•  Gynecological Problems

Bacterial vaginosis, or BV, is an infection of the vagina that's often characterized by itchiness and excessive discharge. Although it's one of the most common vaginal infections, researchers don't yet know how it's spread. It generally affects women of childbearing age, but it's also been found in infants, children with no exposure to sex, and postmenopausal women.

Researchers used to think that BV was fairly harmless. But they've recently found that if untreated, it can put you at risk of more serious disorders, such as inflammation or swelling of the Fallopian tubes or the uterine lining. It has also been associated with pelvic inflammatory disease, an infection of the Fallopian tubes that can lead to permanent tissue scarring and infertility. Bacterial vaginosis has also been linked to endometriosis and health problems following invasive procedures, including the placement of an IUD, according to the Centers for Disease Control and Prevention (CDC).

On top of that, BV can cause complications during pregnancy. According to a 1995 study by the federal government, pregnant women with BV are 40 percent more likely to give birth to premature, low birthweight babies (babies weighing less than 5 pounds) than those without BV. Research has also linked the condition to infection of the amniotic fluid (the liquid surrounding a fetus in the womb), as well as infections following a caesarean section.

Fifty percent of women with BV have no symptoms at all. If you do, you'll probably notice a grayish vaginal discharge, itchiness, redness, and an unpleasant fishy odor. Researchers think the odor is more marked during menstruation and following sexual intercourse.

The symptoms are caused by the bacterium Gardnerella vaginalis. Like many other vaginal infections, BV is thought to reduce the number of health-promoting lactobacilli bacteria in the vagina, a loss that can lead to the proliferation of bad bacteria.

Again, the experts aren't sure. Some research indicates that there's a link with sexual activity, but there is no definitive evidence that it's spread through sex. The presence of a sexually transmitted disease like herpes or chlamydia is considered a risk factor, as is the use of an intra-uterine device (or IUD) for birth control. Newborns can get BV if their mothers are infected with it, so If you're planning to get pregnant, you may want to be tested for the infection. BV is also linked to douching and a lack of certain "good" bacteria (lactobacilli) in the vagina, according to the CDC.

BV is diagnosed by using clinical or Gram-stain tests, according to the CDC. The clinical procedure consists of four steps, three of which must yield a positive result to confirm a diagnosis of BV.

•First your doctor or a nurse takes a sample of your vaginal fluid. Magnified under a microscope, it may show the presence of numerous cells containing BV bacteria.

•Next the vaginal fluid is analyzed. A decrease in white blood cells may signal that BV is present, or a high white blood cell count might indicate more than one infection.

•A lab then checks the fluid to determine whether it's normally acidic, with a pH ranging from approximately 3.9 to about 4.2. If the pH is greater than 4.5, you may have BV.

•A technician adds an alkaline solution to the vaginal fluid and does a whiff test. A fishy odor indicates that BV is in the picture.

The CDC cautions doctors against diagnosing BV by simply taking a culture of the bacterium G. vaginalis, because it's not specific enough to show whether you have the infection.

For some time BV has been treated successfully with metronidazole, an antibiotic in pill form. The recommended treatment is a pill containing 500 milligrams of metronidazole, taken twice a day for 7 days, or metronidazole gel (0.75 percent), applied to the vagina with an applicator once a day for 5 days, according to 2002 guidelines from the CDC. The agency also recommends treating BV with clindamycin, used as a vaginal cream (2 percent) at bedtime once a day for 7 days.

Note: Because clindamycin can damage latex products such as diaphragms and condoms, you should wait to have intercourse until you've finished the treatment. In addition, you shouldn't drink alcohol while you're being treated with metronidazole or for 24 hours afterwards.

If you are pregnant and have BV, or suspect you have it, discuss testing and treatment options with your doctor.

Because the "good" lactobacilli bacteria help control the growth of harmful bacteria and infection, get the nutrients you need to keep them happy. Eating yogurt that contains active acidophilus (you'll find it at health food stores) helps maintain the health of your vagina (although there's no evidence it helps in the treatment of BV). Here are some other tips:

•Wear underpants with a cotton crotch that doesn't trap moisture, and avoid tight-fitting jeans.

•If you swim, be sure to change out of your wet suit when you leave the water. Lots of moisture in your vaginal area can lead to an upsurge in bad bacteria.

•Change out of your work-out clothing immediately after exercising. Wearing damp gym clothes long after your work-out is over is tempting fate.

•Avoid vaginal douching, since it decreases the number of good lactobacilli in the vagina.

•Before you get dressed in the morning, wash and dry your vulva (the outer portion of your genitals).

•Since an IUD increases your chances of getting BV, consider another form of birth control if you have recurring infections.

--Laurie Udesky is an award-winning health and medical journalist based in San Francisco. She has written for AIDS Alert, TB Monitor, Time Inc. Health, and many other publications.

References

First published October 1, 1999
Last updated March 5, 2008
Copyright © 1999 Consumer Health Interactive

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