Bacterial vaginosis is a vaginal infection caused by an imbalance natural bacteria count (normal flora) in the vagina. Bacterial vaginosis is not a dangerous condition, but it can cause annoying symptoms.
Bacterial vaginosis can be experienced by women at any age. However, most cases of bacterial vaginosis occur when women are in their reproductive years, i.e. ages 15–44 years.
Causes of Bacterial Vaginosis
Bacterial vaginosis occurs due to an overgrowth of certain bacteria that are naturally present in the vagina, thereby disturbing the balance of the number of bacteria in the vagina.
Basically, there are two types of bacteria in the vagina, namely good bacteria and bad bacteria. Good bacteria are bacteria Lactobacillus which serves to limit the growth of bad bacteria by maintaining the normal pH or acidity of the vagina. These bacteria dominate the number of bacteria in the vagina, which is about 95%.
While the bad bacteria that naturally exist in the vagina are anaerobic bacteria. When the number of good bacteria decreases, the growth of anaerobic bacteria will increase, which can cause bacterial vaginosis.
The exact cause of the disruption of the balance of bacterial growth in the vagina is not known for certain. However, there are a number of factors that are thought to increase a woman's risk of developing bacterial vaginosis, namely:
- Experiencing hormonal changes due to menstruation, pregnancy, and menopause
- Smoke
- Have a history of sexually transmitted infections
- Frequently changing sexual partners and not using condoms
- Long term use of antibiotics
- Use of intrauterine contraceptives or intrauterine device (IUD)
- Using laundry soap with harsh chemicals to wash underwear
- Clean the vagina with a water spray or use soaps that can cause irritation to the vagina, such as soaps that contain perfume and antiseptic soaps
- Decreased bacteria Lactobacillus naturally
Symptoms of Bacterial Vaginosis
Bacterial vaginosis often causes no symptoms. However, in some women, bacterial vaginosis can be recognized by the appearance of vaginal discharge.
The discharge has a watery texture and is gray or white in color. Vaginal discharge also emits a fishy odor, especially during menstruation or sexual intercourse with a partner.
In addition to vaginal discharge, bacterial vaginosis can also cause several different symptoms, such as vaginal itching, and pain and burning when urinating due to irritation around the vagina.
When to go to the doctor
Immediately consult a doctor if you experience the following conditions:
- Experiencing the above symptoms and are pregnant
- Experiencing the above symptoms and having many or recently changed sexual partners
- Just experienced vaginal discharge that smells and is accompanied by fever
- Have you ever had a vaginal infection, but the vaginal discharge you are experiencing has a different color and texture than before?
- Having a yeast infection in the vagina that doesn't go away even after self-medication using over-the-counter drugs
Symptoms of bacterial vaginosis can mimic those of other infections. Therefore, it is very important to check with a doctor to confirm the diagnosis. Early diagnosis and treatment will reduce the possibility of complications.
Diagnosis of Bacterial Vaginosis
The first step taken by the obstetrician to diagnose bacterial vaginosis is to ask the patient's medical history, lifestyle, and symptoms. The examination is then followed by a general physical examination.
The doctor may also perform several other tests to confirm the diagnosis. The inspection includes:
- Vaginal examinationThe doctor will examine the inside of the vagina with the help of a tool called a speculum to widen the vaginal canal.
- Check the level of acidity (pH) of the vaginaThe doctor will place a pH paper in the patient's vagina to check the acidity of the patient's vagina. Under normal conditions, the vaginal pH is 3.8–4.5. Whereas in patients with bacterial vaginosis, vaginal pH usually rises above 4.5.
- Examination of vaginal secretion samplesSamples of vaginal discharge were taken by swab procedure (swab), then examined in the laboratory to detect the presence of excess anaerobic bacteria growth in the vagina.
Bacterial Vaginosis Treatment
In some cases, bacterial vaginosis will go away on its own without treatment. However, if symptoms continue to appear, it will be dangerous if not treated immediately because it can cause the reproductive organs to become more susceptible to infection or inflammation.
Bacterial vaginosis is generally treated with antibiotics. Antibiotics are used to kill the bacteria that cause this disease. The doctor will give antibiotics, if:
- Symptoms continue
- Symptoms appear during pregnancy
- The patient will undergo a surgical procedure in the pelvic area, such as a hysterectomy
In patients who will undergo pelvic surgery, administration of antibiotics aims to reduce the risk of serious infections that may occur postoperatively.
The following are some types of antibiotics that can be used to treat bacterial vaginosis:
- MetronidazoleMetronidazole is the most commonly used antibiotic and is the most effective in treating bacterial vaginosis. This drug is available in the form of tablets and ovules that are inserted into the vagina.
- ClindamycinThis medicine is in tablet form. Clindamycin is usually given when there are bothersome side effects from taking metronidazole tablets.
- TinidazoleTinidazole is an antibiotic in tablet form. Just like clindamycin, this drug is generally also given if side effects occur due to using metronidazole.
Treatment for bacterial vaginosis usually lasts at least a week. Even if the symptoms are gone, don't stop the medication until your doctor has instructed you to stop. This is done to prevent the infection from happening again.
Complications of Bacterial Vaginosis
Bacterial vaginosis usually does not cause complications. But if left untreated, this condition can lead to a number of serious complications, including:
- Premature birthPregnant women who suffer from bacterial vaginosis are at risk for preterm delivery and post-delivery infections.
- Pelvic inflammatory diseasePelvic inflammation (PID) is a ja type of inflammatory disease of the uterus and fallopian tubes that can reduce fertility.
- Sexually transmitted infectionsBacterial vaginosis increases a woman's risk of developing sexually transmitted diseases, such as the herpes simplex virus, chlamydia, and HIV.
- Infection after surgeryBacterial vaginosis can increase a woman's risk for infection after pelvic surgery, such as a hysterectomy or caesarean section.
Prevention of Bacterial Vaginosis
The main step to prevent bacterial vaginosis is to maintain a balance of bacteria in the vagina. Ways that can be done to maintain the balance of these bacteria include:
Not clean the vagina with water spray
Flushing or cleaning the vagina with a water spray can remove the good bacteria that protect the vagina from infection. If these bacteria are lost, the risk of developing bacterial vaginosis will increase.
Reduce the risk of irritation on vagina
The risk of vaginal irritation can be reduced by:
- Avoid using soaps with fragrances to clean the outside of the vagina.
- Use cotton underwear, and don't wash your underwear using detergent with harsh chemicals.
- Use unscented sanitary napkins.
Prevent sexually transmitted infections
It is important to always have safe sex, for example by not changing partners, or by using a condom during sexual intercourse.