BV/Thrush

BACTERIAL VAGINOSIS

Many women don’t know that vaginal infections are most commonly caused by bacteria rather than yeast (in the case of thrush) and trichomoniasis (a sexually transmitted infection).

BV is the most common cause of vaginal infections in women of childbearing age and is caused by certain bacteria leading to a pH imbalance in the vagina. Most people experience symptoms such as: • Fishy or unpleasant odour • Watery discharge • Greyish white looking discharge • Worsening of the above after sex or during your period Everyone is different, so some women who have BV may not suffer from any symptoms. BV is not a sexually transmitted infection and it should not cause any soreness or irritation.

Thrush or BV?

Many women mistake BV for thrush, but they are two different infections with different symptoms. Because BV treatment is different to thrush treatment, it’s important to know which infection it is, so that the right product can be recommended.

Self-test kits are available so that women can quickly and reliably determine if they have thrush or BV from the comfort of their own home.

The Vagina

The vagina is normally acidic, which helps prevent bad bacteria from growing and maintains the level of good bacteria called lactobacillus. If the pH balance becomes less acidic however, this can affect the health of the vagina. Different factors can affect the pH balance of the vagina, including menstruation, taking antibiotics, over-washing, using an IUD and semen if you sex has taken place without a condom. The imbalance of pH can be accompanied by overgrowth of anaerobic organisms that replace normal lactobacilli, causing BV. The vagina contains a natural balance of microorganisms which help keep the physiological environment in the vagina. This balance of microorganisms is known as vaginal flora. Lactobacilli make up the majority of vaginal flora. Many factors can disrupt the level of lactobacilli in the vagina including antibiotics, hormonal changes and lifestyle factors (e.g. tight clothing, synthetic underwear or washing with harsh soaps and shower gels in the intimate area) which can cause vaginal infections. Maintaining an optimal level of lactobacilli in the vagina is important to help protect against vaginal infections as lactobacilli create a protective barrier over the walls of the vagina, and help to maintain an optimal pH.

Pregnancy and BV

Pregnancy can cause an increase of bad bacteria and lead to problems like a BV infection. Pregnant women should visit their GP to discuss management of BV. It’s best to get checked out as BV can cause complications such as:

• Pelvic inflammatory disease • Increased risk of miscarriage • Increased risk of premature labour

Treating BV

For some women, the first course of antibiotic treatment doesn’t treat BV effectively.

Vaginal pH correction treatments

Vaginal pH correction treatments are a relatively new way of treating BV. These usually involve applying a pessary or gel to the inside of the vagina that changes the acid balance, making it a less hospitable environment for harmful bacteria. Some BV gels also relieve the unpleasant odour and abnormal discharge and come in applicator tubes for ease of use. The recurrence rate of BV with antibiotics can be high. BV gels can provide an effective alternative to antibiotics for treatment and prevention.

Once a woman has been diagnosed with BV, either by self testing or by their doctor, it can usually be successfully treated using a short course of antibiotic tablets or a gel to be applied inside the vagina, which works by helping to regulate the pH balance.

Antibiotics

Metronidazole is the most common antibiotic treatment for BV. It is available as tablets to be taken twice a day for five to seven days, a single larger-dose tablet, or a gel to apply inside the vagina once a day for five days Side effects - Metronidazole can cause nausea, vomiting and a slight metallic taste in the mouth. It is best taken after after eating. Women should be advised not to drink alcohol while taking metronidazole and for at least 48 hours after finishing the course of antibiotics. Drinking alcohol while taking this medicine can cause more severe side effects.

Preventing BV

It is common for BV to return. More than half of women successfully treated with BV find their symptoms return. Women should be advised to:

• avoid using deodorants or perfumed products in and around the vaginal area • Avoid over-washing • Avoid using strong detergent to wash underwear

• Change their tampons or pads frequently • Ensure they wipe from front to back after going to the toilet • Dry their vaginal area after washing, swimming or exercise • Change their underwear after swimming or exercise

WWho? Women of childbearing age, particularly those who are

sexually active

WWhat are the symptoms? Fishy or unpleasant smelling vaginal

discharge, sometimes greyish or watery. Remember that around half of women with bacterial vaginosis have no symptoms

HHow long have they had the symptoms? Women who have frequent

episodes of BV should be advised to see their GP

AAction already taken? Women may have tried washing the area, to

remove the odour, but over-washing can make the problem worse

MMedication? BV is more common in women who use a

IUD for contraception