What is gardnerella?

Gardnerella is a type of bacteria and often used as an informal name for bacterial vaginosis

What is Gardnerella vaginalis?

Gardnerella (Gardnerella vaginalis is the full scientific name) is a bacteria that can be found in the vagina and, much more rarely, in the urethra of men. It even occurs in healthy vaginas — that is vaginas with a healthy bacterial balance — but only in small quantities that don’t do any harm.

The vagina’s bacterial balance depends on “good” lactobacilli keeping too many “bad” bacteria from coming inside the vagina. Sometimes this balance is disrupted, which reduces the number of lactobacilli and allows other bacteria to grow and spread unchecked. Under such circumstances, the Gardnerella bacteria usually is the first to quickly multiply in number. It forms a mucus layer along the vaginal walls. This layer then can be inhabited by other fast-growing bad bacteria.

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When the good lactobacilli aren’t strong enough to prevent or overcome this bacterial overgrowth, bacterial vaginosis (BV) develops, whose signature symptom is a foul-smelling discharge. BV is the standard medical term to describe this condition, but sometimes it’s called “Gardnerella” or “Gardnerella vaginitis”. These are a bit outdated and, of course, it’s much easier to just call it “BV”. In any case, you can use the terms interchangeably when talking to medical professionals.       

BV is a very common condition and ranks as the top vaginal infection in the U.S. Most cases are mild and only last for a few days, so that women often don’t even realize that they had a BV. In fact, about 85% of BV cases every year remain undiscovered 

What are Gardnerella symptoms?

Compared to other genital infections, Gardnerella has only a few symptoms. As mentioned, most cases are completely free of symptoms and can only be proven through a medical test.  However, if the BV doesn’t go away on its own and progresses to a stage where symptoms begin to show, you definitely won’t miss them, as they are quite obvious. You’ll get a greyish or white looking vaginal discharge that often carries an unpleasant odor that smells like rotten fish. The odor usually becomes most intense right after sex.
There aren’t any other common symptoms. BV doesn’t cause rashes or skin discolorations and it’s an entirely painless condition. A mild itching sensation might occur, but that’s rare.      

What causes Gardnerella? 

As earlier mentioned, BV happens when the natural bacterial balance in the vagina has been upset, either because there are too few lactobacilli or too many bad bacteria. Medical research on why and how this bacterial environment changes so far hasn’t found all the answers. But there are several factors that may increase the risk of upsetting the bacterial balance and thereby can trigger BV. The most common risk factors are:   

  • Douching and washing with aggressive soaps. Douching and washing the vagina frequently with soap is a well-intentioned hygiene practice, but it actually does more harm than good. The U.S. Department of Health and Human Services discourages douching because it destroys the vagina’s natural bacteria balance by flushing out or killing the good lactobacilli. This increases the risks of getting a BV or UTI. You shouldn’t wash your vagina with anything but water and —at the most — occasionally with mild, unscented soap. Also, don’t use vaginal wipes or deodorants.  
  • Sex, whether as vaginal intercourse or vagina-to-vagina contact, can introduce bad bacteria into your vagina, raising the risk of these bacteria overtaking the good lactobacilli. Risks are particularly high if you have a new sex partner or frequently change partners. Condoms and good sexual hygiene can help lower these risks.    
  • Using intrauterine devices (IUD) can also bring bad bacteria into your vagina if they aren’t kept clean and sterilized. The same goes for tampons or any other things that may need to be inserted into the vagina.  
  • Hormone changes, such as during and after menopause as well as when pregnant, also raise the risk of developing Gardnerella. One out of five pregnant women will develop BV.

Complications of Gardnerella

During a Gardnerella outbreak, there’s a much higher risk of contracting viral infections from a sex partner. This includes HIV, for which there’s a six-fold increase in transmission risk, as well as herpes and HPV.
Gardnerella also is a risk factor for pelvic inflammatory disease and it raises pregnant women’s risk of experiencing a premature birth or miscarriage.

Therefore, it’s a good idea to seek medical help if you think you have Gardnerella symptoms. This also is important to confirm that it’s indeed a BV and not another infection like herpes or gonorrhea. 

What are the treatment options for Gardnerella?

Even when the BV gets to the point that there’s fishy discharge, it’s still quite likely to go away on its own in a few days’ time.  Normally, it’ll take about a week for the bacterial balance to be restored. Therefore, your doctor may advise you to simply wait. However, if a treatment is deemed necessary, your doctor will most likely prescribe antibiotics to you. Metronidazole and Clindamycin are the common choices and they come as tablets and gels — Metronidazole also is available as a vaginal suppository, if the tablets or gel don’t work.
 
Try to reduce your sexual activity during the treatment period (or in any case when you have an ongoing BV) or use condoms and pay attention to sex hygiene. If you suffer recurring outbreaks of Gardnerella, there’s a chance that you may be getting them from your partner. In that case, your partner will need to be tested and may do a treatment. However, in strict medical terms, BV isn’t considered an STI so that usually your partner won’t need any treatment.   

References:

  1. Brown, Joelle M., et al. “Intravaginal Practices and Risk of Bacterial Vaginosis and Candidiasis Infection among a Cohort of Women in the United States.” Obstetrics & Gynecology, vol. 121, no. 4, Apr. 2013, pp. 773–780, 10.1097/aog.0b013e31828786f8. Accessed 13 May. 2020.
  2. Jones, Ashley. “Bacterial Vaginosis: A Review of Treatment, Recurrence, and Disparities.” The Journal for Nurse Practitioners, vol. 15, no. 6, June 2019, pp. 420–423, 10.1016/j.nurpra.2019.03.010. Accessed 13 May. 2020. 
  3. Koumans, Emilia H., et al. “The Prevalence of Bacterial Vaginosis in the United States, 2001???2004; Associations With Symptoms, Sexual Behaviors, and Reproductive Health.” Sexually Transmitted Diseases, vol. 34, no. 11, Nov. 2007, pp. 864–869, journals.lww.com/stdjournal/pages/articleviewer.aspx?year=2007&issue=11000&article=00006&type=fulltext, 10.1097/olq.0b013e318074e565. Accessed 13 May 2020.

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