Bacterial vaginosis

About

Bacterial vaginosis (BV) is an infection of the vagina caused by an imbalance of naturally occurring bacterial flora. This imbalance can cause a thin, grayish-white discharge and a fishy odor that is very distinct and strong. BV is the most common vaginal infection in women of reproductive age, and can be associated with increased risk of acquiring other sexually transmitted infections, pelvic inflammatory disease and other adverse outcomes such as preterm delivery during pregnancy. Treatment for BV typically consists of antibiotics, however for cases that are recurrent, additional treatment regimens may need to be considered.

Symptoms

The most common symptoms of bacterial vaginosis include a grayish-white discharge with an unpleasant odor, along with itchiness, burning, and irritation in the genital area. Other symptoms can include a fishy odor after sexual intercourse, a burning sensation during urination, and swelling or redness in the genital area.

Causes

The exact cause of bacterial vaginosis (BV) is not yet known. However, some factors that can increase a person’s risk of developing BV include an imbalance in the natural bacteria of the vagina, having multiple sexual partners, having a new sexual partner, douching, and smoking. BV is not caused by poor hygiene or lack of cleanliness.

Risk factors

Bacterial vaginosis is caused by an imbalance of the normal bacteria in the vagina. Risk factors for bacterial vaginosis include:

  • Having multiple sex partners
  • Douching
  • Having a new sex partner
  • Low estrogen levels due to menopause
  • Use of intrauterine devices (IUDs)
  • Tobacco smoking
  • Use of antibiotics
  • Reduced immunity due to HIV or other conditions.

Diagnosis

Bacterial vaginosis is typically diagnosed based on a physical exam and medical history as well as a microscopic examination of vaginal secretions. During the physical exam, a doctor may look for signs of infection such as redness and swelling. During the medical history, a doctor may ask questions about symptoms and risk factors. A doctor may also perform a pH test of the vaginal secretions to check for an imbalance of the bacteria normally found in the vagina. The microscopic examination helps to identify the type of bacteria present in the vaginal secretions. Additionally, a doctor may take a sample of the vaginal secretions to be tested for the presence of bacteria associated with Bacterial vaginosis.

Sub-types

Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance in the bacteria that normally inhabit the vagina. There are three main subtypes of BV: intermediate, excessive, and mixed.

Intermediate BV is a mild form of BV that is usually characterized by a slight increase in the normal acidic vaginal pH. Symptoms may include a thin white or gray vaginal discharge, itching or burning, and a fishy odor.

Excessive BV is a more severe form of BV and is characterized by a pH greater than 4.5. Symptoms may include a thicker, grayish or yellowish vaginal discharge, and an intense fishy odor.

Mixed BV is a combination of intermediate and excessive BV. Symptoms may include a thin to thick gray, yellow, or white vaginal discharge, itching or burning, and a strong fishy odor.

Treatments

The treatment options for Bacterial vaginosis vary depending on the individual, but the most common form of treatment is through the use of antibiotics, such as metronidazole and clindamycin. These antibiotics can be taken orally, or in the form of a vaginal cream or gel. Probiotics, such as lactobacillus taken orally or as gel, can also be used to manage this condition. Additionally, some women may find that over-the-counter treatments are effective, such as boric acid, tea tree oil, and garlic suppositories.

Prevention

  1. Avoid douching.
  2. Use condoms during sexual intercourse.
  3. Wear loose-fitting clothing and underwear.
  4. Avoid scented soaps, lotions, and other hygiene products.
  5. Eat a balanced diet and stay hydrated.
  6. Take probiotic supplements or eat probiotic-rich foods.
  7. Practice good hygiene, including washing the vulva area with warm water only.
  8. Change out of a wet swimsuit or sweaty exercise clothes as soon as possible.
  9. Refrain from smoking or consuming excessive amounts of alcohol.

Gender differences?

Yes, there are indeed gender-specific differences in the presentation and management of Bacterial vaginosis. Women who experience Bacterial vaginosis more often report abnormal discharge, a fishy odor, and vulvovaginal burning and itching. Men, on the other hand, are often asymptomatic.

In terms of management, Bacterial vaginosis is more often treated with antibiotics for women, particularly those who are pregnant. Men, however, are typically not treated for Bacterial vaginosis, as treatment is not necessarily effective and the condition is often self-limiting.

Nutrition

Nutrition plays an important role in the management of bacterial vaginosis. Proper nutrition can help maintain a healthy balance of bacteria in the vagina and reduce the risk of infection. Eating a balanced diet of whole grains, fruits, vegetables, lean proteins, low-fat dairy, and healthy fats can help the body maintain a strong immune system and support healthy gut bacteria. Foods rich in probiotics, such as yogurt, fermented vegetables, and kimchi, can help replenish healthy bacteria in the vagina and help fight off any bad bacteria that can cause infection. It is also important to stay hydrated and avoid foods high in sugar and saturated fats as they can increase inflammation and worsen symptoms of bacterial vaginosis.

Physical Activity

Physical activity does not have an effect on Bacterial Vaginosis. Bacterial Vaginosis is caused by an overgrowth of bacteria in the vagina, and is typically treated with antibiotics.

Further Reading

  1. https://www.ncbi.nlm.nih.gov/books/NBK459216/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5621139/
  3. https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm
  4. https://www.womenshealth.gov/a-z-topics/bacterial-vaginosis
  5. https://www.publichealth.va.gov/infectiondontpassiton/womens-health-guide/bacterial-vaginosis.asp

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