What are the symptoms of bacterial vaginosis. How is bacterial vaginosis diagnosed. What treatments are available for bacterial vaginosis. Can bacterial vaginosis go away on its own. How can you prevent bacterial vaginosis.

Understanding Bacterial Vaginosis: A Common Vaginal Condition

Bacterial vaginosis (BV) is a prevalent vaginal condition characterized by an overgrowth of certain types of bacteria in the vagina. This imbalance can lead to various uncomfortable symptoms and potential health risks if left untreated. While BV is not classified as a sexually transmitted infection (STI), it is more common among sexually active women.

What Causes Bacterial Vaginosis?

The exact cause of bacterial vaginosis remains unclear. However, several factors may contribute to the development of this condition:

• Disruption of the natural vaginal flora
• Multiple sexual partners
• Douching
• Lack of lactobacilli bacteria
• Hormonal changes

Is bacterial vaginosis related to sexual activity? While BV is not considered an STI, sexual activity can increase the risk of developing the condition. Women with multiple sexual partners or new sexual partners are at a higher risk of experiencing BV. Additionally, women who have female sexual partners may be more susceptible to this condition.

Recognizing the Symptoms of Bacterial Vaginosis

Many women with bacterial vaginosis may not experience any noticeable symptoms. However, when symptoms do occur, they can be quite distinct and uncomfortable. The most common signs of BV include:

1. Vaginal discharge: Often described as thin, watery, and gray or white in color
2. Unpleasant odor: A strong, fishy smell, particularly after sexual intercourse
3. Itching or irritation: Around the vaginal opening
4. Burning sensation: During urination

Can bacterial vaginosis symptoms be mistaken for other conditions? Yes, the symptoms of BV can be similar to those of other vaginal infections, such as yeast infections or sexually transmitted infections. This is why it’s crucial to consult a healthcare professional for an accurate diagnosis.

Diagnosing Bacterial Vaginosis: Medical Procedures and Tests

To diagnose bacterial vaginosis, healthcare providers typically follow a multi-step approach:

1. Medical history review: The doctor will ask about your symptoms and sexual history
2. Pelvic examination: A visual inspection of the vagina and cervix
3. Vaginal discharge sample: Collected for laboratory analysis
4. pH testing: To measure the acidity of the vaginal environment
5. Whiff test: Application of potassium hydroxide to the discharge sample to detect a characteristic odor

How accurate are home testing kits for bacterial vaginosis? While over-the-counter testing kits are available, they are not as reliable as professional medical diagnosis. These kits typically only measure vaginal pH, which can be affected by factors other than BV. For a definitive diagnosis, it’s best to consult a healthcare provider.

Treatment Options for Bacterial Vaginosis

Bacterial vaginosis can be effectively treated with antibiotics prescribed by a healthcare provider. The most common treatment options include:

• Metronidazole: Oral tablets or vaginal gel
• Clindamycin: Vaginal cream
• Tinidazole: Oral tablets

Is it necessary to treat bacterial vaginosis if there are no symptoms? In some cases, asymptomatic BV may resolve on its own without treatment. However, treatment is recommended if you are pregnant, planning to undergo gynecological procedures, or experiencing symptoms. Untreated BV can increase the risk of complications, especially during pregnancy.

Duration of Treatment and Follow-up Care

The duration of treatment for bacterial vaginosis typically ranges from 5 to 7 days, depending on the prescribed medication and its form. It’s crucial to complete the entire course of antibiotics, even if symptoms improve before finishing the medication. Follow-up appointments may be necessary to ensure the infection has cleared completely.

Can bacterial vaginosis recur after treatment? Unfortunately, recurrence of BV is common. About 50% of women who have been treated for BV experience a recurrence within 12 months. If you experience frequent recurrences, your healthcare provider may recommend a longer course of treatment or a different antibiotic regimen.

