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Bacterial Vaginosis

Bacterial Vaginosis

Alternate Names

  • vaginitis
  • vaginitis
  • nonspecific vaginitis
  • Bacterial vaginosis

Definition

Bacterial vaginosis is a swelling and irritation of the vaginal tissue resulting in inflammation.

What is going on in the body?

Bacterial vaginosis appears to be caused by an overgrowth of several types of bacteria, some requiring oxygen while others do not. While these bacteria are normally present in the vagina, an overgrowth may cause symptoms of irritation and inflammation.

Risks

What are the causes and risks of the disease?

It is not known for sure what causes this condition. It is probably caused by an overgrowth of certain bacteria that are normally present in the vagina. Bacterial vaginosis that is left untreated or undiagnosed can cause more problems.
For instance:
  • A woman having surgery to remove her uterus, called a hysterectomy, can develop an infection around the edge of the vagina if she has this condition.
  • A pregnant woman may have her membranes break early and go into premature labor if this condition is not treated.
  • If these bacteria ascend into the uterus and fallopian tubes they may cause an infection called pelvic inflammatory disease (PID).

Prevention

What can be done to prevent the disease?

It is not known how to prevent this condition. It is possible that abstinence or using condoms may help, although BV has been reported in virginal women.

Diagnosed

How is the disease diagnosed?

A healthcare professional will perform a pelvic exam to obtain a sample of the vaginal discharge and look at it under the microscope. A specimen may be sent for special testing called polymerase chain reaction (PCR) to identify the specific bacteria causing the inflammation. The presence of special "clue cells" in the vaginal discharge, along with a high white blood cell count, suggest bacterial vaginosis.

Other Risks

What are the risks to others?

It is estimated that 50% of all BV is sexually transmitted. Therefore, the sexual partner of a woman with BV is at risk for bacterial infection of the genital tract.

Treatments

What are the treatments for the disease?

The antibiotic metronidazole (i.e., Flagyl) is used to treat this type of vaginitis. It is available in pill form or as a cream that is applied to the inside of the vagina. Tinidazole (i.e., Tindamax) is another antibiotic that can be taken orally to treat BV. These medications are usually taken for 5 to 7 days. The sexual partner may be treated, depending on the number of previous infections.

Side Effects

What are the side effects of the treatments?

The side effects of metronidazole and tinidazole can include:
  • a metallic taste in the mouth
  • ringing in the ears
  • stomach upset if alcohol is ingested at the same time

After Treatment

What happens after treatment for the disease?

After beginning treatment, symptoms usually go away within a few days. The infection recurs in 15% of women despite attempts at prevention and multiple treatment regimens.

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