How Is Bacterial Vaginosis Treated
BV is often treated with antibiotics. These may come as pills you swallow or as a cream that you insert into your vagina. Regardless of the type of treatment used, its important to follow your doctors instructions and to complete the full round of medication.
Your doctor may prescribe the following antibiotics:
- metronidazole, such as Flagyl and Metrogel-Vaginal, which can be taken orally
- tinidazole, such as Tindamax, which is another type of oral medication
- clindamycin, such as Cleocin and Clindesse, which is a topical medication that can be inserted into the vagina
These medications are usually effective in treating BV. They all have similar side effects, with the exception of metronidazole. This particular medication may cause severe nausea, vomiting, and headaches when taken with alcohol. Make sure to speak with your doctor if you have concerns about any of the possible side effects.
Once treatment is received, BV usually clears up within two to three days. However, treatment usually continues for at least one week. Dont stop taking your medications until your doctor tells you to do so. Its important to take the full course of antibiotics to prevent the infection from coming back. You may need long-term treatment if your symptoms persist or continue to come back.
Pearls And Other Issues
Untreated BV can lead to increased risk of STIs, including HIV and pregnancy complications. In fact, BV appears to increase the risk of subsequent chlamydia or gonorrhea infection by 1.9 and 1.8-fold, respectively. Research has shown that HIV-infected women found to have BV are more likely to transmit HIV to their sexual partners than those without BV. Furthermore, BV has been shown to be associated with up to a six-fold increase in HIV shedding. BV is also a risk factor for herpes simplex virus type 2 infection and the increased risk of infection or reactivation of human papillomavirus. Recent literature has shown that BV predicts HPV persistence, implying that treating even asymptomatic BV in women with HPV coinfection may be warranted.
During pregnancy, BV has been associated with a two-fold increased risk of preterm delivery and a three to five-fold increased risk of spontaneous abortion in women diagnosed with BV in the first trimester. It has also been shown to increase the risk of chorioamnionitis, premature rupture of membranes, and postpartum endometritis. Data suggest an association between BV and tubal factor infertility, and the prevalence of BV is significantly higher in infertile women when compared to fertile women . Studies have shown that women with BV who later receive in vitro fertilization have a lower implantation rate and higher rates of early pregnancy loss.
Is Bacterial Vaginosis Contagious
Although bacterial vaginosis is not considered to be a contagious condition, the role of transmissibility of bacteria among individuals is not fully understood. Since having multiple or new sexual partners increases a woman’s risk of developing bacterial vaginosis, this suggests that spread of bacteria among individuals may alter the balance of bacteria in the vagina and potentially predispose to development of bacterial vaginosis. However, since bacterial vaginosis also occurs in celibate women, other causative factors must also play a role in its development.
It is not possible to contract bacterial vaginosis from toilet seats, swimming pools, or hot tubs, or from touching contaminated objects.
- new or multiple sexual partners , and
- a history of sexually-transmitted infections .
In addition to these questions, the doctor will perform a pelvic exam. During the exam, the doctor notes the appearance of the vaginal lining and cervix. The doctor will also perform a manual exam of the ovaries and uterus. The cervix is examined for tenderness, which might indicate a more serious infection. The doctor may collect samples to check for Chlamydia or gonorrhea infection.
During the diagnosis of bacterial vaginosis, the doctor may perform a “whiff test” with potassium hydroxide liquid. When a drop of KOH testing liquid used in the “whiff test” contacts a drop of the discharge from a woman with bacterial vaginosis, a certain fishy odor can result.
Read Also: Male Uti Treatment Without Antibiotics
Check If You Have Bacterial Vaginosis
The most common symptom of bacterial vaginosis is unusual vaginal discharge that has a strong fishy smell, particularly after sex.
You may notice a change to the colour and consistency of your discharge, such as becoming greyish-white and thin and watery.
But 50% of women with bacterial vaginosis do not have any symptoms.
Bacterial vaginosis does not usually cause any soreness or itching.
