You have been feeling hell as your vagina stinks and you have profuse discharge. You are confused and anxious. You tried to wash it away by douching, but it didn’t really work well. You also have a burning sensation when you pass urine. You are depressed as all this has lead you to give up on sex. You probably have an infection. You should first be informed and then seek medical help immediately.
Understanding bacterial vaginosis
Bacterial vaginosis (BV) is the commonest vaginal infection in women of childbearing age. It is caused by an imbalance of the bacterial population in the vagina (birth canal). The vagina has a flora of bacteria that are considered to be good, beneficial, and natural. These can at times be over numbered by some harmful bacteria, and this disturbs the local balance of resident flora.
Lactobacillus is a rod shaped normal resident of the vagina that produces hydrogen peroxide, it acts like a natural disinfectant and keeps the nature of the vagina acidic. This bacterium is found in abundance in a healthy vagina. In addition, an organism called Gardnerella vaginalis and bacteria that can grow in absence of oxygen, called anaerobic bacteria are also found in fewer amounts in a normal vagina. When the numbers of lactobacilli fall and those of others increase, an infection results and the acidic nature of the vagina is lost. The acidic nature of the vagina is a defense for invasion from external infectious agents. When it is lost, the vagina becomes further susceptible to infection.
The cause for BV is not fully known. More at risk are women who have a new or multiple sexual partners or practice douching. How sexual activity is related to BV is again not clear. Even lesbians and women who have never had sexual activity can get BV. In fact any woman can get one. You cannot get one in the swimming pool or by sharing toilet seats or beddings.
BV is an infection but you may not have acquired it from somebody. Your partner(s) need no treatment if you have been diagnosed BV. The exact cause of BV is not really known. Any woman can get it, though it is more common in women who are sexually active and have multiple partners.
Symptoms
The commonest sign of BV is an abnormal foul smelling discharge from the vagina that typically feels like a fish-like odor. The discharge can be milky or gray. It may be watery or foamy. It may be more copious after sexual activity. Intercourse may get uncomfortable and painful. Other complaints can be an irritation in the vagina or a burning sensation when passing urine. In some women, BV may be deceptively symptomless.
Diagnosis
The doctor will need to inspect your vagina to conduct a clinical examination and collect a sample of your discharge for laboratory analysis. The sample is then examined for bacteria under a microscope and tested for acidity. To facilitate a proper collection of a sample, try and avoid any vaginal deodorants, douches, sex objects or tampons for at least 24 hours prior to seeing the doctor. Schedule your examination when you are not having periods.
Treatment
Treatment is highly recommended for BV even when it is symptomless or not serious. It is even more important to treat it when it has occurred while you are pregnant. BV can lead to your baby being born before term. Such babies are low in weight and face difficulties growing up. The infection in BV can ascend up to your uterus, the womb, and other internal reproductive organs. A severe infection can spread in your pelvis and cause pelvic inflammatory disease. It is important to treat BV if you are to undergo a diagnostic or treatment procedure in the uterus, an abortion, or are planning to have an intrauterine device (IUD) inserted into your uterus for birth control. BV increases the risk of transmission of other sexual transmitted diseases like HIV. BV is usually not serious. In some extreme cases, it can cause infertility. The potential of these complications mandate an early treatment.
Antibiotics are used to treat BV. These include metronidazole and clindamycin. These can be taken by oral route or may be applied locally in the vagina to act at the site of infection. Metronidazole is available in gel form and clindamycin in gel form. In addition, there are also tablets available that need to be inserted into the vagina. These are called vaginal suppositories. When taken by mouth, clindamycin tables of strength 300 mg is taken twice daily for seven days. Metronidazole tablets in strength of 250 mg are taken thrice in day for seven days or in strength of 500 mg are taken twice daily for seven days. Clindamycin arrests the growth of the unwanted bacteria and metronidazole kills them. Sometimes, a repeat cycle of treatment may be required for the more severe infections. BV can occur again in which case it needs to be retreated. Both these antibiotics are active against a variety of organisms that can cause BV and have a broad spectrum of activity. Your partner will not need to be treated. It is rewarding to finish the entire course of medication and not discontinue it when you get some relief.
Prevent it before it gets you!
You can take some precautions to prevent a second or recurrent infection. Keep your vagina clean. Always wipe from front backwards, i.e., from vagina to the anal opening. Avoid too tight underpants. Give up douching. Practice safe sex. Use condoms. If possible, have only one sexual partner. Have yourself examined with your doctor or healthcare advisor regularly and share if you have any untoward symptoms. You can certainly keep your vagina hygienic and healthy and enjoy sex!
