Bacterial vaginosis

Bacterial vaginosis is a condition resulting from a change in the ecology of the vagina: the disappearance of lactobacilli and the development of a mixed anaerobic and aerobic flora. Almost half of cases of bacterial vaginosis are asymptomatic. In the remaining cases, the predominant symptom is an unpleasant vaginal odor.

What is bacterial vaginosis?

Bacterial vaginosis is caused by one of several types of microorganisms normally found in the vagina. The disease is associated with the disappearance of lactobacilli and the development of a mixed aerobic and anaerobic flora. The task of lactobacilli is to make it acidic, which protects against the invasion of pathogenic bacteria. So, when the number of sticks is too few, or it disappears completely – the defense system does not fulfill its function. Then the natural balance between the different types of bacteria is disturbed. The most common overgrowing bacteria that irritate the vaginal and vulvar mucosa are anaerobic bacteria, coli and streptococci. Although the cause of the infection is not fully determined, some role is assigned to improper intimate hygiene and unprotected sexual intercourse.

The first disturbing symptoms that may suggest a vaginal infection are indications for a medical visit. Women with previous episodes of bacterial vaginosis who develop symptoms different from previous ones should discontinue home treatment and see a specialist.

Bacterial vaginosis – infection

Bacterial vaginosis is the most common vaginal infection in women after puberty. The importance of sexual intercourse in disease transmission is unclear. There is a suspicion that males may be passive carriers. This mainly applies to men who have had sexual contacts with various women in a short period of time and do not apply the basic rules of hygiene (washing the genitals after sexual contact). Another evidence of the role of sexual contact in the transmission of infection is the reported frequent coexistence of the disease in lesbians in monogamous relationships who share sexual gadgets.

The most commonly detected microbes in bacterial vaginosis are: Gardnerella vaginalis, Mobiluncus sp., Bacteroides sp., Atopobium vaginae, peptostreptokoki i mikoplazmy.

Factors that increase your risk of bacterial vaginosis:

1. taking antibiotics;
2. vaginal dryness due to endocrine disruptions (low estrogen levels);
3. bacterial infections of other organs, even of the ear or throat;
4. pregnant women (raging hormonal economy),
5. frequent sexual intercourse with multiple partners,
6. lack of proper intimate hygiene, especially during menstruation (menstrual blood neutralizes the acidic environment of the vagina, thus weakening the defensive capabilities),
7. stress (chronic – weakens the immune system).

Remember! Paradoxically speaking, washing your intimate areas too often is not good either. Frequent washing can flush out the natural bacterial flora, while the chemical components found in soaps and deodorants can change the pH of the vagina and irritate its mucosa.

Test yourself for bacterial vaginosis by taking the tests from the STD Test Kit.

Dig. B-1. Exfoliated vaginal epithelial cells are covered with numerous bacteria – clue cells.

Bacterial vaginosis – symptoms

About half of cases of bacterial vaginosis are asymptomatic. In other cases, the predominant symptom is an unpleasant vaginal odor (stale fish). The infection may be accompanied by mild, gray-white discharge. Conversely, itching, dysuria or other symptoms are rare. On examination, there is a small amount of gray or gray-white, homogeneous discharge of thin consistency, adhering to the vaginal walls or labia.

Occasionally, bacterial vaginosis can also affect the urethra. Then the patients experience unpleasant itching and burning of the vagina, accompanied by pressure on the urethra. In addition, women may complain of pain in the labia and a feeling of dryness in the vagina. Usually, these symptoms worsen before menstruation.

Diagnostics of bacterial vaginosis

Several factors are important in the diagnosis of bacterial vaginosis. First, a medical interview with the patient. It is essential for the physician to be able to obtain information about any venereal diseases or other vaginal infections that have occurred in the past. Second – gynecological examination. During the examination, the gynecologist examines the woman’s genitals and looks for potential signs of bacterial vaginosis. Two fingers are inserted into the vagina while pressing the other hand on the woman’s abdomen. Thanks to this, the doctor is able to examine all organs in the vicinity of the pelvis to detect any abnormalities. During the medical examination, the gynecologist may take a sample of vaginal discharge for examination to check whether anaerobic bacteria are not dominant in the vaginal flora.

