Bacterial Vaginosis

What is bacterial vaginosis?

Bacterial vaginosis or commonly known as BV is an infection caused by an imbalance in the bacteria that live in your vagina. Lactobacilli or the good bacteria in your vagina keeps the other bacterias growth under control. BV happens when there is too little lactobacilli causing other bacteria to overgrow. The exact cause of BV infection is unknown.

Is BV common in pregnancy?

Is it estimated about 20% of pregnant women will have this infection at some point during their pregnancy.

Is BV a sexually transmitted disease?

Fortunately,no. However, BV infection is associated with sexual activity.

How do I know whether I have BV? How is the diagnosis made?

Majority of women with BV have no symptoms. Those that do have symptoms may noticed a foul or fishy smelling vaginal discharge which is whitish or greyish in colour. The odour is most noticeable after sex. There may also be burning or itching sensation. The diagnosis will be made by your doctor who will need to take some samples from your vagina and cervix.

How do I prevent myself from getting BV infection?

There are several ways your could perhaps reduce your chance of BV infection:
  • Practice safe sex
  • Do not smoke as cigarette smoking increases risk of BV infection
  • Avoid douching or using scented soaps / lotions on your genitals

What are the implications on my pregnancy if I have BV?

Majority of the women with BV have no complications during their pregnancy. However, BV does increases your risk of having preterm delivery, miscarriages, preterm rupture of membranes1 and risk of uterine infection after delivery.

What is the treatment for BV?

You would be given a course of antibiotics (metronidazole or clindamycin) either via the oral or vaginal route. In most cases, this will clear up the infection. However, about 1/3 of women will have a recurrence of BV within 3 months. You shouldn’t be drinking alcohol whilst taking the metronidazole and 48 hours after completing the antibiotic course to reduce risk of drug interaction.Your partner does not need to be treated as there is no evidence that treating them will reduce your risk of re-infection. One month after your treatment you will be re-screen to ensure that the infection has been eradicated.
 Is there any role of probiotics in the treatment for BV?
Some studies have shown that in addition to antibiotic treatment, adding probiotics containing certain lactobacillus strains such as L.rhamnosus GR-1 and L-reuteri RC-14 could be beneficial for the treatment and prevention of BV. In addition, probiotics could re-establish the normal vaginal ecosystem. 2,3
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1. Leitich H, Bodner-Adler B, Brunbauer M et al. Bacterial vaginosis as a risk factor for preterm delivery : a meta-analysis. Am J Obstet Gynaecol 2003 July; 189(1):139-47
2. Abad CL, Safdar N. The role of lactobacillus probiotics in the treatment or prevention of urogenital infections – a systematic review. J chemother. 2009 Jun; 21(3): 243-252
3. Cianci A, Giordano R, Delia A, Grasson E et al. Efficacy of Lactobacillus Rhamnosus GR-1 and Lactobacillus Reuteri RC-14 in the treatment and prevention of vaginosis and bacterial vaginitis relapses. Minerva Ginecol 2008 Oct; 60(5): 369-76

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