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Millions of females worldwide struggle with bacterial vaginosis. It is one of the commonest vaginal infections in women of reproductive age. Yet despite its widespread occurrence, many women struggle with recognizing its symptoms and seeking treatment for it. This blog aims to provide a better understanding of what causes bacterial vaginosis, its symptoms, and effective steps for management and prevention.
What is Bacterial Vaginosis (BV)?
Bacterial vaginosis is a bacterial infection of the vagina. Many bacteria are a part of the normal flora of the vagina, some that are beneficial and others that are not so much. For optimal vaginal health, balance between these bacteria is essential. When this balance is disrupted and there is an overgrowth of one type over the other, it leads to bacterial vaginosis.
Although bacterial vaginosis is not classified into types, its presentation may vary from person to person:
Based on Symptoms
This infection is symptomatic in most females and bacterial vaginosis symptoms like itching, burning, vaginal discharge (grayish white), and a fishy smell are present. However, in others, there are no obvious symptoms, and the condition may only be diagnosed during a routine gynecological examination.
Based on Recurrence
Bacterial vaginosis can be treated successfully. However, the infection tends to recur in almost 30% to 50% of cases. Multiple reasons can make individuals prone to recurrences of bacterial vaginosis, such as persistent bacterial imbalance, resistance to antibiotics, etc.
How Common is Bacterial Vaginosis?
Bacterial vaginosis is very common among women of reproductive age (approx. 1 in 3 women) all over the world. Although bacterial vaginosis symptoms mostly occur in sexually active females, it is not labeled as a sexually transmitted infection or STI. Women who are not sexually active may get bacterial vaginosis as well. The average age for the diagnosis of bacterial vaginosis is between 15 years to 44 years. However, it can occur in postmenopausal women too, especially those not on hormone replacement therapy.
Females at a higher risk of developing bacterial vaginosis symptoms include those who are pregnant, have an intrauterine device (IUD), have multiple sexual partners, use douches, or are already on antibiotic treatment.
What are the Symptoms of Bacterial Vaginosis?
Bacterial vaginosis is not always symptomatic. Some women do not notice anything out of the ordinary, and the condition is only diagnosed during a doctor’s visit.
Bacterial Vaginosis Symptoms And Signs
Typical signs and symptoms of bacterial vaginosis include:
Grayish white and thin vaginal discharge
Presence of a fishy smell in the vaginal area
Itching and irritation
Burning sensation when passing urine
Bacterial Vaginosis Complications
If bacterial vaginosis is left untreated for an extended period, it can lead to complications such as:
Higher incidence of pregnancy complications (preterm labor, spontaneous abortion)
Higher risk of contracting Pelvic Inflammatory disease (PID)
Higher risk of contracting sexually transmitted infections (STIs)
Higher risk of post-surgical infections (e.g., after C-section, or abortion
With proper treatment and care, bacterial vaginosis is unlikely to cause any serious side effects or complications.
How Do You Get Bacterial Vaginosis (BV)?
Bacterial vaginosis happens when the balance of the normal vaginal flora is disturbed. It leads to bacterial overgrowth, causing bacterial vaginosis symptoms. The predominant bacterial species in the vagina is Lactobacillus. These beneficial organisms make lactic acid and hydrogen peroxide to limit the growth of harmful bacteria. Bacterial vaginosis is linked to a decrease in the overall number of Lactobacillus.
Organisms
Previously, it was believed that the bacteria Gardnerella Vaginalis were solely responsible for causing bacterial vaginosis. However, it has now been proven that several other bacterial species may also be responsible for this infection. The bacteria typically associated with a bacterial vaginosis infection include:
Gardnerella Vaginalis (Most common)
Atopobium Vaginae
Mobiluncus Species
Prevotella Species
Peptostreptococcus
Mycoplasma hominis
Bacterial Vaginosis Causes
The exact cause for the imbalance of vaginal flora in bacterial vaginosis is not known. However, several factors are implicated. These include:
Douching
Douching is a practice where water (or other fluids) are used to clean the vagina. Douching may result in flushing out the beneficial vaginal bacteria, upsetting the biome balance and leading to bacterial vaginosis symptoms.
Scented Personal Care Products
The use of scented personal care or hygiene products (soaps, body washes, bubble baths, or vaginal deodorants) alters the vaginal biome by causing irritation and disturbing its pH balance. These two factors lead to bacterial overgrowth.
Hormonal Changes
Hormonal fluctuations (menstruation, menopause, pregnancy, etc.) in females can lead to an imbalance of the vaginal flora, making them more susceptible to bacterial vaginosis.
Antibiotic Treatment
Prolonged use of antibiotics due to any reason can decrease the number of good bacteria in the vagina. Females being treated for other infections may develop bacterial vaginosis for this reason.
Smoking
Research suggests that due to the impact of smoking on the immune system, it is highly likely that it will cause an imbalance in the bacterial flora of the vagina.
Sex
Females with multiple sexual partners, or with a new partner are more prone to the disruption of the vaginal flora. However, bacterial vaginosis is not classified as a sexually transmitted infection.
Bacterial Vaginosis Treatment
Bacterial vaginosis is diagnosed by taking a detailed history and performing a thorough examination, which is followed by a vaginal sample for microscopy and Gram staining, Whiff test, and pH testing. In low-resource settings where access to labs is limited, a diagnosis of bacterial vaginosis is based on the signs and symptoms. Although effective, there is a possibility of undertreating or overtreating with this approach.
The good news is that bacterial vaginosis is treatable and curable. Bacterial vaginosis treatment includes a combination of suitable antibiotics (Metronidazole, Tinidazole, Clindamycin, Secnidazole) along with lifestyle modifications and avoiding any risk factors or triggers.
Is Bacterial Vaginosis Contagious?
Bacterial vaginosis is not contagious. You will not get it by touching an infected person. It is neither an airborne infection nor sexually transmitted. Therefore, it is not considered a part of STI infections. However, sexually active females of reproductive age, females with more than one partner, or a new partner are at a higher risk of developing bacterial vaginosis. People who are not sexually active can get bacterial vaginosis symptoms as well. Bacterial vaginosis also has nothing to do with poor hygiene.
