vaginal area. Women with Bacterial vaginosis may also experience pain during sexual intercourse or urination.
  • Physical examination: During a physical exam, a healthcare provider may look for signs of Bacterial vaginosis, such as redness or swelling of the vaginal walls.
  • Laboratory tests: A healthcare provider may take a sample of vaginal fluid to be tested in the laboratory. The two most commonly used tests are:
    • Wet mount microscopy: This test involves examining a sample of vaginal fluid under a microscope to look for the presence of "clue cells," which are cells coated with bacteria and are a characteristic feature of bacterial vaginosis.

    • pH testing: A healthcare provider may also test the acidity (pH) of the vaginal fluid. Bacterial vaginosis is associated with a pH greater than 4.5.

In some cases, a gynecologist may also order a culture test to rule out other infections or sexually transmitted infections that may have similar symptoms.

Treatment of Bacterial Vaginosis | When to Consult a Doctor

Bacterial vaginosis (BV) is usually treated with antibiotics to kill the overgrowth of harmful bacteria in the vagina. The most commonly used antibiotics for bacterial vaginosis include:

  • Metronidazole: This antibiotic is available in oral or topical form and is typically taken for seven days.
  • Clindamycin: This antibiotic is available in cream form and is applied to the vagina for seven days.

It's essential to finish the entire course of antibiotics, even if symptoms improve, to ensure the infection gets fully recovered.

In addition to antibiotics, there are other steps you can take to help manage and prevent bacterial vaginosis, including:

  • Avoiding irritants: Avoid using products that irritate the vagina, such as scented soaps, bubble baths, or douches.
  • Practice safe sex: Using condoms during sexual activity can help reduce the risk of bacterial vaginosis and other sexually transmitted infections.
  • Probiotics: Some studies suggest that taking probiotics (either orally or as vaginal suppositories) can help restore the balance of bacteria in the vagina and prevent bacterial vaginosis.
  • Good hygiene: Keep the vaginal area clean and dry, and wipe from front to back after using the toilet.

You can get an appointment with a gynecologist via Healthwire if you suspect you have bacterial vaginosis or are experiencing any symptoms. Left untreated, bacterial vaginosis can increase the risk of more severe health problems.