Overview
Bacterial vaginosis (BV) is a condition that occurs when the balance of natural bacteria in the vagina is disrupted, leading to an overgrowth of certain types of bacteria. It can cause discomfort, pain, or foul-smelling vaginal discharge. BV can affect women of any age but is most common during the reproductive years, possibly due to hormonal changes and sexual activity. Factors that can increase the risk of developing BV include having multiple sex partners, douching, or natural lack of lactobacilli bacteria. In most cases, BV does not cause complications, but it can increase the risk of getting sexually transmitted infections (STIs) or developing infections after gynecological surgery. It's essential to consult a healthcare professional if you experience unusual vaginal discharge or discomfort, have a new sex partner, or suspect a yeast infection that hasn't been alleviated by self-treatment.
Understanding the disease
Symptoms
The symptoms of bacterial vaginosis (BV) include:
- Thin, vaginal discharge that may be gray, white, or green.
- Foul-smelling, "fishy" vaginal odor.
- Vaginal itching.
- Burning during urination. Many people with BV have no symptoms at all. If you experience any of these symptoms or are concerned about your vaginal health, it is recommended to see a healthcare professional for an evaluation.
Risk Factors
The risk factors for developing bacterial vaginosis include having different or new sex partners, engaging in sexual activities without protection, and douching. BV is also more common when the sex of both partners is female. Natural lack of lactobacilli bacteria and certain hormonal changes can also contribute to the development of BV.
Development
Bacterial vaginosis (BV) develops when there is an imbalance in the natural bacteria levels in the vagina, known as vaginal flora. BV occurs when there is an overgrowth of "bad" bacteria called anaerobes, which upset the balance of the flora. This can happen due to various factors, such as having multiple or new sex partners, douching, or a natural lack of lactobacilli bacteria in the vagina.
Assessment and Diagnosis
Triage
You should see a doctor if bacterial vaginosis is suspected when:
- Your vaginal discharge smells unusual and you have discomfort. Your doctor can help find the cause of your symptoms.
- You've had vaginal infections before but your discharge seems different this time.
- You have a new sex partner or different sex partners. Sometimes, the symptoms of a sexually transmitted infection (STI) are the same as those of bacterial vaginosis.
- You thought you had a yeast infection but still have symptoms after self-treatment.
Diagnosis
To diagnose bacterial vaginosis, your doctor may ask questions about your medical history, perform a pelvic exam, take a sample of vaginal discharge to test for "clue cells," and test your vaginal pH.
Management and Treatment
Complications
Potential complications of bacterial vaginosis (BV) may include sexually transmitted infections (STIs), such as HIV, herpes simplex virus, chlamydia, or gonorrhea. If you have BV and have HIV, it may raise the risk of passing the virus to your partner. Additionally, having BV may increase the risk of developing an infection after gynecological surgery, such as hysterectomy or dilation and curettage (D&C). However, it's essential to note that BV typically doesn't cause complications very often.
Prevention
Bacterial vaginosis (BV) can be prevented to some extent. To help prevent BV, avoid using scented products near your genitals, and refrain from douching. Keep your genital area clean by washing with warm water only. Using scented soaps, douching, or other scented products may disrupt the natural balance of bacteria in the vagina, increasing the risk of developing BV. Additionally, BV is more common among sexually active individuals, so practicing safe sex and using condoms can help reduce the risk of contracting BV or other sexually transmitted infections.
Treatment
The treatments for bacterial vaginosis typically involve antibiotics. The most common treatment is oral metronidazole, which is usually taken for 7 days. Other antibiotics may be prescribed, depending on the severity of the infection and the patient's medical history. It is also important to avoid douching, scented products, and using perfumed soaps down there, as these can disrupt the balance of bacteria in the vagina.
Preparing for medical consultation
To prepare for an appointment for bacterial vaginosis, you should:
- Schedule your appointment on a day when you don't have your period, as bleeding may interfere with the doctor's ability to see your vaginal discharge clearly.
- Avoid using tampons, vaginal sprays, douching, or having sex for 24 hours before the appointment.
- List your symptoms, including any that you may not think are related to bacterial vaginosis.
- Bring a list of your medicines and supplements, including vitamins and herbs, along with the dosage and frequency.
- Prepare questions to ask your doctor, such as:
- Can I do anything to prevent bacterial vaginosis?
- What symptoms should I look for?
- Do I need to take medicine?
- Should my partner be tested or treated?
- Are there any special instructions for taking the medicine?
- Are there any products that I can buy without a prescription to treat my condition?
- What can I do if my symptoms come back after treatment?
- Gather information on your medical history, recent exposure to possible sources of infection, vaccination record, and any other key medical information. Remember to ask your doctor for clarification if you don't understand something during the appointment.