Common Things Are Common - Bacterial Vaginosis

In medicine, there is a saying: common things are common. This basically means that in one’s field of medicine, there will be certain patient problems that will be seen over and over again. The diagnosis is usually the common diagnosis and not the rare possibility of a rare disease only seen once in the last one hundred years. In some ways, this is good i.e. usually easy to handle and job security.

For gynecologists, vaginal discharge is one of those common problems. A diagnosis that is often made in patients with this complaint is bacterial vaginosis. Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age. Normally, the vagina has a balance of mostly “good” bacteria and fewer “harmful” bacteria. BV occurs when this balance is disrupted. Often when BV occurs, it is the pH (amount of acidity) that has changed in the vaginal environment. Almost anything that goes in the vagina can be a culprit for disrupting this balance: sex, douching, IUDs, tampons, etc. Risk factors for BV include multiple or new sex partners, douching and cigarette smoking.

The signs of BV may be an increased amount of discharge with or without an unpleasant odor. Some women even report a strong fish-like odor. Other symptoms may be burning, itching or irritation. Some women with BV have no symptoms at all. Vaginal discharge and these symptoms may also be caused by a yeast infection, a sexually transmitted infection, or other more serious conditions so it is very important to see your doctor and have an exam if you experience these symptoms.

In the doctor’s office, an exam will be performed and a swab of the discharge will be taken and tested. If you have BV, there are a few treatment options. There are antibiotic vaginal creams and gels or antibiotic pills to take by mouth. You and your doctor can decide which form is right for you. Although it may be related to sex, you cannot “catch” BV from sex, so a male partner does not have to be treated. In most cases, BV does not cause serious problems. However, untreated BV has been linked to problems in pregnancy, an increased chance of contracting an STD and pelvic inflammatory disease (an infection in the uterus, tubes and ovaries). Unfortunately, BV can occur repeatedly. Sometimes the vaginal bacteria cannot maintain a good balance. There are treatments for these recurrent cases as well. If you have had several episodes of BV, you need to let your doctor know this and treatments may be adjusted. There is not an effective over-the-counter treatment for BV, but there are some over-the-counter products available that may help promote healthy vaginal pH and bacteria. The use of these over-the-counter products should be recommended and approved by your doctor. Self-treating with over-the-counter yeast creams, deodorants and vaginal creams is not recommended without a definite diagnosis.

There are some things you can do to lower your chances of getting BV. Maintaining good vaginal hygiene is important and the best way to stay clean is to use only mild soap and water on the outside every day. It is not necessary to clean “inside” the vagina. Douching is not recommended because it may remove the “good” bacteria and disrupt the bacterial balance. Try to wear clothes that allow the area to stay cool and dry. Also, not smoking and avoiding multiple sex partners may decrease your chance of BV. Furthermore, if diagnosed with BV, it is important to finish your treatment course of antibiotics to completely clear your infection.

Again, if you are experiencing any of these symptoms, it is recommended that you see your doctor for further evaluation.

Currently, The Jackson Clinic Research Department is participating in BV related studies. If you would like more information about this, please call 731-660-8396.

Lolly Eldrige, M.D.