Treatments for Bacterial Vaginosis
Bacterial Vaginosis
Overgrowth of bacteria in the vagina.
Full Answer
Can BV go away on its own?
What are the treatment options for bacterial vaginosis during pregnancy? Antibiotics such as metronidazole (aka Flagyl), clindamycin, and tinidazole are often prescribed and will destroy some of the bacteria that cause symptoms of bacterial vaginosis.
Can BV Stop Me from getting pregnant?
Mar 01, 2022 · It appears that infection with bacterial vaginosis in early pregnancy (second trimester) conveys a greater risk for complications than infection with bacterial vaginosis in …
How to cure chronic BV?
Apr 22, 2022 · Key Pointers. Lactobacilli imbalance in the vaginal microbiome causes bacterial vaginosis. Its symptoms may include thin greyish vaginal discharge with a fishy smell and burning sensation and irritation around the vagina. Vaginal probiotics or ointments with vaginal clindamycin can help alleviate the symptoms.
Why does my BV keep coming back?
Sep 14, 2020 · Bacterial vaginosis (commonly known as BV) is the most common vaginal infection in women of childbearing age. It's caused by an imbalance in the bacteria that live in your vagina. About 1 in 4 women have this infection at some point during pregnancy, though estimates vary widely. Normally, "good" bacteria, called lactobacilli, are in the ...
Should BV be treated in first trimester?
Do you need to treat BV in pregnancy?
Can you treat BV naturally while pregnant?
Can I take metronidazole for BV while pregnant?
Is BV harmful in pregnancy?
Is BV more common during pregnancy?
How can I restore my vaginal pH balance during pregnancy?
- Use a probiotic for vaginal health. It's all about maintaining a healthy microbiome (the community of microorganisms in your body) that makes your vagina unwelcoming to infections. ...
- Use a condom when you have sex. ...
- Stay away from the douche.
Can metronidazole harm early pregnancy?
Can metronidazole cause birth defects?
Can bacterial vaginosis be cured?
BV will sometimes go away without treatment. But if you have symptoms of BV you should be checked and treated. It is important that you take all of the medicine prescribed to you, even if your symptoms go away. A health care provider can treat BV with antibiotics, but BV may recur even after treatment.
Resources for Clinicians
Vaginitis Self-Study Module external icon – An online learning experience that helps users learn how to manage vaginitis. Free CME/CNE available. (November 1, 2017)
How effective is bacterial vaginosis screening?
The effectiveness of screening patients to prevent potentially serious sequelae depends on the prevalence of the condition in the population at risk, readily available and accurate diagnostic tests, consequences of the untreated condition, effective therapy and the overall cost-effectiveness of such intervention. In support of screening pregnant women for bacterial vaginosis are the following factors: the condition is exceedingly common (a prevalence rate of up to 30 percent); reasonably reliable tests are available; the potential consequences of not treating bacterial vaginosis are severe for the mother and the fetus; and moderately effective therapy is available. While these factors bolster screening, many questions regarding screening pregnant women for bacterial vaginosis exist.
Why is bacterial vaginosis not universally effective?
Because the true etiology of bacterial vaginosis remains unknown, therapeutic agents are not universally effective. As a consequence of imprecisely directed treatment (i.e., treating the expression of bacterial vaginosis and not the exact cause), the recurrence of bacterial vaginosis infection is exceedingly common.
Can metronidazole be used during pregnancy?
Topical metronidazole gel (Metrogel) has not been evaluated in the context of bacterial vaginosis during pregnancy. Topical antibiotics usually eradicate local bacterial vaginosis infection, but do not reduce prematurity sequelae because of the lack of access to the upper genital tract. Therefore, systemic antibiotics are probably required ...
Does clindamycin help with preterm birth?
Topical clindamycin vaginal cream is ineffective in reducing the rates of preterm birth. 9, 10 In fact, such treatment actually increases the presence of vaginal Escherichia coli, an organism known to increase the risk for preterm birth. Topical metronidazole gel (Metrogel) has not been evaluated in the context of bacterial vaginosis ...
Is bacterial vaginosis a high risk pregnancy?
While treatment of high-risk pregnant women with bacterial vaginosis reduces the risks for fetal-maternal complications, 2, 3 no data are available to compare bacterial vaginosis treatment outcomes for both women at low risk and women at high risk of fetal-maternal complications. Therefore, currently only women determined to be at high risk for preterm delivery should be considered candidates for screening for bacterial vaginosis. 1, 4
Does bacterial vaginosis reduce preterm birth?