If you’re unsure it’s BV, check for other causes of unusual vaginal discharge.
How To Prevent Bacterial Vaginosis
Bacterial vaginosis is caused by many different factors such as taking antibiotics or using regular soaps for the intimate area so many women find they suffer from BV frequently. Have a look below for our top tips on how to prevent BV. In addition to following these tips, using CanesBalance® BV Gel may help you to prevent BV symptoms in the future. Find out more about CanesBalance®.
Top tips for preventing a BV infection:
- Avoid using deodorants or heavily perfumed products in and around your vaginal area.
- Avoid using strong detergent to wash your underwear.
- Change your tampons or pads frequently.
- Ensure you wipe from front to back after going to the toilet.
- Dry your vaginal area after washing, swimming and working out.
- Change your underwear after swimming and working out.
Don’t Miss: How To Restore Gut Bacteria After Antibiotics
What Are The Clinical Features Of Bacterial Vaginosis
The odour of the creamy white foamy discharge is the most common complaint in bacterial vaginosis, with a positive “whiff” test . The vulva and vagina are not inflamed and any vaginal burning or itching should be explained by another cause of vaginitis, especially aerobic vaginitis. The discharge can cause mild irritation of the skin around the vagina.
In most women, there are no complications from bacterial vaginosis. In pregnancy, there have been reports associating bacterial vaginosis with premature labour and inflammation around the fetus . It is possible that these complications were due to aerobic vaginitis, which is only recently being recognised as distinct from bacterial vaginosis.
What Is The Treatment For Persisting Bacterial Vaginosis
If you have persistent BV then your doctor may want to take further vaginal swabs to check whether there is another cause of the discharge. They will usually suggest that you use the seven-day course of metronidazole if you have not had this before.
Another treatment which may be tried is using metronidazole gel twice a week for up to six months.
If you have a persistent BV infection which does not respond to treatment, and you have an intrauterine contraceptive device then your doctor may advise removing the device until things settle down, as there is some evidence that IUCDs can contribute to persistent BV.
If you have persistent BV and a same-sex partner then treating both of you at the same time is likely to be helpful in preventing persistence and recurrence – even if your partner does not have symptoms.
Don’t Miss: How Can You Get Antibiotics
When Should I Have Treatment For Bacterial Vaginosis
The body is often very good at getting back its own balance. The disruption in the balance of vaginal germs that causes BV may correct naturally, with time. So, if you have no symptoms or only mild symptoms, you may not need any treatment, particularly if you take some of the general healthy steps above.
You normally need treatment for BV if it is causing symptoms, or if the characteristic smell is noticeable to you. If you are pregnant, trying to become pregnant, or about to have a gynaecological procedure then you may be advised to get treatment for BV.
PregnancyIf you are pregnant and you are found to have BV then you will usually be offered antibiotic treatment with oral metronidazole .
If you are trying to conceive and you think you may have BV, it is a good idea to try to eradicate the BV through natural methods or treatment prior to conceiving. If you have symptoms then you should discuss having antibiotic treatment with your doctor.
Termination of pregnancyIf you are found to have BV and are undergoing a termination of pregnancy, treatment with antibiotics may be advised even if you do not have any symptoms. This is because there is otherwise a risk of BV causing infection of the womb or pelvis after the procedure. This could lead to later fertility problems.
Testing For Bacterial Vaginosis
If you think you have bacterial vaginosis you can make an appointment with your GP or local sexual health services.
Your nurse or doctor may perform an internal examination to check the vagina for signs of bacterial vaginosis and use a swab to collect a sample of the discharge from your vagina.
A swab looks a bit like a cotton bud and collecting a sample only takes a few minutes. Although not painful, it may be a little uncomfortable for a moment.
A specially coated paper may be used to test the pH of your vagina.
Sometimes a diagnosis can be made straightaway because of the distinctive appearance of the discharge. Sometimes the sample will be sent to a lab for testing.
