Bacterial vaginosis: The silent infection many women don’t realise they have

Bacterial vaginosis (BV) is a common but often overlooked vaginal infection that affects millions of women worldwide.

Many women may not even realise they have BV, as it can present with mild or no symptoms. However, if left untreated, BV can have serious long-term consequences, affecting reproductive health and increasing susceptibility to other infections.  

What is Bacterial Vaginosis?  

BV occurs when there is an imbalance in the vaginal microbiome, leading to a decrease in beneficial lactobacilli and an overgrowth of harmful bacteria. The exact cause of this imbalance is not always clear, but several risk factors can contribute to its development.  

Symptoms of bacterial vaginosis 

Symptoms can vary in severity, and some women may experience no symptoms at all. When present, common signs include:  

• A thin, greyish-white vaginal discharge  
• A strong, fishy odour, particularly after sex  
• Vaginal itching or irritation  
• A burning sensation during urination  

Despite these symptoms, many women dismiss them or mistake them for other common infections, such as thrush, leading to a delay in diagnosis and treatment.  

Causes and risk factors of bacterial vaginosis 

The exact cause of BV is not fully understood, but certain factors can disrupt the natural balance of vaginal bacteria, including:  

• Douching: This can remove beneficial bacteria and allow harmful bacteria to overgrow.  
• Sex: Though not classified as a sexually transmitted infection (STI), BV is more common in sexually active women.  
• New or multiple sexual partners: Changes in vaginal pH due to new bacteria exposure may contribute to BV.  
• Hormonal changes: Pregnancy, menopause, and hormonal contraception can affect bacterial balance.  

Long-term effects of bacterial vaginosis if left untreated  

BV is more than just an inconvenience—it can have serious health implications if left untreated. Studies have linked untreated BV to:  

• Increased risk of STIs: BV makes the vaginal environment more susceptible to infections such as chlamydia, gonorrhoea, and HIV.  
• Pregnancy complications: Pregnant women with BV are at higher risk of preterm birth, low birth weight, and miscarriage.  
• Pelvic inflammatory disease: BV can spread to the uterus and fallopian tubes, increasing the risk of infertility.  
• Post-surgical infections: Women undergoing gynaecological procedures, such as hysterectomy or abortion, face a higher risk of complications if they have untreated BV.  

Diagnosis and treatment  

Bacterial vaginosis is diagnosed through a vaginal swab, which is tested for bacterial imbalance. Healthcare providers may also assess symptoms and perform a pH test, as BV typically raises vaginal pH above 4.5.  

Treatment usually involves a course of antibiotics, taken orally or applied as a gel or cream. 

In many cases bacterial vaginosis can recur, so it is essential to follow treatment guidelines and avoid risk factors where possible.  

Increased awareness and timely treatment are essential in preventing complications. If symptoms arise, seeking medical advice is crucial to maintaining long-term reproductive health. 

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IOL Lifestyle