Women’s Health : bacterial vaginosis

Bacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina, which upsets the natural balance. Women in their reproductive years are most likely to get bacterial vaginosis, but it can affect women of any age. The cause isn’t completely understood, but certain activities, such as unprotected sex or frequent douching, increase your risk.

Bacterial vaginosis signs and symptoms may include:

  • Thin, gray, white or green vaginal discharge.
  • Foul-smelling “fishy” vaginal odour.
  • Vaginal itching.
  • Burning during urination.

Many women with bacterial vaginosis have no signs or symptoms.

What are the risk factors?

Bacterial vaginosis results from overgrowth of one of several bacteria naturally found in your vagina. Usually, “good” bacteria (lactobacilli) outnumber “bad” bacteria (anaerobes). But if there are too many anaerobic bacteria, they upset the natural balance of microorganisms in your vagina and cause bacterial vaginosis.

Risk factors for bacterial vaginosis include:

  • Having multiple sex partners or a new sex partner : Doctors don’t fully understand the link between sexual activity and bacterial vaginosis, but the condition occurs more often in women who have multiple sex partners or a new sex partner. Bacterial vaginosis also occurs more frequently in women who have sex with women.
  • Douching : The practice of rinsing out your vagina with water or a cleansing agent (douching) upsets the natural balance of your vagina. This can lead to an overgrowth of anaerobic bacteria, and cause bacterial vaginosis. Since the vagina is self-cleaning, douching isn’t necessary.
  • Natural lack of lactobacilli bacteria : If your natural vaginal environment doesn’t produce enough of the good lactobacilli bacteria, you’re more likely to develop bacterial vaginosis.

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How can you prevent it?

To help prevent bacterial vaginosis:

  • Minimize vaginal irritation. Use mild, nondeodorant soaps and unscented tampons or pads.
  • Don’t douche. Your vagina doesn’t require cleansing other than normal bathing. Frequent douching disrupts the vaginal balance and may increase your risk of vaginal infection. Douching won’t clear up a vaginal infection.
  • Avoid a sexually transmitted infection. Use a male latex condom, limit your number of sex partners or abstain from intercourse to minimize your risk of a sexually transmitted infection.

Treatment

To treat bacterial vaginosis, your doctor may prescribe one of the following medications:

  • Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine may be taken as a pill by mouth (orally). Metronidazole is also available as a topical gel that you insert into your vagina. To reduce the risk of stomach upset, abdominal pain or nausea while using this medication, avoid alcohol during treatment and for at least one day after completing treatment — check the instructions on the product.
  • Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that you insert into your vagina. Clindamycin cream may weaken latex condoms during treatment and for at least three days after you stop using the cream.
  • Tinidazole (Tindamax). This medication is taken orally. Tinidazole has the same potential for stomach upset and nausea as oral metronidazole does, so avoid alcohol during treatment and for at least one day after completing treatment.

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