Bacterial Vaginosis
Bacterial vaginosis (BV), the most common vaginal infection, occurs when the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain other bacteria. While the exact cause of BV is unknown, it is usually associated with sexual activity. However, women have never had sex can get BV. BV is not a sexually transmitted infection.
Symptoms
BV is characterized by an unpleasant or “fishy” vaginal odor and a thin, white-to-gray discharge. This vaginal odor may be more noticeable after unprotected sexual contact. BVis sometimes associated with vaginal pain, itching or irritation, but these can also occur.
A burning sensation during intercourse can occur with either BV or a yeast infection. Typically symptoms of a yeast infection include itching and a thick, white discharge. Both BV and a yeast infection may be present together.
Diagnosis
A clinician must examine the vagina for signs of BV and test a sample of vaginal fluid to make an accurate diagnosis.
Treatment
BV is usually treated effectively by using either an oral or vaginal form of the medications metronidazole or clindamycin.
With either oral or vaginal metronidazole, do not drink alcohol during treatment or for 48 hours following the final dose. Even small amounts of alcohol during metronidazole treatment can cause severe nausea and vomiting. Oral metronidazole can also cause a metallic taste in the mouth.
Use of oral clindamycin can lead to diarrhea. The vaginal formulations have fewer side effects, though some women may experience irritation.
Although BV is not transmitted sexually, unprotected sexual intercourse may promote its
development. Treatment of male sexual partners does not lower recurrence.
Complications
While BV is generally considered an annoying but minor condition, it may increase the risk of pelvic infection involving the uterus, ovaries, and fallopian tubes. Recent research suggests that BV makes it easier for a woman to sexually acquire herpes and HIV. In pregnant women, BV is linked to an early birth and other birth complications caused by infections in the uterus.
Prevention
Many women experience recurrences of BV. The exact cause is unknown but risk factors for BV may include:
- more than one sexual partner
- a new or different sexual partner in the past 30 days
- a female sexual partner
- douching
To maintain good vaginal health and make BV less likely to occur, observe the following guidelines:
- Avoid soap, shower gel, or cleansing wipes in the genital area and wash gently with plain water only.
- Use condoms to lessen the risk of recurrences.
- Avoid douching, which upsets the normal bacterial flora in the vagina.
- Cover insertable sex toys with a condom and use a new one every time it is used by a different person.
When to consult a clinician
If any of the following is experienced, contact a clinician:
- bothersome side effects (e.g., rash) while taking medication
- symptoms that persist despite treatment
- the return of symptoms at any time
[HU 406 : updated 10/11]
