YOUR BODY, YOUR HEALTH - UNDERSTANDING BACTERIAL VAGINOSIS

BACTERIAL VAGINOSIS is a common vaginal infection which is described by imbalance in the vaginal natural microbiota.It is different from other infections where BV presents asymptomatic conditions making it difficult to diagnose without clinical evaluation. The reported prevalence of this varies widely from 5% to 50% linking different populations. 1 in 3 women will have BV in their lifetime”.G. vaginalis, Bacteroides (Prevotella) spp., Mobiluncus spp., and Mycoplasma hominis are commonly associsted organisms in BV. Lactobacillus plays a crucial role in maintaining vaginal health by creating an acidic environment, producing hydrogen peroxide and competing with harmful bacteria. In bacterial vaginosis (BV) there is a decrease in Lactobacillus species, leading to an imbalance in the vaginal microbiota. The production of lactic acid by the epithelium and bacterial metabolism causes the vaginal pH to drop to 4.0 to 4.5.

RECOGNIZING THE SYMPTOMS: SIGNS YOU SHOULDN'T IGNORE:

Bacterial vaginosis often presents with a wide range of disagreeable and unsettling symptoms. One of the most common symptoms is unusual vaginal discharge, which can appear thin, grey, white, or green and is often more abundant than usual. Another telltale sign of this illness is an overwhelming, horrible smell, particularly after sex, that is similar to fish.

Common symptom for women is persistant vaginal itching, which is extremely uncomfortable around the vaginal exterior and it worse on urination which is another indication. Further  some may feel discomfort on sexual activity. Though these could be predictions but BV will not show all these signs making it difficult to diagnose.

DIAGNOSIS OF BACTERIAL VAGINOSIS:

Bacterial vaginosis (BV) is diagnosed by a combination of microscopic examination laboratory testing and clinical criteria. Doctors look for clue cells on microscopy thin white vaginal discharge a positive whiff test indicating a fishy odor and a vaginal pH above 4 points. A Gramme stain to calculate the Nugent score and DNA probe testing or NAAT to detect Gardnerella vaginalis are two diagnostic methods that can validate the diagnosis. A thorough medical history and physical examination are also required to rule out additional potential causes of vaginitis. As antibiotics clindamycin or metronidazole are typically used.

TRADITIONAL TREATMENTS FOR BACTERIAL VAGINOSIS:

* METRONIDAZOLE:

The preliminary antibiotic for BV is metronidazole which works better than amplicillin. Research shows that it considerably increase the levels of lactic acid and lactobacilli count. So as the efficacy this is advised as initial line treatment for bacterial vaginosis.

*CLINDAMYCIN:

Some concerns of metronidazole it paved wa for the alternative treatment which is clindamycin. When treating BV, it exhibits short-term failure rates comparable to those of oral metronidazole. Some may experience non bloody diarrhoea, possibly as a result of Clostridium difficile. intravaginal clindamycin cream—especially at higher concentrations—is noticeably more successful than placebo and promotes lactobacilli recolonization.

*RIFAXIMIN:

48% of the cases can be cured by rifaximin vaginal pills which is used for 5 days. Rifaximin raises the content of lactic acid and the ratio of Lactobacillus species to BV-related bacteria.
The metabolites that are normally produced by bacteria related to BV are reduced as a result of treatment.

*LACTATE GEL:

Lactate gel therapy for BV has received more attention recently. This product contains lactic acid and growth substrates for lactobacilli that are buffered at pH 3.5 to 3.8. It demonstrated the same level of effectiveness as oral metronidazole at a one-week follow-up (3).  A flora dominated by lactobacillus reappeared in eleven pregnant women who received intermittent lactate gel treatment.

PREVENTION AND MANAGEMENT:

Controlling and Avoiding Bacterial Vaginosis (BV). In order to prevent the disruption of the vaginal flora it is important to limit the number of sexual partners refrain from douching and practice good vaginal hygiene in order to prevent bacterial vaginosis (BV). Treatment for BV usually entails the use of oral or topical antibiotics such as metronidazole or clindamycin. Even if symptoms improve its crucial to finish the entire course of antibiotics as prescribed. Since recurrences are frequent further care might be required. Additional strategies to preserve vaginal health and prevent recurrence include probiotics and lifestyle changes like using condoms and avoiding irritants. Effective management requires routine physical examinations as well as honest discussion about symptoms and available treatments with medical specialists. To help control the condition patients should be informed about BV and encouraged to seek treatment as soon as symptoms manifest.

REFERENCE:

• Redirect notice, Google. Available at: https://www.google.com/url?sa=i (Accessed: 22 June 2024). Bacterial vaginosis.

• Livengood C. H. (2009). Bacterial vaginosis: an overview for 2009. Reviews in obstetrics & gynecology, 2(1), 28–37.

• Tomás, M., Palmeira-de-Oliveira, A., Simões, S., Martinez-de-Oliveira, J., & Palmeira-de-Oliveira, R. (2020). Bacterial vaginosis: Standard treatments and alternative strategies. In International Journal of Pharmaceutics (Vol. 587, p. 119659). Elsevier BV. https://doi.org/10.1016/j.ijpharm.2020.119659