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BACTERIAL VAGINOSIS (GARDNERELLA) - a patient's
guide
Editorial Team
Overview
Bacterial vaginosis is an imbalance of the normal organisms
in the vagina.
It is not an STD but can be caused by increased sexual
activity.
The condition is common and causes a discharge with a
fish-like odour.
The problem may be more obvious after sex or during menstruation.
Bacterial vaginosis is easily treated with antibiotics.
What is it?
Bacterial vaginosis (BV) was formally called Gardnerella.
The balance of normal bacteria (lactobacilli) is changed
in favour of other bacteria (e.g. gardnerella and some other
species such as bacteroides and mobiluncus).
It is not a STD but is linked to increased sexual activity.
A change in sexual partners and douching may increase the
risk of developing the problem.
The condition produces an unpleasant vaginal discharge
because of an overgrowth of these other bacteria in the
vagina, including an organism known as Gardnerella vaginalis.
It is a common problem. It is thought to cause up to 50
percent of cases of vaginal discharge. It has also been
reported in 15 to 29 percent of pregnant women.
Factors like stress, a presence of another STD, and the
use of perfumed feminine hygiene products may also increase
the risks.
BV may disappear without treatment, but it has been linked
to serious conditions such as pelvic inflammatory disease,
premature labour, recurring urinary tract infections, infections
after labour, uterine infections after abortion or the insertion
of an IUD and surgery (e.g. prior to hysterectomy). Treatment
is recommended in these higher risk situations.
What are the symptoms?
An unusual vaginal discharge is the main symptom of the
condition.
A fish-like odour is noticed. It may be more obvious after
sexual intercourse or during menstruation. The discharge
may be white or have a gray tinge.
However, about half the women who have it do not notice
any symptoms and only discover they have it during a physical
examination followed by laboratory tests.
Ninety percent of women seeking treatment complain of
discharge, 70 percent mention odor and 45 percent have irritation.
What is the treatment?
It is not necessary to treat the condition if it is causing
no symptoms, except in the high risk situations outlined
above.
The condition is easily cured with the use of antibiotics
which can be taken in tablet form or by a cream applied
to the vagina. Treatment is effective in about 90 percent
of cases (e.g. ornidazole for 5 days). One off single ("stat")
doses are safe and effective as well.
Metronidazole (400 mg twice a day for 7 days ) is effective
and seems to has the safest and well documented record in
pregnancy and lactation .
Some treatments should not be taken in the first part
of pregnancy - check with your doctor.
Different antibiotics or suppositories can be used for
recurrent infections.
Sufferers should also be screened for sexually transmitted
diseases.
Male sexual partners do not routinely need treatment and
women without symptoms may decline treatment.
Pregnant women should be treated because of the increased
risks of premature labour.
How can it be prevented?
Avoid douching and feminine hygiene sprays. The use of
condoms for a few months may also be helpful in preventing
the alkalinity of semen affecting the vagina (i.e. reducing
the natural protective acidity).
Future Trends
Researchers are studying the organisms involved in BV and
trying to understand how sexual activity may cause it.
Scientists are also investigating how the condition can
lead to pelvic inflammatory disease and problems in pregnancy.
Getting help
Your doctor, sexual health service or family planning clinic
will be able to help.
It is important to have proper confirmatory swabs done
and get follow up advice if problems persist.
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