How Should I Use This Medicine
This medicine is only for use in the vagina. Do not take by mouth or apply to other areas of the body. Follow the directions on the prescription label. Wash hands before and after use. Screw the applicator to the tube and squeeze the tube gently to fill the applicator. Lie on your back, part and bend your knees. Insert the applicator tip high in the vagina and push the plunger to release the gel into the vagina. Gently remove the applicator. Wash the applicator well with warm water and soap. Use at regular intervals. Finish the full course prescribed by your doctor or health care professional even if you think your condition is better. Do not stop using except on the advice of your doctor or health care professional.
Talk to your pediatrician regarding the use of this medicine in children. While this drug maybe prescribed for children as young as 12 years for selected conditions, precautions do apply.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
Treatment For Bacterial Vaginosis
Bacterial vaginosis is treated with antibiotics. An antibiotic cream or gel to use in the vagina may be given instead of antibiotic tablets by mouth.
While you’re there, make sure you tell the doctor or nurse if you:
- are pregnant
- think you might be pregnant
- are breastfeeding
These may affect the type of treatment you’re given.
What Is The Difference Between Bv And A Vaginal Yeast Infection
BV and vaginal yeast infections are both common causes of vaginal discharge. They have similar symptoms, so it can be hard to know if you have BV or a yeast infection. Only your doctor or nurse can tell you for sure if you have BV.
With BV, your discharge may be white or gray but may also have a fishy smell. Discharge from a yeast infection may also be white or gray but may look like cottage cheese.
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What Are The Symptoms Of Bv
The main symptom you will notice if you have bacterial vaginosis is unusual discharge. Discharge is completely normal and many women and girls experience it. Your vagina self-cleans itself and uses discharge as a way to keep itself clean and free of infection.
During your menstrual cycle the discharge hat is excreted by your vagina will change, this could be because your period is due or you are ovulating. Its important that you get to know your body and what your discharge looks like, this way you can quickly notice anything usual or different which could be a sign of infection.
If you have bacterial vaginosis your vaginal discharge will be:
- White or grey in colour
- Thin or watery
- Strong smelling the smell is described as a fishy and might be more present after sex
Every woman is different and so is your body, you might have bacterial vaginosis without noticing any symptoms at all. Also you might think that you have BV but instead the symptoms you are experiencing are that of thrush. These vaginal infections are often mistaken for one another however the symptoms you experience are very different, for example thrush produces thick cottage-cheese like discharge whereas BV creates watery vaginal discharge.
Is Bacterial Vaginosis A Std
Bacterial vaginosis is not a sexually transmitted disease. However, its considered a “sexually-associated” infection. This is because it’s rarely seen in women who have never been sexually active, explains Kristy Goodman, MS, Assistant Professor at the Southern California University of Health Sciences PA Program.
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Maintain A Healthy Vaginal Ph
When vaginal pH is too highthat is, too basic or alkalineit may encourage the growth of bacteria associated with BV. As a result, maintaining a vaginal pH thats slightly acidic may help prevent reinfection.
How Is Bv Diagnosed
There are tests to find out if you have BV. Your doctor or nurse takes a sample of vaginal discharge. Your doctor or nurse may then look at the sample under a microscope, use an in-office test, or send it to a lab to check for harmful bacteria. Your doctor or nurse may also see signs of BV during an exam.
Before you see a doctor or nurse for a test:
- Don’t douche or use vaginal deodorant sprays. They might cover odors that can help your doctor diagnose BV. They can also irritate your vagina.
- Make an appointment for a day when you do not have your period.
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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.
Antibiotics For Bacterial Vaginosis
Oral antibiotics are the first-choice treatment in pregnant women with BV.
Metronidazole tabletsA full course of metronidazole tablets is the common treatment. Metronidazole is an antibiotic. This clears BV in most cases. It is important to read the leaflet that comes with these tablets for the full list of possible side-effects and cautions. The main points to note about metronidazole include:
- The usual dose is 400-500 mg twice a day for 5-7 days. A single dose of 2 grams of metronidazole is an alternative, although this may be less effective and may cause more side-effects. It is important to finish the course you have been prescribed, and not to miss any tablets.
