About Bacterial Vaginosis

Bacterial vaginosis (BV) is a prevalent condition that results from a disruption of the normal balance of bacteria in the vagina. Typically characterised by symptoms such as a thin, watery, and fishy-smelling vaginal discharge, BV can also be asymptomatic in about half of the cases. The condition is not considered a sexually transmitted infection (STI), but it can increase the risk of acquiring STIs and lead to complications in pregnancy if left untreated.

The disruption in vaginal flora usually involves a reduction in lactobacilli, which are beneficial bacteria that help maintain the acidic environment of the vagina. When these bacteria are depleted, the pH of the vagina increases, enabling the growth of other potentially harmful microorganisms.

Symptoms

Recognize the signs of bacterial vaginosis (BV) with these key symptoms:

● Vaginal Discharge: Often described as thin, watery, and greyish-white. The change in the amount and consistency of discharge is a key symptom.
● Odour: A strong, fishy odour, especially after sexual intercourse or during menstruation, when the pH of the vagina becomes more alkaline.
● Vaginal pH: An elevated vaginal pH greater than 4.5 is typical in cases of BV.
● Itching or Irritation: Less common, but some individuals may experience mild itching or irritation around the vagina.
● Absence of Significant Pain or Soreness: BV does not usually cause soreness or significant pain, distinguishing it from some other vaginal infections.

These symptoms are indicative but not definitive. A medical examination and specific tests are required for an accurate diagnosis.

Diagnosis

Diagnosing bacterial vaginosis (BV) involves a combination of clinical evaluation and laboratory tests to assess the symptoms and confirm the presence of the bacterial imbalance typical of the condition:

● Clinical History and Symptoms: A healthcare provider will start by asking about symptoms, sexual history, and any previous episodes of vaginal infections.
● Physical Examination: During a pelvic exam, the doctor may notice signs indicative of BV , such as a thin, greyish-white vaginal discharge.
● pH Test of Vaginal Fluids: BV is often associated with a vaginal pH greater than 4.5. Testing the pH can help differentiate BV from other vaginal infections like yeast infections, which do not typically raise the vaginal pH.
● Microscopic Examination: A sample of vaginal discharge may be placed on a glass slide and examined under a microscope for “clue cells” (vaginal cells covered with bacteria), which are a hallmark of BV.
● Whiff Test: This test involves adding a few drops of potassium hydroxide to a sample of vaginal discharge to check for a strong fishy odour, which is a positive indication of bacterial vaginosis.
● Nucleic Acid Amplification Tests (NAATs): Though more commonly used for other STIs, NAATs can also detect the DNA of bacteria associated with BV, providing a highly sensitive method for diagnosis.

These diagnostic steps help ensure accurate identification of bacterial vaginosis, allowing for appropriate treatment and management. Regular gynaecological check-ups and discussing any symptoms with a healthcare provider are recommended to maintain vaginal health and prevent complications associated with the condition.

Treatments

Prescription treatments for Bacterial Vaginosis provide focus on restoring the normal bacterial balance in the vagina using prescription antibiotics. Here are the highlighted medicines that My Pharmacy sells:

Zidoval 0.75% Gel (40g)

• Active Ingredient: Metronidazole
• Action: This vaginal gel helps destroy the bacteria causing BV. Metronidazole is applied intravaginally and is effective in reducing and eliminating the overgrowth of anaerobic bacteria typically responsible for BV.
• Usage Instructions: Typically, it is applied once a day for 5 days, depending on the specific medical advice from your healthcare provider.

Dalacin Cream 2% (40g)

• Active Ingredient: Clindamycin
• Action: Clindamycin works by reducing the number of bacteria and is used as an alternative to metronidazole, especially for those who may not tolerate it well.
• Usage Instructions: It is usually applied intravaginally once at bedtime for 7 days or as prescribed by a healthcare provider.

Both metronidazole and clindamycin are proven to be effective in treating bacterial vaginosis, with a regimen that needs to be followed carefully to avoid recurrence and resistance. Recurrence is common, and some cases might require prolonged or repeated treatment. In cases of recurrent bacterial vaginosis, alternative treatments such as prolonged use of metronidazole gel or even oral medications followed by intravaginal boric acid might be considered under medical guidance.

It is important for women undergoing treatment to follow their healthcare provider’s instructions precisely and complete the full course of treatment even if symptoms improve to prevent recurrence. Additionally, during treatment, it is recommended to abstain from alcohol (with metronidazole), avoid sexual intercourse, and not use other vaginal products unless directed by a physician.

Prevention Strategies

Here are some prevention strategies for Bacterial Vaginosis (BV) as suggested by various health sources:

● Avoid Douching: Douching can disrupt the natural balance of bacteria in the vagina and increase the risk of developing bacterial vaginosis.
● Practise Safe Sex: Using condoms correctly and consistently can help prevent bacterial vaginosis, especially when having sexual contact with new or multiple partners.
● Maintain Vaginal Hygiene: Avoid using harsh soaps or vaginal deodorants that can disturb the natural flora of the vagina. Washing with mild, unscented soaps and warm water is generally recommended.
● Consider Probiotics: Although the evidence is mixed, some studies suggest that using probiotics can help maintain a healthy vaginal flora and reduce the risk of bacterial vaginosis. This can include oral probiotics or probiotic vaginal suppositories.
● Regular Gynecological Check-ups: Regular visits to a healthcare provider for check-ups can help monitor and maintain vaginal health, potentially catching and addressing imbalances before they lead to bacterial vaginosis.

Implementing these strategies can help reduce the risk of developing the condition and maintain a healthy vaginal environment. For more detailed advice tailored to individual health needs, consulting a healthcare provider is recommended.

Related Reading

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