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Bacterial vaginosis, which is also known as non-specific vaginitis, is an infection of the vagina that has the peculiar characteristic of not causing inflammation. Left untreated, it can cause odor, infertility, and, in pregnancy, miscarriage.

Bacterial vaginosis is the chronic infection 1 in 3 women has but many women, and their partners, have never heard of. Also known as non-specific vaginitis, bacterial vaginosis is an vaginal infection that does not cause inflammation, that may linger undetected for months or years until it causes traumatic termination of pregnancy. Bacterial vaginosis is a very common vaginal infection — it often causes an abnormal vaginal discharge vaginal odor in up to 50% of sufferers. And not only that, recurrence is common following recommended treatment.[1

Which Bacteria Cause Bacterial Vaginosis?

The bacterium most commonly found in women who develop bacterial vaginosis are members of a group of bacteria known as Gardnerella. These bacteria are relatively small, and they have the unusual characteristic of being "Gram-variable." Usually bacteria are either coated with a thick layer of protein or they are not, that is, they are Gram-positive, and visible under the microscope when treated with a special staining agent, or they are Gram-negative, and detected through other means. The bacteria that cause vaginosis may or may not be detectable with the stain.[2]

What Makes the Bacteria That Cause Bacterial Vaginosis Grow?

It's normal for the vagina to be colonized by trillions of bacteria. In fact, there are more bacteria in a woman's vagina than there are cells in her body, and this is not a bad thing. Usually, probiotic bacteria such as Lactobacillus are present in sufficient numbers to degrade glycogen, a storage form of sugars, into acids that keep the lining of the vagina slightly acidic so that disease-causing bacteria don't multiply fast enough to cause problems. When the friendly, probiotic bacteria are killed by antibiotics, or washed away by douching or bubble baths, then the pH of the vagina rises so that Gardnerella can multiply uncontrolled.

Although you may have read a great deal about "alkalizing urine" as a health practice, the surface of the vagina needs to be acidic, with a pH below 4.5, to keep disease-causing bacteria under control. Gardnerella eventually "smothers" healthy bacteria with a sticky film and raises the pH of the vaginal membrane to 5.5 or higher.[2]

What Do Vaginosis Bacteria Do?

The first, and sometimes only, symptom of bacterial vaginosis is odor. Sometimes this odor is only detected after unprotected sexual intercourse with a man. Semen interacts with chemicals released by the infectious bacteria that release a distinctive "fishy" odor. The doctor may diagnosis vaginosis on the basis of a positive "whiff test." There may be a slight to moderate vaginal discharge. It will be thin, gray, and sticky, adhering to the the surface of the vagina. The vagina may have an unusually "wet" appearance. There usually isn't any interruption in the patterns of urination, although this can happen, and it's relatively rare for this kind of infection to cause any kind of irritation or inflammation.

There may be no effects of the infection at all until the woman becomes pregnant. Women who have untreated bacterial vaginosis infections are at greater risk for miscarriage and for delivery of the baby pre-term. They are also at greater risk for infections with gonorrhea and HIV.

How Common Is Bacterial Vaginosis?

Many experts believe that as many as 70% of women have an infection with bacterial vaginosis at some point in their lives, and up to 80% of men who have sex with women who have been infected with bacterial vaginosis bacteria. 

Epidemologists report that, in the United States alone, 21 million women per year see a doctor about vaginal infections, most of them involving this strain of bacteria.

How Is Bacterial Vaginosis Treated?

Antibiotics usually clear up bacterial vaginosis, although, ironically, antibiotic use often causes bacterial vaginosis. We'll take a look at treatments for bacterial vaginosis that work in the next section.[3]

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