By: Shelagh McNally for Fibroids1
Bacterial vaginosis (BV) is one of the most common vaginal infections in America but it often goes undetected. Sometimes referred to as non-specific vaginitis or Gardnerella vaginitis, BV happens when the bad outweighs the good. All healthy vaginas have some form of bacteria. The good bacteria, lactobacillus (lack-toe bah-sil-li) is responsible for keeping pH balanced and the vagina healthy. When the bad bacteria anaerobes (ann-air-robes) take over, the vagina becomes infected. Symptoms may include pain, itching, or burning especially during urination but the most common symptom is a milky or gray vaginal discharge with a "fishy" smell. However, many women have no symptoms at all.
|Tips for preventing BV:|
Wipe from front to back (away from the vagina) 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 clothing that can trap moisture: Pantyhose (wear pantyhose with cotton crotch) or spandex exercise clothing.
Using condoms may decrease BV recurrence for some women.
Usually BV is not serious if treated immediately. Recent research has confirmed a link between BV and pelvic inflammatory disease (PID) as well as adverse pregnancy outcomes. Women with untreated BV have a 15 times higher than average risk of developing endometriosis and if BV spreads into the uterus or fallopian tubes there can be serious complications. If you have any symptoms you should consult your doctor before having an IUD inserted or getting an abortion. Doctors are now recommending that all pregnant women be screened since BV has been linked to premature birth, intro-amniotic infection and underweight babies. Recent statistics indicate that 23 percent of pregnant women in the Unites States may have BV but many are asymptotic. An equally disturbing trend was found in a 1996 report showing long term BV infected women had an increased susceptibility to HIV infection along with a higher rate of Chlamydia and Gonorrhea.
Doctors are not sure what causes bacterial vaginosis. It’s not considered a sexually transmitted disease but having new sex partners or multiple partners does seem to contribute to the infection. (Celibate women rarely get BV.) According to a 1989 study, treating male partners has not cured the spread or reduced the rate of BV. Other triggers appear to be IUDs, regular douching, extended use of panty liners and washing with heavily perfumed and antiseptic shower gels, soaps and using feminine hygiene sprays. Seattle-based researchers have had some success identifying three new kinds of specific bacterial markers in BV as reported in the November 2005 issue of the New England Journal of Medicine. Although the research is preliminary, researchers hope these findings may contribute to identifying a specific cause of BV and better treatment in the future.
Although many women know when they have a vaginal infection because of the uncomfortable itching and burning, tests should still be done to determine if BV is the culprit. The “whiff” test involves adding a solution of 10 percent potassium hydroxide to vaginal secretions. The presence of a strong fishy odor usually indicates a BV infection. A wet mount involves examining vaginal discharge mixed with a salt solution under a microscope to look for white blood cells that indicate an infection and the presence of clue cells, vaginal epithelial cells that have a fuzzy shape with obscured cells (normal cells have sharp edges). When more than 20 percent of these clue cells are present, there is usually a BV infection. The gram stain is a similar test where a special dye is applied to the slide. The gram-negative bacteria causing BV turns a bright pink while the normal vaginal lactobacilli turns purple. Any lack of lactobacilli is usually a sign of BV. Vaginal pH is another indicator: Normal pH is between 3.8 to 4.5 and higher levels usually indicate some kind of vaginal infection.
Treatment is not complicated. Your doctor may prescribe an antibiotic such as metronidazole or clindamycin. Topical creams or gels can also be used but aren’t as effective and can be more expensive. Some women find a change in diet helps. Including more flax oil, grains, fresh fruit and vegetables and cutting out alcohol, refined sugar and fast foods help reduce the number of outbreaks. Abstinence or using a condom while being treated for BV is also recommended.