"What is bacterial vaginosis"
Bacterial vaginosis (BV) is a very common cause of treatable vaginal discharge in women of childbearing age and occurs when there are too many specific bacteria in the vagina, causing an imbalance.
The prevalence of BV varies between countries and population groups, but a recent systematic review and meta-analysis estimated the global prevalence of BV among women of childbearing age to be 23 to 29 percent. It is also possible to get BV when you are not sexually active.
BV increases the risk of HIV infection, acquisition and transmission of other sexually transmitted diseases, and if left untreated can lead to adverse pregnancy outcomes.
Although the disease can occur worldwide, it is more common in low-resource settings and areas with limited access to healthcare. The exact cause of BV is unknown. While many "good" bacteria are normally found in a healthy vagina, BV is caused by an imbalance between "good" and "bad" bacterial microorganisms. Specifically, an overgrowth of pathogens such as Gardnerella spp., Prevotella spp., Mobilincus spp., Megaspahera spp., Sneathea spp., and mixed anaerobic vaginal species eventually replaces the "beneficial" lactobacilli that help maintain a healthy vaginal environment. The exact cause of this imbalance is unknown, but it has been attributed to douching and having unprotected sex with one or more sexual partners, which can disrupt the natural balance of vaginal bacteria and increase the risk of BV. BV is also the most common vaginal disease in women aged 14 to 44.
“How is BV spread”
We don’t know how sex causes BV. There is also no research that shows that treating a sexual partner affects whether a person gets BV. Having BV can increase the chance of getting other sexually transmitted diseases.
"Signs and Symptoms"
Some women with BV may not notice any symptoms, while others may have the following:
. Unusual vaginal discharge that may be white or gray
. A strong fishy or musty odor from the vagina, especially after sex
. Itching or burning around the vagina
. Burning when urinating
:BV is a very common condition and usually does not cause serious complications. However, if left untreated, it can lead to
. Problems with pregnancy (for example, miscarriage or premature birth)
. Risk of sexually transmitted infections, including HIV
. Pelvic inflammatory disease
. Vaginal douching and douching can increase the risk of BV.
"Diagnosis"
A genital exam is performed to check for vaginal discharge. The most common diagnostic test used for BV is wet microscopy or warm staining of vaginal fluid, possibly combined with vaginal pH measurement and the Amsel sniff test.
Measuring Vaginal pH
In normal cases, the vaginal pH should be acidic (between 3.8 and 4.5). However, in cases of BV infection, the vaginal pH increases (more than 4.5). This change occurs due to a decrease in the number of lactobacilli (beneficial bacteria) and an increase in anaerobic bacteria.
Sniff Test
This test is to identify a specific odor produced by mixing vaginal discharge with 10% potassium hydroxide (KOH). If a fishy odor is detected after adding KOH solution to the discharge sample, this indicates the presence of volatile amines produced in BV.
Combining these two criteria
Measuring vaginal pH and performing the Sniff Test are two of the four Amsel criteria. If these criteria are combined with the presence of a homogeneous gray discharge and the observation of clue cells under the microscope, the diagnosis of bacterial vaginosis infection is made with greater confidence.
Clinical and laboratory evaluations for bacterial vaginosis can be influenced by factors such as recent sexual activity, menstrual cycle, vaginal douching, intravaginal procedure, and use of antimicrobial agents. The diagnosis and possible presence of BV is more widespread among female sexual partners. In situations where laboratory diagnosis is not possible, a syndromic approach to the management, diagnosis, and treatment of vaginal discharge is recommended.
“:The following primary prevention measures may help reduce the risk of BV”
Prevention of bacterial vaginosis (BV) depends on maintaining the natural balance of vaginal flora and reducing risk factors. Here are some preventive measures
Maintain proper hygiene but not too much
. Washing the vagina with lukewarm water is sufficient. Using soaps or harsh chemical products can upset the bacterial balance of the vagina and increase the risk of BV.
. Avoid douching, as this disrupts the natural vaginal flora.
Use cotton underwear and proper ventilation
Cotton underwear helps with airflow and prevents excess moisture from building up in the vaginal area. A moist environment can facilitate the growth of harmful bacteria.
Changes in sexual lifestyle
. Having a consistent sexual partner and reducing the number of sexual partners can reduce the risk of BV. Risky sexual behaviors, such as having unprotected sex, are associated with changes in the natural vaginal flora.
1) . Using condoms helps maintain bacterial balance and prevents the transfer of harmful bacteria.
Avoid long-term use of antibiotics
Antibiotics may kill the beneficial bacteria in the vagina (lactobacilli). Therefore, excessive use without consulting a doctor is not recommended.
Boosting beneficial bacteria
Taking probiotics (either as supplements or through foods like probiotic yogurt) can help maintain a balance of beneficial bacteria in the vagina.
Avoid irritating products
Antibiotics may kill the beneficial bacteria in the vagina (lactobacilli). Therefore, excessive use without consulting a doctor is not recommended.
Stress management and immune system strengthening
Stress and a weakened immune system can disrupt the body's bacterial balance. Practicing stress reduction techniques and eating a healthy diet can help.
"What happens if we don't get treatment"
Sometimes, BV goes away without treatment. However, treatment can help prevent the increased risk of some of the serious health risks associated with BV.
Resources
http://Sexually Transmitted Infections Treatment Guidelines, 2021 .
. Hillier S and Holmes K. Bacterial vaginosis. In: K. Holmes, P. Sparling, P. Mardh et al (eds). Sexually.
Transmitted Diseases, 3rd Edition. New York: McGraw-Hill, 1999, 563-586
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