Bacterial Vaginosis (BV)
By: Trever Jones 2006.03.05
What is Bacterial Vaginosis? (BV)
Bacterial Vaginosis, also known as non-specific vaginitis or Gardnerella vaginitis, is caused by excessive growth of bacteria that are normally present in the vagina. Instead of Lactobacillus bacteria being the most numerous, increased numbers of other organisms are present in the vagina. Bacteria such as Gardnerella vaginalis, Mobiluncus, or Mycoplasma hominis, essentially take over the normal vaginal environment, causing an imbalance among the normally well-regulated organisms. The offending organism was always there, just the ratios have shifted.
BV is the most common cause of vaginal discharge in women. It may be the cause of up to one-half of cases of vaginitis in all women, and the cause of 10-30% of cases in pregnant women.
Transmission
- Not considered a sexually transmitted disease.
- May be found in women who have had no sexual contacts.
- More common in women who are sexually active.
- May be associated with a new sexual partner or having multiple sexual partners.
- Men generally do not have BV or an equivalent
- May be spread between female sex partners.
- May occur in monogamous relationships
- Can occur even when using condoms
- Douching and using IUD’s may increase the risk.
Signs & Symptoms
- More than 50% of women with Bacterial Vaginosis have no symptoms
- Women:
- Excessive discharge from the vagina that may be clear, gray, or white.
- Discharge may be very thin, or very heavy.
- Discharge may have a fishy or musty, unpleasant vaginal odor, especially noticeable after sex.
- Vaginal itching and irritation
Complications
Women:
- Can lead to Pelvic Inflammatory Disease if untreated.
- Can impair fertility.
- Increased risk of endometriosis.
- Increased risk of STD’s, including gonorrhea and HIV.
- Pregnancy:
- Increased risk of premature rupture of the membranes.
- Increased risk of premature birth.
- Increased risk of ectopic pregnancy.
- Increased risk of low birth weight.
Diagnosis
- A health care provider must diagnose BV.
- Visual inspection.
- Microscopic examination of discharge, to rule out Trichomoniasis and yeast infection.
- “Whiff” test-when potassium hydroxide is added to the vaginal discharge, a “fishy” odor is released.
- Absence of normal vaginal lactobacilli on microscopic examination.
Treatment
- If a woman has no symptoms, treatment is not indicated, even if Gardnerella is present.
- Usual treatment is metronidazole (Flagyl) tablets.
- A vaginal cream is also available by prescription.
- A vaginal cream that alters the acidity of the vagina, making it more difficult for the bacteria to multiply, is available.
- Antibiotics, taken orally or via vaginal cream, may also be used.
Prevention
- Use of latex or polyurethane condoms correctly every time you have sex may help reduce the possibility of BV.
- Limit the number of sex partners.
- Practice sexual abstinence, or limit sexual contact to one partner.
- If you are a sexually active woman, have an annual pelvic examination including a Pap smear.
- Don’t douche.
- Limit bubble baths.
- Use all the prescribed medication even if the symptoms go away.