How to deal with bacterial vaginosis

No matter how healthy you are, sometimes the good bacteria that normally reside in your vagina decrease, and harmful bacteria take over. When you go for help because of discomfort or an unusual discharge, a diagnosis of bacterial vaginosis (or BV) may follow.

Bacterial vaginosis is the most common microbiological syndrome among women of childbearing age. Among those who visit South African clinics, the prevalence is just over 42%.

But even though bacterial vaginosis is common, it shouldn’t be ignored. The infection can increase your risk for sexually transmitted infections (STIs) and has been linked to preterm delivery. If you have bacterial vaginosis, your risk for HIV is also about three times higher.

What causes bacterial vaginosis?

Researchers don’t know exactly why some women get bacterial vaginosis more often than others, but they do know that it can be caused by several harmful bacteria. Bacterial vaginosis is also associated with a change in pH, with the vagina becoming more alkaline.

Even though bacterial vaginosis isn’t a sexually transmitted infection (STI), sexual activity does seem to increase a woman’s risk.

Other risk factors include:

  • Smoking
  • Douching
  • Recent antibiotic use
  • Using medicated or perfumed soaps
  • Using strong detergents to wash clothes

Bacterial vaginosis shouldn’t be confused with thrush. While many of the symptoms overlap, thrush is an infection caused by a yeast fungus (most commonly Candida albicans) and not bacteria.

Recognise the symptoms

  • Foul-smelling vaginal discharge
  • Discomfort
  • Itching
  • A burning sensation
  • Vaginal or pelvic pain

It’s important to know that around 50% of women with bacterial vaginosis don’t have any signs or symptoms.

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How is bacterial vaginosis treated?

Treatment is usually aimed at relieving symptoms (if they’re present). If you’re due for surgery (e.g. a hysterectomy or abortion), your doctor is also likely to treat bacterial vaginosis to help prevent postoperative infection.

The standard treatment for bacterial vaginosis is a course of antibiotics (e.g. clindamycin or metronidazole). Unfortunately, antibiotic treatment isn’t always effective. In approximately 30% of women, the infection comes back within three months.

If you suffer from recurrent infections, your doctor may prescribe other treatments (e.g. lactic acid gel) to help return the balance of microorganisms in your vagina to a normal state. A healthy vagina is one that is dominated by friendly lactobacillus bacteria.

What to do

If you think you may have bacterial vaginosis, check in with your doctor. Don’t delay getting treatment, as there are risks.

Practical tips to cut your risk for infection:

  • Use a condom during sex.
  • Keep sex toys clean.
  • Use non-fragranced soap.
  • Avoid washing your clothes with fragrance softeners and harsh soaps.
  • Avoid douching.
  • Quit smoking.

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