Reproductive System & Sexual Disorders: Current Research
Open Access

The Impact of Bacterial Vaginosis

Pamela Desai^{* *}Correspondence: Pamela Desai, Department of Gynecology, Royal College of Obstetricians and Gynaecologists, London, United Kingdom, Email:

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Description

Bacterial Vaginosis (BV) is a common infection caused by an imbalance of vaginal flora. When "good" bacteria like Lactobacillus are abnormally low, "bad" bacteria grow, causing vaginal redness, itching, swelling and a fishy discharge. Sex leads to BV by introducing new bacteria into the body. Risk factors include condom-free sex, multiple sexual partners, smoking, douching and IUDs.

Bacterial Vaginosis (BV) is found worldwide with a prevalence of between 10% and 50%, and is more common in sex workers, in the HIV-positive population, in black and Hispanic women, and in women with new or greater numbers of sexual partners. Having three or more male sexual partners in the last 12 months has been identified as a risk factor for BV. Having a female sexual partner has also been linked to a 60 percent increased incidence of BV. The burden of BV is related not only to the prevalence of the condition, but also to a decrease in quality of life, as well as to anxiety and self-conscious feelings of exclusion due to the stench associated with the infection.

Bacterial vaginosis is a common but depressing condition in which the bacterial balance in the vagina is not synchronized. In general, the body can maintain an ideal balance. But when the balance is disturbed, certain types of bacteria overgrow and cause symptoms. BV is treated immediately and usually does not cause other health problems. With it, it increases the risk of contracting a Sexually Transmitted Disease (STD) or leading to birth defects in pregnant women.

Symptoms of bacterial vaginosis: It is estimated that 21 million women in the United States each year have bacterial vaginosis, with only about three million having symptoms. When they do occur, the symptoms of BV are mild but persistent and may include:

• Gray-white or yellow vaginal discharge

• The smell of "fish" that gets worse after intercourse

• Burning sensation when urinating

• Vaginal itching, redness and swelling

• Vaginal bleeding after intercourse

Although BV symptoms are rare, they can weaken vaginal tissues and increase the risk of STDs such as gonorrhea, chlamydia, trichomoniasis and HIV. If the infection occurs during pregnancy, there is a risk of premature birth, low birth weight and in rare cases miscarriage. Symptoms of bacterial vaginosis include a foul-smelling vaginal discharge. Itching, redness, swelling, inflammation with urination, and bleeding during intercourse are also common.

Causes

Bacterial vaginosis is a condition in which the amount of "healthy" bacteria in the vaginal area rapidly decreases. This permits the "bad" bacteria to multiply at a rapid rate. Lactobacillus, the predominant "good" bacterium, keeps the vaginal environment slightly acidic, preventing the growth of "bad" bacteria. Sex can trigger BV by injecting new or high amounts of bacteria into the vagina. Some common causes of BV are:

• Sex without a condom

• Multiple sex partners

• New sex partners

• Douching

• Bubble baths

• Vaginal deodorants

• Smoking

• Cervical devices (IUDs)

Genetics is also believed to play a role in promoting inflammation or causing adequate production of Lactobacillus. Sex bacteria can lead to vaginosis by injecting new bacteria into the vagina, especially if you do not use condoms or have multiple sex partners. Smoking, douching and IUDs also increase the risk.

Diagnosis

Since bacterial vaginosis is not caused by a single agent, the diagnosis will largely depend on medical history and symptom review along with various lab tests and procedures. These include pelvic exam, pH test to check vaginal acidity, microscopic evaluation of vaginal fluids.

Microscopic examination looks for "clue cells" (meaning vaginal cells filled with bacteria). One gram of stain is also used to separate the "good" bacteria from the "bad", which allows the lab to check for imbalances in the vaginal flora. Additional tests may be performed to rule out other possible causes, such as yeast infection or genital herpes. Diagnosis of bacterial vaginosis usually includes a review of symptoms and medical history, pelvic examination, vaginal pH test, and microscopic evaluation of vaginal fluid.

Treatment

The standard treatment for bacterial vaginosis is a short course of antibiotic medication. Antibiotics are a type of antibiotic that is used to treat bacterial infections. Flagel (metronidazole) and clindamycin are the first-line treatments. Both are exceedingly successful at treating BV and have only minor adverse effects.

Preferred first-line rules

• Metronidazole 500 mg (mg) was taken orally twice a day for seven days

• Metronidazole 0.75% vaginal gel is applied once a day for five days

• Apply clindamycin 2.0% vaginal cream at bedtime for seven days

Alternative therapies include clindamycin vaginal suppository or Tindamax (Tinidazole) tablets. Despite the effectiveness of these medications, recurrence is common and multiple treatments may be needed to completely clear the infection. Side effects include nausea, abdominal pain, cough, sore throat, runny nose and metallic taste in the mouth. In addition to antibiotics, several adjuvant therapies may help. These include probiotics (beneficial live bacteria found in yogurt and probiotic supplements) that can help prevent recurrence. Boric acid (available as a capsule and vaginal suppository) is an oldfashioned remedy of medical interest. During treatment, wear loose pants or skirts to reduce the heat that promotes vaginal moisture and bacterial growth. Reduce itching and swelling by applying a cold cloth or spraying with cold water on the vagina. First-line antibiotics used to treat bacterial vaginosis include oral metronidazole (e.g. flagel), topical metronidazole, and topical clindamycin.

Prevention

Despite how common bacterial vaginosis is, there are steps, take to lower risk. Safe sex techniques and good vaginal hygiene are among them.

Limit the number of sex partners, use condoms properly and consistently, do not douche, avoid bubble baths and vaginal deodorants, wipe back and forth after urination, and avoid IUDs if you have recurrent BV or severe BV.