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Bacterial Vaginosis

Overview

Vaginal discomfort and pain can be caused by bacterial vaginosis (BV). This happens when the normal balance of bacteria in the vagina is upset. A healthy vagina has a specific mix of bacteria; this balance helps to keep it healthy. But when certain types of bacteria multiply too much, it can lead to bacterial vaginosis.

BV can affect people of any age, but it's more frequently seen in women of reproductive age. Changes in hormone levels during this time can make it easier for the "bad" bacteria to grow. Being sexually active is also linked to a higher risk of developing BV. The exact reason for this link isn't fully understood, but factors like unprotected sex and the use of douches might play a role, increasing the risk of developing the condition.

Symptoms

Bacterial vaginosis is a common vaginal infection. It's caused by an imbalance of bacteria in the vagina. While some people don't experience any symptoms, others notice changes in their vaginal discharge and odor.

Common symptoms of bacterial vaginosis include:

  • Unusual vaginal discharge: This discharge might be thin and have a gray, white, or green color.
  • A fishy odor: A strong, unpleasant, "fishy" smell is a key sign.
  • Vaginal itching: This can be a bothersome symptom.
  • Burning during urination: This discomfort is common during urination.

Important Note: Many people with bacterial vaginosis don't have any noticeable symptoms at all.

When to See a Doctor:

It's important to see a healthcare provider if you notice any of the following:

  • Unusual discharge and discomfort: If your vaginal discharge is different than usual and you're experiencing any discomfort, such as itching or burning, it's best to get checked out.
  • Changes in discharge from previous infections: If you've had vaginal infections before, but this time the discharge seems different, it's worth having it evaluated.
  • New or multiple sex partners: If you've recently started having sex with a new partner or multiple partners, it's possible you might have a sexually transmitted infection (STI). Sometimes, the symptoms of an STI can be similar to those of bacterial vaginosis.
  • Yeast infection treatment failure: If you suspect you have a yeast infection and have tried self-treating with over-the-counter remedies but your symptoms haven't gone away, it's important to see a doctor.

A healthcare professional can properly diagnose the cause of your symptoms and recommend the best course of treatment. They can differentiate between bacterial vaginosis, yeast infections, and other possible conditions.

When to see a doctor

See a doctor if your vaginal discharge is unusual.

If you notice a change in your vaginal discharge, especially if it smells bad or makes you feel uncomfortable, it's important to see a doctor. A healthcare professional can figure out what's causing the problem.

If you've had vaginal infections in the past, but this time the discharge feels or looks different, schedule an appointment. This could be a sign of a different type of infection.

If you have a new sexual partner or multiple partners, getting checked out is a good idea. Sometimes, the symptoms of a sexually transmitted infection (STI) can be similar to symptoms of other vaginal infections, like bacterial vaginosis. Knowing the exact cause is crucial for getting the right treatment.

If you thought you had a yeast infection and tried treating it yourself, but the symptoms are still there, don't ignore it. See a doctor to make sure you're getting the right care. A doctor can accurately diagnose the problem and recommend the best course of action.

Causes

Your vagina has natural bacteria, called vaginal flora. A healthy vagina has a balance of "good" and "bad" bacteria. Usually, the good bacteria, called lactobacilli, are more plentiful than the bad bacteria, called anaerobes. This balance keeps your vagina healthy.

Bacterial vaginosis happens when the balance of bacteria in your vagina gets upset. This happens when there are too many of the "bad" bacteria, anaerobes. This imbalance can cause problems.

Risk factors

Bacterial vaginosis (BV) is a common vaginal infection. Several things can increase your chances of getting it.

Multiple or New Sexual Partners: Sometimes people get BV more often if they have multiple sex partners or a new partner. We don't fully understand why, but there seems to be a connection. Interestingly, BV is also more common when both partners are female.

Douching: Your vagina naturally cleans itself. Using douches (rinsing your vagina with water or other solutions) is not necessary and can actually be harmful. Douching can throw off the natural balance of bacteria in the vagina. This can lead to an overgrowth of certain bacteria, like anaerobic bacteria, which can cause BV.

Low Lactobacillus: The vagina usually has healthy bacteria called lactobacilli. If your body doesn't produce enough of these bacteria, you might be more prone to getting bacterial vaginosis.

Complications

Bacterial vaginosis (BV) is usually not a serious problem. However, it can sometimes increase your risk of certain health issues:

Increased risk of sexually transmitted infections (STIs): If you have BV, you're more likely to get other sexually transmitted infections. These include HIV, herpes, chlamydia, and gonorrhea. Having BV can also make it easier to pass HIV to a partner if you already have it.

