Bacterial vaginosis (BV) is among the most prevalent vaginal infections found in women across the globe, with extremely harmful implications for reproductive and overall well-being. The condition emerges as a result of vaginal microbiota imbalance with typically dominant Lactobacillus species overgrown by pathogens such as Gardnerella.

Awareness of the causes, symptoms, and diagnostic methods of bacterial vaginosis is essential for developing an effective management plan, highlighting the importance of collaboration within interprofessional healthcare teams. To doctors—or future medical professionals—being well-versed in this condition is a step toward developing diagnostic expertise and better patient outcomes.

Curious to learn more? Let’s get started.

What is Bacterial Vaginosis?

Bacterial vaginosis is an infection that occurs when an excess of certain bacteria resides within the vagina. A healthy vagina typically contains a mix of bacteria, and these microbes keep each other in check. When the harmful bacteria grow in excess and outnumber the beneficial ones, this bacterial imbalance leads to BV.

Women with BV can have a vaginal discharge with a highly potent “fishy” smell. Some also experience irritation, though many do not feel any symptoms at all.

What are the Symptoms of Bacterial Vaginosis?

Half of the women with BV won’t even know that they have an infection. When they do experience BV symptoms, which are:

• Pain, itching, or burning inside the vagina
• Burning sensation during urination
• A fishy smell that gets worse after sex
• Thin discharge that might be white, grey, or green
• Lower abdominal pain or discomfort
• Raised vaginal pH

Opting for a diagnosis is crucial upon noticing any of these symptoms. Although BV itself is not a major infection, it can lead to complications if not treated promptly. They include:

• Sexually transmitted infections (STIs)
• Pelvic inflammatory disease (PID) 
• Adverse pregnancy outcomes like preterm labour and delivery

What are the Causes of Bacterial Vaginosis?

Bacterial vaginosis stems from a disturbance in the natural balance between beneficial and harmful bacteria in the vaginal environment.

There are various factors that might cause this disruption, including:

• Engaging in sex with a new partner
• Having multiple sexual partners
• Using vaginal douches
• Having sex without condoms or any form of barrier protection
• Being pregnant
• Recent usage of antibiotics

Though BV often happens after sexual relations with a new partner, it is not an STI. Having a BV infection, though, may increase the risk of getting one.

How to Diagnose Bacterial Vaginosis?

Only a medical professional can diagnose bacterial vaginosis. If you experience symptoms or signs of BV, it’s important to book a consultation with your healthcare provider. During your visit, the provider will review your medical history, including any previous vaginal infections or sexually transmitted infections. 

They may also:

1. Perform a Pelvic Exam: Your doctor will put gloved fingers inside your vagina to look for evidence of infection, like vaginal discharge that grows or smelly discharge with a white or greyish colour.
2. Get a Vaginal Discharge Sample: Your healthcare provider will gently insert a speculum into your vagina to obtain a fluid sample on a swab. The sample will then be taken to a lab to identify the bacteria present.

Tests for bacterial vaginosis depend on analysing fluid samples from the vagina. Here are the ones that are routinely used:

• Wet Mount: A sample of vaginal discharge is placed on a microscope slide and examined to identify unusual bacterial presence.
• Whiff Test: The discharge is checked for a fish-like smell, which may appear firmer after adding a specific chemical.
• Vaginal pH Test: This test evaluates the acidity of the vaginal fluid; a pH level higher than usual can suggest bacterial vaginosis.

What Does Bacterial Vaginosis Treatment Include? 

Physicians can prescribe different types of medication to cure bacterial vaginosis. The condition needs to be treated even in the absence of symptoms. Doctors typically provide antibiotics to cure BV, and they may be administered in various forms—oral tablets or granules, or intravaginal like creams, suppositories, ovules, or gels.

Among the most commonly used bacterial vaginosis medications are:

1. Clindamycin: It is available in the form of vaginal cream and by the names Cleocin and Clindesse. Keep in mind that clindamycin reduces the effectiveness of latex condoms throughout treatment and for three days after stopping the medication. Another form of birth control might be required.
2. Metronidazole: Available in pill or gel form when applied vaginally, this medication is present under brands such as Flagyl and MetroGel-Vaginal.
3. Secnidazole: Single-dose oral medication sold under the brand Solosec.
4. Tinidazole: Available in oral tablet form under the brand Tindamax.

Here are some additional pointers to keep in mind:

• Although metronidazole, secnidazole, and tinidazole will not usually disturb hormonal contraception, such as the pill or patch, they can be coupled with nausea or indigestion, especially if combined with alcohol. 
• Consumption of alcohol should be avoided both during and for three days after completing the treatment.
• Sex can also make the symptoms of BV even worse or interrupt the healing process. Therefore, it is best to abstain from intercourse until the whole cycle of medication has been completed and all the symptoms have disappeared.

Most treatments of bacterial vaginosis are a 5 to 7-day commitment. It is best to take the whole course of the drug as directed, even if the symptoms disappear sooner. Stopping the treatment prematurely might lead to a recurrence of the infection.

If your partner has a vagina, they might need to see a healthcare provider to assess whether treatment is necessary. Typically, partners with a penis do not require bacterial vaginosis treatment.

FAQs About Bacterial Vaginosis

1. Can bacterial vaginosis be spread to others?

While BV can come back even after it’s been treated, it’s not considered something that typically spreads between partners. Male partners usually don’t require any treatment. However, BV can be shared between women who engage in sexual activity with one another.

2. How do you know BV is gone?

If your symptoms have resolved after you finish the prescribed treatment, you usually don’t need to undergo additional testing to confirm that the infection has cleared. As long as there are no remaining symptoms, a follow-up test is not required.

3. Is BV contagious?

Bacterial vaginosis is not thought to be a contagious infection. It may, however, be passed during sex among individuals who both have a vagina.

4. Are sores a sign of BV?

BV won’t usually lead to any visible sores on the vagina. If sores do occur, then there must be another infection, such as warts or genital herpes, which would require being diagnosed and treated independently.

5. Can you diagnose BV at home?

Yes, there are over-the-counter home testing kits for bacterial vaginosis. These typically entail swabbing a vaginal fluid sample and then checking the pH level, which will detect imbalances. There are other kits where you can have the sample analysed at a lab.

Conclusion

Bacterial vaginosis (BV) is a relatively minor infection, but it should never be ignored. Left untreated, BV can increase the risk of developing more serious health complications. If there are any alterations in the vaginal discharge or any symptoms of discomfort occur, it’s best to visit a bacterial vaginosis specialist as soon as possible. A course of antibiotics usually cures the condition.

For NEET PG aspirants, a thorough knowledge of bacterial vaginosis is essential, not only to cover their syllabus but also for successful diagnosis as future medical professionals. To assist students in this endeavour, DocTutorials provides in-depth learning through video classes conducted by expert teachers, Quick Revision Programs (QRPs), and high-yield, concise notes. 

All these are designed to enhance test preparation and clinical medical acumen. Try our NEET PG courses today!