Bacterial vaginosis

Bacterial vaginosis is the most common cause of vaginal discharge. It is an infection that can be caused by various bacteria. Bacterial vaginosis is not a sexually transmitted infection. It can be triggered by disruption in the vaginal environment. Some women suffer from persistent problems with recurring bacterial vaginosis.

What causes bacterial vaginosis?

If the natural bacterial environment of the vagina is disrupted, for example through the use of vaginal douches, soaps, sprays, drugs or (cosmetic) surgeries, bacteria can settle and multiply and cause bacterial vaginosis. But the condition can stem from hormonal causes as well: An excess of female sex hormones (resulting from the pill or a pregnancy) as well as a deficit (after menopause without hormone replacement therapy) can lead to the development of bacterial vaginosis.

What are possible symptoms and consequences?

Symptoms include stronger-than-usual vaginal discharge that is often white, sticky and malodorous (sour, fishy), especially after contact with sperm. Vaginal intercourse can also lead to itching, burning, redness and pain. Often, however, there are no symptoms despite a bacterial vaginosis being present. A woman suffering from bacterial vaginosis is at an increased risk of contracting a sexually transmitted infection. Bacterial vaginosis can also lead to pelvic inflammatory disease.

In pregnant women, a bacterial vaginosis increases the risk of a premature delivery.

How is bacterial vaginosis tested for?

Testing involves analysis of a mucosal swab. The same swab is usually also used to exclude sexually transmitted infections that are Chlamydia and Gonorrhoea.

How is bacterial vaginosis treated?

Bacterial vaginosis can be treated with antibiotics. At the same time as (or instead of) an antibiotic treatment, it may be worthwhile to insert yoghurt into the vagina, which promotes the production of lactic acid bacteria. It is also possible to take a product containing lactic acid bacteria purchased at a pharmacy.

Should sexual partners get treatment as well?

As long as no sexually transmitted infection is present at the same time, there is generally no need for sexual partners to get treatment.

How can the (re-)infection be prevented?

In order to avoid disrupting the natural vaginal environment, soaps and sprays in the vaginal area, as well as vaginal douches, should be avoided. It is best to wash the vagina only externally and only with tepid water (no soap). Tampons and sanitary pads should only be used during menstruation, during which time they should be changed regularly. Cotton underwear is better to use than synthetic underwear (which is not breathable). G-strings and very tight trousers should be avoided in case of a predisposition to bacterial vaginosis.

Source: Federal Office of Public Health (FOPH) 2022, lovelife.ch