What is bacterial vaginosis?

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FAQ

Bacterial vaginosis (BV) is a vaginal infection that occurs when the beneficial lactobacilli, which make up the predominant part of the vaginal microbiota, are outgrown by harmful anaerobic bacteria such as Gardnerella vaginalis, and other bacteria that cause BV.

BV is the most common vaginal infection. On a global scale, one third of women of reproductive age are affected by bacterial vaginosis.

The most common symptom is a characteristic and strong malodor, resembling that of fish. The smell arises when the vaginal pH increases, for example after unprotected sexual intercourse or in connection with menstruation. Another common symptom is abnormal vaginal discharge, which may be thin and have a yellow to gray color. For many women the symptoms vary over time, but more than half of all women with BV don’t experience symptoms.

Bacteria are naturally present in the vagina, both protective lactobacilli and other bacteria that are a part of ahealthy vaginal microbiota. Lactobacilli produce lactic acid and small amounts of hydrogen peroxide, which are important components in the defense against harmful bacteria and fungi. If the vaginal environment is altered and harmful bacteria colonize the vagina, there is a shift in balance and the beneficial lactobacilli decreases, which may result in an infection such as bacterial vaginosis. Within hours, the abnormal ”fishy” smelling discharge appears.

Despite the ongoing research investigating the underlying causes of bacterial vaginosis, there are currently no known methods  to completely prevent BV However, you can reduce the risk:

– Use a condom or dental dam, especially when having sex with a new partner.

– Avoid so-called vaginal douches and do not use soap inside the vagina, doing so could harm the good bacteria that are part of the vaginas own natural defense.

Bacterial vaginosis can be diagnosed through a gynecological examination. The gynecologist or midwife performs a whiff test* and collects a swab with vaginal fluid, which is then microscopically examined for BV indicators.  In addition, home test kits, that are often used by inline healthcare providers, are available in pharmacies and on online shops.

 * A whiff test is performed by adding a droplet of potassium hydroxide to a sample of vaginal fluid. Potassium hydroxide elevates pH, and if the patient has bacterial vaginosis, the characteristic fishy odor will appear .

Bacterial vaginosis is not classified as a sexually transmitted infection (STI). However, there is a clear connection between the diagnosis and various sexually transmitted diseases such as chlamydia, gonorrhea, and HIV. The natural defenses of the vagina, based on lactic acid and hydrogen peroxide, is deteriorated during bacterial vaginosis, making you more susceptible to infections and inflammation. It is imperative to treat the underlying infection and restore the natural defenses to avoid further complications such as sexually transmitted diseases and infections.

During pregnancy, an ongoing bacterial vaginosis increases the risk of miscarriage, premature birth, and low birth weight. Therefore, treatment is especially crucial for pregnant women.

Traditionally, bacterial vaginosis has been treated with antibiotics, either administered systemically, as capsules that are swallowed, or locally, as vaginal creams, pessaries, or so-called antiseptics. Bacterial vaginosis may recur even after antibiotic therapy.

Unfortunately, antibiotic therapy also impacts the individual’s own natural and protective bacteria. In addition to the harmful bacteria that the treatment is intended to target, it also kills the beneficial lactobacilli. This causes further imbalance in the microbiotic flora of the vagina, which can lead to vaginal fungal infections resulting in itching, burning, and even more discharge.

Vernivia vaginal mousse is a new over-the-counter treatment that inhibits the harmful bacteria and at the same time increases the number of protective lactobacilli. Read more here.

Traditionally, bacterial vaginosis has been treated with antibiotics, either administered systemically, orally or locally as vaginal creams or vaginal tablet . Antiseptics are sometimes also used.  Sadly, reoccurrence of Bacterial vaginosis is common, even after antibiotic therapy.

Unfortunately, antibiotic therapy not only treats the infection, but it also impacts the bodies’ own natural and protective bacteria. The intended treatment negatively impacts   the beneficial lactobacilli, causing further imbalance of the vaginal microflora. In turn, antibiotic treatments could lead to vaginal candidiasis with concomitant itching, burning, and abnormal discharge.

Vernivia vaginal mousse is a novel over-the-counter treatment that inhibits the harmful bacteria and at the same time increases the number of protective lactobacilli. Read more here.

Unfortunately, antibiotic therapy also impacts the individual’s own natural and protective bacteria. In addition to the harmful bacteria that the treatment is intended to target, it also kills the beneficial lactobacilli. This causes further imbalance in the microbiotic flora of the vagina, which can lead to vaginal fungal infections resulting in itching, burning, and even more discharge.

Vernivia vaginal mousse is a new over-the-counter treatment that inhibits the harmful bacteria and at the same time increases the number of protective lactobacilli. Read more here.

One out of three women of reproductive age experience bacterial vaginosis Treat with Vernivia vaginal mousse

Shame, silence, and suffering

To this day, malodorous vaginal discharge remains a taboo subject. The characteristic fish-like of BV odor is often misinterpreted as a sign of poor intimate hygiene. It is not uncommon that women affected by BV feel embarrassed to the degree that they withdraw from partners and avoid social activities. Women actively attempt to disguise or extensively wash away the smell, however such activities often worsen the intimate issues. 

According to a survey performed by SIFO, (the largest company in Sweden, performing surveys and media-opinion polls) one out of four women aged 18 to 29 have never heard of bacterial vaginosis, despite bacterial vaginosis being the most common vaginal infection, affecting one out of three women of reproductive age.

We believe that the time has come for women to find the courage, and to start talking openly about vaginal discharge and intimate problems. By spreading knowledge, we can contribute to an improved vaginal health. Furthermore, we think it is as important to convey women’s own stories of BV. For this reason, we have gathered quotes from a clinical study where 35 women with bacterial vaginosis were interviewed about how BV have impacted their lives:

Well definitely I did keep a distance away from my friends. I didn’t want them to sit very close to me. Yeah the smell it’s, is embarrassing. Yeah I still go out but I make sure that I wash myself before I go out and really keep an eye on it and don’t stay out too long (Participant 35, age 30).

…it was always worse after sex as well, the smell was always worse, and so, it’s not just the kind of dealing with the odour in the moment, but there’s afterwards and I think, you know, the semen pH changes everything and, and, um, even if he didn’t ejaculate inside me there was still [a] really strong, noticeable smell afterwards which is another disincentive (Participant 7, age 39).

…I guess at this current moment the stress to me, or the, um, the difficulty is uncertainty as to how BV might relate to fertility issues and childbirth issues (Participant 22, age 28).

…it’s an unpleasant smell that’s sort of, it’s the kind of thing people joke about, like having a bad smelling vagina (laughs) is not really an attractive attribute (laughs). It’s like, ‘Oh yeah, I’m that woman’ (laughs) (Participant 1, age 25).

References

  1. Bilardi et al 2013: The burden of bacterial vaginosis.
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