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Bacterial vaginosis
What is bacterial vaginosis (BV)?
Bacterial vaginosis is a disturbance of the microbiological balance in the vagina. Lactobacilli are the bacteria that dominate in the vagina and besides them there are other aerobic and anaerobic bacteria. When uncontrolled growth of anaerobic bacteria occurs (most often Gardnerella vaginalis) causes bacterial vaginosis. It is not a sexually transmitted disease.
How common is bacterial vaginosis?
20-60% of women have bacterial vaginosis at some point in their lives. There are great geographic variations. It also occurs in women who have never had sexual relations.
What are the symptoms of bacterial vaginosis?
50% of women with bacterial vaginosis have no symptoms.
Increased vaginal discharge with an unpleasant odor is the most common symptom of bacterial vaginosis. It is the cause of increased vaginal discharge in about 30% of cases.
How is it diagnosed?
Bacterial vaginosis is a clinical diagnosis.
3 out of 4 criteria must be met to make a diagnosis:
- Grayish homogeneous secretion;
- pH >4.5;
- an unpleasant smell that intensifies after additional potassium hydroxide;
- direct microscopic examination where there are more than 20% of the "clue" cells.
What are the risk factors?
Frequent change of partners, use of antibiotics as well as hygienic and sexual habits is risk factors for bacterial vaginosis. Bacterial vaginosis is often associated with chlamydia infection. The use of contraceptive pills reduces the risk of bacterial vaginosis.
Treatment of bacterial vaginosis
Bacterial vaginosis is treated with antiseptic drugs and antibiotics. The goal is to stop the uncontrolled growth of anaerobic bacteria and restore normal vaginal flora. The first choice is vaginal administration, but it can also be treated with oral therapy. 80-90% respond to therapy, but in 30% of women it recurs.
What are the possible complications?
Bacterial vaginosis increases the risk for infections of the genital organs (sexually transmitted diseases, genital herpes, HIV), postoperative infections, premature birth and infection of the fetal membranes during pregnancy.
Expert advice: frequently asked questions
Answers by: Milan Milenković, MD PhD.
What is vaginal discharge?
Vaginal secretion is a liquid that is found in the vagina and is a physiological phenomenon. In vaginal secretions there are bacteria that represent an ecosystem. Lactobacilli are domineering, but there are also anaerobic and aerobic bacteria as well as fungi. Anaerobic bacteria do not need oxygen. Symptoms and infection occur when this balance is disturbed and the concentration of one group of bacteria increases. During the reproductive period, women secrete 1-4 ml of secretion per day.
What is the normal pH of the vaginal discharge?
3.8-4.4 is the normal pH value for women of reproductive age.
Is bacterial vaginosis an infection?
Bacterial vaginosis is not an infection since there is no inflammatory reaction and is only a disturbed balance of bacteria that normally live in the vagina.
