BV Facts
Vaginal infections are the #1 reason adult women see their health care providers, accounting for 10 million office visits each year.11 BV is the most common vaginal infection20. The incidence varies depending on the population studied. BV has been identified in 32 - 64% of patients visiting sexually transmitted disease (STD) clinics, 12 - 25% of patients in routine clinic populations and 10 - 26% of women in obstetrics clinics. Role of Lactobacillus Lactobacilli are the most prominent organisms in a healthy vaginal ecosystem. Lactobacilli produce lactocidin, acidolin, and lactacin B, whose antibacterial effects provide added protection against infection. Hydrogen peroxide-producing lactobacilli help maintain a healthy vaginal pH that inhibits overgrowth of harmful flora. In the presence of hydrogen-peroxide producing lactobacilli, there is a reduced incidence of BV, chlamydia and trichomoniasis, as well as a decreased vaginal colonization by pathogenic bacteria such as Gardnerella vaginalis, Mycoplasma hominis and Ureaplasma urealyticum. Hydrogen peroxide is toxic to a wide variety of microorganisms at levels attainable in the vaginal fluid of women with vaginal lactobacilli. Top BV signs and symptoms Patients with BV may present a variety of symptoms or no symptoms. Half of women with BV may be asymptomatic (patients may have symptoms, but do not complain). The outward signs of BV may include an unpleasant vaginal odor in varying degrees and an excessive white or gray vaginal discharge with a milk-like consistency that can stain undergarments. Vaginal itching or burning is also sometimes present. Women often report that the odor is particularly embarrassing after sexual intercourse. When semen mixes with vaginal secretions, it lowers the acidity level to make the odor particularly strong. Odor may also be more apparent around the time of menses. Other signs of BV can be determined only through an examination by a health care professional. These include a decreased vaginal acidity (a vaginal pH of more than 4.5 as measured with pH paper) and the presence of "clue" cells -- epithelial cells coated with bacteria, seen in a vaginal discharge sample when viewed under a microscope. Potassium hydroxide may also be added to a vaginal discharge sample to enhance and help detect any fishy or foul odor. It has been estimated that up to 40 percent of women with BV may experience no outward symptoms or discomfort at all, although this perception may be due to lack of communication by patients.13 Women may be embarrassed to talk to their health care provider about vaginal odor or other symptoms, but open communication is critical to ensuring an accurate diagnosis. Because of the increased health risks associated with BV, a growing number of physicians advocate the use of simple office procedures to screen for this condition during routine gynecological examinations. Top Diagnosis A vaginal infection can be precisely identified by a three-minute, three-step testing procedure on a single sample of vaginal discharge. The testing requires only pH paper, potassium hydroxide (KOH), saline solution and a microscope for a wet mount, and may be performed immediately by appropriate support staff in the office. For virtually pennies in time and expense, this easy testing procedure can provide immediate health benefits from accurate diagnosis, as well as long-term savings by ensuring proper treatment and prevention of more serious conditions associated with BV and trichomoniasis or those conditions marked by candidiasis.
Top Treating sexual partners BV is not considered a sexually transmitted disease (STD), although it may be associated with sexual intercourse. According to the Centers for Disease Control's (CDC) 1998 Guidelines for the Treatment of Sexually Transmitted Diseases, routine treatment of sex partners is not recommended because clinical trials indicate that a woman's response to therapy and the likelihood of relapse or recurrence are not affected by treatment of her sex partners. For more information visit the Centers for Disease Control at http://www.cdc.gov. Treatment Options A variety of antibacterial medications are used to treat bacterial vaginosis. Metronidazole is the most commonly prescribed medication.8 Both oral (tablets) and intravaginal treatments are available. Metronidazole has a targeted action against the harmful bacteria present in BV, yet it does not destroy the protective lactobacilli that protect against yeast and harmful bacteria. Clindamycin, an antibiotic available in oral and intravaginal form, may also be used to treat BV. Top |
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