Bacterial Vaginosis

Bacterial vaginosis: symptoms, diagnosis and treatment

Bacterial vaginosis (BV) is a disorder of the vaginal microbiocenosis, characterized by a decrease in the number of lactobacilli and an increase in the number of opportunistic microorganisms, mainly Gardnerella. This disease is one of the most common gynecological diseases and occurs in 15-20% of women.

The main symptoms of bacterial vaginosis are an unusual vaginal discharge with an unpleasant odor that may resemble a fishy odor. The discharge is usually white, thick and sticky, and may foam. Some women may have additional symptoms such as itching and dysuria.

The diagnosis of bacterial vaginosis is established based on the presence of at least three of the following signs: grayish discharge, vaginal discharge pH greater than 4.5, the presence of clue cells in native vaginal discharge smears, and a positive amino test. Additional signs may be a very small number of lactobacilli and leukocytes in the vaginal contents.

Treatment of bacterial vaginosis involves the use of chemotherapeutic agents with an antianaerobic spectrum of activity, such as clindamycin or metronidazole. Treatment may be local or systemic. Local treatment includes the use of vaginal forms of chemotherapy, such as metronidazole gel or Flagyl and Arilin suppositories containing metronidazole. In addition, to prevent candidal vaginitis, it is recommended to prescribe antifungal agents simultaneously with the start of local treatment.

Systemic treatment is based on the use of oral forms of metronidazole or clindamycin for 7 days. It is important to note that the use of clindamycin and metronidazole is contraindicated in the first trimester of pregnancy.

The second stage of treatment is the use of eubiotics, such as acylact or lactobacterin, in the form of vaginal suppositories for 7-10 days. This stage is carried out if the results of testing the vaginal discharge for fungi are negative.

Relapses of bacterial vaginosis can occur in the next 7-10 months after treatment and are observed in 30-60% of patients. To prevent relapses, it is recommended to maintain an optimal balance of vaginal microflora through proper nutrition, avoidance of excessive hygiene and the use of probiotics. It is also recommended to avoid sexual contact until complete recovery and use condoms to prevent re-infection.

In general, bacterial vaginosis is a reversible disease that can be successfully treated if you consult a doctor promptly and follow recommendations for treatment and prevention of relapses. If you suspect that you have bacterial vaginosis, you should consult a gynecologist for diagnosis and treatment.