Preventing Bacterial Vaginosis: Lifestyle Changes and Precautions

While it’s not always possible to prevent bacterial vaginosis, certain lifestyle changes and precautions can help reduce the risk of developing this condition:

• Practice safe sex: Use condoms consistently and correctly
• Limit sexual partners: Having multiple partners increases the risk of BV
• Avoid douching: This practice can disrupt the natural balance of vaginal bacteria
• Use gentle, unscented products: For personal hygiene and laundry
• Wear breathable underwear: Choose cotton or other natural fibers
• Maintain good hygiene: Wipe from front to back after using the bathroom

Are probiotics effective in preventing bacterial vaginosis? Some studies suggest that probiotics, particularly those containing Lactobacillus species, may help prevent BV or reduce recurrence. However, more research is needed to establish their effectiveness definitively. Consult your healthcare provider before starting any probiotic regimen.

The Impact of Bacterial Vaginosis on Overall Health

While bacterial vaginosis is often considered a minor condition, it can have significant implications for overall health, particularly if left untreated. Some potential complications and associated risks include:

1. Increased susceptibility to sexually transmitted infections, including HIV
2. Higher risk of pelvic inflammatory disease (PID)
3. Complications during pregnancy, such as preterm birth or low birth weight
4. Increased risk of post-surgical infections following gynecological procedures

Does bacterial vaginosis affect fertility? While BV itself does not directly cause infertility, it can increase the risk of developing pelvic inflammatory disease, which can lead to fertility problems. Additionally, BV during pregnancy may increase the risk of miscarriage or preterm birth.

Psychological and Social Impact

The symptoms of bacterial vaginosis, particularly the unpleasant odor, can have a significant impact on a woman’s self-esteem and sexual relationships. It’s important to address these psychological aspects and seek support if needed. Open communication with partners and healthcare providers can help alleviate anxiety and ensure proper management of the condition.

Bacterial Vaginosis Research: Current Trends and Future Directions

Research into bacterial vaginosis continues to evolve, with scientists exploring new avenues for prevention, diagnosis, and treatment. Some current areas of focus include:

• Understanding the vaginal microbiome and its role in BV
• Developing more accurate diagnostic tools
• Exploring alternative treatment options, such as probiotics and bacteriophages
• Investigating the link between BV and other health conditions
• Studying the impact of hormonal contraceptives on BV risk

What new treatments for bacterial vaginosis are on the horizon? Researchers are exploring several innovative approaches, including vaginal microbiome transplants, personalized probiotic therapies, and novel antimicrobial compounds. While these treatments show promise, they are still in the experimental stages and require further study before becoming widely available.

Bacterial Vaginosis in Special Populations

Certain groups of women may face unique challenges when it comes to bacterial vaginosis. Understanding these special considerations is crucial for appropriate management and care:

Pregnant Women

Bacterial vaginosis during pregnancy can increase the risk of complications such as preterm birth, low birth weight, and miscarriage. Pregnant women with BV may require more frequent monitoring and specific treatment approaches to minimize these risks.

Postmenopausal Women

Postmenopausal women may experience changes in vaginal pH and microbiome composition due to decreased estrogen levels. This can affect their susceptibility to BV and may require different management strategies.

Women with Compromised Immune Systems

Women with weakened immune systems, such as those with HIV or undergoing chemotherapy, may be more susceptible to BV and its complications. These individuals may require more aggressive treatment and prevention strategies.

How does bacterial vaginosis affect women with HIV? Women with HIV who have BV may experience increased viral shedding, potentially increasing the risk of HIV transmission. Additionally, BV may make these women more susceptible to other opportunistic infections.

Myth-busting: Common Misconceptions About Bacterial Vaginosis

There are many myths and misconceptions surrounding bacterial vaginosis. Let’s address some of the most common ones:

1. Myth: BV is a sexually transmitted infection.
   Fact: While sexual activity can increase the risk of BV, it is not classified as an STI.
2. Myth: BV only affects women who are sexually active.
   Fact: Women who are not sexually active can also develop BV, although it is less common.
3. Myth: Poor hygiene causes BV.
   Fact: Excessive cleaning or douching can actually increase the risk of BV by disrupting the natural vaginal balance.
4. Myth: BV will always go away on its own.
   Fact: While some cases may resolve without treatment, many require antibiotic therapy to clear the infection.
5. Myth: Male partners need to be treated for BV.
   Fact: Treatment of male partners is not typically recommended, as BV is not considered an STI.

