nonspecific vaginitis, Gardnerella vaginitis

What is bacterial vaginosis?

Bacterial vaginosis is caused by an overgrowth of bacteria (bugs) that are normally only present in the vagina in small numbers. When these bacteria are present in large numbers they may cause symptoms such as an abnormal discharge or odour. Bacterial vaginosis is sometimes called nonspecific vaginosis or Gardnerella vaginitis.

What are the symptoms?

There may be an increase in normal vaginal secretions (fluid leaking from the vagina). There may be a strong odour from the vagina, and the smell may be worse after unprotected sex. Some women may not have any symptoms. Other infections may be present at the same time as bacterial vaginosis. It is therefore important to take tests to rule out sexually transmitted infections as well.

How is it diagnosed?

During a medical examination the doctor or nurse may notice a discharge or odour. The normal acidity of the vaginal fluid may have changed to become more alkaline, even though the woman may not have noticed any symptoms.

Bacterial vaginosis can be diagnosed easily by doing a vaginal swab test. Results of this test will be available before you leave the sexual health clinic and the doctor can prescribe treatment.

How is it transmitted?

It is not clear whether bacterial vaginosis is sexually transmitted, but it is more common in women with more than one sexual partner. It often develops soon after intercourse with a new partner, and it can be associated with other sexually transmitted infections. It is also common in women who have sex with other women and it is possible that bacteria can be transmitted on fingers or sex toys.

What is the treatment for bacterial vaginosis?

If a woman has no symptoms, usually no treatment is required.

Treatment should be given when a woman has symptoms, or if she is about to have a gynaecological procedure (such as insertion of an IUD or termination of pregnancy) which could allow bacteria into the uterus (womb).

Treatment is usually metronidazole (Flagyl) antibiotic tablets, taken for seven days. Metronidazole may cause nausea or an upset stomach, but these effects can be reduced by taking the tablets with meals. Do not drink alcohol during this treatment or you may get a severe hangover.

If you are unable to take metronidazole the doctor can prescribe other antibiotics or vaginal creams.

Can bacterial vaginosis recur?

Yes. A return of symptoms is very common, sometimes within a few weeks of treatment. Treating the male partner of an infected woman does not seem to prevent recurrences so is not recommended.

Sometimes a longer course of treatment may reduce the return of symptoms.

How can bacterial vaginosis be prevented?

It is not clear yet why some women get bacterial vaginosis.

Although no infection like bacterial vaginosis is found in men, if you have sex with casual acquaintances, insist that your male partner uses a condom. This may reduce the risk of contracting bacterial vaginosis, while also protecting you from other sexually transmitted infections.

Original material provided by Auckland Sexual Health Service. Reviewed by everybody in May 2008.