is a type of vaginal inflammation that results from the overgrowth of one of several types of bacteria normally present in the vagina, upsetting the natural balance of vaginal bacteria.
Women in their reproductive years are most commonly affected by bacterial vaginosis, but any woman can experience the condition. Doctors don’t know exactly why bacterial vaginosis develops, but certain activities, such as unprotected sexual intercourse or frequent douching, put you at higher risk of the condition.
Bacterial vaginosis signs and symptoms may include:
However, many women with bacterial vaginosis have no signs or symptoms at all.
Bacterial vaginosis results from an overgrowth of one of several organisms normally present in your vagina. Usually, “good” bacteria (lactobacilli) outnumber “bad” bacteria (anaerobes) in your vagina. But if anaerobic bacteria become too numerous, they upset the natural balance of microorganisms in your vagina, resulting in bacterial vaginosis.
Risk factors for bacterial vaginosis include:
Multiple sex partners or a new sex partner.
The link between sexual activity and bacterial vaginosis isn’t entirely clear, but bacterial vaginosis occurs more often in women who have multiple sex partners or a new sex partner. Bacterial vaginosis also seems to occur more frequently in women who have sex with women.
The practice of rinsing out your vagina with water or a cleansing agent (douching) upsets the natural balance of your vaginal environment. This can lead to an overgrowth of anaerobic bacteria, which in turn can result in bacterial vaginosis. Since the vagina is self-cleaning, douching isn’t necessary.
Natural lack of lactobacilli bacteria.
If your natural vaginal environment doesn’t produce enough of the good lactobacilli bacteria, you’re more likely to develop bacterial vaginosis.
Generally, bacterial vaginosis doesn’t cause complications. But under certain circumstances, having bacterial vaginosis may lead to:
In pregnant women, bacterial vaginosis is linked to premature deliveries and low birth weight babies.
Sexually transmitted infections.
Having bacterial vaginosis makes women more susceptible to sexually transmitted infections, such as HIV, herpes simplex virus, Chlamydia or Gonorrhea. If you have HIV, bacterial vaginosis increases the odds that you’ll pass the virus on to your partner.
Infection risk after gynecologic surgery.
Having bacterial vaginosis may be associated with a greater chance of developing a post-surgical infection after procedures such as hysterectomy or dilation and curettage (D&C).
Pelvic inflammatory disease (PID).
Bacterial vaginosis can sometimes cause PID, an infection of the uterus and the fallopian tubes that can increase the risk of Infertility.
TREATMENTS AND DRUGS
To treat bacterial vaginosis, your doctor may prescribe one of the following medications:
Metronidazole (Flagyl, Metrogel-Vaginal, others).
This medicine may be taken orally — as a pill that you swallow. Metronidazole is also available for use topically, as a gel that you insert into your vagina. To avoid the potential for stomach upset, abdominal pain or nausea while using this medication, avoid alcohol during treatment and for at least one day after completing treatment — check the instructions on the product.
Clindamycin (Cleocin, Clindesse, others).
This medicine is available as a cream that you insert into your vagina. One effect of using clindamycin cream is that it may weaken latex condoms during treatment and for at least three days after you stop using the cream.
This medication is taken orally. Tinidazole has the same potential for stomach upset and nausea as oral metronidazole does, so avoid alcohol during treatment and for at least one day after completing treatment.
Generally, it’s not necessary to treat a woman’s male sexual partner, but bacterial vaginosis can spread between female sexual partners. Female partners should seek testing and, if indicated, treatment of bacterial vaginosis. It’s especially important for pregnant women with symptoms to be treated, as this may decrease the risk of premature delivery or low birth weight.
Take your medicine or use the cream or gel for as long as your doctor prescribes it — even if your symptoms go away. Stopping treatment early may increase the likelihood of recurrence.
Despite effective treatments for bacterial vaginosis, recurrence of symptoms within three to 12 months is common. Researchers are exploring treatment regimens for recurrent bacterial vaginosis. If your symptoms recur soon after treatment, talk with your doctor about treatment options, one of which is extended-use metronidazole therapy.
A self-help approach is lactobacillus colonization therapy — which attempts to boost the number of good bacteria in your vagina and re-establish a balanced vaginal environment — possibly accomplished by eating certain types of yogurt or other foods containing lactobacilli. However, research to determine the benefits and risks of probiotic therapy is lacking.
LIFESTYLE AND HOME REMEDIES
To help prevent bacterial vaginosis:
Minimize vaginal irritation.
Stay out of hot tubs and whirlpool spas. Rinse soap from your outer genital area after a shower, and dry the area well to prevent irritation. Use mild, nondeodorant soaps and unscented tampons or pads.
Your vagina doesn’t require cleansing other than normal bathing. Repetitive douching disrupts the normal organisms that reside in the vagina and can actually increase your risk of vaginal infection. Douching won’t clear up a vaginal infection.
Use a male latex condom, limit your number of sex partners or abstain from intercourse to minimize your risk of a sexually transmitted infection.