Bacterial Vaginosis

Question 1

What is bacterial vaginosis?

Answer 1

imbalance of bacteria within the vagina (overgrowth of anaerobic bacteria)

-it is not an STI

Question 2

pathophysiology- BV

Answer 2

an overgrowth of anaerobic bacteria in the vagina, causing a loss of lactobacillia (good bacteri) which usually keeps the pH under 4.5. Due to the loss of lactobacillia, the pH rises, creating a more alkaline environment to enable more anaerobic bacteria to multiply

Question 3

examples of anaerobic bacteria in BV?

Answer 3

-Gardnerella vaginalis (most common)
-Mycoplasma Hominis
-Prevotella

Question 4

presentation of bv?

Answer 4

50% asymptomatic

fishy smelling discharge!!

-no irritation/ discomfort/ itch- that might be a sign of another co occuring infection

Question 5

Investigations for bv?

Answer 5

Vaginal pH- tested using a swab and pH paper, ( normal pH is 3.5- 4.5) BV occurs if pH above 4.5

High Vaginal swab:
microscopy - ‘Clue cells’ (epithelial cells from cervix that have bacteria stuck inside)

Question 6

treatment for BV?

Answer 6

1st line= Metronidazole 400mg bd x 5-7/7 oral or by vaginal gel
2nd line= Topical clindamycin 2% cream or metronidazole 0.75% gel