Several research ers have demonstrat ed that treatment of bacterial vaginosis in pregnant women reduces the rate of preterm birth. 2, 3 Hauth and colleagues 2 showed that pregnant women who had bacterial vaginosis and an increased risk for preterm delivery (previous history of preterm delivery or low prepregnant weight of less than 50 kg [110 lb]), and who received metronidazole (Flagyl) and erythromycin therapy, had significantly reduced rates of preterm delivery when compared with women given placebo (39 percent versus 57 percent). Morales and colleagues 3 demonstrated that oral metronidazole therapy reduced the rate of preterm births for pregnant women with bacterial vaginosis and a previous history of preterm birth when compared with women who received placebo (18 percent versus 39 percent).
Can a pregnant woman have bacterial vaginosis?
Clearly, a casual approach to pregnant women with symptoms or clinical signs of bacterial vaginosis appears unjustified. Symptomatic pregnant women with confirmed bacterial vaginosis should be treated. 1 Whether asymptomatic pregnant women deserve, and would benefit from, therapy is less well defined. More than one half of all women with bacterial vaginosis have no symptoms of the lower genital tract; nevertheless, they are still afflicted. One could easily argue that treatment should be implemented for pregnant women because of the increased probability of serious complications, regardless of the absence of symptoms.
How to diagnose BV?
BV can be diagnosed by using clinical criteria (i.e., Amsel’s diagnostic criteria) ( 999) or by determining the Nugent score from a vaginal Gram stain ( 1000 ). Vaginal Gram stain, considered the reference standard laboratory method for diagnosing BV, is used to determine the relative concentration of lactobacilli (i.e., long gram-positive rods), small gram-negative and gram-variable rods (i.e., G. vaginalis or Bacteroides ), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. A Nugent score of 0–3 is consistent with a Lactobacillus -predominant vaginal microbiota, 4–6 with intermediate microbiota (emergence of G. vaginalis ), and 7–10 with BV. Clinical diagnosis of BV by Amsel criteria requires at least three of the following four symptoms or signs:
What is the best test for BV?
In addition to the Amsel criteria, multiple POC tests are available for BV diagnosis. The Osom BV Blue test (Sekisui Diagnostics) detects vaginal sialidase activity ( 1003, 1004 ). The Affirm VP III (Becton Dickinson) is an oligonucleotide probe test that detects high concentrations of G. vaginalis nucleic acids (>5 x 10 5 CFU of G. vaginalis/ mL of vaginal fluid) for diagnosing BV, Candida species, and T. vaginalis. This test has been reported to be most useful for symptomatic women in conjunction with vaginal pH measurement and presence of amine odor (sensitivity of 97%); specificity is 81% compared with Nugent. Finally, the FemExam Test Card (Cooper Surgical) measures vaginal pH, presence of trimethylamine (a metabolic by-product of G. vaginalis ), and proline aminopeptidase ( 1005 ). Sensitivity is 91% and specificity is 61%, compared with Nugent. This test has primarily been studied in resource-poor settings ( 1005 ), and although it has been reported to be beneficial compared with syndromic management, it is not a preferred diagnostic method for BV diagnosis.
Can BV be used during pregnancy?
BV treatment is recommended for all symptomatic pregnant women because symptomatic BV has been associated with adverse pregnancy outcomes , including premature rupture of membranes, preterm birth, intra-amniotic infection, and postpartum endometritis ( 989, 991, 1036 ). Studies have been undertaken to determine the efficacy of BV treatment among this population, including two trials demonstrating that oral metronidazole was efficacious during pregnancy by using the 250 mg 3 times/day regimen ( 1037, 1038 ); however, oral metronidazole administered as a 500 mg 2 times/day regimen can also be used. One trial involving a limited number of participants revealed treatment with oral metronidazole 500 mg 2 times/day for 7 days to be equally effective as metronidazole gel 0.75% for 5 days, with cure rates of 70% by using Amsel criteria to define cure ( 1039 ). Another trial demonstrated a cure rate of 85% by using Gram-stain criteria after treatment with oral clindamycin 300 mg 2 times/day for 7 days ( 1040 – 1043 ).
Is BV treatment recommended for women?
Treatment for BV is recommended for women with symptoms. Established benefits of therapy among nonpregnant women are to relieve vaginal symptoms and signs of infection. Other potential benefits of treatment include reduction in the risk for acquiring C. trachomatis, N. gonorrhoeae, T. vaginalis, M. genitalium, HIV, HPV, and HSV-2 ( 971, 986 – 988, 990, 1010 ). No data are available that directly compare the efficacy of oral and topical medications for treating BV.
Can you douch for BV?
Douching might increase the risk for relapse , and no data support use of douching for treatment or symptom relief.
Should women with BV be tested for HIV?
All women with BV should be tested for HIV and other STIs.
Is clindamycin safe for pregnancy?
