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Every healthy vagina has bacteria, but when the balance between good bacteria and bad bacteria is disrupted, an infection ensues.
What is Bacterial Vaginosis?
Bacterial vaginosis, or BV, is a common infection caused by an overgrowth of bacteria, like Gardnerella vaginalis, in the vagina. Professor Horace Fletcher, Consultant Obstetrician Gynaecologist, explains, “It occurs when the helpful bacteria that are useful to maintain the pH and normal oxygenation of the vagina are killed.”
How is it caused?
That depends on the patient. “The causes of BV are vague,” says Professor Fletcher, “so determining the exact cause can be difficult.” However, certain things have been shown to increase your risk of developing one.
BV is not caused by poor feminine hygiene. In fact, it can be caused by some attempts to “clean” the vagina, like douching, which OBGYN Dr Robyn Khemlani warns against. “It disrupts the vaginal balance and can increase your risk of vaginal infection.”
The vagina is self-cleaning. It produces mucous that flushes out bacteria, semen, blood etc. Dr Robyn Khemlani notes that “the vagina doesn't require cleansing other than normal bathing.” With regards to the vulva, the outer part of the female genitals, water is usually enough, but a mild, unscented soap can occasionally be used.
Symptoms of Bacterial Vaginosis
Bacterial vaginosis does not always have symptoms. For some women, the symptoms may be present but mild. That said, the following are the most common symptoms related to the infection:
Foul-smelling discharge (often fishy) that is thin and white or grey.
Vaginal itching or burning
Burning pee
Itching around the vagina
Pain during sexual intercourse
Who is at risk?
BV is the most common vaginal infection, so being female is the foremost risk factor for developing this infection.
Other risk factors include:
Having unprotected sex (i.e. not using a condom)
Having multiple sex partners
Having a new sexual partner
Having an intra-uterine device
Recent or recurrent use of certain broad-spectrum antibiotics (more on that below)
Using perfumes and other scented products, including wipes, sanitary napkins, panty liners, tampons, feminine washes, soaps and laundry detergents.
Professor Fletcher notes that pregnant women are more likely to develop bacterial vaginosis because “during pregnancy, they produce large amounts of steroid hormones, like progesterone, which makes them more prone to infection.”
Getting Diagnosed
Your doctor may take a sample of any vaginal secretions, which are then examined under a microscope. “The usual anaerobic overgrowth is with Gardnerella,” Professor Fletcher explained. “This can be seen on microscopic examination of the vaginal cells as millions of dots. These are the infected cells (also called clue cells).”
Another, more modern diagnostic method is the use of DNA Probes. “With that, swabs or a urine sample are collected in labs across Jamaica, and the specimens are then sent to be tested. We don’t test for all the anaerobes or anaerobic bacteria. Gardnerella vaginalis is the most common bacteria that causes BV, so that is what is tested for.”
How Is It Treated
“Self-treating is not advisable,” says Dr Khemlani. “It would be best to come in to see the gynaecologist.” Trying to self-treat the infection, e.g. with douching or herbal steam baths can, in fact, worsen it. The most effective treatment for BV is a course of antibiotics.
Wait…if antibiotics can cause BV, why are antibiotics used to treat it?
The answer lies in the type of antibiotics and/or how often they’ve been used. “The broad-spectrum antibiotics, such as tetracycline, can kill the normal bacteria which are usually protective,” Professor Fletcher explains. “Sometimes the infection is actually caused by long-term antibiotic use or recurrent antibiotic use. The treatment of bacterial vaginosis is with specific, targeted antibiotics such as metronidazole or tinidazole or if the others don’t work, clindamycin.”
Conclusion
Bacterial vaginosis is common and easily treated. If you are dealing with any symptoms, call your gynaecologist, so you can get back to good health.
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