Higher risk of infection after surgery: Having BV might make you more susceptible to infections after certain gynecological procedures, such as a hysterectomy or a D&C (dilation and curettage). These procedures involve opening the uterus, and BV can make it easier for bacteria to enter and cause an infection.

Possible link to pelvic inflammatory disease (PID): BV can sometimes lead to PID. PID is an infection that affects the uterus and fallopian tubes. PID can increase the risk of problems getting pregnant in the future.

Potential pregnancy complications: Some past studies suggested a connection between BV and pregnancy problems like premature birth and low birth weight babies. However, more recent research suggests that other factors, like a history of early deliveries, might play a larger role in these risks. Despite this, if you notice BV symptoms during pregnancy, it's crucial to get tested. Your doctor can then determine the best course of treatment for you.

Prevention

Preventing Bacterial Vaginosis: Simple Steps

Bacterial vaginosis (BV) is a common vaginal infection. Here are some easy steps to help lower your risk:

1. Gentle Hygiene:

Avoid using scented products like soaps or lotions on your genitals. The scents can irritate the delicate vaginal tissues. Instead, simply wash with warm water. Using unscented tampons and pads is also a good idea. Your vagina naturally cleanses itself, and extra cleaning isn't necessary or helpful.

2. Avoid Douching:

Douching is not a good way to treat or prevent BV. It can actually make the problem worse. Your vagina is designed to maintain its own healthy balance of bacteria. Douching disrupts this balance, increasing your risk of infection. It's best to avoid douching altogether.

3. Safe Sex Practices:

Bacterial vaginosis isn't always caused by sex, but it can be spread through sexual contact. Practicing safe sex is essential to lower your risk of sexually transmitted infections (STIs) which can include BV. Using latex condoms or dental dams during sex and thoroughly cleaning any sex toys you use can help. Reducing the number of sexual partners or abstaining from sex are also good ways to lower your risk.

Important Note: If you think you have BV or any other vaginal infection, it's important to see a doctor for diagnosis and treatment. This information is for general knowledge and shouldn't replace professional medical advice.

Diagnosis

Doctors diagnose bacterial vaginosis (BV) in several ways:

  1. Talking about your health history: Your doctor will ask about any past vaginal infections or sexually transmitted infections (STIs). This helps them understand your overall health and potential risk factors for BV.

  2. Checking a sample of vaginal discharge: A small sample of your vaginal discharge will be collected. This sample is then examined under a microscope. Doctors look for "clue cells." Clue cells are vaginal cells that are unusually coated with bacteria. The presence of clue cells is a strong indication of bacterial vaginosis.

  3. Measuring vaginal acidity: A simple test called a pH test can be used to measure the acidity level of your vagina. A special pH strip is placed in your vagina and the reading is taken. A pH level of 4.5 or higher is often a sign of BV. A healthy vagina typically has a lower pH.

These methods help your doctor accurately identify bacterial vaginosis so they can recommend the best treatment.

Treatment

Bacterial vaginosis (BV) is a common vaginal infection. Doctors typically treat it with antibiotics. Here are some common options:

1. Metronidazole (Flagyl, Metrogel-Vaginal, etc.): This medicine comes in two forms: a pill you swallow and a gel you put into your vagina. Important: Avoid alcohol while taking this medicine and for a full day afterward. Side effects might include nausea or stomach upset. Always follow the specific instructions on the medicine label.

2. Clindamycin (Cleocin, Clindesse, etc.): Clindamycin is available as a vaginal cream, pills, or suppositories (small, melted medicines). The cream and suppositories might weaken latex condoms, so avoid sex while using these and for at least three days after stopping. Use another form of birth control during this time.

3. Tinidazole (Tindamax): You take this medicine by mouth. It can cause stomach discomfort, so avoid alcohol during treatment and for a few days afterward.

4. Secnidazole (Solosec): This medicine is a one-time dose taken with food. It comes as granules you sprinkle onto soft food like applesauce, yogurt, or pudding. Important: Eat the mixture within 30 minutes of mixing, and don't chew the granules.

Partner Treatment: Usually, a male partner doesn't need treatment. However, if a female partner has symptoms, she should be tested and treated, as BV can spread between partners of the same sex.

Important: Finish the entire course of medicine, even if your symptoms disappear. Stopping treatment early can lead to the infection returning, called recurrent bacterial vaginosis.

Recurrent BV: It's common for BV to return within a few months to a year, even after proper treatment. Researchers are looking into better ways to prevent this. If your symptoms come back soon after treatment, talk to your doctor. Sometimes, a longer course of metronidazole might be an option.

Probiotics: Some people think probiotics might help, but more research is needed. In one study, probiotics weren't any better than a placebo (a fake treatment) at preventing BV from coming back. Therefore, probiotics are not currently recommended as a treatment for BV.

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Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.

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