Location:
Call: 040 4488 5333
[email protected]

24 September, 2021

Bacterial Vaginosis

Bacterial vaginosis is a vaginal infection caused by bacteria. It is the most common cause of abnormal vaginal discharge that happens in reproductive-age women. It can cause a “fishy” odor and vaginal irritation in some women. Others may not have any symptoms.

SYMPTOMS

Most of the females with bacterial vaginosis will not have any symptoms but when they have, it includes-

  • Burning feeling while micturation
  • Fishy smell mostly after sex
  • Itching
  • Thin white, gray, or green discharge

RISK FACTORS

It is rarely seen in females who are not sexually active. It most commonly affects-

  • Pregnancy
  • Unprotected Intercourse
  • Have an intrauterine device (IUD)
  • Have multiple sex partners
  • Have a new sex partner
  • Have a female sex partner
  • Use douches
  • Smoking
  • Perfumed bubble baths, vaginal deodorants, and few scented soaps
  • Washing underwear with strong detergent

CAUSES

BV is due to an imbalance of natural vaginal bacterial flora. Why this happens is not clear.

The role of bacteria

Bacteria is present allover our bodies, but some are beneficial while others are harmful. These bacteria become infectious when number of harmful bacteria increases.

The vagina is house for mostly “good” bacteria and some harmful bacteria. BV occurs when the harmful bacteria outgrows the good bacteria in number.

A vagina should contain bacteria called lactobacilli. These bacteria produce lactic acid, making the vagina slightly acidic. This prevents growth of other bacteria.

Acidity of vagina decreases if levels of lactobacilli decreases leading to growth of other bacteria’s. However, exact relationship of these harmful bacteria with BV is not known.

COMPLICATIONS

Bacterial vaginosis doesn’t generally cause complications. Sometimes, having bacterial vaginosis may lead to:

During pregnancy– In pregnant women, bacterial vaginosis is linked to loss of pregnancy, early rupture of amniotic membranes, Chorioamnionitis, premature deliveries and low birth weight babies due to preterm labours.

After Delivery-Postpartum Endometritis, an irritation or inflammation of uterine lining.

Sexually transmitted infections– Bacterial vaginosis makes women more susceptible to sexually transmitted infections, like HIV, herpes simplex virus, chlamydia or gonorrhea. If you have HIV, bacterial vaginosis increases the chances of passing on the virus to your partner.

Infection risk after gynecologic surgery- such as hysterectomy or dilation and curettage (D&C).

Pelvic inflammatory disease (PID) – Bacterial vaginosis can sometimes cause an infection of the uterus and the fallopian tubes therefore the risk of infertility increases.

Studies have shown that success rate of IVF decreases in BV.

PREVENTION

  • Minimize vaginal irritation- by using mild or nonscented soaps and tampons or pads.
  • Don’t douche- douching disrupts the vaginal balance and may increase your risk of vaginal infection. 
  • Avoid Sexually transmitted diseases- Use a male latex condom, limit your number of sex partners.
  • Always wipe from front to back instead of back to front after using the bathroom.
  • Wear cotton or cotton-lined underwear. Bacteria thrive in moist environments. Cotton helps wick away moisture.

DIAGNOSIS

The doctor will:

  • Ask about your medical history- about previous STIs, etc.
  • Do an overall physical exam
  • Do a pelvic exam- for signs of infection, condition of pelvic organs
  • Take a sample of discharge from your vagina to look for  bacteria
  • Test your vaginal pH. A vaginal pH of 4.5 or higher is associated with bacterial vaginosis.

TREATMENT

Often it remains asymptomatic, but women with signs and symptoms should take treatment to avoid complications.

Often antibiotics (metronidazole, clindamycin, tinidazole) are required to treat BV. This could be a tablet or a cream or gel you put into your vagina. Most females need to take treatments for 5 to 7 days. Finish full course of medicines, even if the symptoms go away. Incomplete medications course can lead to recurrence.

Since BV can be spread through sex, so it is advisable to avoid sexual contact till treatment is finished. Female sexual partners should see their doctor to find out if they need treatment.

IUDs users with BV can opt for other forms of contraception.

