Seunga (Jasmine) Han, PharmD Student
In our previous articles, we have discussed potential causes of abnormal vaginal discharge. So far, we’ve covered yeast infections and trichomoniasis. Along with the aforementioned causes, bacterial vaginosis is another potential explanation for abnormal discharge.
What is bacterial vaginosis?
Bacterial vaginosis is an infection of the vulva and vagina and isn’t usually sexually transmitted. It’s one of the most common cause of vaginal discharge.
What are the symptoms?
Unlike trichomoniasis and vaginal yeast infections, bacterial vaginosis doesn’t involve itchiness or inflammation in the vagina. Bacterial vaginosis involves:
- Copious amounts of vaginal discharge that is grey or milky, and thin.
- Fishy odour.
However, it’s been reported that 50% of individuals with bacterial vaginosis are asymptomatic.
How do you treat it?
- Symptomatic women, including women with HIV and pregnant women, should be treated with oral or intravaginal metronidazole, or intravaginal clindamycin, as first-line treatments.
- Women should abstain from sex or use condoms consistently during treatment, but routine treatment of sex partners is not needed because bacterial vaginosis (BV) is not sexually transmitted.
- Use of Lactobacillus-containing probiotics, either orally or intravaginally, might increase eradication rates and reduce recurrence rates of BV in non-pregnant women.
- Treatment of asymptomatic BV may be warranted before hysterectomies to prevent BV-associated posthysterectomy vaginal-cuff cellulitis.
If you’re experiencing the symptoms mentioned above and are suspecting bacterial vaginosis, you must go seek help from a physician. In Canada, first-line treatment requires a prescription antibiotic – either oral or intravaginal metronidazole, or intravaginal clindamycin. As mentioned in our previous article, it’s important to avoid alcohol consumption during and for 24 hours after completion of metronidazole treatment. Some other side effects of metronidazole include upset stomach and dark-coloured urine.
While oral metronidazole and clindamycin may be used at any stage of pregnancy, intravaginal metronidazole and clindamycin are not recommended in pregnancy due to potentially negative outcomes for the fetus.
Since bacterial vaginosis is usually not sexually transmitted, treatment of sexual partners isn’t necessary. Abstinence until completion of treatment or use of condoms is recommended for the duration of treatment.
We hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
RESOURCES
- RxTx
- DynaMed Plus
- Public Health Agency of Canada. (2013, February 01). Section 4-8: Canadian Guidelines on Sexually Transmitted Infections – Management and treatment of specific syndromes – Vaginal discharge. Retrieved November 5, 2018, from https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/sexually-transmitted-infections/canadian-guidelines-sexually-transmitted-infections-26.html
