Overview
Diagnosis of Bacterial Vaginosis (BV)
Bacterial vaginosis is diagnosed through a combination of clinical evaluation and laboratory tests:
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Medical history review: Your doctor asks about previous vaginal infections, sexually transmitted infections, and risk factors for BV.
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Pelvic exam: The doctor inspects the vagina for signs of infection and palpates the pelvic organs by inserting two fingers into the vagina while pressing on the abdomen.
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Vaginal discharge analysis: A sample of discharge is collected to identify clue cells, which are vaginal cells covered with bacteria and indicate BV.
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Vaginal pH testing: A pH strip may be used to measure vaginal acidity. A pH of 4.5 or higher suggests bacterial vaginosis.
Additional tests may be performed if the diagnosis is uncertain or to rule out other infections that mimic BV. Accurate diagnosis is important to ensure effective treatment and prevent recurrence.
Treatment for Bacterial Vaginosis
Treatment of BV focuses on eradicating the bacterial overgrowth and restoring healthy vaginal flora:
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Metronidazole (oral or vaginal gel): Avoid alcohol during treatment and for 24 hours after. Possible side effects include nausea and stomach discomfort.
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Clindamycin (vaginal cream, oral pill, or suppository): The cream and suppositories may weaken latex condoms. Sexual activity should be avoided during treatment and for at least three days afterward.
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Tinidazole (oral): May cause stomach upset. Alcohol should be avoided during treatment and for three days after completion.
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Secnidazole (single-dose oral granules): Granules are mixed with soft food and consumed within 30 minutes without chewing.
Sexual partners who are male typically do not require treatment. Female partners with symptoms should be evaluated and treated to prevent reinfection. Completing the full course of antibiotics is crucial, even if symptoms resolve early, to prevent recurrence.
Recurrence and Prevention
Recurrent BV is common, occurring within 3 to 12 months in some patients. Extended-use metronidazole therapy may be recommended for recurrent cases.
Current evidence does not support the use of probiotics as a reliable treatment for BV. Maintaining proper vaginal hygiene, avoiding unnecessary antibiotics, and seeking timely medical care can help reduce the risk of recurrence.
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