Bacterial Vaginosis

Bacterial Vaginosis is caused by an excessive growth of one of several bacteria normally present in your vagina. Usually “good” bacteria ( i.e. Lactobacilli) outnumber the “bad” bacteria ( i.e. anaerobes) in the vagina. The good bacteria normally protect the vagina by maintaining a level of acidity and preventing the growth of pathogens.

If anaerobic bacteria ( more specifically – Gardnerella Vaginalis) become too excessive, they can upset the natural balance in the vagina, resulting in Bacterial Vaginosis.

Bacterial vaginosis is caused by an imbalance between the species normally present in the vagina that leads to an increase in harmful bacteria and a decrease in the good bacteria, i.e. the lactobacilli. Some clinical symptoms that are used to establish bacterial vaginosis are :

• Foul ( “or fishy”) odour from the vagina
• Existence of leukorrhea ( i.e. a thick and sticky vaginal discharge that is white or grey).
• Vaginal pH level higher than 4.5
• Presence of “clue-cells” upon examination. During this examination the cells are observed under the microscope to check whether or not they are covered with or contain bacteria.

Bacterial vaginosis does not necessarily present symptoms. When it does present symptoms, they may be:

• Vaginal Itching
• A burning sensation during urination
• Whitish or greyish leukorrhea ( or discharge)
• Unpleasant odour ( or foul smelling “fishy” vaginal odour)

Bacterial vaginosis takes place when certain types of bacteria normally present in the vagina begin to multiply in large numbers. Certain factors could increase the risk of bacterial vaginosis. These are:

• Vaginal Douching : Using water or a cleansing agent ( douching) to rinse out your vagina can upset the natural balance of the vaginal environment. Excessive Douching can lead to the overgrowth of anaerobic bacteria which can results in bacteria vaginosis.
• Hormonal changes due to menopause can lead to vaginal dryness, which may cause a greater incidence of vaginal infections, including bacterial vaginosis.
• Natural lack of lactobacilli bacteria in the vagina
• Atrophic Vaginitis predisposes the vagina to bacterial infections such as bacterial vaginosis.
• Trichomonas and bacterial vaginosis also give a more alkaline result on pH testing (pH>4.5).

Bacterial Vaginosis generally does not cause complications :

However, under certain circumstances, having bacterial vaginosis can sometimes be the cause of pelvic imflammatory disease (PID) , an infection of the uterus and fallopian tubes that can increase the risk of infertility.

Bacterial vaginosis may lower the natural defenses of vaginal flora and thus it may increase the risk of contracting a sexually transmitted disease and HIV.

In addition, having Bacterial Vaginosis may lead to :

(a) Preterm birth. In pregnant women, bacterial vaginosis is linked to premature deliveries and low birth weight babies.

(b) Infection risk after gynecologic surgery. Having bacterial vaginosis may be associated with a greater chance of developing a postsurgical infection after procedures such as hysterectomy or dilation and curettage (D&C).

While we may provide information related to certain medical conditions and their treatment, should a medical condition exist, promptly see your own doctor or qualified healthcare professional.

Bacterial vaginosis is normally treated by antibiotics. Some commonly prescribed antibiotics are metronidazole, clindamycine. However, relapses could take place. Please see your healthcare professional should symptoms recur.

Recurrent Bacterial Vaginosis is generally defined as 3 or more episodes of Bacterial Vaginosis per year, recurrence rates are estimated to be as high as 30% at 3 months, reaching up to 80% at 9 months and necessitating repeated administration of antibiotics