Is it true that certain foods can trigger bacterial vaginosis? There is limited scientific evidence linking specific foods to BV. However, maintaining a balanced diet rich in probiotics and avoiding excessive sugar intake may support overall vaginal health. It’s important to focus on overall health and hygiene practices rather than attributing BV to specific dietary choices.

Living with Bacterial Vaginosis: Coping Strategies and Support

Dealing with bacterial vaginosis can be challenging, especially for women who experience recurrent infections. Here are some strategies to help cope with BV and maintain vaginal health:

• Educate yourself: Learn about BV and its management to feel more in control
• Communicate openly: Discuss concerns with healthcare providers and partners
• Join support groups: Connect with others who have experienced BV
• Practice self-care: Maintain good hygiene and overall health
• Explore stress reduction techniques: Stress may impact vaginal health
• Consider counseling: If BV is affecting your mental health or relationships

Are there any natural remedies that can help manage bacterial vaginosis symptoms? While scientific evidence is limited, some women report relief from BV symptoms using natural remedies such as tea tree oil, garlic, or apple cider vinegar. However, it’s crucial to consult a healthcare provider before trying any alternative treatments, as they may cause irritation or interfere with prescribed medications.

The Importance of Regular Check-ups

Regular gynecological check-ups are essential for maintaining vaginal health and detecting conditions like bacterial vaginosis early. These visits provide an opportunity to discuss any concerns, undergo necessary screenings, and receive personalized advice on prevention and management strategies.

How often should women be screened for bacterial vaginosis? There is no standard recommendation for routine BV screening in asymptomatic women. However, women who have experienced BV in the past or are at higher risk may benefit from more frequent check-ups. Discuss your individual needs with your healthcare provider to determine the most appropriate screening schedule.

In conclusion, bacterial vaginosis is a common vaginal condition that, while often uncomfortable, can be effectively managed with proper diagnosis and treatment. By understanding the causes, symptoms, and prevention strategies, women can take proactive steps to maintain their vaginal health and overall well-being. Remember that open communication with healthcare providers and partners is key to addressing any concerns and ensuring optimal management of this condition.

Vaginal Bacteria Overgrowth (Bacterial Vaginosis)

What is bacterial vaginosis?

Bacterial vaginosis (BV) is an overgrowth of a certain type of bacteria in the vagina (birth canal). It is a common condition that may or may not cause symptoms.

What is the cause?

It’s normal to have some bacteria in the vagina, but sometimes there are too many of certain types of bacteria. Doctors don’t know what causes this imbalance of bacteria. One possible cause is douching (cleaning out the vagina with water or other fluids).

Most cases of bacterial vaginosis happen in sexually active women. Women who have more than 1 sexual partner have a greater risk of this problem. However, women who are not sexually active can also have vaginosis.

What are the symptoms?

Many women don’t have any symptoms. When women do have symptoms, the most common symptom is a discharge from the vagina. The discharge may be gray or yellowish and smell bad. For example, it may smell fishy, especially after sex. You may also have itching around the opening of the vagina. Sometimes BV can cause pain or burning in the vagina that does not go away.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history. You will have a pelvic exam, and your provider will get a sample of vaginal discharge for lab tests.

How is it treated?

Untreated bacterial vaginosis sometimes goes away on its own. Sometimes, if you scratch the area to relieve itching, you may get an infection. Rarely, it may cause vaginal pain that keeps bothering you. If bacterial vaginosis is causing itching, pain, or other problems, it may need to be treated with antibiotics. The medicine for bacterial vaginosis may be taken by mouth or it may be a cream or gel that you put into the vagina. The symptoms usually go away within a few days after you start treatment.

How can I take care of myself?

Follow your healthcare provider’s instructions. Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• What activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent bacterial vaginosis?

• Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
• Have just 1 sexual partner who is not having sex with anyone else.
• If you have had sex and are worried that you may have been infected, see your healthcare provider even if you don’t have any symptoms.
• Do not douche.

Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2013-10-18
Last reviewed: 2014-11-18

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

Bacterial vaginosis – Better Health Channel

Summary

Read the full fact sheet

• Bacterial vaginosis can cause a watery, white or grey vaginal discharge with a strong smell.
• Bacterial vaginosis may develop soon after sex with a new partner.
• An antibiotic known as metronidazole is used to treat the infection.

About bacterial vaginosis

Bacterial vaginosis (BV) is caused by an imbalance of the bacteria normally present in the vagina. In women with BV, the normal healthy bacteria (in particular, lactobacilli) are replaced by an overgrowth of other mixed bacteria. The exact cause of BV is unknown.

Symptoms of BV

Symptoms of BV may include:

• watery, white or grey discharge from the vagina
• a strong or unusual odour from the vagina, often described as a ‘fishy smell’.

Bacterial vaginosis may occur at the same time as sexually transmissible infections (STIs).

How BV is spread

Although it is not clear how BV is transmitted, it is more common in women who are sexually active. It sometimes develops soon after intercourse with a new partner. Women who have female sexual partners may be at higher risk than women who have sex with only male partners.

Research has not conclusively found a link between BV and specific sexual practices or acts. However, recent evidence supports the use of condoms to reduce the risk of this infection.

Diagnosis of BV

Diagnosis is made based on signs and symptoms and lab tests. During a medical examination, your doctor may notice:

• copious vaginal discharge
• odour from the vagina
• decreased acidity of the vaginal fluid on pH testing.

Treatment for BV

If you have no symptoms, treatment is usually not required as this condition is self-limiting (will go away by itself).

Seek treatment if:

• you are about to have a medical procedure that could allow bacteria into the uterus – for example, insertion of an IUD, or termination of pregnancy
• you are pregnant – BV can cause early onset of labour. Talk to your GP, obstetrician or midwife about treatment for BV if you are pregnant
• the symptoms of BV are affecting your quality of life and you are avoiding sex because of it.

Antibiotics are used to treat BV

An antibiotic called metronidazole can be used to treat the infection. If your doctor prescribes metronidazole you will need to:

• Take the antibiotic twice a day for seven days.
• Take the tablets after meals – this can reduce the nausea and upset stomach that is sometimes associated with metronidazole.
• Avoid drinking alcohol during treatment.

Your doctor can prescribe a vaginal cream (such as clindamycin) if you are unable to take metronidazole. Clindamycin is applied to the vagina for seven nights.

Recurrences of BV

Even after treatment, about half of the women with BV will get the condition back within six to 12 months. Treating the male partner of an infected woman does not seem to reduce the risk of recurrence, but further research is being done in this area.

Prevention of BV

Most cases of BV appear to be associated with sexual activity. Condoms have been shown to protect against infection, and safe sexual practices are recommended for all women, regardless of the gender of their partners.

Where to get help

• Your GP (doctor)
• Melbourne Sexual Health CentreExternal Link Tel. (03) 9341 6200 or 1800 032 017 or TTY (for people with a hearing impairment) (03) 9347 8619
• Sexual Health Victoria (SHV)External Link. To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
• Thorne Harbour HealthExternal Link (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• Barwon Health Sexual Health ClinicExternal Link Tel. (03) 4215 0000
• Gateway Health Clinic 35External Link, Wodonga Tel. (02) 6022 8888 or 1800 657 573
• Ballarat Community Health Sexual Health ClinicExternal Link Tel. (03) 5338 4500
• Bendigo Community Health Sexual Health ClinicExternal Link Tel. (03) 5448 1600 or (03) 5434 4300
• Marie Stopes AustraliaExternal Link Tel. 1800 003 707 (24 hours)

This page has been produced in consultation with and approved
by:

Diagnosis of bacterial vaginosis, DNA quantitatively [real-time PCR]

A study aimed at identifying the genetic material (DNA) of microorganisms Lactobacillus spp., Gardnerella vaginalis, Atopobium vaginae by real-time polymerase chain reaction, for the diagnosis of bacterial vaginosis.

