WHAT IS AN ABNORMAL VAGINAL DISCHARGE?
As young girls start to menstruate and become young women, hormonal changes result in a normal vaginal discharge that may be watery, mucus-like or milky white, depending on the different phases of the menstrual cycle.3,4 BV is the most common vaginal infection throughout a woman’s reproductive years and extends beyond into the menopause.5
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
WHAT CAUSES AN ABNORMAL VAGINAL DISCHARGE?
Although vaginitis can have a variety of causes, it is most often associated with infection.8 This infection could be caused by harmful bacteria, or a fungus or could be a combination of both known as a mixed infection. In the majority of cases (up to 50 % of cases), women present with a vaginal infection caused by bacteria, this is commonly known as Bacterial Vaginosis.9,10 Bacterial Vaginosis is the most common cause of an abnormal vaginal discharge.9,11 It is more common than vaginal fungal infections, commonly referred to as thrush. 9,10
WHAT CAUSES BACTERIAL VAGINOSIS?
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?
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 VAGINOSIS
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 TREATED
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 VAGINOSIS –
Vaginal Symptom Checklist
Please answer the following questions9,11
If you answered ‘YES’ to more than one of the FOUR questions, you may have Bacterial Vaginosis.9,17
Bacterial Vaginosis may be associated with slight itching or burning.18 These symptoms require further evaluation for other possible causes of vaginal discharge.9,10
If you’d like to find out more information about BV please Click here
- 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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