I overheard a conversation that I shouldn't have been listening to but as usual by the time I put my headphones in and pumped up the sound it was too late. Apparently not to be confused with thrush, the experts say...


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Bacterial vaginosis (BV) is also sometimes called anaerobic vaginal discharge, non-specific vaginal discharge or Gardnerella vaginal discharge. BV is one of the most common vaginal infections.

Causes

Although the exact causes of BV are unknown, it is caused when the delicate eco-system of the vagina is upset because of the rapid growth of several kinds of bacteria that normally live in the vagina.
Small organisms called Lactobacilli help to keep the pH at the right level, but using antibiotics, soaps and even having sex can leave the vagina more alkaline, thereby encouraging bacterial growth. BV may also be associated with douching and smoking. Anecdotally, there appears to be a link between BV and times of stress in a woman’s life


Symptoms

While some women with BV may be asymptomatic or don’t have any symptoms, others may present with some distinguishing symptoms such as a thin, off-white, grey vaginal discharge accompanied by a "fishy" or "musty" odor which gets stronger during menstruation, after sex and after washing with soap. The redness and itching that is associated with yeast or thrush infections tends to be absent with BV.


Treatment

BV can be treated with over the counter topical (vaginal) or oral antibiotics such as metronidazole or clindamycin. On occasion however, it may require long-term or repeat treatments. Many doctors believe metronidazole shouldn't be used during the first three months of pregnancy as its safety has not been established.

During the treatment cycle, it is recommended that you refrain from having sex. In general, it is not necessary to treat male sex partners. BV may occur between women who have sex with other women, in which case both partners need to be treated.


Risks

For many women, BV is a nuisance, but for others it can have a serious effect on their reproductive health. If left untreated, BV can lead to abnormal pap smears, further infection and adverse pregnancy outcomes, such as miscarriage, preterm labour and birth as well as post birth intrauterine infection.
It could also significantly increase a woman’s chance of HIV infection by up to four times and make her more susceptible to other Sexually Transmitted Infections (STIs) such as trichomoniasis and chlamydial cervicitis.


Recurrence

Recurrence of BV is very common and has been reported to be as high as 70% over a period of nine months following initial diagnosis. In this situation, long-term treatment over 6 months using a vaginal preparation has been reported to be effective.

source: health24.com  Reviewed by Dr Sumayya Ebrahim, gynecologist in private practice at the Park Lan Clinic, Johannesburg, April, 2010

 

What causes bacterial vaginosis?

Researchers have had difficulty determining exactly what causes bacterial vaginosis. At present, it seems to be that a combination of multiple bacteria must be present together for the problem to develop. Bacterial vaginosis typically features a reduction in the number of the normal hydrogen peroxide-producing lactobacilli in the vagina. Simultaneously, there is an increase in concentration of other types of bacteria, especially anaerobic bacteria (bacteria that grow in the absence of oxygen). As a result, the diagnosis and treatment are not as simple as identifying and eradicating a single type of bacteria. Why the bacteria combine to cause the infection is unknown.

Certain factors have been identified that increase the chances of developing bacterial vaginosis. These include multiple or new sexual partners, intrauterine devices for contraception, recent antibiotic use, vaginal douching, and cigarette smoking. However, the role of sexual activity in the development of the condition is not fully understood, and bacterial vaginosis can still develop in women who have not had sexual intercourse. (hands)

Sourc2: medicine.net Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

 

How can BV be treated

BV is not completely understood by scientists, and the best ways to prevent it are unknown. However, it is known that BV is associated with having a new sex partner or having multiple sex partners.

The following basic prevention steps can help reduce the risk of upsetting the natural balance of bacteria in the vagina and developing BV:

•Be abstinent.

•Limit the number of sex partners.

•Do not douche.

•Use all of the medicine prescribed for treatment of BV, even if the signs and symptoms go away.

Sources

Centers for Disease Control and Prevention.  Sexually Transmitted Diseases Treatment Guidelines, 2006.  MMWR 2006: 55 (No. RR-11)

Hillier S and Holmes K. Bacterial vaginosis. In: K. Holmes, P. Sparling, P. Mardh et al (eds). Sexually Transmitted Diseases, 3rd Edition. New York: McGraw-Hill, 1999, 563-586.


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