Vaginitis is the term used to define disorders of the vagina caused by infection, inflammation, or changes in normal vaginal flora. Vaginal problems are one of the main reasons women seek medical attention. It is estimated that no clear infectious etiology can be assigned in 15% to 50% of women
Some women develop chronic vulvovaginal disorders that are difficult to diagnose and treat, even for specialists. Therefore, based on the well-known and complex vaginal ecosystem, we aim to provide a review of less well-known vaginal disorders that go beyond microbiological concepts and generate real challenges in clinical diagnosis and treatment. These disorders include aerobic vaginitis, desquamative inflammatory vaginitis, atrophic vaginitis, and cytolytic vaginitis.
Bacterial vaginosis (BV) is the most common cause of an abnormal vaginal discharge in women of child bearing age. Women with BV have an imbalance among-st the normal bacteria that are found in the vagina. It is not a sexually transmitted infection (STI). It can be easily treated with antibiotics. In a few women BV recurs and further treatment may be needed. Having BV makes it easier for your body to be infected with a sexually transmitted infection, so we recommend that you should have routine tests for all STIs including chlamydia, gonorrhoea, trichomonas, syphilis and HIV.
How is bacterial vaginosis spread?
Researchers do not know the cause of BV or how some women get it. We do know that the condition typically occurs in sexually active women. BV is linked to an imbalance of “good” and “harmful” bacteria that are normally found in a woman’s vagina. Having a new sex partner or multiple sex partners, as well as douching, can upset the balance of bacteria in the vagina. This places a woman at increased risk for getting BV.
We also do not know how sex contributes to BV. There is no research to show that treating a sex partner affects whether or not a woman gets BV. Having BV can increase your chances of getting other STDs. BV rarely affects women who have never had sex. You cannot get BV from toilet seats, bedding, or swimming pools.
What are the signs and symptoms of BV?
Many women have no signs or symptoms. If you do have symptoms, they may include: • Unusual vaginal discharge. The discharge can be white (milky) or gray. It may also be foamy or watery. Some women report a strong fish-like odor, especially after sex. • Burning when urinating • Itching around the outside of the vagina • Vaginal irritation These symptoms may be similar to vaginal yeast infections and other health problems. Only your doctor or nurse can tell you for sure whether you have BV.
How do I prevent BV?
Approximately 30% of patients will experience a recurrence within three months of the initial treatment, and more than 50% will experience recurrence within one year. It is not entirely understood why recurrence is so common. Using condoms with male partners and avoiding douching has shown to reduce the risk of recurrence.
If you experience more than three BV episodes in one year, you may benefit from a longer treatment regimen, which you can discuss with your primary care provider. Though the evidence is limited, some research studies show that specific probiotics may play a beneficial role in preventing recurrent BV. If you have experienced multiple bouts of BV, “Fem Dophilus” or “RepHresh Pro B” oral probiotics may be helpful in restoring normal vaginal flora. If you still have symptoms after you complete the course of antibiotics, please come back for another exam.
BV is easily treated with an antibiotic called metronidazole either as a single dose or spread over 5 to 7 days. Vaginal treatments by inserting either metronidazole gel or clindamycin cream are also available.
Metronidazole tablets or vaginal gel: you should avoid alcohol whilst taking the treatment and for 48 hours afterwards. Alcohol interacts with metronidazole and may make you feel nauseated and sick.
Intravaginal clindamycin cream: weakens latex condoms so they may break, best to avoid sex or use non–latex condoms such as ‘Avanti’. If you are breast feeding it may be preferable to use a vaginal treatment such as metronidazole gel or clindamycin cream as treatments by mouth may affect the taste of breast milk.