Vaginosis - Bacterial Vaginal Infection

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Vaginosis - Bacterial Vaginal Infection
Vaginosis - Bacterial Vaginal Infection
Video: Vaginosis - Bacterial Vaginal Infection
Video: What is bacterial vaginosis? | Infectious diseases | NCLEX-RN | Khan Academy 2023, February

Bacterial vaginal infection

A bacterial vaginal infection (vaginosis) is a pathological change in the vaginal environment due to the increased colonization of various pathogenic germs (especially the Gardnerella vaginalis bacterium). The "good" lactic acid bacteria (lactobacilli) are thereby displaced. These lactic acid bacteria ensure an acidic pH value in the vagina and protect against pathogens.


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  • What are the symptoms?
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  • How are the costs going to be covered?

The microbiological balance of the vagina shifts due to the excessive colonization of the bacterium Gardnerella vaginalis as well as other anaerobic bacteria (bacteria living without oxygen) and mycoplasma. The lactic acid bacteria decrease and other bacteria in the vaginal flora can multiply strongly.

Note The bacterial vaginal infection is not a sexually transmitted disease. It can also occur in sexually inactive women. However, there is an increased risk in women who frequently change sex partners.

What are the symptoms?

A bacterial vaginal infection does not always cause discomfort and often goes unnoticed. Sometimes, however, the change in the vaginal environment can cause a noticeable smelling gray-white discharge (“fishy” smell). This can be foamy or thin. In addition, itching, skin irritation (burning sensation) and vaginal dryness can occur in the outer vaginal area. These symptoms can also indicate an infection of the vagina (vaginitis). Discomfort when urinating or pain during intercourse are also possible.

The bacterial vaginal infection is one of the most common infections of the vagina. Around one in five women in 100 is affected. In about a third of women, the infection heals on its own. The bacterial vaginal infection increases the risk of further infections in the female genital tract such as:

  • Vaginal inflammation with "more complicated" germs,
  • Inflammation of the lining of the cervix (cervicitis)
  • Endometritis (inflammation of the uterine cavity)
  • Inflammation of the fallopian tubes (adnexitis) as well
  • Inflammation of the outer pubic parts (vulvitis).

If there is already a "slight" inflammation, the risk of contracting other sexually transmitted diseases also increases.

Note A bacterial vaginal infection during pregnancy can increase the risk of complications such as premature labor or miscarriage and premature birth.

How is the diagnosis made?

If a bacterial vaginal infection is suspected, the gynecologist will examine the vagina and take a sample of the vaginal secretions. This sample (smear) is used to measure the pH of the vaginal secretion and to determine which types of bacteria it contains. For a confirmed diagnosis (bacterial vaginosis), at least three of the following four findings must be made during the gynecological examination:

  • gray-white discharge,
  • vaginal pH greater than 4.5 (normal vaginal pH 3.7 to 4.5),
  • KOH test positive ("Whiff test"): After adding a ten percent potassium hydroxide solution, a typical amine odor ("fishy odor") arises,
  • microscopic detection of so-called key cells (“clue cells”): These are epithelial cells that are covered with a carpet of bacteria.

If the therapy is unsuccessful, the suspicion that other pathogens are present that should be clarified by an extensive bacterial and microbiological examination in a special laboratory is reasonable.

How is the treatment carried out?

A bacterial vaginal infection is usually treated with antibiotics (e.g. metronidazole, clindamycin). They can be given as a tablet or as a suppository. Clindamycin is also available as a vaginal cream. The duration and intensity of the therapy depends on the active ingredient, form of application, dosage and severity of the symptoms.

Further therapy options

In order to protect the vaginal flora and restore its balance, lactobacillus preparations (live lactic acid bacteria) can be administered. However, the benefits of this therapy option have not yet been adequately investigated. They are usually given in combination with antibiotics.

Note The use of natural products such as tea tree oil, yoghurt, vinegar or lemon water to acidify the vaginal environment has not been examined in large studies for its effectiveness or safety. However, those affected repeatedly report successful therapy with these natural remedies.

Since antibiotic treatment kills not only the “bad” bacteria, but also useful bacteria in the vaginal flora, a side effect can sometimes be a fungal infection of the vagina (candidiasis). Other possible side effects:

  • Metallic taste in the mouth as well
  • Nausea & vomiting (rather rare).

Therapy during pregnancy

The bacterial vaginal infection increases the risk of premature rupture of the bladder, premature labor, and premature delivery. The reasons for this are various biochemical reactions between the fetus and the uterus and on the cervix. There is an increased formation of prostaglandins, which have a labor-triggering effect. For this reason, a bacterial vaginal infection that occurs during pregnancy should also be treated with antibiotics (systemic). Alternatively, local vaginal treatment with metronindazole can be considered. Clindamycin may also be prescribed after the first trimester.

Whom can I ask?

If you have complaints or suspect infection, you can contact a doctor for gynecology and obstetrics.

How are the costs going to be covered?

All necessary and appropriate therapies are covered by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

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