Bv

Bacterial Vaginosis
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Vaginal discharge, fishy odor, itching
Complications	Increased risk of STIs, pregnancy complications
Onset
Duration
Types	N/A
Causes	Imbalance of vaginal bacteria
Risks	Multiple sexual partners, douching
Diagnosis	Clinical examination, laboratory tests
Differential diagnosis	N/A
Prevention	N/A
Treatment	Antibiotics
Medication	N/A
Prognosis	N/A
Frequency	Common
Deaths	N/A

Bacterial Vaginosis (BV) is a common vaginal condition caused by an imbalance in the normal bacterial flora of the vagina. It is characterized by a shift in the vaginal microbiota, where there is a decrease in Lactobacillus species and an overgrowth of other types of bacteria, particularly anaerobic bacteria.

Epidemiology

Bacterial Vaginosis is the most common cause of vaginal discharge among women of childbearing age. It is estimated that BV affects approximately 29% of women in the United States. The prevalence of BV varies globally and is influenced by factors such as sexual behavior and hygiene practices.

Pathophysiology

The normal vaginal flora is predominantly composed of Lactobacillus species, which help maintain a low pH environment by producing lactic acid. In BV, there is a reduction in Lactobacillus and an increase in anaerobic bacteria such as Gardnerella vaginalis, Atopobium vaginae, and Mobiluncus species. This shift leads to an increase in vaginal pH and the characteristic symptoms of BV.

Risk Factors

Several factors can increase the risk of developing BV, including:

• Having multiple or new sexual partners
• Douching
• Smoking
• Lack of condom use
• A history of sexually transmitted infections (STIs)

Clinical Presentation

The most common symptoms of BV include:

• Thin, white or gray vaginal discharge
• A strong fishy odor, especially after sexual intercourse
• Vaginal itching or irritation
• Burning sensation during urination

However, some women with BV may be asymptomatic.

Diagnosis

Diagnosis of BV is typically made based on clinical criteria known as Amsel's criteria, which include:

• Homogeneous, thin, white discharge that smoothly coats the vaginal walls
• Presence of clue cells on microscopic examination
• Vaginal fluid pH greater than 4.5
• A fishy odor of vaginal discharge before or after adding 10% potassium hydroxide (KOH), known as the "whiff test"

Alternatively, BV can be diagnosed using the Nugent score, a scoring system based on the microscopic evaluation of a Gram-stained vaginal smear.

Complications

BV is associated with several complications, including:

• Increased susceptibility to STIs, including HIV
• Complications during pregnancy, such as preterm birth and low birth weight
• Pelvic inflammatory disease (PID)

Treatment

The primary treatment for BV is antibiotics. The most commonly prescribed antibiotics include:

• Metronidazole (oral or vaginal gel)
• Clindamycin (vaginal cream or oral)

It is important for patients to complete the full course of antibiotics even if symptoms resolve. Recurrence of BV is common, and additional treatment or lifestyle modifications may be necessary.

Prevention

Preventive measures for BV include:

• Avoiding douching
• Limiting the number of sexual partners
• Using condoms during sexual intercourse
• Maintaining good vaginal hygiene

See Also

• Vaginitis
• Sexually transmitted infection
• Pelvic inflammatory disease

External Links

• [CDC - Bacterial Vaginosis](https://www.cdc.gov/std/bv/default.htm)
• [Mayo Clinic - Bacterial Vaginosis](https://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279)