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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]

Ten Things Women (And The Men In Their Lives) Need To Know About Bacterial Vaginosis

Bacterial vaginosis is a condition that produces few or no symptoms at all, until it results in a heartbreak. Keeping bacterial vaginosis under control requires a doctor's help -- it's not possible for women to know for sure which kind of bacteria are causing their symptoms without examination of a culture under a microscope -- but keeping the infection from coming back may require changes in lifestyle or habits.

1. Bacterial vaginosis can be transmitted by dirty hands.

Teenaged girls who develop bacterial vaginosis often have just started masturbating, and don't know that clean hands or stimulatory devices are a must. It's also important for both partners to have "clean" sex, to avoid transmitting bacteria and other germs to the lining of the vagina.

2. Most kinds of douching and bubble bath increase the risk of infection.

The body's defense against the microorganisms that cause bacterial vaginosis is Lactobacillus bacteria. When these bacteria are washed away, the lining of vagina becomes more alkaline, and disease-causing bacteria can multiply. A douche with vinegar and water, however, reduces the risk of vaginal infection, by lowering the pH of the lining of the vagina so the vaginosis bacteria don't multiply.

3. Untreated bacterial vaginosis can cause serious complications after abortion.

Women who do not get treatment for bacterial vaginosis, possibly because they do not know they have bacterial vaginosis, are at increased risk for a complication called cellulitis after they have abortions. Failure to get treatment for bacterial vaginosis is not in and of itself a reason not to have an abortion, but it is a reason for increased medical care after the procedure.

4. Bacterial vaginosis increases a woman's risk of yeast infections.

Bacterial vaginosis usually does not cause severe inflammation, but yeast infections usually do. If a woman suspects vaginosis on the basis of a private "whiff test" and then develops itching, redness, and increased discharge, the problem may have progressed to a Candida infection.

5. Bacterial vaginosis can occur in girls even before they have their first period.

Pre-pubescent girls sometimes develop bacterial vaginosis. This does not mean they have had sex.[4]

6. Women who have bacterial vaginosis should wash with hypoallergenic bar soaps or no soap at all.

It's important to get "too clean" if you have bacterial vaginosis, so the protective Lactobacillus bacteria can re-establish themselves. Mild, bar soaps are OK, but anything sudsy, with large bubbles, can set up new infections.

7. Women should not have an IUD (intrauterine device) inserted unless they are sure they are free of bacterial vaginosis.

Many doctors will prescribe antibiotics to women who are getting IUD's just to make sure vaginosis does not cause any complications. There aren't any clinical trials to support this practice, but it seems like a reasonable precaution. It's important to reintroduce healthy bacteria after finishing the antibiotics, however.[5]

8. Once a woman has recovered from bacterial vaginosis, applying probiotics will keep it from coming back.

It's not necessary to use probiotic products continuously. One Italian study found that 96% of women who used probiotics just once every six months stayed free from bacterial vaginosis for the duration of the clinical trial.

9. Femine hygiene products are not recommended for women who have a history of bacterial vaginosis.

Sprays and washes kills the helpful bacteria that keep pathogenic bacteria in check.

10. New sexual partners may cause new bacterial infections.

Even more men carry the bacteria that cause bacterial vaginosis than women. Sex with a new male partner is a reason to become aware of the possibility of changes in women's health. Having sex with barrier protection (a condom, not an IUD), however, greatly reduces the risk of introducing the infection.

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