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What is Bacterial Vaginosis?
Bacterial Vaginosis is
benign infection of the vagina. It goes by the names non-specific vaginitis,
Gardnerella vaginitis, or simply Gardnerella. It is also referred to by its
acronym of B.V.. Gardnerella is the most common bacteria involved. But it can be
caused by a large variety of organisms. These are mostly categorized as anerobic
bacteria.
Who gets
it?
All women. It is the
most common vaginal infection, especially among reproductive age women. But, it
occurs in girls, and post-menopausal women as well. It is not considered a
sexually transmitted disease. It is seen in virgins. Nevertheless, some vaginal
infections occur because the woman's partner harbors them. It is suspected, but
not proven that bacterial vaginosis' cure or recurrence rates will improve, if
her male partner is treated.
It is a spontaneously arising infection. One or more of the offending bacteria
overgrows in the vagina. It is a change in the normal bacteria and organisms of
the vagina from aerobic to anerobic. Aerobic vs anerobic simply refers to the
bacteria's metabolism -- does it need oxygen or not. (No vaginal bacteria is in
there doing Tae Bo). The offending organisms were always there, just the ratios
have shifted. It is much like a yeast infection.
Douching, bubble baths, or other solutions women use to flush their vaginas are
associated with more Bacterial Vaginosis.
Symptoms
A bad smelling
discharge is what usually brings the woman into the doctor. It is described as
whitish with a gray or yellowish tint. It is thin and watery. It may get worse
after her period or vaginal sex. Some have sensations of itching or burning.
Women sometimes confuse this with yeast infections. Yeast does not look, nor
smell, nor feel like Bacterial Vaginosis. The reason women mix them up is
because they are the two most common vaginal infections.
How Serious
Is It?
Still, it is
estimated 5%-30% of reproductive age women have it and have no symptoms. It is
not currently thought of as a dangerous infection. In typical circumstances, it
will not threaten her health, future fertility or life if it is unnoticed or
untreated. In most women, it can go away on its own. However, more recent
studies are beginning to implicate B.V. in Pelvic Inflammatory Disease. Part of
the uncertainty here, stems from the numerous changes in the definition of BV and
the uncertainty of diagnosis. And it is known to lead to serious complications
in pregnancy or those undergoing gynecological surgery.
The
Diagnosis and Test Results and Why
A sample of the
discharge is sent to the lab. The test is called a wet prep. Signs of Bacterial
Vaginosis can be seen on routine Pap smears as well, but often misses it.
Clue cells. These are the big red flag. Clue cells are actually big globs
of bacteria stuck to vaginal wall cells. Once the doctor sees this, she usually
stops reading the report and starts writing the prescription.
Bacteria There's 100 to 1000 times more of them. Gardnerella may be
mentioned specifically. Also, Hemophilus, or Bacteroides, Mobiluncus,
Peptostreptococcus, and Mycoplasm.
pH this indicates the acidity of the vagina. It may be about 5.
No inflammation The types of bacteria called anerobes produce a substance
called succinate. This suppresses the normal inflammatory reaction that this
huge influx of bacteria would otherwise cause. There are few white cells (WBCs)
on the report.
Purulent cervicitis, Trichomonas , and yeast infections must be excluded to
diagnose Bacterial Vaginosis. Cervicitis would show signs of inflammation.
Trichomonas would show the organism itself and WBCs. Its discharge may be
greenish, but also gray or yellowish, so it is hard for the average woman (or
average doctor) to tell it from B.V. Trichomonas discharge is described as
'frothy' (good luck knowing that one when you see it!) Yeast would show the
organism in the lab sample. The woman experiences itching much more often than
with BV and yeast doesn't have much of a smell.
Beside western medicaments Chinese herbal formulas have proven to have satisfactory results in helping vaginosis.
