Bacterial Vaginosis
Bacterial vaginosis (BV) is the most common cause of vaginitis symptoms among women of childbearing age. It previously was called nonspecific vaginitis or Gardnerella-associated vaginitis. Health experts are not sure what role sexual activity plays in BV. BV reflects a change in the growth of vaginal bacteria. This chemical imbalance occurs when different types of bacteria outnumber the normal, “good” ones. Instead of Lactobacillus (a type of normal bacteria that can live naturally in the vagina) being the most numerous, increased numbers of bacteria such as Gardnerella vaginalis, Bacteroides, Mobiluncus, and Mycoplasma hominis are found in the vaginas of women with BV. Researchers are studying the role that each of these germs may play in causing BV, but they do not yet understand the role of sexual activity in developing BV. A change in sexual partners, using an IUD (intrauterine device), and douching may increase a woman’s risk of getting BV.
Symptoms
The main symptom of BV is an abnormal, foul-smelling vaginal discharge. Some women describe it as a fish-like odor that is most noticeable after having sex. Nearly half of the women with signs of BV, however, have no symptoms. A health care provider may see these signs while giving a physical examination and may confirm the diagnosis by doing lab tests of vaginal fluid.
Other symptoms may include
- Thin vaginal discharge, usually white or gray in color
- Pain during urination
- Itching around the vagina
A health care provider can examine a sample of vaginal fluid under a microscope, either stained or in special lighting, to look for bacteria associated with BV. Then, they can diagnose BV based on Absence of lactobacilli Presence of numerous "clue cells" (cells from the vaginal lining that are coated with BV germs) Fishy odor Change from normal vaginal fluid.
Treatment
Health care providers use antibiotics such as metronidazole or clindamycin to treat women with BV. Generally, male sex partners will not be treated.
Complications
In most cases, BV causes no complications. There have been documented risks of BV, however, such as an association between BV and pelvic inflammatory disease (PID). PID is a serious disease in women which can cause infertility and tubal (ectopic) pregnancy. BV also can cause other problems such as premature delivery and low-birth-weight babies. Therefore, some health experts recommend that all pregnant women, whether or not they have symptoms, who previously have delivered a premature baby be checked for BV. A pregnant woman who has not delivered a premature baby should be treated if she has symptoms and laboratory evidence of BV. BV also is associated with increased chances of getting gonorrhea or HIV infection. (HIV, human immunodeficiency virus, causes AIDS.)
Credit: National Institute of Health.