Bacterial vaginosis

Causes

The specific cause of its origin is not known, but it should not be considered a sexually transmitted disease but is caused by an alteration in the normal flora of the vagina. In this condition there is an increased growth of anaerobic bacteria in the vagina and of a bacteria called Gardnerella vaginalis.

These bacteria must be found in the vagina in small amounts but when its growth increases, it exceeds Lactobacillus, which is the bacteria of the normal flora of the vagina. Lactobacillus produces substances that maintain the normal and healthy balance of microorganisms in the vagina. If this balance is broken, an infection occurs.

Bacterial vaginosis are usually produced in a polymicrobial way, that is, by more than one microbe, the most frequent being the Gardnerella vaginalis, but other microbes such as mycoplasmas can also appear.

The cause of this imbalance is not known, it is true that it is more frequent in women with sexual intercourse, and increases in those who have relationships with more than one partner but it also appears in non-sexually active women.

Symptoms

About 50-70% of women with bacterial vaginosis do not have any symptoms. Those with symptoms describe increased discharge that may be white or grayish in color. This discharge can be light or profuse.

Sometimes they describe a bad smell from the discharge "like fish." The bad smell usually increases after sexual intercourse or around menstruation. May feeling itching or burning although it is less frequent and much less annoying than that produced by. Occasionally the infection occurs with painful intercourse, postcoital itching or urinary discomfort. Another possible symptom is low blood loss after sexual intercourse.

Bacterial vaginosis does not usually cause swelling of the lips nor with redness of the skin and vaginal mucosa, which is why it is not considered vaginitis.

Diagnosis

Diagnosis of this infection is not easy on examination alone. When placing a vaginal speculum to visualize the vagina, a non-irritating foamy gray discharge with a characteristic odor. A sample of the vaginal culture is taken with a stick with a cotton tip for study in the laboratory.

The appearance of clue cells in cytology

In the Pap smear Some normal cells such as those can be found, but sometimes typical cells of bacterial vaginosis called “clue cells” or patty cells or battered cells are seen. Many asymptomatic women are diagnosed with bacterial vaginosis upon receiving the cytology report at their regular gynecological check-up.

The importance of bacterial vaginosis lies especially in its complications, especially in pregnancy. Complications are very rare, but they can be significant. Women with bacterial vaginosis in pregnancy have a higher risk of preterm birth or having underweight babies.

Consequences

They can also produce a higher rate of breakage of the bag of waters before the end of pregnancy, the so-called premature rupture of membranes. Bacterial vaginosis produces postpartum, as well as after abortion curettage, a greater appearance of endometritis, which consists of endometrial infection and requires strict antibiotic treatment.

In non-pregnant women, bacterial vaginosis increases the risk of developing a pelvic inflammatory disease, consisting of infection of the womb and fallopian tubes. This disease can lead to subsequent infertility or an increased rate of ectopic pregnancies.

Due to the decreased concentration and activity of vaginal lactobacilli, vaginosis increases the risk of suffering from a sexually transmitted infection, such as. It also increases the risk that HIV-positive woman pass the infection on to your partner. The susceptibility of contracting other sexually transmitted diseases such as chlamydia, gonorrhea or herpes simplex is also increased.

Treatment

Although sometimes bacterial vaginosis may go away without treatment, every woman with symptoms of suffering from it should be treated to avoid complications. Treatment can be both orally and vaginally. The vaginal route is generally preferred for its similar effectiveness but with fewer side effects.

As it is a bacterial infection, the treatment is antibiotic and metronidazole is as effective as clindamycin. Although the medication takes effect very quickly, it is important that the entire regimen is carried out to achieve maximum effectiveness. Vaginal treatment is the same in non-pregnant women as in pregnant women.

The sexual partner does not need to be treated as it has not been shown to decrease the relapse rate in women. In cases of permanent or recurrent vaginosis, the treatment regimen is changed and if it persists, the usefulness of adding to the treatment regenerating products for the vaginal flora.

In pregnant women it is not necessary to do a routine bacterial vaginosis test, but it is necessary in asymptomatic women who have previously had a premature delivery.

Prevention

For the prevention of bacterial vaginosis, vaginal washes that alter the normal flora of the vagina should be avoided. You should not self-medicate and above all you should complete the treatment indicated by your doctor. Having had bacterial vaginosis on one occasion does not prevent it from coming back.