How is Bacterial Vaginosis Diagnosed and Treated?

By Elizabeth Stannard Gromisch HERWriter

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Bacterial vaginosis is a type of infection caused by an imbalance of the bacteria in the vagina. Normally, there is a balance between the good bacteria (lactobacilli) and bad bacteria (anaerobes). But when the amount of anaerobes in the vagina throws off the balance, bacterial vaginosis occurs.

Symptoms such as a foul-smelling, discolored vaginal discharge and burning during urination may happen with bacterial vaginosis. However, more women have asymptomatic bacterial vaginosis. As many as 84 percent of women with the infection report not having any symptoms, according to the Centers for Disease Control and Prevention.

Diagnosing bacterial vaginosis will involve a physical examination and laboratory tests. Before starting the pelvic examination, the health care provider will ask about the woman’s medical history, including if she has a history of sexually transmitted diseases or vaginal infections.

During the pelvic examination, the health care provider will examine the woman’s external and internal genitalia. The external genitalia examination involves the woman putting her feet into stirrups to spread apart her legs, so that the health care provider can visually check for signs of infection.

To internally examine, the health care provider will put on a glove, and insert two fingers into the vagina. With her other hand, she will press down on the woman’s abdomen. This allows her to check the woman’s pelvic organs.

To test for an abnormal balance of bacteria in the vagina, the health care provider will need to take a sample of the woman’s vaginal secretion to send for laboratory tests.

Another test she may do is an acidity test. With this test, the health care provider inserts a pH test strip in the woman’s vagina, testing for how acidic her vagina is.

If the pH of her vagina is 4.5 or higher, it is an indicator of bacterial vaginosis, according to the MayoClinic.com.

Antibiotics are the medications of choice for treating bacterial vaginosis. The U.S. Department of Health and Human Services Office on Women’s Health noted that women may be prescribed clindamycin or metronidazole.

Both pregnant and non-pregnant women can receive these medications. However, the Centers for Disease Control and Prevention noted that the dosages they receive will differ.

Women prescribed clindamycin, which is a cream, will insert it for seven days in their vagina. This treatment can weaken latex condoms, with the effects lasting up to five days post-use.

Metronidazole is available as an oral antibiotic, taken twice daily over seven days, or a gel, inserted into the vagina for five to seven days. This treatment may cause nausea or abdominal pain. The MayoClinic.com recommended avoiding alcohol while on metronidazole to avoid these side effects.

While clindamycin and metronidazole are popular choices for treating bacterial vaginosis, tinidazole is a third option. An oral medication, tinidazole is taken once a day.

The duration of treatment, which is two to five days, depends on the strength of the particular prescription. Like metronidazole, tinidazole may cause nausea.

While bacterial vaginosis is treatable, it can recur.

References

Centers for Disease Control and Prevention. Bacterial Vaginosis Statistics. Web. 25 June 2012.
http://www.cdc.gov/std/bv/stats.htm

U.S. Department of Health and Human Services. Bacterial Vaginosis Fact Sheet. Web. 25 June 2012
http://www.womenshealth.gov/publications/our-publications/fact-sheet/bacterial-vaginosis.cfm

Centers for Disease Control and Prevention. Bacterial Vaginosis. Web. 25 June 2012
http://www.cdc.gov/STD/bv/STDFact-Bacterial-Vaginosis.htm

MayoClinic.com. Bacterial Vaginosis. Web. 25 June 2012
http://www.mayoclinic.com/health/bacterial-vaginosis/DS01193/METHOD=print

Reviewed June 26, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.