- Some people feel sick or may be sick when they take metronidazole. This is less likely to occur if you take the tablets straight after food. A metallic taste is also a common side-effect.
- Do not drink any alcohol while taking metronidazole, nor for 48 hours after stopping treatment. The interaction of metronidazole with alcohol can cause severe sickness and vomiting, and may also cause flushing and an increased pulse rate.
- Metronidazole can get into breast milk in small amounts but will not harm your baby, although it may make the milk taste different. The manufacturer recommends that if you are breastfeeding you should take the 5- to 7-day lower dose course of metronidazole rather than the single large dose.
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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.
Maintain Healthy Vaginal Ph
Maintaining a healthy vaginal pH is essential to preventing and treating BV. “BV occurs when there is an overgrowth of bacteria that is normally found in the vaginal canal,” Hill says, “Alterations in the vaginal pH allow the normal bacteria to flourish.”
Denniston concurs, adding that in addition to a proliferation of “multiple potentially pathogenic bacterial species,” BV is also characterized by a decrease in “normal lactobacillus species,” necessary in regulating vaginal flora. She notes that “healthy lactobacillus species decrease with intercourse without condoms, douching, lubricants, and antibiotics.”
Hill adds that engaging in unprotected sex with a new sexual partner can also upset vaginal pH.
Medications For Bacterial Vaginosis
Bacterial vaginosis is a bacterial infection in the vagina. It is the most common cause of abnormal vaginal odor and discharge in young women and is caused by a change in the balance and type of bacteria which are normally present in the vagina.
Although BV is not considered a sexually transmitted disease, the risk of developing BV seems to increase the more sexual partners a woman has.
Normally, Lactobacillus bacteria are the most common type of bacteria within the vagina. These produce chemicals that keep the vagina mildly acidic. In BV, numbers other types of bacteria within the vagina that are usually only present in small numbers increase and disrupt both the pH of the vagina and its lining. This can result in BV, and symptoms may include:
- Mild itching in and around the vagina
- Bad-smelling, fishy odor that is more noticeable during menstruation or after sex)
- Pain when urinating.
Some women with BV have no symptoms, which is a bit concerning because if BV isnt treated it can increase the chance of women developing STDs , pelvic inflammatory disease, and possibly increase the risk of miscarriage. In women who are pregnant, BV can result in premature labor and delivery, premature rupture of membranes, and postpartum uterine infections.
How Are Antibiotics Used
Symptoms are usually treated with an antibiotic such as clindamycin or metronidazole as a cream, vaginal suppositories or tablets, or oral tablets. Treatment can last one to seven days depending on the exact drug used, its form and the dose, and the severity of the symptoms. Your doctor can help you decide what type of treatment is most suitable for you.
If you’ve been prescribed , it’s important to be careful about using them correctly. That especially means using the medicine regularly and for as long as prescribed: Stopping early, for instance if the symptoms have already cleared up, contributes to the development of resistant strains of .
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How Bv Is Spread
Although it is not clear how BV is transmitted, it is more common in women who are sexually active. It sometimes develops soon after intercourse with a new partner. Women who have female sexual partners may be at higher risk than women who have sex with only male partners. Research has not conclusively found a link between BV and specific sexual practices or acts. However, recent evidence supports the use of condoms to reduce the risk of this infection.
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.
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Local Acidification Of Vaginal Fluid
BV is characterized by the alkalinization of vaginal fluid prompting some authors to propose correcting the vaginal pH in order to treat BV. The results have been discordant. In two randomized double-blind clinical trials, vaginal acidification alone was an ineffective therapy for BV compared with placebo or metronidazole., However, in another randomized study, the combination of oral metronidazole 500 mg twice daily and 5 g lactic acid vaginal gel at bedtime for 7 days was found to be better than metronidazole alone at promoting lactobacilli colonization and reducing malodorous vaginal discharge. Moreover, not only was the lactic acid well tolerated but it also reduced recurrence of symptomatic BV.
Bacterial Vaginosis Treatment And Prevention
Bacterial vaginosis doesnt necessarily have to be treated if there are no symptoms. However, if you are pregnant, its important you seek treatment because you can be at risk of complications such as miscarriage and premature delivery.
