• Bacterial Vaginosis

    Definition

    Bacterial vaginosis is an infection of the vagina. It is associated with an imbalance of bacteria in the vagina.
    Vagina
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    Causes

    A mix of good and bad bacteria are normally found in the vagina. Bacterial vaginosis occurs when there is an increase in the amount of bad bacteria. The increased bad bacteria causes a decrease in good bacteria. This imbalance can lead to symptoms.
    It is not clear exactly what causes the increase in bad bacteria.

    Risk Factors

    Factors that may increase your chance of bacterial vaginosis include:
    • Antibiotic use
    • Smoking
    • Douching
    • Having a new sexual partner or multiple partners
    • Having sex without a condom
    • Using an intrauterine device (IUD) for birth control
    Any woman can get bacterial vaginosis, including those who have never had sex.

    Symptoms

    Some women with bacterial vaginosis do not have any symptoms.
    Symptoms that can develop include:
      Abnormal vaginal discharge
      • Color: white or gray
      • Consistency: thin, foamy, or watery
      • Odor: fish-like, especially after sex
    • Burning feeling while urinating
    • Itching around the vagina
    • Vaginal irritation
    There are several different conditions that can causes these symptoms. Your doctor will help you determine the cause of your symptoms.

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    Tests may include the following:
    • A pelvic exam to look for signs of bacterial vaginosis
    • A sample of fluid from the vagina to look for specific bacteria or other infectious agents

    Treatment

    Bacterial vaginosis can lead to complications such as:
    Treatment is important even if you do not have any symptoms. The main course of treatment is prescription antibiotic pills or vaginal creams. Finish all medication as prescribed by your doctor even if the symptoms have gone away. This can prevent the infection from recurring.
    Avoid sexual intercourse during treatment. If you do have sexual intercourse, use condoms. Usually, male sexual partners do not need to be treated. Talk with your doctor about the best treatment plan for you.

    Prevention

    To help reduce your chances of getting bacterial vaginosis, take the following steps:
    • Abstain from sex or remain monogamous.
    • Use condoms when having sex.
    • Do not use douches.
    • Visit your doctor for regular pelvic exams.
    • After bowel movements, wipe from front to back, away from the vagina.

    RESOURCES

    The American Congress of Obstetricians and Gynecologists http://www.acog.org

    Sexually Transmitted Diseases Home Page http://www.cdc.gov

    Women's Health.gov http://www.womenshealth.gov

    CANADIAN RESOURCES

    Sexuality and U http://www.sexualityandu.ca

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Bacterial vaginosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated September 25, 2012. Accessed March 4, 2013.

    Bacterial vaginosis - CDC Fact Sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm. Updated September 1, 2010. Accessed March 4, 2013.

    Bacterial vaginosis fact sheet. US Department of Health and Human Services Womens Health website. Available at: http://womenshealth.gov/publications/our-publications/fact-sheet/bacterial-vaginosis.cfm. Updated September 1, 2008. Accessed March 4, 2013.

    Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.

    Martin HL, Nyange PM, Richardson BA, et al. Hormonal contraception, sexually transmitted diseases, and risk of heterosexual transmission of human immunodeficiency virus type 1. J Infect Dis. 1998;178:1053-1059.

    Martin HL, Richardson BA, Nyange PM, et al. Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. J Infect Dis. 1999;180:1863-1868.

    Myer L, Kuhn L, Stein ZA, et al. Intravaginal practices, bacterial vaginosis, and women's susceptibility to HIV infection: epidemiological evidence and biological mechanisms. Lancet Infect Dis. 2005;5:786-794.

    Taha TE, Hoover DR, Dallabetta GA, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS. 1998;12:1699-1706.

    Van de Wijgert JH, Morrison CS. Cornelisse PG, et al. Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women. JAIDS. 2008;48:203-210.

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