Bacterial Vaginosis: Causes, Symptoms, Treatment and Cost

A bacterial imbalance in the vagina causes a specific kind of vaginal illness known as bacterial vaginosis. It is not a sexually transmitted infection, but it can increase a woman’s risk for acquiring sexually transmitted infections, including HIV.

• Acute Bacterial Vaginosis: This type of bacterial vaginosis is caused by an increase in the number of normal vaginal bacteria, including Gardnerella vaginalis, Prevotella species, and other anaerobic organisms.
• Chronic Bacterial Vaginosis: Chronic BV occurs when symptoms persist or recur for over a month.
• Recurrent Bacterial Vaginosis: Recurrent BV is defined as having four episodes within a year.

Bacterial vaginosis is caused by an alteration in the normal balance of bacteria in the vagina (BV).The cause of this imbalance is unknown, but may be related to:

• Sexual activity
• Changes in hormones
• Douching
• Certain types of birth control.
• Other potential contributing factors are:
• Poor vaginal hygiene
• Wearing tight or synthetic clothing which traps moisture near the genitals.

• Vaginal discharge that smells strongly like fish.
• Grey or white discharge.
• Burning or itching sensation in the vagina.
• Painful urination
• Pain during intercourse.

• Avoid douching and scented hygiene products.
• Change tampons and pads regularly.
• Wear cotton underwear and loose-fitting clothing.
• Clean the genital area properly, but avoid scrubbing or using harsh soaps.
• Use condoms during sexual activity.
• Limit sexual partners to reduce risk of contracting STDs.

• Physical exam: The doctor may check the genitals for warts, sores, discharge, or other signs of infection.
• Vaginal cultures: The doctor may take a sample of the discharge and send it off to a lab to be tested to see which bacteria is causing the infection.
• pH Test: The doctor may use a swab to get a sample of the vaginal fluids and then measure their acidity (pH). A higher than normal acidity could indicate an infection such as BV.
• Vaginal swab test: A vaginal swab test is done using a cotton swab on the walls of the vagina or on the cervix (the opening between the uterus and vagina) that will allow for testing for certain bacteria associated with BV.
• Pap smear test: It is done by taking cells from the vagina or cervix which are sent off for laboratory testing. Results from this test can help diagnose infections caused by certain bacteria and viruses including BV, HPV, chlamydia, gonorrhea and others.
• DNA amplification tests such as polymerase chain reaction (PCR): These tests are used to detect specific DNA sequences that are associated with bacterial organisms that cause BV like Gardnerella vaginalis.
• Wet Mount Testing: This test involves looking at cells under the microscope; if there are an abnormal amount of white blood cells, then BV is likely.
• Microscopy: This involves analyzing cells or other particles using a microscope; to diagnose BV, an increase in particular bacteria (Gardnerella vaginalis) can indicate BV.

• Long-term Bacterial Vaginosis can make a woman more likely to get gonorrhoea and chlamydia, which are sexually transmitted diseases.
• Pelvic inflammatory disease might arise from it (PID).
• Pelvic organ prolapse can occur if the bacteria travel upwards through the vagina into the uterus, fallopian tubes, or bladder.
• Individuals who have BV have an increased risk of contracting HIV if they engage in unprotected sexual activity with a partner who is already infected with the virus.
• Bacterial Vaginosis also increases the risks of preterm labor and postpartum endometritis during childbirth.

• Drink plenty of water and fluids: Maintaining a healthy level of hydration helps to promote vaginal health and clean out harmful toxins.
• Maintain a healthy diet: Eating a balanced diet with plenty of probiotics, such as yoghurt and sauerkraut, helps to maintain the balance of healthy bacteria in the vagina.
• Use garlic: Since it naturally inhibits the growth of fungi and bacteria, garlic is a useful weapon in the battle against BV.
• Try tea tree oil: Because of its antimicrobial characteristics, tea tree oil may be useful in the fight against the bacteria that cause BV.
• Practice good hygiene: Washing the genital area with warm water and mild soap can help prevent the spread of infection-causing bacteria.

