What is BV? (bacterial vaginosis): Causes, Symptoms, Treatment

Last updated on July 28th, 2018 at 05:15 am

BV or bacterial vaginosis is a common problem experienced by women in their reproductive ages. It is due to abnormal changes in the flora of the vagina.

The vagina is normally made up of different kind of bacterial cells and other cells.The good bacterial of the vagina is the lactobacillus. They ensure the normal pH of the vagina. However, other anaerobic organism can cause a change in the pH of the vagina with reduction in the number of good lactobacillus bacteria.

In the united states, 30 percent of women are affected by bacterial vaginosis (BV). However, it is more common in developing countries in Africa, some parts of Asia and Europe.

Bacterial vaginosis increases the risk of contacting HIV in women or other sexually transmitted infections such as trichomonas infection, Chlamydia, Gonorrhea and syphilis.

In addition, BV can be treated and cured in women. If you develop symptoms of BV you should see your doctor for treatment.

What is BV (bacterial vaginosis) and what causes it?

BV simply mean bacterial vaginosis. The organism that causes BV are Gardnerella vaginalis, Bacterioides and Mycoplasma hominis. However, Gardnerella is commonly seen in some women without sign of the disease.

The vagina is made up of good and bad bacteria. Anything that affects this normal flora will kill the good bacteria with resultant increase in the number of bad bacteria. These bad bacteria can now cause symptoms of the disease.

Some of the ways to cause this shift to more bad bacteria are

• Douching. This is using running water to wash the vagina. It can affect the normal balance of the vagina and lead to BV.
• BV is not a sexually transmitted disease. However, there is an increased chance of women contacting the disease if they have a female sex partner.
• BV can be transmitted to women from their male partners. This is more common in women with uncircumcised male partners.

What are the signs and symptoms of bacterial vaginosis (BV)?

Women with BV complain of foul smelling vaginal discharge. It is often described by women as fishy smell. However, in women with BV, there is no inflammation. This means that women will only have abnormal discharge but no pain, irritation, redness or swelling of the vulva. Only a few will complain of mild itching of the vulva.

This abnormal vaginal discharge is usually common during and after your period. The color of vaginal discharge is greyish or creamy white discharge that usually adheres to wall of the vagina.

If you are between 14 and 49 years and experience any of these symptoms, you should see your doctor.

How is Bacterial vaginosis (BV) diagnosed?

Women that develop the above symptoms will have a clue if they have the disease. However, BV symptoms can mimic other vaginal infections. Therefore, testing and treatment is important for women.

The way to diagnose BV include

The whiff test. This is often done by adding potassium hydroxide to a sample of your vagina discharge. The presence of fishy smell or odor is likely due to Bacterial vaginosis.

By checking vaginal pH. The normal vaginal pH is between 3.5 to 4.5. During bacterial vaginosis infection there is an increase in the pH due to reduced good bacteria (lactobacillus). To detect this, a sample of your vaginal discharge is collected and tested with litmus. pH that is high is suggestive of BV.

Amsel creteria and testing

To detect BV, atleast 3 amsel criteria is needed. They include

• Presence of clue cells. These are epithelial cells that are covered by bacterial cells
• Presence of fishy odor after adding hydrogen peroxide
• Increased pH more than 4.5
• Naked eye examination of vaginal discharge is creamy greyish in color.

To diagnose bacterial vaginosis there should be atleast 3 of these factors present.

Hay/Iso criteria

This have 3 grades

Grade 1. The good bacteria (lactobacillus) predominates.

Grade 2. The good bacteria is seen with the bad bacteria (Gardnerella vaginalis, Mycoplasma hominis)

Grade 3. This is bacterial vaginosis due to predominance of bad bacteria.

What is Bacterial vaginosis (BV) treatment?

During your visit to your doctor, history and examination is done. Samples will be collected and tested. If BV is diagnosed, it will be treated. The drug of choice is metronidazole (Flagyl) and clindamycin.

Flagyl is usually given orally or as a cream. Oral therapy is 2g stat or 400mg twice daily for 5 days. The cream can also be applied for 5 days. Side effects include vomiting, dizziness, seizures. If you experience any side effects of this drug inform your doctor.

Clindamycin is also used to treat BV. However, it is more expensive but more effective than Flagyl. In addition, it can cause abdominal pain, bleeding gums and cracks in the skin.

What are the complications of Bacterial vaginosis (BV) in women?

• Pregnant women with first trimester bacterial vaginosis infection can have late second trimester miscarriage.
• Preterm baby
• Low birth weight baby 
• Increased chance of contacting sexually transmitted infections
• Premature rupture of membrane
• Pelvic inflammatory disease (PID)

In pregnancy, BV can be treated with flagyl.

How can Bacterial vaginosis be prevented in women?

• Stop douching as it affects the normal vaginal flora.
• Stop Sex. Avoiding sex is an easy way to prevent the disease. However, if this is not possible use condoms and limit sexual partners
• Inform your doctor of any abnormal foul smelling vaginal discharge.
• Avoid Vaginal soap wash or use of strong detergents.

Frequently asked questions about BV

Can a man become infected by this bacterial infection?

The bacteria is found in the male urethra and penis. However, male sex do not get Bacterial vaginosis.

Can BV clear up on its own?

Yes. In some women BV can clear up on its own. However, some women will develop severe infection. It is therefore important to see your doctor for testing and treatment.

Now its your turn. Have you experienced abnormal discharge that is foul smelling. Share your experiences.