AdvantageBioCare Multi-Gyn Active Gel for treatment of vaginal infections

Common Vaginal Infections : Bacterial Vaginosis

In the normal healthy vagina, large numbers of lactobacilli are present. Lactobacilli produce lactic acid and a small amount of hydrogen peroxide, which keep the vaginal environment acidic. The pH of the vagina during the reproductive years is normally between 3.8 and 4.2. For reasons that are not fully understood, the vaginal ecosystem changes in women with bacterial vaginosis, and there is less lactobilli present and hence the pH becomes more alkaline.

Bacterial Vaginosis commonly referred to as BV is characterised by an increase in the vaginal pH over 4.5, a reduction in or absence of lactobacillus colonization, and overgrowth of several bacteria.

What are the usual symptoms?

Typically, women will present to their doctor with a vaginal discharge that is often more noticeable in the latter half of the menstrual cycle. Some women find their discharge is heavier than usual, leading to annoying vulva wetness and mild irritation.

The discharge is usually a pearly grey/white colour and has the consistency of milk. Commonly, women will complain of an unpleasant strong fishy odour or even a slight ‘bubbling’ sensation.

In about 50% of women with clinical BV, there are no or minimal symptoms and the condition is diagnosed incidentally during a Pap test or other routine gynaecological examinations.

How common is it?

BV is the most prevalent form of vaginal disturbance in women of reproductive age. It is much more common, for example, than Thrush. The average incidence varies from 10% to 35% in a population of gynaecology inpatients to up to 60% in women attending a sexual health service.

Factors that increase the risk of bacterial vaginosis are lower socioeconomic status, multiple sexual partners (male & female), the presence of an intrauterine device and having sex with other women.

Is it sexually transmitted?

There may be an indirect association between BV and sexual activity. BV is more common in women who have had more than three sexual partners (male or female) in the preceding 12 months.

Why is the treatment of Bacterial Vaginosis important?

For most women, BV is simply an annoying and slightly embarrassing condition. When picked up coincidentally, the advice is to simply ask if the woman has noticed a change in her normal vaginal discharge and treat her if the answer is yes.

If likely BV is reported on a Pap test report and the condition was not clinically obvious at the time of examination, there is usually no need for treatment. However, there are some circumstances when the presence of BV is associated with the potential for serious complications.

These include:

● During pregnancy

Bacterial Vaginosis is associated with an increased risk of miscarriage, premature rupture of the membranes, chorioamnionitis, preterm delivery and post-partum endometritis. Unfortunately, it is uncertain whether even prompt treatment of the condition significantly reduces the risk of preterm delivery.

● Gynaecological surgery and instrumentation

Endometritis and pelvic infection are more common when caesarean section, termination of a pregnancy or insertion of an intrauterine device is performed in a woman with bacterial vaginosis. Women with known BV should receive appropriate antibiotic cover at the time of such procedures.

● Increased risk of HIV acquisition

BV has been associated with increased risk of human immunodeficiency virus (HIV). The loss of the protective lactobacillus – dominant vaginal flora, has been hypothesised to increase the risk of HIV acquisition in women with BV.

How is the diagnosis made?

The diagnosis of bacterial vaginosis is often suspected by the clinician before examination on the basis of the symptoms described by the woman. With the easy availability of oral and vaginal anti-Candida treatment, most women will have used these and failed to get relief from their symptoms before they present to their doctor.

Examination will usually reveal an increased amount of discharge and the characteristic of the discharge (consistence, odour and pH).

Information sheets

Pregnancy & Bacterial Vaginosis