What is Bacterial Vaginosis?

Bacterial vaginosis is a disease that occurs in the vagina and is considered to be a type of vaginal inflammation. The root cause for this disease is the imbalance of bacteria in the vagina - there is usually an overgrowth of bacteria thereby affecting the natural balance of bacterias in the vagina. The change is usually evident when there is a significant increase in anaerobic bacteria present in the vagina - this increase of bacterial presence ranges from 100% to 1000%. Although this disease can occur to a woman of any age, it commonly occurs to women who are in their reproductive years. This disease may go away on its own but is usually treatable with antibiotics and consumption of probiotics can aid in the prevention of re-occurrence.

Modes of Transmission

Although bacterial vaginosis is not a sexually transmitted infection, sexual activities have been studied with the presence of bacterial vaginosis microbiota. They were found below:

  • Male Partners. The microbiota was found in various areas of male genitalia - these include penis, urethra and coronal sulcus.
  • Female Partners. Since bacterial vaginosis occurs in women’s vagina, those who are engaged in a female-to-female partnership are at an increased risk of getting bacterial vaginosis.

Testing and Diagnosis

Bacterial Vaginosis is diagnosed by getting a swab from inside the vagina. This swab is tested in the laboratory and the diagnosis is confirmed through the following criteria:

  • Whiff Test. The Whiff test determines if there is a characteristic “fishy odor” on wet mount. This is performed through the addition of potassium hydroxide to the vaginal discharge on a microscopic slide. If this test is considered positive with the characteristic fishy odor, then it is highly suggestive that the patient has bacterial vaginosis.
  • pH Test. The pH level of the vagina likely indicates bacteria growth. The normal pH level of the vaginal environment is 3.8-4.2. With the use of litmus paper, the swab is tested to check it’s acidity level if the pH level is greater than 4.5 then it can be diagnosed that there is vaginal alkalinization which indicates that the patient has the likeliness of having bacterial vaginosis.
  • Clue Cells. Clue cells are epithelial cells that are distinctly covered with bacteria. If clue cells are present in the swab sample, then it is likely that the patient has bacterial vaginosis. To get a clear visualization of this clue cells - the vaginal discharge placed on a microscopic slide is dropped with sodium chloride.

Risk Factors

Although there is no named root cause of bacterial vaginosis, there are many risk factors identified for bacterial vaginosis, these include the following:

  • Engaging in multiple sex partners. Although bacterial vaginosis is not treated as a sexually transmitted infection, most cases of women who have bacterial diagnosis have sexual activities with more than one sex partner.
  • Lactobacilli Bacteria Deficiency. Just like any other mineral and vitamin that’s good for your body, the presence of lactobacilli in the natural vaginal environment is essential in diseases such as bacterial vaginosis.
  • Douching. Douching is the practice of cleaning the vagina or genitals with water or cleansing agent. These cleansing agents and their ingredients may affect the natural balance of bacteria in your vagina - which leads to an increase of anaerobic bacteria thereby developing bacterial vaginosis. Professional medical personnel has always emphasized that the vagina is self-cleaning and practices such as douching are not necessary and can possibly do more harm than good.

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Tips For Prevention

  • Abstain from sex. Being sexually active increases the chance of getting bacterial vaginosis so if you want to avoid acquiring this disease and other sexually transmitted infections, it is better to abstain from sex.
  • Use condoms. Since bacterial vaginosis microbiota can be present in the penis, it is better to use condoms, especially if you or your partner are engaging in multiple sexual activities.
  • Avoid douching and use only doctor-approved washes for your vagina. Douching disturbs the balance of the bacteria in your vagina so it is best to use mild washes and those only recommended by your doctor. The vagina has a self-cleaning environment so there is no need to use harsh cleaning agents.

Frequently Asked Questions

Who are at high risk of getting Bacterial Vaginosis?

Anybody can have Bacterial Vaginosis if they are not sexually active. However, people who are engaged in below activities are even at higher risk of getting the disease:

  • People who have multiple sexual partners - this includes male to female relationships and female to female relationships.
  • People with natural bacteria imbalance or those who are lacking lactobacilli bacteria.
  • People who practice douching or cleansing of the vagina with the use of cleansing agents - this type of practice usually disturbs the balance of lactobacilli and anaerobic bacteria in the vaginal environment.

What are the complications of having Bacterial Vaginosis?

Although bacterial vaginosis can go away on its own, if a person acquires it - they have a higher risk of getting sexually transmitted infections such as syphilis, gonorrhea, chlamydia and even HIV/AIDS.

Additionally, if you have a female partner then it is highly likely that you will transmit the virus to your partner.

For women who are still in their reproductive years, bacterial vaginosis can cause Pelvic Inflammatory Disease (PID) - a disease that increases the risk of fertility.

Lastly, if a woman who has bacterial vaginosis undergoes gynecologic surgery, then they have also an increased risk of getting a post-surgery infection.

Can Bacterial Vaginosis be cured?

Yes. Like most infections, bacterial vaginosis can be cured with the use of antibiotics. The most common antibiotics issued are clindamycin and metronidazole. These medicines can come in the form of tablets, gel or cream.

I have been diagnosed with Bacterial Vaginosis, is it possible to be infected again?

Yes. Being diagnosed and treated from Bacterial Vaginosis does not guarantee that you won’t be affected again. If you are treated through antibiotics, then there is a high chance that the disease will re-occur again within three months. If this occurs, then your doctor would have to recommend a longer time for the treatment of the disease.

Are there any other symptoms presented if Bacterial Vaginosis is left untreated?

Most women who have affected with bacterial vaginosis do not present any symptoms but some experienced the following symptoms:

  • Burning sensation during urination
  • Foul or “fishy” odor in your vaginal
  • Itchy vagina
  • Vaginal discharge that has a color of gray, white or green

Does having a monogamous relationship help in preventing Bacterial Vaginosis?

Anybody can get bacterial vaginosis, even those who are not sexually active but having a monogamous sexual partner will decrease your chance of getting bacterial vaginosis from being transmitted on to you.

Written by Mark Riegel, MD

Quick Snapshot

Can it be cured?

Yes. Bacterial vaginosis is easily treated.

Type of Infection

Bacterial. Caused by various bacteria.

How is treated?

Antibiotics. Metronidazole or Clindamycin taken for 5 to 7 days.

Recovery Time

Upto 2 weeks. One to two weeks can be needed for symptoms to fully disappear.

Can I have sex?

No. Sex with female partners should be avoided to prevent spread of the infection.

Can I get re-infected?

Yes. Doctors are unsure of the precise cause of bacterial vaginosis.

Do I Have Bacterial Vaginosis?

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