Although older studies indicated a possible link between using vaginal clindamycin during pregnancy and advers e outcomes for the newborn, newer data demonstrate that this treatment approach is safe for pregnant women ( 1044 ). Although metronidazole crosses the placenta, no evidence of teratogenicity or mutagenic effects among infants has been reported in multiple cross-sectional, case-control, and cohort studies of pregnant women ( 1041 – 1043 ). These data indicate that metronidazole therapy poses low risk during pregnancy. Data from human studies are limited regarding the use of tinidazole in pregnancy; however, animal data demonstrate that such therapy poses moderate risk. Thus, tinidazole should be avoided during pregnancy ( 431 ). Data are insufficient regarding efficacy and adverse effects of secnidazole, Clindesse 2% vaginal cream, metronidazole 1.3% vaginal gel, and 750-mg vaginal metronidazole tablets during pregnancy; thus, their use should be avoided.
What Causes Bacterial Vaginosis In Pregnancy?
BV is caused by the imbalance of lactobacilli in the vaginal microbiome ( 3 ). Lactobacilli are responsible for maintaining an acidic environment in the vagina, which prevents the overgrowth of other bacteria and clinical indications of intrauterine infection. The risk of acquiring BV is higher in asymptomatic women who
What Are The Signs And Symptoms Of Bacterial Vaginosis?
Most women with BV may not experience noticeable symptoms. Nevertheless, if you suspect you have BV, check for the following symptoms and contact your healthcare professional ( 4 ):
How Is Bacterial Vaginosis Diagnosed?
BV is diagnosed and screened in pregnant women based on the healthcare provider’s discretion and available facilities. However, some common diagnostic procedures are ( 5)
How Is Bacterial Vaginosis Treated During Pregnancy?
No OTC medicines are available for treating BV. Therefore, doctors mostly prescribe antibiotic treatment, such as metronidazole or oral clindamycin. Since antibiotics also affect the good bacteria in the vagina, they are not prescribed unless necessary.
What Are The Complications Of Bacterial Vaginosis During Pregnancy?
BV in pregnant women may increase the risk for the following adverse pregnancy outcomes if left untreated ( 1) ( 7 ):
Can Bacterial Vaginosis Resolve By Itself During Pregnancy?
BV is usually a mild condition that resolves by itself in a few days. However, if the infection persists, it may harm the mother and the baby. Hence, consult your doctor beforehand to prevent future complications.
How Can You Reduce Your Risk For Bacterial Vaginosis?
Taking measures to increase the growth and concentration of lactobacillus bacteria is the first step to help reduce your risk of acquiring BV in pregnancy. Clinical trials have shown that adding probiotics to your diet can help in this regard ( 8 ).
What to do if your partner has BV?
If your partner has BV, use a dental dam during oral sex. If you smoke, here's another reason to quit: Smoking cigarettes increases your risk for BV. Don't douche or use feminine hygiene sprays or scented soaps on your genitals. These products may upset the delicate balance of bacteria in your vagina.
How long does it take for a BV to recur?
In fact, up to 30 percent of women have symptoms again within three months and over half of women have a recurrence within a year. Antibiotics usually kill off most of the bacteria that cause BV, but there's no way to get the "good" bacteria to grow back faster so they can hold the "bad" bacteria in check.
How to tell if you have BV?
At least half the women who get BV have no symptoms at all. If you do have symptoms, you might notice: 1 A thin white or gray discharge 2 A strong, fishy smell. This odor is most apparent after sex, when the discharge mixes with semen. 3 Itching or irritation in your genital area 4 Burning when you urinate
Can you screen for BV at first visit?
If you don't have symptoms of BV but are at high risk for preterm delivery, your caregiver may or may not screen you at your first prenatal visit. Experts debate whether it's beneficial to do so because the evidence is conflicting.
Can a woman with BV have a baby?
Most women with BV have perfectly normal pregnancies. And up to half of the cases of BV in pregnant women resolve on their own. Still, studies have shown that having BV when you're pregnant is associated with: An increased risk of preterm birth and having a low-birth-weight baby.
Can you treat BV while pregnant?
Don't try to treat a BV infection by yourself with over-the-counter medications. If you're diagnosed with BV, you'll be given a course of antibiotics that are considered safe to take during pregnancy. (Unlike with some other infections, your partner won't be treated.)
Can you treat BV by yourself?
Don't try to treat a BV infection by yourself with over-the-counter medications.
How to cure BV during pregnancy?
Bacterial vaginosis treatment during pregnancy is mostly based on the restoration of pH of the vagina. Vaginal pH correction treatment: This brings us to the next cure for BV during pregnancy. Vaginal washes and pH neutral soaps help correct the altered pH of the vagina.
Why does BV occur during pregnancy?
