GSE
Bacterial Vaginosis - Symptoms
Symptoms of bacterial vaginosis (BV)
Bacterial vaginosis is not dangerous, but it can
cause disturbing symptoms. Symproms vary among
particular types of vaginitis, with some overlap:
-
Vaginal discharge and odor that usually has an
unpleasant odor, although 50% to 75% of women with the condition experience no
symptoms.
Discharge is generally grayish-white but can be of any color or consistency.
-
Normal discharge is common when
estrogen
levels are high.
Normal vaginal discharge is commonly milky white or mucoid, odorless, and
nonirritating.
-
Slight bleeding
often occurs when
estrogen
levels abruptly
decrease
-
Discharge due to vaginitis is accompanied by pruritus
(itching),
vaginal soreness / redness from inflammation, and
sometimes dysuria
(burning, painful urination) or mild bleeding.
Itching may interfere with sleep. Painful
intercourse may also occur.
-
In atrophic vaginitis.
Discharge is scant, dyspareunia is common,
and vaginal tissue appears thin and dry. Atrophic vaginitis is an inflammation
of the vagina (and outer urinary tract) due to the thinning / shrinking of the
tissues and decreased lubrication -all commonly due to lack of
estrogen, which happens naturally during
perimenopause and more so in post-menopause
In
women of reproductive age. Vaginitis is usually infectious. The most
common types are bacterial vaginosis, candidal vaginitis and trichomonal
vaginitis (which is sexually transmitted). Normally in women of reproductive
age:
-
Lactobacilli are the predominant constituent of normal
vaginal flora
.
Their c
olonization keeps vaginal pH in the normal acidic range (3.8 -
4.2), thereby preventing overgrowth of pathogenic bacteria.
-
High
estrogen
levels maintain
vaginal thickness, bolstering local defenses
-
Factors that predispose to overgrowth of bacterial
vaginal pathogens.
May include the following:
• An alkaline vaginal pH due to menstrual blood,
semen, or a decrease in lactobacilli
•
Poor hygiene
•
Frequent douching
In postmenopausal women :
-
Usually, a marked decrease in
estrogen
causes vaginal
thinning, increasing vulnerability to infection and inflammation.
Some treatments (eg, oophorectomy, pelvic radiation, certain chemotherapy drugs)
result in loss of estrogen. Decreased estrogen predisposes to atrophic
vaginitis.
-
Poor hygiene.
Can lead to chronic vulvar inflammation due to
chemical irritation from urine or feces or due to nonspecific infection. (E.g.
in patients who are incontinent or bedridden)
-
Bacterial vaginosis, candidal vaginitis, and trichomonal
vaginitis are uncommon among postmenopausal women.
May occur in those with risk factors.
In women of all ages
:
-
Conditions that
predispose to vaginal or vulvar infection include
:
•
Fistulas between the intestine and genital tract
-
allow intestinal flora to seed the genital
tract
•
Pelvic radiation or tumors -
which break down tissue and thus compromise
normal host defenses
-
Noninfectious vulvitis accounts for up to 30% of
vulvovaginitis cases.
Possibly resulting from:
•
Hypersensitivity or irritant reactions.
To hygiene sprays or perfumes, menstrual
pads, laundry soaps, bleaches, fabric softeners, fabric dyes, synthetic fibers,
bathwater additives, toilet tissue, or, occasionally, spermicides, vaginal
lubricants or creams, latex condoms, vaginal contraceptive rings, or diaphragms
