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What is gardnerella?

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

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What is Gardnerella vaginalis?

Gardnerella (Gardnerella Vaginalis is the full scientific name) is a bacteria that can be found in in smal amounts in the vagina and, more rarely, in the urethra of men. In small quantities, it is part of the normal vaginal flora, and does not cause any harm.

Bacterial balance in the vagina, depends on “good” lactobacilli, which keeps more harmfull basteris at bay. Sometimes this balance is disrupted, which reduces the number of lactobacilli and allows other bacteria to grow and spread unchecked. Under such conditions, Gardnerella is usually the first to quickly multiply in number.  It can then form a mucus layer along the vaginal walls which allows other fast-growing "bad" bacteria to thrive.

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When the good lactobacilli aren’t strong enough to prevent or overcome this bacterial overgrowth, bacterial vaginosis (BV) develops.  The primary symptom of BV is a foul-smelling discharge.

While BV is the standard medical term used to describe this condition, it is also called “Gardnerella” or “Gardnerella vaginitis”. You can use the terms interchangeably when talking to a medical professional.       

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 have had BV. In fact, about 85% of BV cases every year remain undiagnosed. 

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 BV doesn’t go away on its own and progresses to a stage where symptoms begin to show, you definitely won’t miss them. You’ll get a greyish or white looking vaginal discharge that often carries an unpleasant fish-like odor. The odor usually becomes most intense right after sex.
There aren’t any other common symptoms. BV doesn’t cause rashes or skin discoloration and is entirely painless. A mild itching sensation may occur, but that too is rare.      

What causes Gardnerella? 

As mentioned earlier, BV happens when the natural bacterial balance in the vagina is disrupted. Medical research on how and why this disruption occurs has not provided any clear answers.  However, there are several factors that may increase the risk of developing BV.

Common risk factors are as follows:   

  • 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 bacterial balance by killing or washing out good lactobacilli. You shouldn’t wash your vagina with anything but water or occasionally, with mild, unscented soap. Also, avoid vaginal wipes or deodorants.  
  • Sex, whether as vaginal intercourse or vagina-to-vagina contact, can introduce foreign bacteria into your vagina, and disrupt the balance of lactobacilli. Risks are especially high if you have a new sex partner, or if you frequently change partners. Condoms and good sexual hygiene can help lower these risks.    
  • Using an intrauterine device (IUD) can introduce bad bacteria into your vagina if the devices aren’t kept clean and sterilized. The same goes for tampons or anything that may need to be inserted into the vagina.  
  • Hormone changes, such as occur during and after menopause as well as during pregnancy, 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 may also be a risk factor for developing pelvic inflammatory disease, and raises the risk of premature delivey during pregnancy.

Therefore, it’s a good idea to seek medical help if you think you have Gardnerella symptoms. It is also important to confirm that the infection is indeed BV and not an STI such as herpes or gonorrhea. 

What are treatment options for Gardnerella?

Even when 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 takes about a week for bacterial balance to be restored. Therefore, your doctor may advise you to simply wait. If treatment is deemed necessary, your doctor will most likely prescribe antibiotics. Metronidazole and Clindamycin are the most common choices.  Both come as tablets or gels.  Metronidazole is also available as a vaginal suppository.
 
Try to reduce your sexual activity during the treatment period (or when you have BV), or at least use condoms. If you suffer form recurring Gardnerella infections, 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 also require 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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