Synonyms Russian

Bacterial vaginosis, DNA [real-time polymerase chain reaction], quantitative analysis.

Synonyms English

Bacterial vaginosis, DNA [polymerase chain reaction, real-time PCR], quantitative, qRT-PCR.

Test method

Real-time polymerase chain reaction.

Units

GE/mL (genomic equivalents per milliliter).

What biomaterial can be used for research?

Urogenital scraping.

General information about the study

Bacterial vaginosis is a pathological process that occurs mainly in women of reproductive age and is characterized by a change in the composition and ratio of the vaginal microflora. It is a common cause of abnormal discharge, may be associated with the development of pelvic inflammatory disease in women, and increases the risk of contracting sexually transmitted infections. The development of bacterial vaginosis also increases the risk of pregnancy pathologies: premature birth, spontaneous abortion, low birth weight, postpartum endometritis, vaginitis. It should be noted that 50% of women with bacterial vaginosis may be asymptomatic.

In healthy women of reproductive age, the total number of microorganisms in the vaginal discharge is 10 ⁷ -10 ⁹ cfu / ml (colony forming units per milliliter) and consists of more than 40 different species. Doderlein sticks, lactobacilli (Lactobacillus spp.) predominate: L. crispatus, L. jensenii, L. acidophilus, L. brevis. They maintain a constant biochemical composition and have a protective function. Lactobacilli have the ability to convert glycogen into lactic acid, produce hydrogen peroxide, which allows you to maintain a constant vaginal pH, reducing acidity. At the same time, the growth of opportunistic microflora is suppressed. With bacterial vaginosis, there is dysbiosis, a violation of the ratio and an increase in the growth of opportunistic, facultative anaerobic, anaerobic bacteria and mycoplasmas. These microorganisms include Gardnerella vaginalis, Atopobium vaginae, Prevotella spp. , Mobiluncus spp., Ureaplasma urealyticum and a number of others. A decrease in the number of lactobacilli and an overgrowth of opportunistic microorganisms leads to disorders that can be clinically manifested by inflammation of the vaginal walls – vaginitis, accompanied by severe itching, burning, and abnormal discharge.

Most often in bacterial vaginosis, the number of microorganisms increases: Gardnerella vaginalis, Atopobium vaginae. Gardnerella vaginalis belongs to the opportunistic microflora of the vagina, is a facultative anaerobe. Microorganisms are detected in 95-99% of women with bacterial vaginosis, including its recurrent course. Excessive reproduction of gardnerella leads to the displacement of Lactobacillus spp. prevailing in the vagina at a normal rate. and stimulates the overgrowth of anaerobic bacteria and mycoplasmas. The risk of developing gardnerellosis is increased by vaginal douching, the use of intrauterine contraceptives and spirals, chlamydial or gonococcal infection, etc. The bacterium Atopobium vaginae is a Gram-positive anaerobic bacillus found in 99-100% of patients with bacterial vaginosis. It plays a role in the development of pelvic inflammatory disease in women, often found in recurrent bacterial vaginosis. The detection of these microorganisms plays an important role in the timely diagnosis of bacterial vaginosis, including its asymptomatic course, the prevention of complications, as well as in the appointment of the correct pathogenetic therapy.

Diagnosis of bacterial vaginosis is based on a combination of clinical manifestations and laboratory findings. In laboratory diagnostics, it is important to determine the species composition of the vaginal microflora and determine the ratio of microorganisms. This determines the number of bacteria Lactobacillus spp. and other microorganisms.

