Advice for your Patients
Bacterial Vaginosis
Bacterial Vaginosis (BV) is caused by a disruption to the normal
flora of the vagina leading to an opportunistic overgrowth of
bacteria, mainly Gardnerella vaginalis, Prevotella species,
Mycoplasma hominis, and Mobiluncus species. Overgrowth of these
anaerobic organisms can cause an increased vaginal pH of up to
7.0.
BV is the most frequently occurring cause of vaginosis,
approximately twice as common as thrush. Experts estimate that at
least 1 in 3 women, and perhaps most women, will develop BV at some
point in their life.
Symptoms
The main symptom of BV is usually a thin, white-grey coloured
homogeneous discharge which often has a fishy smell. Other symptoms
may include soreness in and around the vagina.
Causes
The main causes of this bacterial imbalance include:
- sex without a condom (semen is quite alkaline)
- perfumed intimate products
- frequent douching (washing out the normal harmless bacteria
along with the unwanted organisms)
- use of IUDs (a ‘foreign body’ which can facilitate the
development of unwanted bacteria)
- antibiotic therapy
Other causes can include new or multiple sexual partners, same
sex sexual partners, the menopause and hormone
imbalances.
Diagnosis
In clinical practice, BV is normally diagnosed using the Amsel
criteria. An alternative is to use a Gram stained vaginal smear
with the Hay / Ison criteria or the Nugent criteria.
Complications
Whilst it is considered unusual for BV to cause complications in
otherwise healthy, non-pregnant women, it is thought that both the
incidence and importance of BV has been underestimated. It is only
through recent research that the presence of BV has been implicated
in pelvic inflammatory disease and tubal infertility, and has been
shown to increase the risk of acquiring and transmitting HIV.
Connections with the fact that nitrosamine, which is produced by
bacteria that appears in BV, can be cancerous has also been
discussed.
BV can cause significant complications in pregnant women and in
women undergoing gynaecological procedures.
Treatment
BV can be treated with a course of oral or topical antibiotics;
the current treatment of choice is metronidazole. The cure rate is
80-90%, but with a recurrence rate of 50-70% in 4-6 weeks.
Research has recently been undertaken to demonstrate the
effectiveness of a product containing lactic acid and glycogen gel
in redressing vaginal imbalance (see How balance activ vaginal gel Can Help Your
Patients).
For more information, please download our Health Care Practitioners’ Brochure.