Bacterial vaginosis (BV) is an infection of the vagina. It results from a change in the normal balance of vaginal bacteria.
BV usually doesn’t cause any other health problems. But it can lead to issues, especially when you’re pregnant or trying to get pregnant.
BV is a disturbance in the mix of bacteria in the vagina. Normally there is a healthy mix of millions of ‘friendly’ germs (bacteria) in our bodies, including in the vagina – we rely on them being there and they are a part of what keeps us healthy. In BV, the balance of vaginal bacteria is altered.
The type of bacteria called anaerobic bacteria (bacteria that grow in an environment without air) increase in number, whilst another type, called lactobacilli, dies off. This disturbance in the bacteria makes the inside of the vagina slightly less acidic than usual. This slight reduction in acidity then encourages the growth of more anaerobic bacteria and fewer lactobacilli.
Although the changes of BV don’t usually cause pain or itching, they do tend to cause a discharge which can smell stronger than usual. Sometimes it smells ‘fishy’, particularly after sexual intercourse. It can be watery and grayish in color. This can be distressing and make women feel unclean. Some women then try to douche or wash themselves with soaps or perfumes – but this will only disturb the vagina more (because soaps are too alkaline for the inside of the vagina) and will make the problem worse.
Bacterial vaginosis — usually called BV — is a bacterial infection. It happens when the different kinds of healthy bacteria in your vagina get out of balance and grow too much. BV is often caused by gardnerella vaginalis, the most common type of bacteria in your vagina.
Anything that changes the chemistry of your vagina’s pH balance can mess with bacteria levels and lead to infection — like douching or using vaginal deodorants and other irritating products. Learn more about keeping your vagina healthy.
Bacterial vaginosis isn’t a sexually transmitted infection. But having sex with a new partner, or multiple partners, may increase your risk for BV. And sex sometimes leads to BV if your partner’s natural genital chemistry changes the balance in your vagina and causes bacteria to grow.
Although it is not clear how BV is transmitted, it is more common in women who are sexually active. It sometimes develops soon after intercourse with a new partner. Women who have female sexual partners may be at higher risk than women who have sex with only male partners.
Research has not conclusively found a link between BV and specific sexual practices or acts. However, recent evidence supports the use of condoms to reduce the risk of this infection.
BV rarely affects those who have never had sex.
You cannot get BV from toilet seats, bedding, or swimming pools.
About half of the time, women with BV have no symptoms. But they can include:
Bacterial vaginosis doesn’t generally cause complications or itself is not harmful, but it can increase the riskTrusted Source of other health issues.
Chorioamnionitis significantly increases the chance of an early delivery. If the newborn lives, they have a higher risk of cerebral palsy.
BV may directly increase the likelihood of difficulty conceiving. And it may increase the risk of health complications that can affect fertility.
Bacterial Vaginosis Diagnosis The doctor will:
BV sometimes clears up without treatment. However, the symptoms can resemble those of other health issues, such as gonorrhea or trichomoniasis. And untreated BV can lead to complicationsTrusted Source, especially during pregnancy.
For these reasons, getting a professional diagnosis is key to ensure that the treatment is successful.
BV may also increase the risk of complications following a hysterectomy or some types of abortion. Some doctors recommend giving BV treatment to everyone who has these procedures, regardless of whether they have BV symptoms.
Male partners do not usually require treatment. However, BV can transmit from a male to multiple female sexual partners.
Below, we explore some treatment options for BV.
Antibiotics are effective in up to 90%Trusted Source of BV cases, but the condition often comes back again within a few weeks.
Below are some antibiotic medications that a doctor may prescribe for BV.
Metronidazole is the most common antibiotic treatment for BV.
It is available in these forms:
Metronidazole interacts harmfully with alcohol. This combination can make a person seriously unwell and cause side effects such as nausea and vomiting.
Clindamycin is an alternative antibiotic. It may work if metronidazole is not effective or if the infection recurs.
Clindamycin cream is the first-line treatment that a person applies inside their vagina. A person does this at bedtime for 7 daysTrusted Source.
Instead, doctors may prescribe clindamycin tablets, which a person takes twice a day for 7 days, or clindamycin ovules, which a person inserts into their vagina at bedtime for 3 days.
Clindamycin ovules and cream weaken latex, so barrier methods of contraception may be less effective during the treatment.
Some examples of these methods include:
The FDA has recently approved a new clindamycin gel, Xaciato, for the treatment of BV in females aged 12 years and older.
Learn more about the dosage and application of metronidazole and clindamycin here.
Tinidazole is another antibiotic that can treat BV if metronidazole does not work or if the condition recurs. A person takes a 2-g oral doseTrusted Source once a day for 2 days. Or, they take a 1-g dose once a day for 5 days. Anyone using this medication should avoid alcohol and take their doses with food to minimize the risk of gastrointestinal side effects.
Some women with BV say that things settle more quickly and symptoms are eased by applying a thin coat of plain, live yogurt to the outside of the vagina daily, and by applying a small amount of plain live yogurt on a tampon for internal use before bed.
The evidence that live yogurt is helpful in treating or preventing BV is mixed, with some trials saying that it is helpful and some saying that it is not helpful. Overall specialists feel that there is not enough evidence in its favor to suggest it over other treatments.
Astodrimer sodium gel is a new kind of treatment for BV. It can be bought without a prescription online as Betafem® BV gel. It treats BV by creating a physical barrier that repels bacteria from coming close to and sticking to the vaginal wall. A 2019 trial showed that astodrimer gel once daily for seven days was well tolerated by women and provided rapid improvement in BV symptoms. Patients improved, or were cured at the same rate as with conventional antibiotics.
Treatment with acetic and lactic acid gels aims to keep the vaginal pH at less than 4.5, to encourage lactobacilli to grow, and to discourage anaerobic bacteria from growing. Some studies have suggested that long-term use of vaginal acidifiers of this type reduces recurrences of BV. However, other studies suggest that this treatment, whilst harmless, is not effective.
Lactobacillus suppositories and oral tablets are sold in some health food shops, for use in BV.
Orally consumed probiotics are believed to reach the vagina via the bowel. There is some evidence that this can be helpful in treatment and in prevention of BV. These studies suggest treatment needs to continue for at least two months. Other studies don’t show a clear benefit. Overall, specialists feel that there is not enough evidence in its favor to suggest it over other treatments.
Intravaginal lactobacillus treatment seems as though it ought to be an obvious solution – why not put the right bacteria where they are meant to go? However, results of studies on vaginal treatments with lactobacilli are also mixed, with some studies suggesting this treatment is effective and others not.
Bacterial Vaginosis https://my.clevelandclinic.org/health/diseases/3963-bacterial-vaginosis
Bacterial vaginosis https://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279
Bacterial Vaginosis https://www.webmd.com/women/guide/what-is-bacterial-vaginosis
What is bacterial vaginosis? Symptoms and causes https://www.medicalnewstoday.com/articles/184622
Bacterial Vaginosis (BV) https://www.msdmanuals.com/home/women-s-health-issues/vaginal-infections-and-pelvic-inflammatory-disease/bacterial-vaginosis-bv
Bacterial Vaginosis
https://patient.info/sexual-health/vaginal-discharge-female-discharge/bacterial-vaginosis
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