(ID)- Bacterial Vaginosis

Question 1

What is bacterial vaginosis?

Answer 1

Imbalance in vaginal microbiome
Overgrowth of anaerobic bacteria and loss of lactobacilli

Question 2

What is the most common anaerobic bacterial overgrowth in bacterial vaginosis?

Answer 2

Gardnerella vaginalis

Question 3

What symptoms are experienced in bacterial vaginosis?

Answer 3

• Increased vaginal discharge
• Fishy odour, particularly after intercourse
• Vaginal itching or irritation (less common)
• Grey-white watery discharge

Question 4

Who is most commonly affected by bacterial vaginosis?

Answer 4

Women of childbearing age
Common in sexually active women

NOT AN STI

Question 5

How is bacterial vaginosis diagnosed?

Answer 5

Amsel criteria
- Elevated vaginal pH > 4.5
- Homogenous grey or milky discharge
- Positive whiff test (add 10% potassium hydroxide to produce fishy odour)
- Clue cells on wet mount

Question 6

How can bacterial vaginosis be treated?

Answer 6

Metronidazole
Clindamycin

Orally or intravaginally

Question 7

What can increase the risk of bacterial vaginosis?

Answer 7

• Pregnancy
  Due to hormonal changes
  Does not generally cause issues in the majority of pregnancies
• Multiple sexual partners or new sexual partner
• Douching
• Lack of consistent condom use

Question 8

What are some differential diagnoses for bacterial vaginosis?

Answer 8

Vulvovaginal candidiasis
- White, curd-like discharge
- Itching
- Burning
- Dyspareunia

Trichomonas vaginalis infection
- Purulent, frothy, greenish discharge
- Pruritis
- Dyspareunia
- Dysuria

Chlamydia or Gonorrhoea
- Increased vaginal discharge
- Lower abdominal pain

Atrophic vaginitis
- Thin, watery discharge
- Postmenopausal women
- Dryness
- Burning
- Dyspareunia

Question 9

What are the risks of BV during pregnancy?

Answer 9

Premature birth
Low birth weight

Mostly no issues