Bacterial Vaginosis (BV) during pregnancy occurs due to the imbalance of good and bad bacteria in the vagina. Vagina has a lot of good bacteria. They are of the same family as the ones found in the curd. Lactobacillus and yeast are present in the vagina.
Why does BV cause spotting?
Bacterial vaginosis spotting: Bacterial vaginosis spotting is due to the tearing of vaginal walls. BV during pregnancy can spread to the uterus and causes tearing of membranes. It can result in vaginal bleeding and passing of vaginal tissue. Spotting is the most important symptom of BV during pregnancy.
What percentage of pregnant women have bacterial vaginosis?
Bacterial vaginosis during pregnancy is the condition of having an outbreak of harmful bacteria in the vagina area. 10-30% of pregnant women have Bacterial Vaginosis (BV). Woman having a previous bacterial vaginosis infection are more prone to bacterial vaginosis during pregnancy. Certain ethnic groups are also at higher risk of BV during pregnancy.
How to cure BV?
Decide this home remedy for BV considering your skin sensitivity. Tea tree oil: Tea tree oil is also a natural cure for bacterial vaginosis during pregnancy. Applying tea tree oil to your vagina can kill the bacteria and correct the pH. Cranberry juice: Drinking cranberry juice is beneficial for your pregnancy.
When do women get bacterial vaginosis?
The second trimester is the time most women get bacterial vaginosis.
Can a woman have bacterial vaginosis while pregnant?
Bacterial Vaginosis Symptoms. About 50-70% of the woman having bacterial vaginosis during pregnancy don’t experience any symptoms. It is only when they have sex, the fishy odor makes them worry about bacterial vaginosis. There are no distinct symptoms of bacterial vaginosis during pregnancy.
What is BV discharge?
Bacterial vaginosis (BV) (also known as nonspecific vaginitis) is caused by several different types of bacteria. Many women don’t experience any symptoms, but some may develop a white or grayish, fishy-smelling discharge. In some cases, the discharge may also appear frothy.
What to do if you have a yeast infection while pregnant?
If the diagnosis of a yeast infection is confirmed by a medical professional, it is likely they will either suggest an over the counter treatment, or they may prescribe oral medication, antifungal creams, or suppositories. Read more about dealing with yeast infections during pregnancy.
What are the different types of vaginal infections?
Four types of vaginitis include trichomoniasis, yeast infections, bacterial vaginosis, and atrophic vaginitis. This article will focus on the two types most pertinent to pregnant women: yeast infections and bacterial vaginosis.
Can pregnant women get vaginal inflammation?
Treating vaginitis naturally during pregnancy is a frequent concern for expecting mothers. Vaginitis is a general term for the inflammation of the vagina. Vaginitis is common but can be very annoying as it tends to be reoccurring and may interfere with sexual intercourse.
Can bacterial vaginosis be treated naturally?
Unfortunately, bacterial vaginosis cannot be treated naturally. It is important to take action and contact your healthcare provider because bacterial vaginosis has been associated with preterm delivery, low-birth-weight infants, preterm/pre-labor membrane rupture, and late-term miscarriages.
What are the complications of having BV during the first trimester of pregnancy?
One other complication for having BV during the first trimester of pregnancy is Intra Amniotic infection.
What happens if you don't treat BV?
Bacterial vaginosis if not treated will lead to different complications and can increase the risk of getting a sexually transmitted infection. There are different complications that can arise if a pregnant woman gets BV during the first trimester of her pregnancy. Miscarriage occurs during the first 20 weeks of pregnancy.
What percentage of women get infected with bacterial vaginosis during their first trimester?
Being pregnant brings a lot of emotions and one of them is joy, the joy of being able to conceive a human being inside your womb, however, there are around 10-30% of women who are pregnant who get infected with bacterial vaginosis during their first trimester pregnancy. This type of infection cannot be easily avoided.
Why is it more likely to get a vaginal infection while pregnant?
Summary. When a woman is pregnant there is a higher chance for her to have vaginal infections because of the increased hormones during pregnancy. Bacterial vaginosis is usually diagnosed by a simple swab of the vaginal discharge.
Why does BV occur?
This brings up BV; Bacterial Vaginosis usually occurs if there is a sudden difference in the bacterial population in the vaginal ecosystem. This allows the “good” bacteria Lactobacilli to have a significant decrease and the increase in the proliferation of bad bacteria in the vagina.
Why is it important to notify your medical provider of pregnancy?
It is important that you notify your medical care provider so you know the necessary steps that need to be taken. These symptoms must not be ignored. There is a possibility that when there is pain and bleeding, the chances of the pregnancy to continue can be lower.
Can BV cause complications?
Bacterial Vaginosis in pregnant women is common and may cause complications during her pregnancy. This article will tackle what happens when a woman gets BV During Pregnancy First Trimester.