Modern diagnostic methods include real-time polymerase chain reaction (RT-PCR). This is a molecular diagnostic method that allows you to identify the genetic material of the pathogen under study. It is characterized by high rates of diagnostic sensitivity and specificity, the speed of obtaining the final result. A feature of the method is the ability to detect DNA (deoxyribonucleic acid) of bacteria even with their low content in the biological material under study. The method is based on a multiple increase in the number of copies of a DNA region specific to a given pathogen. At the same time, a quantitative assessment of the DNA of Bacteria (total number of bacteria), Lactobacillus spp., Gardnerella vaginalis, Atopobium vaginae is performed with an analysis of the ratio of the concentrations of these microorganisms. The method is used to diagnose bacterial vaginosis, including its asymptomatic course, in women with pregnancy pathologies, with the development of inflammatory complications after pregnancy, as well as in the appointment and control of ongoing therapy. When evaluating the results of RT-PCR, DNA fragments of both living and destroyed microorganisms are detected, so the result of the study will remain positive for some time, even if the treatment was chosen correctly.

What is research used for?

• For quantitative detection of DNA pathogens Lactobacillus spp., Gardnerella vaginalis, Atopobium vaginae.
• To determine the ratio of the amount of DNA of pathogens Lactobacillus spp., Gardnerella vaginalis, Atopobium vaginae.
• For diagnosing the etiology of bacterial vaginosis and its complications.
• For the appointment of pathogenetic therapy for bacterial vaginosis and to assess the control of ongoing treatment.

When is the examination scheduled?

• With clinical manifestations of bacterial vaginosis (abnormal vaginal discharge, itching, burning), as well as with its asymptomatic course.
• With the development of complications of bacterial vaginosis, pathology of pregnancy: premature birth, spontaneous abortion, low birth weight, development of postpartum endometritis, vaginitis.
• When prescribing and monitoring ongoing therapy for bacterial vaginosis. 96 GE/ml.

  Lactobacillus DNA: not less than the concentration of Bacteria DNA.

  Gardnerellavaginalis DNA: does not exceed the concentration of Lactobacillus DNA.

  Atopobium vaginae DNA: does not exceed the concentration of Lactobacillus DNA.

  The results are issued with a doctor’s opinion.

  Reasons for the increase:

  • the presence of DNA of microorganisms Lactobacillus spp., Gardnerella vaginalis, Atopobium vaginae;
  • bacterial vaginosis caused by a violation of the ratio of pathogens Lactobacillus spp., Gardnerella vaginalis, Atopobium vaginae.

  Reasons for the downgrade:

  • absence of bacterial vaginosis caused by a violation of the ratio of pathogens Lactobacillus spp., Gardnerella vaginalis, Atopobium vaginae.

  Important Notes

  • RT-PCR tests detect DNA fragments from both living and destroyed microorganisms, so the test result will remain positive for some time, even if the treatment was chosen correctly.

  Also recommended

  [09-007] Gardnerella vaginalis DNA [real-time PCR]

  [09-116] Vaginal microbiocenosis analysis. 16 indicators, DNA quantitatively [real-time PCR]

  [09-117] Analysis of vaginal microbiocenosis. 8 parameters, DNA quantitatively [real-time PCR]

  [10-048] Culture for Gardnerella vaginalis

  [10-055] Study of vaginal microbiocenosis with determination of sensitivity to antibiotics

  Who orders the examination?

  Gynecologist, obstetrician-gynecologist, urologist, internist, general practitioner.

  Literature

  • Kusters JG, Reuland EA, Bouter S, Koenig P, Dorigo-Zetsma JW. A multiplex real-time PCR assay for routine diagnosis of bacterial vaginosis // Eur J Clin Microbiol Infect Dis. 2015 Sep;34(9):1779-85.
  • Oakley BB, Fiedler TL, Marrazzo JM, Fredricks DN. Diversity of human vaginal bacterial communities and associations with clinically defined bacterial vaginosis // Appl Environ Microbiol. 2008 Aug;74(15):4898-909.
  • Bradshaw CS, Tabrizi SN, Fairley CK, Morton AN, Rudland E, Garland SM. The association of Atopobium vaginae and Gardnerella vaginalis with bacterial vaginosis and recurrence after oral metronidazole therapy // J Infect Dis. 2006 Sep 15;194(6):828-36.

