Women's Health

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Bacterial Vaginosis (BV)

Overview:

Bacterial vaginosis (BV) is caused by the overgrowth of the natural vaginal bacteria.
BV is a common infection, especially among pregnant women.
The cause of BV is not fully understood; it is not caused by poor hygiene.
The women affected by BV may not show any signs or symptoms.
Frequent washing (especially with deodorant soap) may result in disrupting the vaginal balance.

Introduction:

Bacterial vaginosis (BV) is attributable to overgrowth of one of several bacteria naturally found in your vagina, resulting in a smelly vaginal discharge. Making the vagina less acidic than usual, BV results in the increase of the ‘bad’ bacteria. BV can affect women of any age, with the women in reproductive age (15-41 years old) being at higher risk. BV is not a sexually transmitted infection; nor can it be transmitted through toilet or swimming pools.

Names:

Bacterial vaginosis (BV), Gardnerella vaginitis, Gardnerella

Causes:

The vagina contains ‘good’ and ‘bad’ bacteria. Normally, the ‘good’ bacteria are larger in number than the ‘bad’.

But if there are too many ‘bad’ bacteria, they upset the natural bacterial (and acidic) balance of vagina, causing the occurrence of BV.

Risk factors:

Any factors that may upset the bacterial balance in the vagina, such as:
Douching and overuse of vaginal lotions;
Previous infection of a sexually transmitted disease;
Use of an intrauterine device (IUD) for contraconception;
Use of deodorant soap;
Hormonal changes associated with puberty, pregnancy and menopause;
Overuse of some medications (e.g. antibiotics);
Having a new sex partner;
Having multiple sex partners;
Smoking.

Symptoms:

Women with BV may not show any signs or symptoms. However, the common BV symptoms include:

Gray, white or green vaginal discharge;
Foul-smelling ‘fishy’ vaginal odor;
Vaginal itching;
Burning during urination.

These symptoms, however, may be triggered by other inflammations and health conditions.

When to see a doctor?

If the woman has vaginal discharge that's abnormal and associated with an odor or fever, especially during pregnancy, to rule out the other possibilities of infections, and to prevent complications.

Complications:

Being at a higher risk of sexually transmitted infections.
Pelvic inflammations: including the inflammations affecting the fallopian tubes and ovaries, which may increase the risk of infertility.
Problems conceiving (e.g. preterm birth, low birth weight, placental inflammation, and post-delivery endometritis (especially in the case of C-section delivery).

Diagnosis:

Medical history
Clinical examination
Other tests, including: taking a sample from the vaginal discharge to test the vaginal acidity.

Treatment:

BV can be treated by the antibiotics prescribed by a gynecologist, either as oral tablets or topical creams. Taking the tablets or applying the cream or gel should continue for as long as prescribed, even after the symptoms disappear. Discontinuing the medicine too soon may lead to recurrence of the infection. Douching won't clear up a vaginal infection.

Prevention: