Bacterial Vaginosis • Symptoms & Treatment

Many women know it: vaginal problems, especially in the external area, combined with unpleasant smell, itching and discharge. At first most people think it is a vaginal thrush. In addition to vaginal mycosis, there is another common infection in the genital area, bacterial vaginosis. In contrast to vaginal thrush, which is usually triggered by yeasts of the Candida genus, bacteria are the cause here.

Article content at a glance:

Discharge: what is normal and when is it better to see a doctor?

Symptoms of bacterial vaginosis

The bacterial vaginosis usually comes on suddenly. The symptoms are very uncomfortable and affect the quality of life. However, there are also many women who have a slightly milder form of bacterial vaginosis. The symptoms then occur only to a mild extent or not at all.

The following symptoms are typical:

The fishy smell is caused by amines. These are ammonia derivatives formed by the bacteria.

A disturbed vaginal environment is the cause of bacterial vaginosis

The healthy vaginal flora has an acidic environment with a pH value of around 4. Lactic acid bacteria, also called lactobacilli, are responsible for this. If lactic acid bacteria are present in sufficient numbers, the vaginal environment forms an effective barrier against bacteria and fungi.

In bacterial vaginosis, however, the amount of lactic acid bacteria has decreased – the "vaginal flora ecosystem" is upset. Why the beneficial lactobacilli disappear cannot always be explained.

Possible triggers are:

• Sexual intercourse
• stress
• too frequent washing in the genital area
• Vaginal douches
• Incorrect stool hygiene (important: always wipe from front to back!)
• Infections
• Antibiotics
• Smoke
• It is also discussed whether vitamin D deficiency could be a risk factor.

If the number of lactic acid bacteria is too low, the pH value of the vagina rises and the healthy vaginal environment is out of balance. The result: harmful bacteria increase excessively. These include Gardnerella vaginalis, a very small number of which are part of the normal vaginal flora, as well as mobiluncus and other germs that usually come from the intestine or naturally settle on the skin.

Is Bacterial Vaginosis an STD?

Because vaginal colonization often occurs after sexual intercourse with a new partner, many women believe that bacterial vaginosis is contagious and transmitted during sex. However, it is not a classic sexually transmitted disease such as syphilis or gonorrhea. Only bacteria that are normally found in the urogenital area and the human intestine are involved.

However, sexual intercourse can encourage them to reproduce. If the bacteria have multiplied strongly, additional transmission (infection) can take place through sexual intercourse. In men, Gardnerella infection manifests itself with swelling and inflammation of the foreskin and glans, as well as some discharge that also smells bad.

It is therefore sensible to refrain from sexual intercourse in the case of bacterial vaginosis until the symptoms have subsided under the appropriate treatment. Depending on the extent of the infection, the doctor will decide whether the man needs treatment. However, experts do not recommend routine treatment by the partner.

Wellness tips for the vagina

Treat bacterial vaginosis with medication

The diagnosis of bacterial vaginosis is usually quick. The doctor takes a smear from the vagina. If at least three of the following criteria apply, then it is definitely a vaginal disease:

• whitish-gray discharge
• Vaginal pH higher than 4.5
• under the microscope there is a dense colonization with Gardnerella vaginalis
• fishy smell

This also makes it possible to determine whether vaginal thrush or inflammation of the mucous membrane of the cervix (cervicitis) is the cause of the symptoms.

Once the diagnosis of bacterial vaginosis has been made, the gynecologist recommends antibiotics depending on the severity of the inflammation. The active ingredients metronidazole, clindamycin or nifuratel are possible. They are given orally as tablets or intravaginally as a suppository or cream.

Lactic acid preparations are also available as suppositories, gels or creams so that the vaginal flora regains its balance. Once the bacterial vaginosis has subsided, a cure with lactobacilli makes sense. The woman uses suppositories or the cream with the beneficial microbes for at least seven days before going to sleep.

Home Remedies For Bacterial Vaginosis?

Various natural products have proven effective against bacterial vaginosis. However, they only have a very mild effect and should only bridge the time until the doctor's visit if there are pronounced problems:

• yogurt: Dip a tampon or cotton ball in unsweetened natural yogurt and insert it into the vagina.

• Vinegar water: Do the same with diluted apple cider vinegar or prepare a hip bath with warm water and two cups of vinegar.

• Lemon water: The ascorbic acid (vitamin C) of lemon also relieves the symptoms of bacterial infection of the vagina when applied locally. Please only use diluted juice here, as anything else would irritate the sensitive vagina even further.

• Black tea: The tannins in tea can inhibit bacterial growth. Boil strong black tea, let it cool, and soak a cotton ball or tampon with it.

Garlic and tea tree oil are also often recommended as home remedies for bacterial vaginosis, but are not advisable. Its ingredients also irritate the mucous membrane.

Bacterial vaginosis can have consequences

Even if the symptoms are not severe or go away quickly, bacterial vaginosis increases the risk of serious illnesses. These are ascending infections. These are:

• Fallopian tube inflammation
• Ovarian inflammation
• Vulvitis (inflammation of the outer pubic area, i.e. the area around the vagina, labia, pubic mounds)
• Inflammation of the lining of the cervix (cervicitis)

Therefore, the pH value of the vagina must always be checked before inserting a coil or a pessary (intrauterine coil, intrauterine device). If it is too high, this should be treated before the contraceptive is used.

Measure vaginal pH yourself

A good way to measure the pH value of the vagina yourself is to use special measuring strips from the pharmacy. This allows you to control the healing process and detect recurring bacterial vaginosis in the early stages. This precautionary measure is especially important for pregnant women. The imbalance of the vaginal flora can have particularly serious consequences for them.

Myths and Facts About the Vagina

Bacterial vaginosis in pregnancy

Bacterial vaginosis is a great risk for pregnant women. Incorrect colonization of the vaginal flora can lead to the following complications:

This is why gynecologists definitely recommend treatment to pregnant women with a diagnosed bacterial vaginosis, even if there are no severe symptoms. Strictly as directed by the doctor, pregnant women are allowed to use certain antibiotics as tablets or vaginal creams after the third month.

In the preceding first trimester of pregnancy (trimester / trimester) many doctors try to get the symptoms of bacterial vaginosis under control with home remedies and lactic acid.