Bacterial vaginosis
Bacterial vaginosis (BV) is a common vaginal condition characterized by an imbalance in the normal bacterial flora of the vagina, leading to an overgrowth of harmful bacteria. It is most prevalent among females aged 15 to 44, with higher incidence rates noted in Black and Hispanic women. While some women may be asymptomatic, others might experience symptoms such as abnormal gray or white discharge with a fishy odor, burning during urination, and vaginal irritation. If left untreated, BV can lead to complications during pregnancy and increase the risk of other infections, including sexually transmitted infections (STIs) and HIV transmission.
The exact causes of BV are not fully understood, but factors such as sexual activity, douching, hormonal changes, and hygiene practices may contribute to its development. Diagnosis typically involves a physical examination and tests to assess vaginal fluid. Treatment is usually straightforward, involving antibiotics either orally or as vaginal creams. Preventative measures include practicing safe sex, avoiding douching, and maintaining proper hygiene. For those experiencing symptoms, consulting a healthcare provider is essential for proper diagnosis and treatment.
Bacterial vaginosis
- ANATOMY OR SYSTEM AFFECTED: Genitalia, reproductive system, skin, vagina
Definition
Bacterial vaginosis is a mild infection of the vagina. Although it is usually treated easily, it may indicate another, more serious condition. It can also lead to complications during pregnancy, such as low birth weight and premature delivery, and a higher risk of pelvic inflammatory disease if the bacteria infect the uterus and fallopian tubes.
There is an association between bacterial vaginosis and a higher risk of being infected with the human immunodeficiency virus (HIV) or other sexually transmitted infections. If a woman has HIV and also bacterial vaginosis, she risks transmitting HIV to her partner during unprotected sexual activity. The use of antiretroviral therapy greatly reduces the risk of HIV transmission, however, even when bacterial vaginosis is present.
Causes
Bacterial vaginosis is caused when the normal balance of bacteria in the vagina is disrupted. Normally, the vagina has helpful or commensal bacteria (lactobacilli) and harmful bacteria (anaerobes), bacteria that do not need oxygen to live. Sometimes the harmful bacteria overgrow, reducing the amount of helpful bacteria in the vagina. The cause of this overgrowth is not understood. In some cases, it may be related to sexual activity through the transfer of harmful bacteria from a sexual partner. Douching, genetic factors, hormonal changes, and hygiene issues may also cause changes in the vaginal microbiome.
Risk Factors
In females ranging in age from 15 to 44, bacterial vaginosis is the most common vaginal medical condition. Black and Hispanic women have higher rates of bacterial vaginosis. The factors that increase the chance of developing bacterial vaginosis include smoking, using douches or feminine sprays, having unprotected sex without a condom, having a new sexual partner or multiple partners, and using an intrauterine device (IUD) for birth control.
Symptoms
Some women with bacterial vaginosis do not have any symptoms. Others experience abnormal white or gray vaginal discharge with a thin consistency and a fishy odor, especially after sexual activities. Other symptoms include a burning feeling while urinating, itching around the vagina, vaginal irritation, and pain during sexual activities.
If any of these symptoms appear, one should not assume they are caused by bacterial vaginosis. These symptoms may be caused by other conditions. However, one should contact a healthcare provider if these symptoms appear.
Screening and Diagnosis
A doctor will ask about symptoms and medical history and perform a physical exam. Tests may include a pelvic exam to look for signs of bacterial vaginosis and obtaining a sample of fluid from the vagina to test for signs of infection.
Treatment and Therapy
Bacterial vaginosis should be treated as soon as the patient experiences symptoms, or if the patient is pregnant, treatment should begin even without symptoms. Bacterial vaginosis is easily treated with antibiotics in the form of pills or vaginal creams prescribed by a doctor.
Prevention and Outcomes
To help reduce the chance of getting bacterial vaginosis, one should abstain from sexual activities or remain monogamous, use condoms during sexual activities, avoid using douches or feminine sprays, and visit a doctor for regular pelvic exams. To avoid a recurrence of bacterial vaginosis, patients should finish all prescribed medication, even if the symptoms go away. One should also wash diaphragms and other reusable birth control devices thoroughly after use, avoid wearing pantyhose and clothing that traps moisture in the vagina, and, after bowel movements, wipe oneself from front to back (away from the vagina).
Bibliography
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