Bacterial vaginosis (BV) is a bacterial infection of the vagina, commonly caused by various bacteria including the gardnerella vaginalis bacteria. It is not a sexually transmitted disease, but it tends to occur in women who are sexually active. The symptoms of BV include vaginal discharge and irritation. As a bacterial infection, BV is usually treated with antibiotics such as Clindamycin or Metronidazole.
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Written by Dr Kimberly Langdon, MD
Information last reviewed 06/21/19
Bacterial vaginosis (BV) is a common bacterial infection of the vagina. It is caused by an imbalance of the microbes that are found naturally inside the vagina. The vagina contains lactobacilli, a type of bacteria that produces lactic acid and helps to prevent other bacteria from growing. If other bacteria, such as gardnerella vaginalis, enter the vagina, they can harm the lactobacilli, allowing other more problematic bacteria to grow. This can lead to the symptoms of bacterial vaginosis i.e. irritation, fishy odor and vaginal discharge. Bacterial vaginosis is usually treated by antibiotics which can be taken orally e.g. Metronidazole or applied as a cream inside the vagina .e.g. Dalacin (Clindamycin) or Zidoval (Metronidazole) Cream.
A healthy vagina contains a number of lacto acidic environment inside the vagina that helps to prevent other bacteria from growing and causing an infection. Bacterial vaginosis is caused by other bacteria entering the vagina and damaging the lactobacilli. This alters the acidity of the environment allowing other bacteria to grow and producing the symptoms of irritation, fishy odor and vaginal discharge.
50% of women with bacterial vaginosis do not experience any symptoms and you do not have to experience all of these symptoms to have bacterial vaginosis. However, the signs and symptoms of bacterial vaginosis include:
A diagnosis of bacterial vaginosis is made by asking about your symptoms, but often involves a physical examination and a swab test to rule out STIs that could cause similar symptoms.
You will be asked about which symptoms you are experiencing i.e. irritation, fish odor, vaginal discharge, when you noticed these symptoms and how long you have been experiencing them. You may also be asked questions about your sexual activity and how this could relate to your symptoms.
A doctor may want to examine your vagina to check for the following:
A swab may be taken from inside the vagina - this is usually done to rule out STIs. A lab test may be done to test the acidity of the vagina, as a slightly more alkaline environment may indicate infection. There may also be microscopic examination of the discharge to look for cells from the surface of the vagina that have bacteria attached to their surface.
There are various factors that may increase your likelihood of getting bacterial vaginosis. These risk factors include:
The first step to combat bacterial vaginosis is to avoid any contributing factors such as douching, tampons, bubble baths etc. This should help make it easier for your body to return to its normal healthy state.
Antibiotics are the best treatment for bacterial vaginosis. Metronidazole and Clindamycin are the preferred medications. Both are available as topical creams that are applied directly inside the vagina. But oral tablets of Metronidazole are usually the first line treatment.
Probiotics containing lactobacilli have also shown some promise in resolving bacterial vaginosis for short periods of time, but avoiding risk factors and a course of antibiotics are usually required for recurrent bacterial vaginosis.
No, in fact, douching makes a woman more prone to BV and other problems. This is because douching can harm the natural balance of bacteria in your vagina, making it more likely that you will experience bacterial vaginosis and other infections such as a yeast infection.
Not the inside of the vagina, only the external surfaces should be cleaned with mild warm water and rinsed. The vagina is naturally self-cleaning. Use of soaps - especially scented products - can upset the natural balance of bacterial and acidity that help to keep the vagina clean and healthy.
No, the vagina normally produces a clear, white, or slightly yellow discharge. Most women will experience some form of vaginal discharge every day. The consistency and colour of discharge can change over the duration of the menstrual cycle, becoming thicker during ovulation. You only need to be concerned about vaginal discharge if any of the following factors apply:
White or Grayish
Fishy odor - usually worse after sex
Pain during sex and urination
Some irritation is possible
Itching, burning, irritation
Often transmitted sexually - much more common in sexually active women.
Rarely transmitted sexually
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