Bacterial vaginosis

Edited by Eugenio Ciuccetti, Obstetrician

Generality

Bacterial vaginosis is probably the most common vaginal infection among women today.

It is a condition characterized by the alteration of the normal vaginal ecosystem and its pH; that is, an imbalance concerning the microorganisms that, in physiological conditions, populate and defend the vaginal environment itself (the so-called saprophytic flora).

In particular we will have a decrease of Lactobacilli (or Bacillus of Doderlein), usually deputies to keep the vaginal environment slightly acid (a normal vaginal pH is about 4.5), therefore protected from the development of harmful bacteria.

Causes

The real cause of bacterial vaginosis is still the subject of study and investigation. Traditionally the main responsible was identified in the so-called Gardnerella vaginalis and it was believed that its transmission took place mainly through sexual intercourse. This is why a high number of partners was considered an important risk factor. The male sperm among other things modifies the pH of the vagina and hinders the development of the Lactobacilli.

However, more recent studies - without denying the theories of the past - have highlighted a more complex and articulated picture. Today it is therefore more appropriate to suspect that the onset of a Bacterial Vaginosis is linked to the simultaneous interaction of different causes rather than to a single microorganism or behavior.

Risk factors

Among the most significant risk factors should be reported incorrect intimate hygiene (for example, excessive use of lavender), the use of antibiotics or intrauterine mechanical contraceptives such as the spiral, previous pregnancies and a certain genetic predisposition (it seems for example that the black population is statistically more affected). It has also been observed that this pathology is rare both in prepubertal girls and in women after menopause. This can perhaps be attributed to fewer relationships and sexual partners in these two age groups, but also to the characteristic hormonal framework that differentiates them from the fertile period.

Symptoms

To learn more: Vaginal Symptoms

The most frequent symptoms are: the vaginal odor (which women often mistakenly attribute to a simple problem of insufficient personal hygiene) and white-greyish and milky vaginal discharge. The bad smell of spoiled fish is caused by amines like Cadaverina and Putrescina, produced by bacterial metabolism. Rarely however - unlike what happens in Candida or Trichomonas infections - there is a feeling of itching and irritation.

Complications

Bacterial vaginosis - like all vaginal infections - may initially appear as a trivial problem and therefore be ignored or underestimated. On the contrary - also in consideration of the high risk of complications and recurrences - it should always be promptly diagnosed and properly treated.

Otherwise, for example, there will be greater risks of developing later alterations in the cervix or a real pelvic inflammatory disease. In pregnancy then the Bacterial Vaginosis is often associated with early rupture of the membranes and premature births.

Treatment

To learn more: Drugs for the treatment of Bacterial Vaginosis

The therapy - local or intravaginal - must necessarily be prescribed by the doctor. Bacterial vaginosis cannot and should not be treated by doing one's own thing and relying on simple over-the-counter remedies. One of the most widely used drugs in this field is Metronidazole.

Prevention

The prevention of Bacterial Vaginosis - and vaginal infections in general - also passes through some basic hygiene and daily behavior rules. For example, the use of substances with non-acid pH or anti-lactobacillary activity facilitates the infectious process. Irrigations, sanitizing sprays, soaps and perfumed talcs should be avoided.

The irrigations in fact alter the natural saprophytic flora present in the vagina; perfumed talcum powder can produce irritations of the vaginal mucosa.

We should also avoid wearing synthetic underwear as well as jeans and pants that are too tight, such as to retain moisture and heat, creating favorable conditions for the development of harmful microorganisms.

When they finally dry and clean the private parts, you should always perform a movement that goes from the front to the back and not vice versa. This is to avoid the easy and risky transport of bacteria from the rectum to the vagina and thus prevent vaginosis.