  Burning in the vagina: causes and treatment

  Diseases accompanied by burning in the vagina, as a rule, are the reason for contacting a gynecologist, less often a dermatovenereologist. In the beginning, it is necessary to exclude dangerous types of infection that can cause burning, such as sexually transmitted infections (STIs).

  Vaginal burning may be caused by:

  • Chlamydia
  • Mycoplasma
  • Herpes
  • Trichomonas
  • Atrophy 900 62
  • Bacterial vaginosis
  • Allergy
  • Thrush
  • Aerobic vaginitis
  • Gonorrhea

  However, more frequent In some cases, the cause of the disease is microorganisms that normally live in the vagina. But for various reasons, they can be quite aggressive, provoking symptoms of intimate discomfort.

  Let’s analyze the main diseases that provoke the appearance of itching in the vagina, associated with the manifestation of the aggressiveness of the normal flora.

  Aerobic vaginitis

  Aerobic vaginitis is an inflammation of the vaginal mucosa that occurs when an increase in the number of microorganisms that should normally be found in fewer numbers. Statistics show that the disease occurs quite often, mainly in women aged 21 to 30 years (32.3%) ⁸ .

  A patient with aerobic vaginitis will have E. coli (Escherichia coli), enterococci, group B streptococci (Streptococcus agalactiae) and staphylococci (Staphylococcus aureus) in microbiological tests ⁸ . All these microorganisms can be found in small quantities throughout our body. Therefore, aerobic vaginitis does not belong to the “classic” infections.

  Symptoms , which are often combined with burning in the vagina in aerobic vaginitis: copious discharge with a putrid odor, general discomfort, discomfort during sex.

  Bacterial vaginosis

  Almost 90% of women with abnormal discharge are diagnosed with bacterial vaginosis. Why does this disease occur and how is it treated?

  Read more

  Bacterial vaginosis

  Bacterial vaginosis is a disease that is also often manifested by a burning sensation in the vagina. Bacterial vaginosis, like aerobic vaginitis, is caused by an overgrowth of certain bacteria normally found in the vagina. However, it is important to note that with bacterial vaginosis, the number of “good” and “useful” bacteria, lactobacilli, decreases simultaneously. With this disease, a large number of Gardnerella vaginalis can often be seen in microbiological analyzes ¹ . This most often occurs due to a decrease in immunity, exacerbation of chronic diseases, improper observance of the rules of intimate hygiene. Thus, this disease as a whole is characterized by a violation of the ratio of normal microflora and requires timely treatment, which can significantly reduce the risk of complications.

  Symptoms that are often associated with vaginal burning in bacterial vaginosis: rotten fish-smelling discharge that may be worse after washing with alkaline cleansers (shower gels, soaps) or after sexual intercourse ⁸ . Other manifestations (itching, soreness and burning) appear infrequently.

  Thrush

  Vulvovaginal candidiasis, like the previous described diseases, is a consequence of a violation of the normal microflora of the vagina. Almost every woman has had at least one episode of thrush in her life. In this case, the cause of the development of this disease are fungi of the genus Candida ⁸ . The most common representative here is Candida albicans. Less commonly, the cause of thrush is other fungi from the same genus (in 8-20% of cases) – C. glabrata, C. tropicalis, C. krusei ⁸ . Studies show that the presence of rarer varieties compared to C. albicans is an unfavorable factor for a more severe course of the disease. You can easily find out exactly which type of thrush occurs in a particular patient with the help of a microbiological study.

  Symptoms , which are often combined with a burning sensation in the vagina with thrush: cottage cheese-like discharge, discomfort during sex, sometimes painful sensations can be observed during urination.

  Atrophic processes of the vulva and vagina

  Burning of the genitals may be due to physiological causes against the background of age-related processes – atrophy.

  More often this occurs in postmenopausal women due to a deficiency of estrogen (a certain type of hormone), which is associated with the “turning off” of the ovaries. Similar manifestations can also occur at a young age with impaired ovarian function against the background of some disease.

  With age-related atrophic processes in the mucosa of the vulva and vagina, along with burning, dryness, discomfort in the genital area, hot flashes, night sweats, sleep disturbance and other symptoms will occur ⁹ .