Treatment is with antibiotics such as metronidazole, tinidazole or clindamycin, which may be given as oral tablets, or a vaginal antibiotic cream or gel. More than one course of treatment may be needed. You can also buy an acidic jelly for the vagina over the counter to help correct the acid balance of the vagina. It is not normally necessary to treat sexual partners, but spread between female sexual partners is possible.
If you have had bacterial vaginosis, there are some things you can do to help prevent further episodes. In particular, avoid smoking, douching or using perfumed talcs or deodorants around your vagina.
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What May Interact With This Medicine
Do not take this medicine with any of the following medications:
- alcohol or any product that contains alcohol
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What Is The Difference Between A Yeast Infection And Bv
BV and vaginal yeast infections have similar symptoms but different causes and treatments, but both cause inflammation of the vagina vaginitis.
One of the differences between BV and a yeast infection is that BV produces a foul-smelling, fishy order, while a yeast infection produces no vaginal odor. Additionally, a yeast infection may cause redness and inflammation of the vulva, while BV doesnt produce such symptoms.
To determine whether a vaginal infection is BV or a yeast infection, a doctor may:
- Ask about the persons medical history, including previous vaginal infections, which may have been sexually transmitted.
- Perform an examination to look for signs of infection and vaginal discharge.
- Take a sample of the discharge for analysis, to see whether an overgrowth of harmful bacteria or fungi is present.
- Test the pH of the vagina, as a pH of 4.5 or above can indicate BV.
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Effects Of Coconut Oil On Bacteria
Coconut oil has demonstrated antimicrobial effects on several different kinds of bacteria, including E. coli and bacteria that cause staph infections.
BV, however, is most often caused by the bacteria Gardnerella vaginalis. And current medical research hasnt shown that coconut oil can kill or prevent the spread of this bacteria.
Ask About Boric Acid Suppositories
Boric acid has been used to maintain vaginal health for centuries. Its available over-the-counter as a vaginal suppository.
Some recommend using it alongside antibiotic treatment. A on the use of boric acid shows its a promising effective treatment.
A clinical trial is also being conducted to determine whether vaginal boric acid suppositories are as effective at treating BV as antibiotics. The results are pending.
Boric acid poses some serious risks. If taken by mouth, it can lead to poisoning and even death. Pregnant people shouldnt take boric acid, as it can pose risks to a developing fetus.
Speak to your healthcare provider if youre considering this option to make sure its safe for you.
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Why Is Vulvar And Vagina Care Important
Many women experience uncomfortable, vaginal infections at one time or another. The area around the entrance to the vagina can also become irritated. Steps can be taken to relieve and prevent vulvar discomfort and vaginal infections.
Not all vaginal infections are alike and home treatments can worsen some types. If you have any concerns about your vulvar or vaginal health, or notice unusual changes in vaginal discharge, contact your healthcare provider if the problem persists.
My Personal Experience With Recurrent Bacterial Vaginosis
I was 23 and about to go on a weekend trip with my new boyfriend. I had never heard of BV, and by the fifth day of itching, burning, and discharge, I misdiagnosed myself with a yeast infection. I didnt want to wait for a doctor, so the night before my trip, I went to CVS and spent $30 on Monistat 1. I applied it before I went to bed, and the next morning, I woke up in some of the worst pain of my life. It was like being stung by 1,000 wasps. My vagina spent the weekend expelling the Monistat and ruining five pairs of cotton panties. I spent the weekend running to the bathroom every hour to apply Vagisil it barely helped.
When I got back to the city, I visited a doctor and told her about my nightmarish weekend. She told me that most of her patients have similar stories about confusing their bacterial vaginosis for a yeast infection and erroneously using Monistat. This is why it’s so important to see a doctor at the first sign of trouble down there. Monistat only worsened the problem, and I would have been on the road to recovery sooner had I seen a doctor right away.
My doctor put me on antibiotics, and after two days, the smell and itch faded. After four days, most of the symptoms were gone. My vagina was healthy and happy again! But … not for long. Before I knew it, my BV was back with a vengeance. In fact, after the initial incident, I got BV after my period every single month for 19 months.
This article was first published in 2015 and has been updated
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