Bacterial vaginosis is a vaginal infection caused by the abnormal proliferation of natural bacteria in the vagina is the main cause of vaginal discharge in women of childbearing age. The vaginosis is related to the growth of various bacteria, especially a called Gardnerella vaginalis , which may cause discharge with unpleasant odor, smell type of fish.
In this paper will cover the vaginal discharge caused by bacterial vaginosis, especially by bacteria . Gardnerella vaginalis Other vaginal discharge causes are addressed in the following article: VAGINAL |VAGINITIS .
CAUSES OF BACTERIAL VAGINOSIS
The vagina is an organ naturally inhabited by various bacteria, some “good,” some “bad.” The lactobacilli are the “good” bacteria and are usually in higher amounts (about 95% of the population), potentially preventing the growth of bacteria causing diseases through the vaginal pH control and competition for food.
Bacterial vaginosis occurs when there is a breakage of this balance, resulting in a decrease in lactobacilli and an increase flora “bad” that can be composed of several bacteria, including: Gardnerella vaginalis , Prevotella , Porphyromonas , Bacteroides ,Peptostreptococcus , Mycoplasma hominis , Ureaplasma urealyticum , Mobiluncus , Fusobacterium andAtopobium the vagina . Of these bacteria, Gardnerella vaginalis appears to be the most characteristic of the micro-organism vaginosis, being present in over 96% of cases.
We do not know yet very well what leads to this deregulation of the natural bacterial flora of the vagina, but some risk factors are known:
– Multiple sexual partners.
– Perform vaginal douching frequently.
– Smoking (read: HARM CIGARETTE | Smoking cessation ).
– Recent antibiotic use (read: ANTIBIOTICS | Types, resistance and indications ).
– IUD use.
Bacterial vaginosis is a typical disease of women of childbearing age; We do not know why, but is more common in women of African descent.
The classification of bacterial vaginosis as a sexually transmitted disease (STD) is currently accepted, although still controversial. In favor of classification as DST weighs the fact that promiscuity is one of the risk factors for its development. Another positive factor is that the use of condoms to reduce the incidence of this infection. Furthermore, even virgin female or no recent sexual intercourse can develop bacterial vaginosis.
SYMPTOMS OF BACTERIAL VAGINOSIS
Two in three women with bacterial vaginosis do not have any symptoms. Those with symptoms, the most common is a grayish discharge with a strong odor, often described as discharge with fishy smell. This vaginal discharge smelly usually worse after intercourse.
Unlike other causes of vaginal discharge which typically includes vaginitis (inflammation of the vagina), bacterial vaginosis causes little or no inflammation, therefore, does not usually present with symptoms of pain, itching or dysuria (painful or uncomfortable to urinate).
DIAGNOSIS OF BACTERIAL VAGINOSIS
The diagnosis of bacterial vaginosis is based on set of symptoms and laboratory findings. If you have complaints of discharge, the gynecologist will do a complete gynecological examination and take samples of secretions.
Through examination of secretions it is possible to evaluate the pH of the vagina (that is less acidic in vaginosis) and search for microorganisms using a microscope. In vaginosis is a simple test done in the office, consisting in the addition of 10% potassium hydroxide in vaginal secretion to increase the release of the characteristic pungent smell of fish.
By examining the microscope can identify calls clue-cells , cells typical of bacterial vaginosis. It is also possible to identify other bacteria that cause discharge than vaginosis, such as fungi, for example.
The culture of the secretions to identify bacteria has no role in the diagnosis since up to 60% of women without vaginosis have Gardnerella vaginalis and other bacteria in their vaginas. Have Gardnerella vaginalis does not necessarily mean that a woman will develop vaginosis.
COMPLICATIONS OF BACTERIAL VAGINOSIS
Even in patients without symptoms, vaginosis can cause some complications. These include:
– Increased risk of contamination by other STDs * if there is relationship with contaminated partner.
– Increased risk of STD transmission * for the partner if the patient is infected with an STD.
– Increased risk of pelvic inflammatory disease, mainly after gynecological surgeries.
– Increased risk of preterm birth in pregnant
– HIV (read: HIV TRANSMISSION | How do you get AIDS? ).
– Gonorrhoea (read: GONORRHEA | Symptoms and Treatment ).
– Chlamydia (read: Chlamydia | Symptoms and Treatment ).
– HPV (read: HPV | CANCER COLON THE WOMB | Symptoms and vaccine ).
– genital herpes (read: HERPES LIP | gENITAL HERPES | Symptoms and treatment ).
TREATMENT OF BACTERIAL VAGINOSIS
In about 1/3 of cases vaginosis disappears spontaneously, due to the recovery of the population of lactobacilli. Therefore, only indicates treatment if any symptoms or if the patient is about to perform a gynecological surgery.
The treatment, where indicated, is made with antibiotics by oral or intravaginal route.The most commonly prescribed are metronidazole or clindamycin for seven days (read: METRONIDAZOLE | pill, cream and gel ). Another option is tinidazole.
When prescribed a course of clindamycin intravaginally should avoid sex with condoms for up to five days after the end of treatment, because the antibiotic weakens the latex, reducing its effectiveness as a protective barrier.
Like vaginosis is not necessarily an STD, it is not necessary to treat the partner. There is evidence that the partner treatment influences the cure rate of the patient. In cases of homosexual relationship between women there are still doubts whether the treatment of the partner is required.
The treatment of bacterial vaginosis in asymptomatic pregnant women is controversial because there is no evidence that it reduces the incidence of premature births. Currently only indicated if the pregnant woman has high risk of premature birth or present preterm background related to the presence of vaginosis.
Treatment with antibiotics cure vaginosis but does not act directly in their causes. Therefore, the recurrence rate is high, about 30% in three months and up to 50% in one year. Patients with more than three episodes per year benefit from a long-term treatment for up to six months with intravaginal metronidazole.
The consumption of yogurt with lactobacilli is not effective in preventing, since these lactobacilli are different from those who live in the vagina.