Recommended Reading: What Antibiotics Are Given For Strep
What Is The Cause Of Bacterial Vaginosis
Bacterial vaginosis is due to a disturbance of normal bacterial equilibrium in the vagina. Lactobacilli are usually the most common bacteria in the vagina. In bacterial vaginosis, there is an overgrowth of other bacteria, especially Gardnerella, Bacteroides, Peptostreptococcus and Mobiluncus species. These are anaerobic bacteria, that is, they grow in the absence of oxygen.
Predisposing factors for bacterial vaginosis include recent use of broad-spectrum antibiotics, decreased oestrogen production , intrauterine device , and an increased number of sexual partners. It is associated with elevated pH> 4.5 within the vagina.
Bacterial Vaginosis In Pregnancy
If you develop bacterial vaginosis in pregnancy, there’s a small chance of complications, such as premature birth or miscarriage.
But BV causes no problems in the majority of pregnancies.
Speak to a GP or your midwife if you’re pregnant and your vaginal discharge changes.
Page last reviewed: 22 November 2018 Next review due: 22 November 2021
Also Check: Which Antibiotic For Dog Uti
What Are The Symptoms
The most common symptom is a smelly vaginal discharge. It may look grayish white or yellow. A sign of bacterial vaginosis can be a “fishy” smell, which may be worse after sex. About half of women who have bacterial vaginosis do not notice any symptoms.
Many things can cause abnormal vaginal discharge, including some sexually transmitted infections . See your doctor so you can be tested and get the right treatment.
How Is It Treated
Doctors usually prescribe an antibiotic to treat bacterial vaginosis. They come as pills you swallow or as a cream or capsules that you put in your vagina. If you are pregnant, you will need to take pills.
Bacterial vaginosis usually clears up in 2 or 3 days with antibiotics, but treatment goes on for 7 days. Do not stop using your medicine just because your symptoms are better. Be sure to take the full course of antibiotics.
Antibiotics usually work well and have few side effects. But taking them can lead to a vaginal yeast infection. A yeast infection can cause itching, redness, and a lumpy, white discharge. If you have these symptoms, talk to your doctor about what to do.
Also Check: Can Antibiotics Lower Your Immune System
Testing The Acid Level Of Your Vagina
The discharge of BV has a typical pH level which is higher than normal vaginal pH.
pH is measured on a scale from 0 to 14 . Pure water, which is neutral has a pH of 7.
- The normal pH of the vagina is 3.8-4.5.
- As soon as the pH increases above 4.5, anaerobic bacteria start to overgrow and lactobacilli start to die off.
Your doctor or nurse may suggest that they take a sample of your discharge and test it with some pH paper. You can buy a kit from a pharmacy to do this test yourself at home.
What Is The Treatment For Persistent Bacterial Vaginosis
If you have persistent BV then your doctor may want to take further vaginal swabs to check whether there is another cause for the discharge. They will usually suggest that you use the seven-day course of metronidazole if you have not had this before.
Another treatment which may be tried is using metronidazole gel twice a week for up to six months.
If you have a persistent BV infection which does not respond to treatment, and you have an intrauterine contraceptive device then your doctor may advise removing the device until things settle down, as there is some evidence that IUCDs can contribute to persistent BV.
If you have persistent BV and a same-sex partner then treating both of you at the same time is likely to be helpful in preventing persistence and recurrence – even if your partner does not have symptoms.
You May Like: How To Get Rid Of A Kidney Infection Without Antibiotics
Bacterial Vaginosis In Children
Bacterial vaginosis is most common in sexually active women of reproductive age, which means that it can affect teenage girls. It is possible to get BV without being sexually active because it can be caused by other factors.
For example, menstrual bleeding disrupts that natural pH of the vagina, making it more susceptible to microbiome imbalances. In addition, diet, smoking, perfumed soaps, bubble baths, and even stress are risk factors for bacterial vaginosis.
If you are concerned about your childs health, consult a doctor about the most age-appropriate testing for bacterial vaginosis.
Who Is At Risk
It is not completely understood why some women develop bacterial vaginosis and others don’t. It is more common:
- in women with more than one sexual partner
- when women change sexual partner
- in women who have sex with other women.
