Bacterial vaginosis (BV) can be a daunting condition for women, especially those within the child-bearing age. The foul smell, itching, and pain associated with this condition, especially during urination or sexual intercourse can be an irritating experience.

Also referred to as nonspecific vaginitis, bacterial vaginosis is among the most common vaginal complaints in women of child-bearing age.

Iba Mayale, a gynecologist at Doctors Plaza Clinic Kimironko, Kigali, describes BV as a vaginal condition that produces vaginal discharge and results from an overgrowth of certain kinds of bacteria in the vagina.

"Bacterial vaginosis is a mild infection of the vagina caused by bacteria. Normally, there are a lot of good bacteria and some bad bacteria in the vagina. The good types help control the growth of the bad types. In women with bacterial vaginosis, the balance is upset. There are not enough good bacteria, but rather too many bad bacteria,” he explains.

Mayale further explains that, it is not a true bacterial infection but rather an imbalance of the bacteria that are normally present in the vagina.

On the other hand, Dr Heritier Gashema, a senior resident in obstetrics and gynaecology at University Teaching Hospital, Kigali (CHUK), says bacterial vaginosis is not dangerous, but it can cause disturbing symptoms resulting from having multiple sex partners, douching and smoking.

The main cause of BV is overgrowth of anaerobic gram negative rods (bacteria) with the major one being gardnerella vaginalis.

He also explains that the condition is more common in women who are sexually active, although it is not clear what role sexual activity plays in the development of BV. It can still occur if one is not sexually active as well, he adds.

"Any woman can get BV. However, some activity or behaviour can upset the normal equilibrium of bacteria in the vagina and put women at increased risk,” says Gashema.

symptoms

The symptoms of BV may mimic those found in yeast infections of the vagina and trichomoniasis, an STD, according to experts.

Gashema explains that yeast infection is a fungal infection while BV is a bacterial infection. BV is also associated with foul smelling discharge with pruritus (itching).

He further notes that the symptoms of BV may include an abnormal amount of vaginal discharge, with the vaginal discharge being thin and grayish white and vaginal odor (foul-smelling or unpleasant fishy odor). The vaginal discharge and odour are often more noticeable after sexual intercourse. Pain that comes with sexual intercourse or urination is also one of the rare symptoms.

According to Mayale, the symptoms of bacterial vaginosis, if present, can occur any time in the menstrual cycle, including before, during or after the menstrual period.

Severity of the disease depends on load of the microbes entering the body and overall health status of the individual.

"The amount of vaginal discharge that is considered normal varies from woman to woman. Therefore, any degree of vaginal discharge that is abnormal for a particular woman should be evaluated,” he advises.

Diagnosis

Bacterial vaginosis is known to increase the risk of getting some sexually transmitted infections, as well as pelvic infections.

Gashema, therefore, advises women to check with a gynecologist, as the tests will also be able to identify BV from other infections.

"Doctors diagnose bacterial vaginosis by asking about the symptoms, doing a pelvic exam, and taking a sample of the vaginal discharge. The sample can be tested to find out if you have the condition,” he says.

Mayale also advises women, especially pregnant ones, to visit a gynaecologist if they notice any abnormal discharge to rule out other infections and prevent complications.

"It’s important to determine whether you have bacterial vaginosis (BV) or a similar condition, such as trichomoniasis or gonorrhea. These can both also cause abnormal vaginal discharge,” he says.

Mayale explains that this risk is small, it appears more significant for women who have had these complications in a previous pregnancy. BV causes no problems in the vast majority of pregnancies.

Treatment

Mayale notes that bacterial vaginosis is usually a mild problem that may go away on its own in a few days but warns that it’s common for BV to return.

It can, however, lead to more serious problems and therefore he advises women to get tested and get the right treatment.

"The causes of bacterial vaginosis aren’t fully understood, so it’s not possible to completely prevent it. However, you may be able to lower your risk of developing the condition if you avoid using scented soaps, perfumed bubble bath and antiseptic bath liquids, using vaginal deodorant, vaginal douching, using strong detergents to wash your underwear, and limit the number of sexual partners,” says Gashema.

"BV can usually be successfully treated using a short course of antibiotic tablets or an antibiotic gel you apply inside your vagina.In most cases, you’ll be prescribed antibiotic tablets to take twice a day for five to seven days,” Mayale adds.