VAGINOSIS, BACTERIAL

About Your Diagnosis
Bacterial vaginosis is a vaginal disorder in which women experience infection-like symptoms, although technically it is not an infection. It occurs when the “unhealthy” bacteria in the vagina multiply and outnumber the “healthy” bacteria that normally grow there. Currently, it is the most common vaginal disorder in the United States. It is diagnosed by examining the vaginal discharge under a microscope and checking the pH in the office. It can also be diagnosed by sending a sample of the discharge to a laboratory to be tested. Bacterial vaginosis is completely curable with appropriate treatment;
however, it can recur. Bacterial vaginosis may occur spontaneously, sometimes after resuming sexual activity or after changing partners. Controversy exists as to whether it is actually sexually transmitted. If it recurs after treatment, it may be helpful if your partner is treated.

Living With Your Diagnosis
Symptoms of bacterial vaginosis include:
• Increased vaginal discharge that may be gray.
• Vulvar and/or vaginal irritation.
• A “fishy” odor.

Treatment
Bacterial vaginosis can be treated by using a vaginal antibiotic cream or by taking an oral antibiotic. Both ways are equally effective. You and your doctor can discuss the pros and cons of oral versus vaginal treatment. Taking the antibiotic orally can occasionally cause mild nausea. Some women dislike
the cream because it is “messy.” Whichever treatment you select, do take or use all the medication as directed. If you stop before you complete treatment, even if the symptoms have resolved, bacterial vaginosis may recur. Anytime an antibiotic is used, orally or vaginally,a yeast infection may follow. (This is because the antibiotic “kills” the “healthy, protective” bacteria as well as the “unhealthy” bacteria, allowing the yeast to grow.) If you experience vulvar or vaginal itching after treatment, you can purchase an overthe-counter antiyeast medication, such as Monistat, Femstat, or Gynelotrimin, or purchase the generic equivalent (just as effective as brand names) and use it as directed. If the itching does not resolve, call your doctor.

The DOs
• Take or use all your medication as prescribed. If you do not finish the medication, the bacterial vaginosis may be incompletely treated, so it may recur.
• There is some evidence that eating yogurt with live acidophilus bacteria may help keep the vagina healthier and help prevent infection. So you may want to eat 8 ounces of yogurt daily, especially if you are having problems with recurrent vaginal infections. (Yogurt is a great source of calcium anyway! And all women should take in 800 mg of calcium daily. Eight ounces of yogurt has 300 mg of calcium.)

The DON’Ts
• Refrain from intercourse while you are being treated.
• Do not drink any alcoholic beverages if metronidazole (Flagyl) is prescribed; you could become very nauseated.

When to Call Your Doctor
• If you become nauseated and cannot take the medication.
• You continue to have symptoms after you have completed the course of treatment.
• If you treated yourself for a presumed yeast infection and the itching has not resolved.