Bacterial vaginosis is termed as vaginosis rather than vaginitis as it is related to alteration in the regular vaginal flora rather than due to any specific infection. In other words, it occurs when the balance of bacteria in the vagina is upset, and if any bacteria grows more than the other. There will be a considerable decrease in lactobacilli with an increase in the growth of other anaerobic bacteria. Bacterial vaginosis is a polymicrobial condition.
It is not sexually transmitted with a variable incubation period. About 50% of women are asymptomatic carriers of infection, but the majority complain of vaginal discharge without itching. If the production of good lactobacilli doesn’t take place, there are more chances of bacterial vaginosis. The physician may examine the vagina for vaginal discharge and also perform some tests to determine Bacterial vaginosis.
Symptoms of Bacterial Vaginosis:
- Burning during urination
- White Discharge
- Foul smell vaginal odour
- Vaginal itching
Characteristics of Vaginal Discharge:
- White, non-viscous discharge adherent to the vaginal wall
- The pH of discharge is more than 4.5
- Fishy odour
- Presence of clue cells
- Increased number of Gardnerella vaginalis
- Reduced number of lactobacilli and leukocytes
The woman has minimal vulvar irritation. The diagnosis depends on wet smear and culture. The smear reveals a clean background with few inflammatory cells and other organisms but scanty lactobacilli.
Many epithelial cells present as granular cytoplasm caused by small gram-negative bacilli adhering on their surface. Free-floating clumps of Gardnerella are seen. This infection can cause PID, chorioamnionitis, premature rupture of membrane and preterm labour.
Cause of Bacterial Vaginosis:
- Usage of douches and washes to clean vagina
- Bath with intensely perfumed bubble, shower gels or antiseptic solutions
- Washing underwear with a too strong detergent
- Using the intrauterine device for contraception
Prevention of Bacterial Vaginosis:
- Avoid usage of douches to clean the vagina.
- Don’t use soap while cleaning, just use water.
- Limit intercourse sexual partners
- Test for STDs
- Clean sex toys
Complications of Bacterial Vaginosis:
- HIV infection
- STDs like Herpes simplex virus, gonorrhoea
- Human papillomavirus may come.
- Risk of pelvic inflammatory disease
- Loss of pregnancy
- Preterm Delivery
- Premature baby
- Low weight baby
Treatment for Bacterial Vaginosis:
- 7 day course of metronidazole 500mg twice a day works effectively in 80% cases
- Most doctors prescribe antibiotics like metronidazole,clindamycin and tinidazole to treat bacterial vaginosis, this could be either tabs or ointment to apply on vagina
- The infection may persist if you don’t follow the medication course prescribed.
- Lacteal is a protein-free acidifying gel which neutralises the vaginal pH.
- Bacterial vaginosis can be spread even through sex. Dont have sex until your symptoms are gone.
- Should take antibiotics for a longer time
- Ecoflora capsule which contains lactobacillus rhamnosus and lactobacillus reuteri which are probiotic agents, effective against gram-negative pathogens and resistant to spermicides and also have anti-inflammatory activity. They also have collagen-binding proteins that prevent pathogen adhesions. Ecoflora is contraindicated for pregnant women.
If you are experiencing any of the above symptoms as discussed above and looking for the treatment, you can consult with Dr Sarah Hussain, the leading female Gynaecologist in London. Request a call for treatment