Apart from vaginal discharge and unpleasant vaginal odor, which increases after adding 10% KOH solution to the sample, it is necessary to determine the vaginal pH above 4,7 or to find the so-called microscopic examination. clue cells, which should account for no less than 20% of the epithelial cells in the vaginal discharge sample [clue cells are epithelial cells with blurred boundaries, covered (speckled with numerous bacteria] (Fig. B-1).

Another test used in the laboratory diagnosis of BV is the determination of the so-called Nugent index. It involves the assessment of microscopic preparations of vaginal discharge stained by the Gram method, in which attention is drawn to the absence of lactobacilli and the presence of bacteria (rods) of various shapes. In addition, it is cultivated for Gardnerella vaginalis and other aerobic and anaerobic bacteria.

Treatment of bacterial vaginosis

Oral preparations as well as topical gels and creams are useful in the treatment of bacterial vaginosis. During the treatment, sexual intercourse should be stopped until the symptoms of acute inflammation disappear.

Clindamycin is an antibiotic gel that is applied inside the vagina for 7 days. Cream with clindamycin reduces the effectiveness of latex condoms, and this effect may persist for up to 5 days after the end of the cream application.

Treatment of bacterial vaginosis is based on oral administration of Metronidazole (500 mg twice a day for 2 days or oral metronidazole in a single dose of 7 g). You can also use: clindamycin orally (2 mg twice a day for 300 days), clindamycin in a 2% vaginal cream used once a day (night) for 7 days or metronidazole in a 2% gel vaginally once a day (night) for Five days. Do not drink alcohol while taking this medicine as it may cause stomach discomfort (abdominal pain, nausea).

Another preparation is Clindamycin – an antibiotic that comes in the form of a gel intended for use inside the vagina. The drug should be used for a period of 7 days. Please note that this gel reduces the effectiveness of latex condoms, and the effect may last up to five days after discontinuation. Drug treatment should be followed according to medical recommendations, even after symptoms have subsided. Treatment should not be stopped too early as this will increase the risk of an infection returning.

Warning: Oral metronidazole should not be used in women during the first trimester of pregnancy.

For bacterial vaginosis, you can use the Dermoxen BACTOR antibacterial vaginal globules available without a prescription from Medonet Market.

How can I prevent bacterial vaginosis?

Several preventive measures are listed below:

1. protect yourself during sexual intercourse – thanks to the use of condoms you will avoid sexually transmitted diseases;
2. avoid sexual contact with a large number of partners, especially new ones. It will also help you avoid possible STDs;
3. do not rinse the vagina – apart from the usual bathing / showering, you do not need to perform other activities; too frequent or excessive washing of intimate areas disturbs the natural bacterial flora in the vagina, which increases the risk of infection;
4. try to minimize vaginal irritation by thoroughly rinsing soap residue from the intimate area and avoid bathing in the jacuzzi; try to use non-irritating cosmetics and unscented tampons and pads;
5. during menstruation, frequently change pads or tampons, and if you are predisposed to infections, do not use tampons because they irritate the mucosa;
6. avoid wearing pants for too long and often (especially in summer), as it promotes perspiration and, at the same time, the multiplication of bacteria; when you return home, change into something loose and airy.

Lit .: [1] Bailey JV, Farquhar C., Owen Ch .: Bacterial vaginosis in lesbians and bisexual women. In Sex Trans Dis 2004, 31 (11); 691-4. [2] Mroczkowski TF, Nowicki R., Gwieździński Z .: Vaginal and vulvar infections. [In:] Mroczkowski TF (ed.): Sexually transmitted diseases. Czelej Publishing House, Lublin 2006, 147-81.

Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House