BV

Question 1

What is BV

Answer 1

Overgrowth of bacteria that are usually only present in the vagina in small numbers. This can cause abnormal discharge and odour.

Question 2

BV is the most common cause of ________________ in people of childbearing age

Answer 2

Abnormal discharge

Question 3

Up to ________% of people with BV are asymptomatic

Answer 3

50%

Question 4

Is BV an STI?

Answer 4

No
But some evidence to support contribution of sexual transmission to its pathogenesis

Question 5

Risk factors for BV

Answer 5

Sexual partner change
Vaginal douching
Presence of IUD

Question 6

Protective factors for BV

Answer 6

Hormonal contraception (regardless of type)
Condom use
Male partner who is circumcised

Question 7

Can BV recur?

Answer 7

Recurrence is common

Question 8

Symptoms of BV

Answer 8

White vaginal discharge
Offensive fishy odour

Question 9

Complications of BV

Answer 9

Spontaneous abortion, premature labour, chorioamnionitis, postpartum endometritis
PID
Endometritis, post termination of pregnancy or IUD insertion
Often associated with STIs
HIV transmission and acquisition

Question 10

Does routine screening and treatment help reduce the risk of complications of BV?

Answer 10

No

Question 11

Indications for testing for BV

Answer 11

Vaginal discharge
Vaginal odour

Question 12

Treatment of BV is predominantly aimed at ____________ and is indicated in ___________ people

Answer 12

alleviating symptoms
symptomatic

Question 13

1st line treatment for BV

Answer 13

Metronidazole BD for 7 days

Question 14

2nd line treatment for BV

Answer 14

Metronidazole 2g stat
Ornidazole BD for 5 days
Clindamycin BD for 7 days

Question 15

Treatment for BV in pregnancy or breastfeeding

Answer 15

Metronidazole BD for 7 days

Question 16

Recommended treatment in post menopausal women

Answer 16

Menopause alters the vaginal microbiome, which affects the validity of laboratory diagnostic criteria for BV. Symptoms may be related to atrophic vaginitis. Consider the use of topical oestrogen

Question 17

Recommendation if IUD in place and positive BV

Answer 17

Leave IUD in place and treat as recommended

Question 18

When to refer if recurrences

Answer 18

> 3 recurrences in 12 month period

Question 19

Is contact tracing required?

Answer 19

No

Question 20

Should you treat male partners?

Answer 20

Not been shown to reduce risk of recurrence so not recommended

Question 21

Should you treat female partners?

Answer 21

Assessment and treatment of positive female partners reasonable - but no evidence that it will reduce recurrences

Question 22

Follow up or test of cure required?

Answer 22

No - only if symptoms persist or recur