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A vaginal discharge is considered abnormal if it occurs in large amounts, is thicker than usual, has an unpleasant smell or if it is accompanied by other vaginal symptoms such as itching or pain.7
ContentsBack to top
- WHAT CAUSES AN ABNORMAL VAGINAL DISCHARGE?
- WHAT CAUSES BACTERIAL VAGINOSIS?
- WHAT ARE THE SYMPTOMS OF BACTERIAL VAGINOSIS?
- HOW DO THE SYMPTOMS OF BACTERIAL VAGINOSIS COMPARE TO NORMAL VAGINAL DISCHARGE?
- RISKS OF UNTREATED BACTERIAL VAGINOSIS
- BACTERIAL VAGINOSIS CAN BE TREATED
- IDENTIFYING BACTERIAL VAGINOSIS
WHAT CAUSES AN ABNORMAL VAGINAL DISCHARGE?Back to top
WHAT CAUSES BACTERIAL VAGINOSIS?Back to top
The vagina is colonised with Lactobacilli, which are bacteria that form part of the normal vaginal environment and these Lactobacilli help to maintain the acidic pH of the vagina.4,11,12 The acidic pH creates a hostile environment for other bacteria, thus keeping infection at bay.11 If the number of Lactobacilli are decreased, the pH of the vagina becomes more alkaline and other bacteria can multiply, which may lead to Bacterial Vaginosis.11 Thus, Bacterial Vaginosis represents a change in the vaginal ecosystem.12
It is not known why some of us get Bacterial Vaginosis more than others. Reports have shown that the bacteria present in the vagina may be influenced by genetics and/or race.11,12 Bacterial Vaginosis is also more prevalent in women who are sexually active or have recently had a change of sexual partner, but other factors have also been identified which may increase the likelihood of getting Bacterial Vaginosis, these include:13,14,15,16
- Douching or use of a vaginal deodorant
- Medicated or perfumed soaps and bath products
- Strong detergents to wash underwear
- Semen in the vagina after unprotected intercourse (semen is alkaline and changes the pH balance in the vagina)
- An intra-uterine contraceptive device
- Being overweight
- Hormonal changes during the menstrual cycle
WHAT ARE THE SYMPTOMS OF BACTERIAL VAGINOSIS?Back to top
Bacterial Vaginosis is characterised by these typical signs and symptoms:
- Increased vaginal discharge9
- Thin whitish / grey discharge9
- Fishy odour9
Bacterial Vaginosis tends to produce a milky-white or grey cloudy discharge with an unpleasant musty or fishy smell.9,17 The odour may become stronger after sexual intercourse or after washing with soap, both of which make the pH of the vagina more alkaline, thereby encouraging bacterial growth. 7
RISKS OF UNTREATED BACTERIAL VAGINOSISBack to top
If left untreated, Bacterial Vaginosis may increase your risk of problems and complications.9,14,17
- Fertility problems
- Complications during pregnancy (e.g. miscarriage or premature birth)14,17
- Increased risk of getting a bladder infection14
- Increased risk of an infection after gynaecological surgery14
- Increased risk of pelvic inflammatory disease9,11
- Easier acquisition of HIV17
BACTERIAL VAGINOSIS CAN BE TREATEDBack to top
Speak to your doctor or pharmacist to assist in the diagnosis of Bacterial Vaginosis. For most women, Bacterial Vaginosis is easily treated with an antibiotic, your doctor or pharmacist would be able to recommend a convenient and effective treatment for you.
IDENTIFYING BACTERIAL VAGINOSISBack to top
Please answer the following questions9,11
- Impact Rx – October 2020. Data on file, February 2019.
- Product Approved package insert October 2000.
- Onderdonk AB, Delaney ML, Fichorova RN. 2016. The human microbiome during bacterial vaginosis. Clin Microbiol Rev 29:223–238. doi:10.1128/CMR.00075-15.
- Mayo Clinic. Bacterial vaginoses [online May 2019] [cited 20 November2019]; Available from URL: https://www. mayoclinic. org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279.
- Hoffman JN, You HM, Hedberg EC, et al. Prevalence of Bacterial Vaginosis and Candida among Postmenopausal Women in the United States. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 69(8), S205–S214, doi:10.1093/geronb/gbu105.
- Mark KS, Tenoria B, Stennett CA, et al. Bacterial vaginosis diagnosis and treatment in postmenopausal women: a survey of clinician practices. Menopause. 2020 June; 27(6): 679–683. doi:10.1097/GME.0000000000001515.
- Goje O. Bacterial Vaginosis (BV) [online] [cited 14 November 2019]; Available from URL: https://www.merckmanuals.
- Owen MK, Clenney TL. Management of vaginitis. Am Fam Physician 2004;70:2125-2132.
- Ries AJ. Treatment of Vaginal Infections: Candidiasis, Bacterial Vaginosis, and Trichomoniasis. J Am Pharm Assoc. 1997;NS37(5):563-569.
- Kingsburgh D, Strydom K-A. The aetiology, diagnosis and management of the vaginal discharge syndrome. Ampath Chat 2020 (Feb); Edition 66: 1- 4.
- Mashburn J. Etiology, Diagnosis, and Management of Vaginitis. Journal of Midwifery and Women’s Health 2006;51(6):423-430.
- Muzny CA, Schwebke JR. Pathogenesis of Bacterial Vaginosis: Discussion of Current Hypotheses. J Infect Dis 2016;214(S1):S1–5.
- Onderdonk AB, Delaney ML, Hinkson PL, et al. Quantitative and Qualitative Effects of Douche Preparations on Vaginal Microflora.
Obstet Gynecol 1992;80:333-338.
- Eckert LO. Acute vulvovaginitis. N Engl J Med 2006;355:1244-52.
- Thrush and Bacterial vaginosis. Looking after your sexual health [online] [cited November 2019]; Available from URL: http://www.sexualhealthsheffield.nhs.uk/wp content/uploads/2015/03/thrush-bacterial-vaginosis-information-and-advice.pdf.
- Brookheart RT, Lewis WG, Peipert JF, et al. Association between obesity and bacterial vaginosis as assessed by Nugent score. Am J Obstet Gynecol. 2019 May ; 220(5): 476.e1–476.e11. doi:10.1016/j.ajog.2019.01.229.
- Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR / June 5,2015 / Vol. 64 / No. 3.
- Livengood C. Bacterial Vaginosis: An overview for 2009. Reviews in Obstetrics & Gynecology 2009;2(1):28-37.
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