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Bacterial
vaginosis
‘Bacterial vaginosis’ is a very common
condition in women. In fact, it is much more common than thrush.
If your genital area smells fishy, this is almost certainly
the cause. It is an imbalance of the bacteria in the vagina.
Its previous name was ‘anaerobic vaginosis’, and
some medical textbooks still use this term.
What is bacterial vaginosis?
Every woman has harmless bacteria in her vagina. In bacterial
vaginosis, some of the bacteria multiply too much, so that
more are present than is normal (especially Gardnerella and
Mobiluncus bacteria). And the numbers of other friendly bacteria,
especially the ‘lactobacilli’ type, are decreased.
In other words, bacterial vaginosis is not an infection caught
from your partner – it is due to bacteria that are
normally present in the vagina.
Symptoms of bacterial vaginosis
-
The main
symptom is a fishy smell in the genital area. You may notice
that the smell is worse after sex and during your
period.
-
There is
usually a discharge, which is watery and greyish-white in
colour.
-
Bacterial
vaginosis does not cause soreness or irritation.
If untreated, bacterial vaginosis may possibly increase the
risk of pelvic inflammatory disease (infection of the Fallopian
tubes that lead from the ovaries to the uterus).
Why women get bacterial vaginosis
Putting antiseptic in your bath water, or using bubble baths,
can make a bacterial imbalance more likely. Another cause
is douching (squirting antiseptic or soapy liquid into the
vagina). Some women douche the vagina because they think
it is hygienic, but the opposite is true. The vagina cleans
itself very effectively and douching makes infections more
likely.
What you should do
If you think you have bacterial vaginosis, you need to see
your doctor because the treatment, an antibiotic called metronidazole,
is available only with a doctor’s prescription. Metronidazole
cures the problem in 90% of women, but causes an unpleasant
metallic taste in the mouth, though this disappears after
the treatment is finished. It can also cause a slightly nauseous
feeling. You should not drink alcohol while you are taking
it.
If
it comes back. Unfortunately, the cure may not be permanent.
The symptoms return in about half of women. In this situation,
there are three possible courses of action.
-
See
your doctor again for a repeat of the metronidazole treatment,
or to try another antibiotic.
-
Try acetic
acid vaginal jelly (Aci-Jel), which you can buy
from a pharmacy without a prescription. The pack contains
a special applicator for inserting the jelly into the vagina – use
one applicatorful, twice a day. It restores the natural acidity
of the vagina, which may encourage a return to the natural
balance of bacteria. It is not known whether or not Aci-Jel
damages condoms and contraceptive diaphragms.
-
Try yoghurt.
Make sure the container says ‘live yoghurt’,
because this contains live lactobacilli bacteria. It is
the friendly lactobacilli bacteria that are reduced in
numbers
in bacterial vaginosis. Gently smear a small amount of
yoghurt over the vulva (the area around the opening of
the vagina),
and also put some inside the vagina. The easiest way to
do this is to use a tampon with its applicator. Push the
tampon
back inside the applicator so you have a space for about
a teaspoonful of yoghurt. Then insert the tampon in the usual
way, which will push the yoghurt into the top of the vagina.
Remove the tampon an hour later. Do this twice a day for
a week. According to the medical journal Bandolier,
which looks at the scientific evidence for treatments,
some research has
shown that women using yoghurt treatment felt their symptoms
were improved (www.jr2.ox.ac.uk/bandolier/band60/b60-3.html).
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If
you have an intrauterine contraceptive device (‘coil’)
and bacterial vaginosis is very troublesome, consider having
the device removed. Bacterial vaginosis is more common
in women using this type of contraception.
If
you have a partner. Your partner does not need to be treated,
even if you keep getting bacterial vaginosis. There is no scientific
evidence to suggest that treating your partner makes a difference.
If
you are planning pregnancy. In the past, bacterial vaginosis
was thought to be just a nuisance, but not harmful in any way.
There is now evidence that it doubles the likelihood of a premature
birth. So if you are intending to become pregnant, you should
have bacterial vaginosis treated beforehand. If you have had
premature labour in the past, your doctor will probably test
you for anaerobic vaginosis during your pregnancy and treat
you with antibiotics if necessary.
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