As the name suggests, bacterial vaginosis is the result of an overabundance of the bacteria naturally found within the vagina, upsetting the proper balance, and causing an uncomfortable inflammation. Typically the ‘good’ bacteria outnumber the anaerobic or ‘bad’ bacteria, germs that can survive without the presence of oxygen. If these anaerobic bacteria become too numerous, they can cause inflammation and infection
This is most common in women during their reproductive years, but it can affect women of any age. While the causes are not explicitly understood, certain activities are known to increase your risk, such as:
- Having multiple sex partners, or a new sex partner. Doctors do not fully understand the link between sexual activity and vaginosis, but the condition occurs more often in women who have multiple sex partners, or when having intercourse with a new sex partner. It also tends to occur more frequently in women who have sex with other women.
- Douching. Rinsing out your vagina with water or a cleansing solution upsets the natural balance of bacteria in the vagina, which can cause to an overgrowth of anaerobic germs, and thus bacterial vaginosis. Since the vagina is self-cleaning, douching is not necessary/
- A natural lack of lactobacilli (or ‘good’) bacteria. If your vagina’s natural environment doesn’t produce enough of these good bacteria to counterbalance the bad bacteria, you’re more likely to develop bacterial vaginosis.
What are the Symptoms and Effects of Bacterial Vaginosis?
Though many women with this condition show no signs, particularly notable symptoms of bacterial vaginosis might include:
- Thin, grey, white or green vaginal discharge
- A foul-smelling or ‘fishy’ vaginal odour
- Vaginal itching
- A burning sensation during urination.
While these symptoms are often not serious, and easily treated, if left untreated they might cause complications later on, such as:
- Preterm birth. In pregnant women, bacterial vaginosis has been linked to premature deliveries and babies with low birth weights.
- Sexually transmitted infections (STIs). Having bacterial vaginosis can make you more susceptible to infections such as chlamydia, gonorrhoea, herpes and even HIV. If you have HIV, bacterial vaginosis will increase the odds that you pass the virus onto sexual partners.
- Infection risk after surgery. Bacterial vaginosis may increase the risk of developing an infection after gynaecologic surgery, such as a hysterectomy (the removal of the uterus) or an oophorectomy (the removal of an ovary).
- Pelvic Inflammatory Disease (PID). Bacterial vaginosis can sometimes cause PID, an infection of the uterus and fallopian tubes that might increase your risk of infertility.
How Can Bacterial Vaginosis Be Treated?
Like with many infections and uncomfortable conditions, the first step in treatment is understanding proper prevention. Though the causes of bacterial vaginosis are elusive, and thus hard to prepare for, you can still help prevent development of the condition by avoiding douching, minimising your risk of STIs, and minimising irritation to the vagina due to harsh chemicals or scented hygiene products.
If you believe you have bacterial vaginosis, consult your healthcare professional. Though embarrassing, or unpleasant, it is much better to speak up about bodily issues that are causing you discomfort, so they can be accurately diagnosed and the problem treated before it becomes more serious. If you suspect bacterial vaginosis, your doctor may:
- Ask questions about your medical history, including previous vaginal infections or STIs
- Perform a pelvic exam, visually inspecting your vagina for signs of infection. This will usually involve inserting two fingers into your vagina while pressing on your abdomen with the other hand to check your pelvic organs for signs of infection or disease.
- Take a sample of your vaginal secretions, which might be done to check for an overgrowth of ‘bad’ bacteria in your vaginal flora. Your doctor might examine the sample under a microscope looking for clues, particularly vaginal cells covered with bacteria that are a sign of vaginosis.
- Test your vaginal pH levels, by placing a pH strip in your vagina. If your pH levels are 4.5 or higher—that is to say less acidic than normal—this may be a sign of bacterial vaginosis.
If the presence of bacterial vaginosis is confirmed, your doctor might prescribe you any of the following medicines, depending on the severity of the infection, or a desired solution:
- Metronidazole. This medicine is either taken as a pill, or as a topical gel inserted into the vagina. To reduce the risk of abdominal pain or nausea, avoid alcohol during treatment and for at least 24 hours after completing treatment. Metronidazole is also an option for an extended use therapy, in the case that your vaginosis is persistent or continues to recur.
- Clindamycin. This medicine is available as a topical cream inserted into your vagina. The cream may weaken the latex of condoms during treatment, and for at least three days after you stop using the cream—discuss this with your partners and plan accordingly.
- Tinidazole. This is an oral medication, with the same potential for stomach upset as metronidazole, so avoid alcohol during treatment and for at least three days after completing treatment.
- Secnidazole. This is a single-dose antibiotic taken orally. It comes as a packed of granules that you can sprinkle onto a soft food such as yoghurt or custard. Eat the mixture within thirty minutes, taking care not to chew the granules.
Take your medication for as long as your healthcare professional prescribes it, even if your symptoms seem to go away. Stopping treatment early may increase the risk of recurrence, and your vaginal flora may not yet be returned to normal. It is common for vaginosis to recur regardless, within three to twelve months of treatment, and effective treatments to stop this recurrence are still being researched. If your symptoms return soon after treatment, talk with your healthcare professional about your options.
While it is generally not necessary to treat a male partner if you are infected, bacterial vaginosis can easily transfer to a female partner—they should seek testing around the same time as you. It is especially important for pregnant women with symptoms of bacterial vaginosis to seek treatment to avoid premature births, or low birth weights.
If you are experiencing the symptoms of Bacterial Vaginosis, make an appointment with Dr.Nicole Stamatopoulos here.