It is also possible that the problem bacteria can be transmitted on fingers or sex toys.
Read Also: What Probiotic Should You Take With Antibiotics
The Bacteria In Bacterial Vaginosis
The vagina contains different types of bacteria, or vaginal flora. Lactobacilli bacteria produce lactic acid, rendering the vagina somewhat acidic and keeping other bacteria from growing there. Reduced lactobacilli levels lower the vaginas acidity, giving harmful bacteria the opportunity to multiply.
BV is not a true bacterial infection. Instead, it occurs when there are a disproportionate number of the usual vaginal bacteria. It is not considered a true infection in which there are foreign bacteria, as is the case with numerous sexually transmitted diseases.
Often referred to as nonspecific vaginitis, BV was formerly called Gardnerella vaginitis. It was named for the bacteria suspected of being responsible for the condition, Gardnerella vaginalis. Bacterial vaginosis, the current moniker, reflects the concept that more than one kind of bacteria can be present in the vagina and can overproduce.
Bacterial vaginosis entails a variety of bacteria besides Gardnerella that fuse togetherBacteroides, Eubacterium, Lactobacillus, Fusobacterium, and Peptostreptococcus, to name a few. For unknown reasons, these bacteria join forces to create an imbalance in the vagina. Although the number of lactobacilli that produce hydrogen peroxide may be lowered, there may be a higher intensity of anaerobic bacteria that grow when oxygen is lacking, as well as other kinds of bacteria. Because so many possible combinations exist, it is difficult to diagnose and treat BV.
Enhancing Healthcare Team Outcomes
BV is a common presentation in clinical medicine. Healthcare workers and nurse practitioners who see patients with BV should always assess for the presence of other STIs. In addition, BV during pregnancy is associated with a high rate of preterm delivery and spontaneous abortions. Thus, the importance of screening for BV during pregnancy. The outcomes for women who get treated for BV are good, but the failure to treat can lead to further morbidity.
You May Like: How To Build Good Gut Bacteria After Antibiotics
What Causes Bacterial Vaginosis
Experts are not sure what causes the bacteria in the vagina to get out of balance. But certain things make it more likely to happen. Your risk of getting bacterial vaginosis is higher if you:
- Have more than one sex partner or have a new sex partner.
- Douche.
You may be able to avoid bacterial vaginosis if you limit your number of sex partners and don’t douche or smoke.
Bacterial vaginosis is more common in women who are sexually active. But it can occur if you are not sexually active as well.
When Should You Call Your Doctor
Bacterial vaginosis can be hard to distinguish from other types of vaginal infection. Consider the following if you have any signs of vaginal infection.
if you:
- Develop lower belly pain and a fever higher than 38.3°C along with a vaginal discharge.
- Are pregnant and have symptoms of a vaginal infection.
- Have vaginal discharge with an unusual or foul odour.
- Have vaginal itching.
- Have pain during sex or during urination.
- Develop any other discomfort or discharge that may mean you have a vaginal infection.
If you have not been diagnosed with bacterial vaginosis but you have symptoms that concern you, see:
Don’t Miss: Can You Use Triple Antibiotic Ointment On Genital Herpes
Could Lactic Acid Bacteria Help
Lactic acid are believed to help restore healthy vaginal flora and suppress harmful bacteria, but treatments that use lactic acid bacteria are not as well tested as . There are hardly any studies testing them on their own they are usually used in combination with antibiotics. But no has been found that vaginosis clears up any better with this combination. Little is known about possible side effects.
Vaginal Acetic And Lactic Acid
Treatment with acetic and lactic acid gels aims to keep the vaginal pH at less than 4.5, to encourage lactobacilli to grow, and to discourage anaerobic bacteria from growing. Some studies have suggested that long-term use of vaginal acidifiers of this type reduces recurrences of BV. However, other studies suggest that this treatment, whilst harmless, is not effective.
You May Like: Can I Buy Antibiotics At The Store
