Bacterial vaginosis
Shiv Shanker Pareek in The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Bacterial vaginosis is a common condition affecting the vagina, in which the balance of normally occurring bacteria becomes altered resulting in abnormal discharge. The condition is associated with an increase in vaginal pH, making it more alkaline, which is due to a decrease in lactobacilli – bacteria naturally present in the vagina which produce lactic acid – allowing other bacterial species to overgrow. It is not clear why the bacterial balance of the vagina changes but several factors may be involved, including: sexual activity – sexually active females are more prone to bacterial vaginitis, Smoking and presence of intrauterine device. Many cases of bacterial vaginosis are asymptomatic. Pregnant women may be more likely to miscarry late in the pregnancy or undergo premature delivery, and suffer postpartum endometriosis. Douching with scented and antiseptic soaps or gels should be avoided. Clindamycin 2% cream should be used for women allergic to metronidazole and those breastfeeding.
Women's health
Gina Johnson, Ian Hill-Smith, Chirag Bakhai in The Minor Illness Manual, 2018
The two commonest causes of abnormal vaginal discharge in primary care are bacterial vaginosis (BV) and candida. BV is more common than candida but under-diagnosed, candida is over-diagnosed and over-treated. Microscopy is the most reliable way to make a diagnosis, but it is unlikely to be available in primary care. Caused by an overgrowth of anaerobic bacteria in the vagina at the expense of the normal commensal lactobacteria. A change in pH or hormone balance, or a course of broad spectrum antibiotic, may trigger yeast multiplication and symptoms. Heavy Menstrual Bleeding is a common problem; in 50% of women, no underlying cause can be found. Possible diagnoses include fibroids and endometriosis. Vomiting and persistent, severe diarrhoea can interfere with the absorption of combined oral contraceptives. A woman whose period is due when she is on holiday, or taking part in a religious or sporting event, may request medication to delay her period.
Sexually transmitted infections
Sarah Bekaert in Women's Health, 2018
This chapter covers the more common sexually transmitted infections (STIs), and outlines their symptoms, how they are transmitted and the treatment available. STIs can be transmitted by penetrative sex, oral sex and digitally. Anogenital warts are the commonest viral STI diagnosed at genitourinary medicine clinics. It usually takes 1 to 3 months from the time of infection for warts to appear. Genital chlamydial infection is an important reproductive health problem, because 10–30% of infected women develop pelvic inflammatory disease (PID), which if left untreated can cause fertility problems and chronic pain. Sexual intercourse can alter the pH of the vagina, which thrush and bacterial vaginosis may then colonise. Sexual activity can introduce bacteria to the urethra in both men and women, causing cystitis. Episodes of cystitis are often associated with the onset of sexual intercourse, and women who have regular intercourse have three to four times as many episodes of infection per year as women who are not having intercourse.
Bacterial vaginosis: a primer for clinicians
Published in Postgraduate Medicine, 2019
Suzanne Reiter, Susan Kellogg Spadt
Bacterial vaginosis (BV) affects approximately one third of women in the United States. While often asymptomatic, BV infection may be accompanied by serious health consequences, such as preterm birth and pelvic inflammatory disease, and may facilitate acquisition of sexually transmitted infections. Identifying appropriate patients for screening, such as pregnant women, women planning pregnancy, and women with multiple and/or new sexual partners, is imperative for treatment. Diagnosis of BV has traditionally depended on the presence of vaginal discharge and odor, elevated pH, and clue cells as determined by microscopy, but newer diagnostic modalities that utilize molecular techniques allow for more convenient and accurate testing for BV. Approved treatment options consist of antibiotics administered as oral or intravaginal formulations. Patient counseling and education regarding treatment options, including adherence to prescribed treatments, appropriate hygienic practices, and treatment of symptomatic same-sex partners, are crucial to optimize patient outcomes and prevent recurrence.
Bacterial vaginosis: an update on diagnosis and treatment
Published in Expert Review of Anti-infective Therapy, 2009
Hans Verstraelen, Rita Verhelst
Bacterial vaginosis is the most common cause of vaginal complaints. Bacterial vaginosis is further associated with a sizeable burden of infectious complications. Diagnosis relies on standardized clinical criteria or on scoring bacterial cell morphotypes on a Gram-stained vaginal smear. A few point-of-care tests have not gained footage in clinical practice, but molecular diagnosis is now pending. Treatment remains cumbersome and clinicians are currently rather poorly armed to treat bacterial vaginosis in the long run. As an adjuvant to standard treatment with antibiotics, alternative treatments with antiseptics and disinfectants, vaginal-acidifying and -buffering agents, and probiotics hold some promise for long-term prevention.
Comparative efficacy of probiotic yoghurt and clindamycin in treatment of bacterial vaginosis in pregnant women: A randomized clinical trial
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2012
Sedigheh Hantoushzadeh, Fateme Golshahi, Pouya Javadian, Soghra khazardoost, Shahnaz Aram, Shahrzad Hashemi, Bahare Mirarmandehi, Sedigheh Borna
Objective: This study was performed to determine the comparative efficacy of probiotic yoghurt and clindamycin in the treatment of bacterial vaginosis in pregnant women in the third trimester. Methods and materials: This randomized clinical trial was performed as an open-label study. 310 symptomatic patients with BV were recruited. Diagnosis of BV was through Amsel criteria. The patients were randomly assigned to receive either probiotic yoghurt (100 g twice a day/week) or orally administered clindamycin (300 mg twice a day/week). Results: Ten patients in probiotic group and 9 subjects in clindamycin group had symptom recurrence (p > 0.05). 132 patients in probiotic group and 105 subjects in clindamycin group had pH decrease (p 0.05). Twelve patients in probiotic group and seven subjects in clindamycin group had preterm birth. Nine women in probiotic group and five subjects in clindamycin group had PROM (p > 0.05). Conclusions: According to the obtained results, it may be concluded that probiotics would have a good efficacy in the treatment of bacterial vaginosis in pregnancy leading to decreased burden of subsequent preterm birth.
Related Knowledge Centers
- Bacterial Infections
- Vagina
- Trichomoniasis
- Trichomonas Vaginalis
- Vaginitis
- Douche
- Yeast Infection