Bacterial Vaginosis

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

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

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
• Smoking
• Being overweight
• Hormonal changes during the menstrual cycle

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

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If left untreated, Bacterial Vaginosis may increase your risk of problems and complications.^9,14,17

These include:

• 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 disease^9,11
• Easier acquisition of HIV¹⁷

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.

Vaginal Symptom Checklist
Please answer the following questions^9,11