Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance in the natural bacteria present in the vagina. To put in more simple words, it results when the “harmful” bacteria take over the “good” bacteria.

The main culprit is Gardnerella vaginalis, a type of bacteria that normally lives inside the vagina. Other commonly involved organisms include Prevotella, Bacteroides, Peptostreptococcus and Fusobacterim.

The precise mechanism of bacterial vaginosis has not yet been described. However there are many known risk factors that increase the lieklihood of developing the condition. These factors include the following:

• Sexual activity: BV is more commonly observed in individuals who are sexually active. Having multiple sexual partners or a new sexual partner can increase the risk. It is not considered a sexually transmitted infection (STI), but the exact relationship between sexual activity and BV is not yet fully understood.

• Vaginal douching: Douching, which involves rinsing or cleaning the vagina with water or other solutions, can disrupt the natural balance of bacteria in the vagina. This disruption can increase the risk of developing BV.

• Antibiotic use: The use of certain antibiotics can disrupt the natural bacterial balance in the vagina, leading to an increased risk of BV. This includes both oral antibiotics and those used for vaginal infections.

• Hormonal changes: Fluctuations in hormonal levels, such as those that occur during pregnancy or menopause, can affect the vaginal environment and increase the risk of BV.

• Natural lack of lactobacilli: Lactobacilli are beneficial bacteria that help maintain the acidic pH of the vagina and prevent the overgrowth of harmful bacteria. Some individuals naturally have lower levels of lactobacilli, which can increase their susceptibility to BV.

The signs and symptoms of bacterial vaginosis can vary from person to person, but the following are commonly reported:

1. Vaginal discharge: A primary symptom of BV is a thin, white or grayish discharge that is often described as having a fishy odor. The odor may be more noticeable after sexual intercourse.
2. Unpleasant odor: The vaginal discharge associated with bacterial vaginosis often has a distinct, unpleasant odor that can be particularly noticeable after sexual activity or during menstruation.
3. Vaginal itching or irritation: Some individuals with BV may experience itching or irritation in and around the vagina. However, this symptom is not as common as the discharge and odor.
4. Burning sensation during urination: In some cases, BV can cause a burning sensation or discomfort while urinating. This symptom may be similar to that of a urinary tract infection (UTI).
5. Absence of significant pain or inflammation: Unlike some other vaginal infections or conditions such as yeast infections or sexually transmitted infections (STIs), bacterial vaginosis typically does not cause significant pain, redness, or swelling.

The primary treatment for BV is a course of antibiotics, usually taken orally or applied topically.. Metronidazole (Flagyl) and Clindamycin (Cleocin) are the most commonly used molecules. It is essential to complete the full course of antibiotics as prescribed by the healthcare provider, even if symptoms improve before the treatment is finished. BV that does not resolve after one course of treatment may be cured by giving a second course of the same agent or by switching to another agent (eg, from metronidazole to clindamycin or from clindamycin to metronidazole).

It is important to note that BV can recur even after successful treatment in more than 50% of women. To minimize the risk of recurrence, it may be beneficial to consider the following:

• Patients should be advised to stop douching or using bubble bath or any other over-the-counter vaginal hygiene products. Patients should wash only with hypoallergenic bar soaps or no soap at all and should avoid liquid soaps and body washes.

• Use condoms during sexual intercourse, as this may help prevent the introduction of bacteria into the vagina.

• If using an intrauterine device (IUD), follow proper hygiene and cleaning procedures as recommended by the healthcare provider.

It is crucial to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to your specific situation. They can provide personalized advice and address any concerns you may have regarding treatment and prevention of BV.

Yours in good health,

MDLINE HEALTH