Summary about Disease
Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance of bacteria in the vagina. Normally, the vagina contains a balance of "good" and "bad" bacteria. BV occurs when there is an overgrowth of anaerobic bacteria (the "bad" bacteria) and a decrease in lactobacilli (the "good" bacteria). It's not considered a sexually transmitted infection (STI), but it is associated with sexual activity. Many women with BV have no symptoms.
Symptoms
Thin, white or gray vaginal discharge
Fishy odor, especially after sex
Vaginal itching
Burning during urination (less common) Some women with BV have no noticeable symptoms.
Causes
The exact cause of BV is not fully understood, but it involves an imbalance of vaginal bacteria. Factors that can disrupt the balance and increase the risk of BV include:
Douching: Douching disrupts the natural balance of bacteria in the vagina.
New or multiple sex partners: Sexual activity can introduce new bacteria into the vagina.
Lack of lactobacilli: A decrease in the "good" bacteria, lactobacilli, makes it easier for other bacteria to overgrow.
Natural lack of lactobacilli
Smoking
Medicine Used
The most common antibiotics used to treat BV are:
Metronidazole: Available as oral pills or vaginal gel.
Clindamycin: Available as a vaginal cream or oral pills. A doctor's prescription is required for these medications. It is important to finish the entire course of medication, even if symptoms improve, to prevent recurrence.
Is Communicable
BV is not considered a sexually transmitted infection (STI), but it is associated with sexual activity. It's believed that sexual activity can disrupt the balance of bacteria in the vagina, increasing the risk of BV. However, women who have never been sexually active can also get BV. It is not typically spread to male partners.
Precautions
Avoid douching: Douching disrupts the natural balance of bacteria in the vagina.
Limit the number of sexual partners: Having multiple partners increases the risk of BV.
Use condoms: Condoms can help prevent the spread of bacteria during sexual activity.
Avoid scented soaps or hygiene products in the vaginal area: These can irritate the vagina.
Wear cotton underwear: Cotton is breathable and helps keep the vaginal area dry.
After bowel movements, wipe from front to back: This helps prevent bacteria from the rectum from entering the vagina.
How long does an outbreak last?
With appropriate antibiotic treatment, symptoms typically improve within 2-3 days, and the infection is usually cleared within a week. However, recurrence is common, and some women may experience repeated episodes of BV. Without treatment, the symptoms may persist for weeks or months.
How is it diagnosed?
BV is diagnosed through a pelvic exam. During the exam, the doctor may:
Take a sample of vaginal discharge to examine under a microscope for an overgrowth of bacteria.
Test the pH of the vaginal fluid: BV is often associated with a higher than normal pH level.
Perform a "whiff test": A sample of vaginal discharge is mixed with potassium hydroxide. A fishy odor suggests BV.
Timeline of Symptoms
The timeline of symptoms can vary:
Onset: Symptoms can appear gradually over several days or weeks, or they may appear suddenly.
Progression: The discharge and odor may become more noticeable over time.
Resolution (with treatment): Symptoms usually improve within 2-3 days of starting antibiotics and resolve within a week.
Without treatment: Symptoms may persist for weeks or months and can lead to complications.
Important Considerations
BV can increase the risk of getting STIs, such as HIV, herpes, chlamydia, and gonorrhea, if exposed.
In pregnant women, BV can increase the risk of premature birth and low birth weight.
It's important to see a doctor for diagnosis and treatment. Self-treating can be harmful and may mask other infections.
Even after successful treatment, BV can recur. Talk to your doctor about ways to prevent recurrence.
BV does not typically cause long-term health problems if treated.