Bacterial vaginosis (BV) is a common vaginal infection that occurs when the balance of bacteria in the vagina becomes disrupted. In a healthy vagina, a balance of different types of bacteria keeps the vaginal environment acidic which helps to prevent overgrowth of harmful bacteria. However, in BV, there is an overgrowth of bacteria such as Gardnerella vaginalis which can cause a thin, grayish discharge with a strong fishy odor, itching and irritation. BV is not considered a sexually transmitted infection although sexual activity can increase the risk of developing it. It’s important to see a healthcare provider if you suspect you have BV as untreated BV can lead to complications such as pelvic inflammatory disease and an increased risk of contracting sexually transmitted infections.
Types Of Bacterial Vaginosis
There is only one type of bacterial vaginosis (BV) but the severity of the infection can vary among individuals. Some women may have mild symptoms or no symptoms at all while others may experience more severe symptoms such as itching, burning and a strong unpleasant odor. The underlying cause of BV is an overgrowth of certain types of bacteria in the vagina, the specific bacteria involved can vary from person to person. Gardnerella vaginalis is the most commonly associated bacteria with BV but other bacteria such as Atopobium vaginae and Prevotella spp. may also be present. There is only one type of BV, the presentation and underlying bacterial composition can vary.
Symptoms Of Bacterial Vaginosis
The symptoms of bacterial vaginosis (BV) can vary from person to person and some women may not experience any symptoms at all. However, common symptoms of BV can include:
Vaginal itching or irritation.
A strong, unpleasant fishy odor.
Burning sensation during urination.
A thin, grayish white vaginal discharge.
Vaginal discharge that increases after sexual intercourse.
These symptoms can also be indicative of other vaginal infections or sexually transmitted infections so it is important to see a healthcare provider for an accurate diagnosis. Additionally, some women with BV may not experience any symptoms at all which is why routine gynecological exams are recommended even in the absence of symptoms.
Causes Of Bacterial Vaginosis
The exact cause of bacterial vaginosis (BV) is not fully understood but it is believed to be due to an imbalance of the normal vaginal bacterial ecosystem. In a healthy vagina, a balance of different types of bacteria keeps the vaginal environment acidic which helps to prevent overgrowth of harmful bacteria. However, in BV, there is an overgrowth of bacteria such as Gardnerella vaginalis which can cause the characteristic symptoms. Factors that can contribute to this bacterial imbalance and the development of BV include:
Antibiotic use.
Multiple sexual partners or a new sexual partner.
Douching or using certain vaginal hygiene products.
Using an intrauterine device (IUD) for contraception.
It is important to note that BV is not considered a sexually transmitted infection although sexual activity can increase the risk of developing it. Additionally, while these factors can increase the risk of developing BV, it is not always possible to identify a specific cause.
Risk Factors Of Bacterial Vaginosis
There are several risk factors that can increase the likelihood of developing bacterial vaginosis (BV) including:
IUD use: Women who use an intrauterine device (IUD) for contraception may be at higher risk of developing BV.
Antibiotic use: Antibiotics can disrupt the normal balance of bacteria in the vagina which can lead to an overgrowth of harmful bacteria and the development of BV.
Sexual activity: Women who are sexually active or who have multiple sexual partners are at higher risk of developing BV.
Hormonal changes: Changes in hormone levels such as those that occur during pregnancy or menopause can increase the risk of BV.
Vaginal hygiene practices: Douching or using certain vaginal hygiene products can disrupt the natural balance of bacteria in the vagina increasing the risk of BV.
It is important to note that while these factors can increase the risk of developing BV not all women who have these risk factors will develop the condition and BV can also occur in women without any known risk factors.
Diagnosis Of Bacterial Vaginosis
The diagnosis of bacterial vaginosis (BV) is typically made by a healthcare provider based on the patient’s symptoms, a physical exam and laboratory tests. During the physical exam, the healthcare provider may look for signs of BV such as a thin, grayish white vaginal discharge with a characteristic odor. Laboratory tests that may be used to diagnose BV include:
pH test: A sample of vaginal discharge is tested to determine the acidity or alkalinity of the vaginal environment which can help identify BV.
Whiff test: A sample of vaginal discharge is mixed with potassium hydroxide (KOH) which can release a characteristic fishy odor if BV is present.
Wet mount microscopy: A sample of vaginal discharge is examined under a microscope to look for the presence of certain types of bacteria associated with BV.
In some cases, a culture of the vaginal discharge may be taken to identify the specific bacteria causing the infection. It is important to see a healthcare provider for an accurate diagnosis as other vaginal infections or sexually transmitted infections can have similar symptoms.
Treatment Of Bacterial Vaginosis
Bacterial vaginosis (BV) is typically treated with antibiotics which can be prescribed by a healthcare provider. Common antibiotics used to treat BV include metronidazole and clindamycin which can be administered orally or topically in the form of creams or gels. It is important to complete the full course of antibiotics even if symptoms improve or disappear to ensure that the infection is fully cleared. Sexual partners do not need to be treated for BV as it is not considered a sexually transmitted infection. In addition to antibiotics, there are some self care measures that may help manage BV symptoms and prevent recurrence including:
1. Avoiding douching or using other vaginal hygiene products that can disrupt the natural balance of bacteria in the vagina.
2. Wearing breathable, cotton underwear and avoiding tight fitting clothing that can trap moisture.
3. Eating a healthy diet and managing stress levels which can help support overall vaginal health.
It is important to follow up with a healthcare provider after completing antibiotic treatment to ensure that the infection has been fully cleared and to address any ongoing symptoms or concerns.
Conclusion
Bacterial vaginosis (BV) is a common vaginal infection that can cause symptoms such as a thin, grayish white vaginal discharge with a strong, unpleasant odor, vaginal itching or irritation and burning during urination. While the exact cause of BV is not fully understood, it is believed to be due to an imbalance of the normal vaginal bacterial ecosystem. Seeing a healthcare provider is important for an accurate diagnosis and to address any ongoing symptoms or concerns.
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