Bacterial Vaginosis
Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of childbearing age. Studies in antenatal clinics and gynaecology clinics show a prevalence of approximately 12 per cent in the UK. It is commoner in women of Afro-Caribbean origin and in those who have an intrauterine device (IUD).
The normal vagina is usually an acidic environment and there are plenty of good bacteria called lactobacilli in the vagina. In bacterial vaginosis the environment becomes less acidic and the lactobacilli disappear. Instead million of pathogenic bacteria develop. The most common of them is a special called gardenella. There are many other bacteria which cause bacterial viginosis.
Bacterial Vaginosis manifests typically with itching around the vulvo-vaginal region with a thin colourless or yellow discharge. This discharge emits a fishy odour which is very characteristic of this condition. You might have noticed this smell around the time of menstruation. Bacterial Vaginosis arises spontaneously around the time of menstruation and may resolve spontaneously in mid-cycle.
Bacterial Vaginosis is diagnosed by a set of four criteria. Vaginal ph >4.5, release of fishy smell on addition of potassium hydroxide, presence of clue cells and a characteristic discharge on examination.
Clue cells are actually vaginal epithelial cells which are so covered with bacteria that their borders are not visible under a microscope.
In some cases doctors may ask for a culture of the vaginal discharge, but it is generally not done.
Bacterial Vaginosis like yeast infection is easily treated. It responds very well to single 2gram dose of Metronidazole, also called Flagyl commonly. Alternatively ointments and pesseries are also available, but the ease and convenience of oral Flagyl is unbeatable. Flagyl is a unpleasant to taste and hece some may prefer to take one tab thrice a day for 3-4 days.
Bacterial Vaginosis can be prevented by a few simple precautions. Hygiene is paramount, especially during menstruation. While washing you should not use vaginal douches or soaps on your vagina. These agents kill the lactobacilli and promote colonisation of your vagina by the disease causing bacteria. You should also avoid wearing tights and tight underwear. Also be careful while using public bathrooms.
Most cases of Bacterial Vaginosis are cured by these measures, however some women may relapse. Such women may benefit from weekly Flagyl orally.
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