WOMEN: VAGINAL PROBLEMS. BACTERIAL VAGINOSIS
The suffix ‘osis’ means ‘a condition of. Bacterial vaginosis (also called non-specific vaginitis) doesn’t cause inflammation of the vagina, but it is a common cause of abnormal vaginal discharge. Like candidiasis, it is caused by an overgrowth of micro-organisms that normally live in the vagina in small quantities.
The main bacterium that overgrows is called Gardnerella vaginalis, but there is also overgrowth of an assortment of other bacteria including anaerobes (bacteria that can live and grow without oxygen). When other bacteria get a hold in the vagina, its normal main inhabitants – Döderlein’s bacilli – are vanquished and can’t maintain the normal, healthy acidity of the vagina. The vaginal environment becomes totally disturbed.
We don’t know why this happens, only that it’s more likely to affect women who are run down, so immunity must have something to do with it. But not all rundown women get bacterial vaginosis: perhaps some women are more susceptible to this manifestation of poor health.
Symptoms of bacterial vaginosis
The most common complaint is a bad smell from the vagina, often worse after intercourse. It’s often described as a sour, cheesy or fishy smell. There may also be a smelly discharge, which may be thick and gluey or thin and watery, sometimes frothy, scant or copious, and varies from
greyish to yellow in colour. Bacterial vaginosis rarely causes tenderness of the genitals, itch, or pain with sex.
How is bacterial vaginosis diagnosed?
The smell and appearance of the discharge in a non-inflamed vagina are suspicious; especially if the vagina is less acid than usual (this is tested by placing a strip of litmus paper against its wall). If on-the-spot examination of a drop of the discharge shows no Döderlein’s bacilli but very many other bacteria and ‘clue’ cells (cells of the vaginal lining with bacteria all over their surfaces), the diagnosis is pretty sure. If any doubt remains, a swab of the discharge can be sent to a laboratory for further tests.
Treatment
If bacterial vaginosis is causing symptoms, treatment is by oral tablets of metronidazole or tinidazole. For the first attack a single dose is usually effective. If the problem recurs a longer course generally gives better results. Very troublesome recurrences may be helped by using an intravaginal antibiotic cream as well as metronidazole by mouth.
Bacterial vaginosis isn’t sexually transmissible, so there is no need to treat your partner.
If Gardnerella is found by chance (in swabs or a Pap smear) and there are no symptoms, treatment is unnecessary: remember that it is a normal vaginal inhabitant.
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Tags: Women’s Health
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