• Eat more probiotic-rich foods such as yogurt, kefir, kimchi, sauerkraut, tempeh, and miso.
• Eat a lot of foods that are high in prebiotics, such as apples, artichokes, bananas, asparagus, garlic, and onions.
• To ensure you receive the required amounts of vitamins and minerals, include a variety of fruits and vegetables in your diet.
• In order to consume more omega-3 fatty acids, increase your intake of fish and flaxseeds.
• Drink plenty of water to help the body cleanse toxins and pathogens.

• Avoid sugary and processed foods: These foods can cause an imbalance in the body’s natural pH, which can lead to an increase in bad bacteria.
• Avoid alcohol and caffeine: Both of these can dehydrate the body, which can reduce the amount of healthy bacteria in the vagina.
• Avoid scented products: These products may contain chemicals that irritate the delicate tissues of the vagina and upset its natural balance of bacteria.

• Make lifestyle changes: Keep a balanced diet, dress comfortably in cotton, refrain from douching, and lower your stress levels.
• Medications: Treatment for bacterial vaginosis often involves the use of medications. The primary objectives of treatment are to eradicate the bacterial overgrowth and return the vaginal environment to normal.
• Use probiotics: Probiotics help cure and prevent BV by slowing the development of problematic bacteria in the vagina.
• Boric acid suppositories:A naturally occurring chemical with antibacterial and antiseptic qualities is called boric acid. It can be inserted into the vagina to help reduce the number of bacteria in the area and treat bacterial vaginosis.
• Laser Treatment: In cases where other treatments fail, laser treatment may be used to destroy bacteria that cause bacterial vaginosis.

It is advised to speak with a doctor who focuses in treating gynaecological issues for the best outcomes.

• Antibiotics: These drugs work by killing bacteria that cause Bacterial Vaginosis, such as Metronidazole, Tinidazole, and Clindamycin.
• Antifungals: These drugs help to reduce the growth of yeast that can cause Bacterial Vaginosis, such as Fluconazole and Miconazole.
• Topical Ointments: These ointments can help to reduce the symptoms of Bacterial Vaginosis, such as Miconazole cream or Clindamycin cream.

Generally, it can take anywhere from a few days to a couple of weeks for symptoms to clear up completely.

No, the results of the therapy are not long-lasting.

Treatment typically helps reduce symptoms and improve quality of life, but it does not provide a cure.

Depending on the condition being treated, treatments may need to be ongoing or repeated, and some conditions may require lifestyle changes in order to maintain the effects of treatment over time.

• Post-treatment guidelines for bacterial vaginosis include the following:
• Avoid douching.
• Use condoms during sex to help prevent reinfection.
• To keep the area dry and prevent irritation, use loose-fitting clothing and cotton underwear.
• Even if you begin to feel better before the medication course is up, always finish the course of medication that your doctor has prescribed for you.
• Avoid any sexual contact until your partner has been treated as well, even if you are no longer experiencing symptoms.
• After three months, you should have another test to confirm that the infection is gone and to determine whether or not your spouse needs treatment as well.

Generally, medications such as antibiotics, antifungals, or probiotics will range from ₹150 to ₹500 for a single course of treatment.

Some treatments may require multiple courses and can cost up to ₹1,000.

Other treatments such as laser therapy may cost up to ₹15,000.

Common side effects are:

• Nausea
• Vomiting
• Headache
• Abdominal pain.
• Other side effects may include:
• Itching
• Burning
• Vaginal discharge.
• Occasionally, certain BV medications might lead to allergic reactions or skin rashes.
• After antibiotic therapy, some women report an increase in vaginal discharge and a mild burning or stinging sensation.

In some cases, the symptoms of BV may worsen after treatment with antibiotics due to the overgrowth of other organisms in the vagina.

If you have issues related to Bacterial Vaginosis, you should see a doctor near you because it can lead to problems like 'STD, PID, and pelvic organ prolapse,' which can take anywhere from a few months to years to treat, depending on how bad the problem is.