To treat bacterial vaginosis, following medicaions can be prescribed:

  • Metronidazole- This is given as oral forms mostly. Metronidazole is also be given as a topical gel to insert into the vagina. It is the most commonly used antibiotic. It is preferred over other antibiotics if the woman is breastfeeding or pregnant.
  • Clindamycin -This medicine is available as a cream that you insert into your vagina. Clindamycin creams are known to weaken latex condoms- so take adequate precautions for atleast 3 days after stopping the treatment.
  • Tinidazole-This medication is taken orally. Tinidazole reacts with alcohol, so avoid alcohol during treatment and for at least three days after completing treatment.
  • Secnidazole -This is an antibiotic you take orally in one dose. 

Generally it is not necessary to treat an infected woman’s male sexual partner, but it can spread among female sexual partners, so female partners should be tested and treated accordingly. It’s especially important for pregnant women with symptoms to be treated to decrease the risk of premature labour.

RECURRENCE

Around one-third of women whose symptoms disappear with treatment will have a recurrence within 3 months, and half will have a recurrence within 6 months.

If more than three episodes occur within 12 months, the doctor may prescribe a vaginal metronidazole gel to use twice a week for 3 to 6 months.

While current research shows there may be some benefit to probiotic therapy, more research is needed on the subject.

SIMILAR ARTICLES

blog featured image

29 July, 2026

Irregular Periods: When to Investigate

Period irregularity is something many women experience at some point, and most learn to live with it, at least for a while. A late period during a stressful month, a lighter cycle after illness, a missed period after a long flight. These variations are common and usually self-correcting. The problem is that irregular periods are also how the body signals conditions that genuinely need attention, and because the irregularity can feel familiar, it is easy to keep waiting for things to normalise when they never will without proper evaluation.Knowing where the line sits between normal variation and something worth investigating is genuinely useful.What counts as irregularA normal menstrual cycle runs anywhere from 24 to 38 days, measured from the first day of one period to the first day of the next. Variation of up to eight days between the shortest and longest cycle is considered normal. Lengths ranging between 8 and 20 days of variation are considered moderately irregular, and variation of 21 days or more is considered very irregular.Changes outside the cycle length are also irregular. Periods that are either much heavier or lighter than normal, periods that are much longer or shorter than normal, periods between periods, and periods that are absent altogether, in a woman not pregnant, breastfeeding, or in menopause,
Read More
blog featured image

29 July, 2026

Fertility Decline: What Women Should Know

Conversations about fertility tend to happen too late. Women often begin thinking seriously about their reproductive timeline only when they are ready to conceive. At this point, some of the most important biological facts have already been playing out for years without their awareness. The decline in female fertility with age is one of the most consistently misunderstood aspects of reproductive health, and the gap between what women know and what the biology actually shows is significant.This is not about creating anxiety. It is about giving women accurate information early enough to make genuinely informed decisions.The Fundamental BiologyA woman is born with all the eggs she is going to have in her lifetime. Her eggs age with her, decreasing in quality and quantity. Age is the single most important factor affecting a woman's fertility.Females are born with a finite number of oocytes. The number of oocytes peaks in the womb at around 20 weeks of gestation and subsequently declines steadily until approximately age 32, after which the number decreases at a greater rate until age 37, beyond which oocyte numbers drop even more rapidly.This is not something that can be slowed by fitness, diet, or general good health. Even though women today are healthier and taking better care of themselves than ever before, improved
Read More
blog featured image

29 July, 2026

PMOS: Causes Beyond Hormones

Most patients understand Polycystic Metabolic Ovarian Syndrome, or PMOS, as a hormonal condition. Irregular periods, elevated androgens, and ovarian cysts on an ultrasound. The hormonal picture is real, but it is only part of the story. Decades of research have made it increasingly clear that PMOS is far more complex than a hormonal imbalance in isolation. It involves the metabolic system, the immune system, the gut, and genetics, all interacting in ways that produce a condition that looks different in every woman who has it.Understanding the fuller picture of what causes PMOS matters because it changes how the condition is managed and why lifestyle interventions work as well as they do.What PMOS Actually InvolvesPolycystic Metabolic Ovarian Syndrome is a complex endocrine and metabolic disorder, typically characterised by hirsutism, hyperandrogenism, ovulatory dysfunction, menstrual disorders, and infertility. The name itself reflects what the condition truly is. The metabolic component is not secondary to the ovarian and hormonal picture. It is central to it. Treating the hormonal symptoms without addressing the underlying metabolic drivers is one reason PMOS management often produces only partial results.Insulin Resistance Sits at the CentrePMOS insulin resistance, where cells throughout the body fail to respond normally to insulin, is considered the primary pathological basis for the reproductive dysfunction seen in PMOS.
Read More
Loading booking..