How do I Treat Bacterial Vaginosis?

Physicians usually treat bacterial vaginosis with antibiotics. An antibiotic is a substance used to kill bacteria or block its growth. In its medicinal form, an antibiotic may be given as a pill, topical cream, or intravenously, through an injection. The most common antibiotics prescribed for bacterial vaginosis are metronidazole, clyndamycin, and tinidazole.

Bacterial vaginosis (BV), previously called Gardnerella vaginosis, is a condition in which the proportion of beneficial bacteria with harmful bacteria in the vagina becomes imbalanced. Bacteria are microscopic, unicellular organisms that are ubiquitous, or present in every environment on Earth, including the human body. Originally, scientists thought that Gardnerella bacteria were responsible for bacterial vaginosis, but it is now clear that several types of bacteria may contribute to this condition. These bacteria occur naturally in limited amounts in a normal vagina, but for unknown reasons, some bacteria may grow excessively and cause BV. Symptoms may include an BV patients usually exhibit no symptoms, but may present with an unpleasant, fish-like vaginal odor, gray or white vaginal discharge, and occasionally burning or itching during urination.

Because BV is not totally understood by scientists, it is difficult to treat bacterial vaginosis preventatively. Certain risk factors, such as douching and sex, particularly sex with multiple partners, increase the likelihood of developing BV. Douching, or vaginal irrigation, is a process of rinsing out the vagina through squirting water into the vaginal cavity. While it was a popular hygienic practice in the past, douching is now discouraged because it often leads to imbalances in vaginal bacteria. A woman may decrease her likelihood of developing bacterial vaginosis by not douching and being abstinent, but even with these risk factors eliminated, her vaginal bacteria may still become imbalanced.

If a woman suspects she has BV, a physician will examine the patient’s vaginal discharge to diagnose either bacterial vaginosis or another vaginal infection that presents similar symptoms, such as a yeast infection or trichomonas. The patient will usually receive a pelvic exam to exclude the possibility of a more serious condition. The physician will likely take a smear of the woman’s discharge to examine under a microscope, looking for classic characteristics of BV, notably clue cells and low amounts of lactobacilli. The physician may also conduct a whiff test, in which the discharge sample is put in contact with a drop of potassium hydroxide. If it is positive, a fishy odor will arise.

Physicians may use several different antibiotics to treat bacterial vaginosis. Because it is believed to be the most effective treatment, metronidazole is commonly prescribed in either its pill form, called Flagyl®, or its topical form, called Metrogel®. Clyndamycin cream, or Cleocin®, and oral tinidazole, or Tindamax®, are also effectively used to treat bacterial vaginosis. Oral metronidazole may cause side effects of nausea, headaches, loss of appetite, and more serious side effects in rare cases. The topical antibiotics do not cause these side effects, but may contribute to the development of a yeast infection.

Several over the counter and homeopathic remedies are popular to treat bacterial vaginosis. Yogurts containing live acidophilus may be eaten, applied topically to the vagina, or inserted into the vagina via a tampon which has been dipped in yogurt. Yogurt treatment is a mild and widely used method of balancing bacteria. Other possible remedies include garlic, gentian violet, tea tree oil, Lactobacillus supplements, and vitamin supplements. Women using home remedies to treat bacterial vaginosis should be aware that misdiagnosis or inadequate treatment of BV can lead to serious complications, especially if the patient is pregnant.