Gardnerella Vaginitis (Bacterial Vaginosis)

What Is It?

Bacterial vaginosis is a gynecological condition caused by a change in the type of bacteria found in the vagina. Under normal circumstances, bacteria belonging mostly to the Lactobacillus family live harmlessly in the vagina and produce chemicals that keep the vaginal environment mildly acidic. In bacterial vaginosis, Lactobacillus bacteria are replaced by other types of bacteria that normally are present in smaller concentrations in the vagina. This shift away from Lactobacillus results in bacterial vaginosis.

Scientists do not fully understand the reason behind this change. Risk factors that seem to increase the likelihood of bacterial vaginosis include a history of multiple sex partners, a sexual relationship with a new partner, the use of vaginal contraceptive products that contains the chemical nonoxynol-9 and frequent vaginal douching.

Bacterial vaginosis is the most common cause of abnormal vaginal odor and discharge. For most women, bacterial vaginosis is simply a nuisance, and the goal of treatment is to relieve symptoms.

Bacterial vaginosis commonly is diagnosed during pregnancy. Bacterial vaginosis has been implicated as a risk factor for premature labor and delivery, premature rupture of membranes and postpartum uterine infections. This is why pregnant women may be checked for bacterial vaginosis even when they have no symptoms.

Symptoms

Up to 50 percent of women diagnosed with bacterial vaginosis do not have symptoms. In others, it causes an unpleasant vaginal odor and a white vaginal discharge. For some women, these symptoms are especially bothersome during or after intercourse. The white discharge seen in bacterial vaginosis tends to have a thinner consistency than the "cheesy," thick discharge seen in vaginal yeast (Candida) infections. Significant irritation of the vulva or pain during intercourse is uncommon with bacterial vaginosis. So if you have these symptoms, your doctor will check for other possible causes.

Diagnosis

In addition to asking you to describe the vaginal odor and discharge, your doctor will ask you about your menstrual history (last menstrual period), number of sex partners, previous vaginal or urinary tract infections, history of sexually transmitted infection and pelvic infection, methods of contraception and pregnancy history, and personal hygiene issues such as douching and your use of feminine deodorants, tightly fitting undergarments and tampons. Your doctor also may ask if you have any other diseases, such as diabetes, or if you have used antibiotics recently.

Your doctor can diagnose bacterial vaginosis based on the results of a gynecological examination and laboratory tests of your vaginal fluid. There is no perfect test, but if you have three of the following four criteria, there is a 98 percent chance that you have bacterial vaginosis: