Bacterial vaginosis

Bacterial vaginosis is a very common reason for gynecological consultation for women of childbearing age, but it is a benign condition. It is important, however, that it be treated properly to avoid certain complications.

Various factors are involved in the development of bacterial vaginosis. It should be understood that, regardless of the cause, the infection is always caused by a very specific reason: a pH imbalance in the vagina. 

In this article, we will go into more detail about the causes, symptoms, treatments, and prevention methods of bacterial vaginosis, and more.

What are the symptoms?

While bacterial vaginosis doesn't always have symptoms, they are difficult to ignore when they do.

These include:

• Itching
• Irritation
• Vaginal discharge that is greenish, grayish or whitish in colour
• Watery discharges
• A strong, fishy smell, which tends to be accentuated after sex, during menstruation or after cleaning the genitalia

Unlike yeast vaginitis (or vaginal yeast infection), bacterial vaginosis very rarely causes inflammation in the vaginal walls. To better assess signs and symptoms, understanding the causes and risk factors is essential.

What is bacterial vaginosis?

As touched upon above, the vagina is an environment with a normally acidic pH. Its tissues are colonized by millions of non-pathogenic bacteria (known as "good bacteria") which maintain an adequate pH level balance. These lactobacilli are a true protective shield for the vagina.

However, other bacteria, such as Peptostreptococcus, also inhabit the vaginal flora. When the pH becomes more alkaline than its ideal level, these pathogenic bacteria overcome the lactobacilli. This is when infections like bacterial vaginosis and yeast vaginitis can develop.

Women of childbearing age are more prone to developing bacterial vaginosis. However, we note that even young girls who have not yet reached puberty may experience it and require treatment.

Risk factors

To date, not every diagnosis of bacterial vaginosis can be explained by a specific factor. However, there are a few things that can predispose some women to develop it, such as:

• Taking medication (such as an antibiotic)
• According to hypotheses: many sexual partners or a new sexual partner
• Douching
• Taking the contraceptive pill, for some women
• Wearing underwear made of synthetic fabrics, such as nylon or lace, as well as wearing thongs
• Taking hormones, such as estrogen

Complications

Although safe and easy to treat, bacterial vaginosis can cause very serious complications, such as infection of the internal sex organs (uterus and ovaries).

Complications are particularly serious in pregnant women. Infection of the uterine membranes surrounding the fetus, as well as other imbalances, can develop, greatly increasing the chances of a premature labor. It is therefore important to see a doctor if you are pregnant and have symptoms suggesting bacterial vaginosis.

Prevention

Some women live with recurrent episodes of bacterial vaginosis - often before or after menstruation, or after sex. In this case, it is even more important to highlight the prevention methods. These remain applicable to all women who wish to properly prevent any infection.

The best preventive practices are:

• Always wiping from front to back when using the toilet
• Avoid using perfumed or deodorant products on (or in) the genitals, as well as very strong detergents and soaps
• Changing feminine protection products frequently during menstruation
• Washing with plenty of water, or with a neutral and unscented soap (there are products specially designed for cleaning the vulva at your pharmacy)
• se changer après la baignade, pour ne pas rester trop longtemps dans un vêtement humide, sujet à la prolifération des bactéries
• Changing damp clothing quickly after swimming, to prevent the proliferation of bacteria
• Changing your underwear after rigorous physical exercise
• Changing your underwear daily

How is bacterial vaginosis diagnosed?

First of all, it is vital to mention the importance of consulting a doctor when signs and symptoms of bacterial vaginosis appear, regardless of age.

The doctor will take time to learn about the current symptoms and be able to rule out other possible causes. If they suspect bacterial vaginosis, they examine the vagina to collect a sample of the fluids. This sample will then be sent to the nearest laboratory to verify the presence of the bacteria involved in bacterial vaginosis.

During the same exam, the doctor will check for signs of infection in the internal organs, such as the ovaries and uterus - which would require more advanced treatment.

Treatment

The doctor will inevitably prescribe an antibiotic.

Whether administered topically or orally, the body generally tolerates antibiotic treatment well. However, it can cause some side effects like nausea, dizziness, and headache. Your pharmacist can advise you on how to minimize these side effects.

Despite these side effects, it is strongly recommended to complete the antibiotic treatment as prescribed by the doctor, even if the symptoms disappear. If it is intentionally interrupted by the patient, the chances of curing bacterial vaginosis are reduced.

In many cases, especially in women who experience bacterial vaginosis frequently, the infection returns after treatment.

When should a doctor be consulted?

It is normal for a woman to develop one or more bacterial vaginosis during her lifetime. This should not, however, be an excuse to refrain from sharing her signs and symptoms with a doctor. As mentioned above, complications can ensue, and only the right treatment can help the body fight this infection.

If in doubt, a healthcare professional, such as your pharmacist, can provide guidance on the best option for you.