Clive Anderson - AT THE DERMATOLOGIST BACTERIAL VAGINOSIS (BV) is the most common vaginal inflammation affecting 10 to 64 per cent of women. It may be the cause of an abnormal
discharge in one-half of the cases and in 10-30 per cent
of pregnant women.
The primary cause of BV is the overgrowth of anaerobic bacteria. The healthy vagina includes a small amount of certain bacteria and yeasts. Some of these bacteria are 'good bacteria' with protective properties, while others are 'bad bacteria' producing undesirable symptoms when they predominate. The 'good bacteria' are the Lactobacilli and they secrete a natural disinfectant, similar to hydrogen peroxide that helps to maintain the healthy and normal balance of micro-organisms in the vagina.
If the population of these good bacteria is disrupted the so-called 'bad bacteria' will be allowed to increase in numbers disrupting the vaginal ecosystem. The result is an increased vaginal discharge that has a foul, fishy odour. The colour and amount of the discharge will vary from person to person. Burning or itching may accompany the discharge.
The diagnosis of BV is made by examining a sample of the discharge. The first test determines the area's pH. Normal pH is less than 4.5. In women with BV, the pH is usually greater than 4.5. The second test tries to determine the odour released from the discharge.
NOT SEXUALLY TRANSMITTED
Finally, the doctor will examine the discharge under the microscope to find certain cells. Bacterial vaginosis has not been proven to be a sexually transmitted infection. It may be found in women who have never had sex. There does, however, appear to be an increased incidence in ladies who have several sexual partners. Treatment of the sexual partners has not been found to prevent recurrent episodes of BV.
Some women get BV over and over again. It is not clear why this happens but good hygiene may prevent recurrences: -
Wipe from front to back after bowel movements to avoid spreading bacteria from the rectum to the vagina
Keep the vulva (outside of the vagina) dry and clean
Do not douche. Douching is never a good idea, especially with BV
Avoid feminine hygiene sprays, harsh soaps, or soaps with lots of perfume
Avoid clothing that can trap moisture such as pantyhose (wear the ones with cotton crotch) or latex exercise clothing
Using condoms may decrease BV recurrence for some women.
BV is usually not serious. In some cases, however, it can cause infections in the uterus and fallopian tubes. It is important to treat BV, especially before having an IUD inserted, before an abortion or before doing tests on the uterine lining. BV during pregnancy may cause the baby to be born too soon.
Bacterial vaginosis responds quickly to treatment with tablets, creams or pessaries. The seven-day course of tablets is reported to have the highest cure rate. It is important to complete the full course of treatment even if the symptoms are gone. Some of the prescribed medications should not be taken with alcohol as nausea and vomiting may occur.
Remember, if you experience signs of a vaginal infection it is important that a diagnosis is made by your physician most vaginal infections are not yeast infections! Self-treatment with over-the-counter (OTC) remedies for yeast infections will not cure a bacterial infection and may increase your risk of complications.
Dr. Clive Anderson is a Dermatologist and Venereologist: email: yourhealth@yahoo.com.