  Vaginal burning caused by an allergic reaction

  It is not uncommon for an unpleasant symptom in the genital area to be caused by an allergic reaction to intimate hygiene products, lubricants, or vaginal medications.

  Vaginal burning caused by sexually transmitted infections (STIs)

  It is important to remember that the exact cause of vaginal burning can only be determined by a doctor based on examination and laboratory diagnosis!

  Chlamydial infection (chlamydia)

  The causative agent of this infection is Chlamydia trahomatis, a microorganism that occupies an intermediate position between bacteria and viruses, that is, it has the properties of both ³ . Chlamydia is more common in people under 25 years of age ⁴ . Risk factors are: frequent change of sexual partners, casual sex without using a condom. In 70-95% of women, the disease can proceed without any symptoms. Mucous discharge mixed with pus, painful sex, itching, burning of the genitals, painful urination, pain in the lower abdomen and menstrual irregularities are less commonly observed ⁴ .

  Gonorrhea

  Gonorrhea caused by gonococci (Neisseria gonorrhoeae) is one of the most common sexually transmitted infections. Every year about 60 million cases of gonorrhea are registered in the world ⁵ . Typical complaints: purulent discharge, itching, burning of the genitals, pain during sex, pain during urination, aching pain in the lower abdomen ⁵ .

  Trichomoniasis

  Trichomoniasis is an infection caused by a parasite (Trihomonas Vaginalis) ³ . Each year, up to 250 million people are registered with trichomoniasis ³ . Usually sick people are concerned about discharge from the genital tract of a gray-yellow or sometimes greenish color (the discharge may be foamy) with an unpleasant odor, itching and burning of the genitals, pain during urination and during sexual intercourse, discomfort in the lower abdomen ⁶ .

  Mycoplasma infection

  Mycoplasma genitalium is a pathogen that causes inflammation of the urethra (urethra), cervix, and other pelvic organs. Mycoplasma infection, according to the literature, ranges from 10% to 45% of all inflammatory gynecological diseases. Half of the infected women have no complaints ¹ . Among the complaints, there are: discharge of a mucopurulent nature, itching, burning in the vagina and on the skin of the perineum (infrequently), soreness, discomfort during urination.

  Genital herpes

  Genital herpes is a chronic viral disease. The causative agent is the herpes simplex virus II and / or type I. In 70% of cases, infection occurs from a sexual partner who has an asymptomatic course of the disease, which is the main insidiousness of genital herpes ⁷ . The main route of infection transmission is sexual. The isolation of herpes viruses can also occur in the absence of visible elements, for example in the area of ​​the cervix, urethra or oral cavity ³ . Herpes can affect the urethra, vagina, cervix, bladder, and rectum.

  What is important to know about genital herpes?

  The initial episode is characterized by vivid clinical manifestations, often with symptoms of intoxication (malaise and fever up to 38 °C). Rashes on the skin and mucous membranes are typical, they look like elements with transparent contents (vesicles). After the opening of the bubbles, small ulcers are formed, erosion of a small size.

  Genital herpes rash may be accompanied by pain, burning, and discomfort where it started ⁷ .

  If a woman has had casual unprotected sex or changed partners before the burning sensation in the vagina, then it is necessary to undergo an examination by a gynecologist to rule out sexually transmitted infections.

  Diagnosis of the cause of burning in the vagina

  If you experience burning of the genital organs, as well as symptoms, including discharge from the genital tract, discomfort, itching, soreness of the genitals, you should immediately consult a gynecologist.

  At the appointment, the doctor will take swabs to examine and identify the cause of the disease. The following methods can be used for diagnosis:

  • Microscopic method . The doctor directly under the microscope determines the type of pathogen.
  • Culture of microorganisms vaginal swab on special nutrient media to determine the pathogen and its sensitivity to antimycotics (antifungal drugs).
  • PCR diagnostics (polymerase chain reaction) is a modern method of laboratory identification of microorganisms by DNA molecule.

  Vaginal burning treatment

  Vaginal burning treatment should be prescribed by a doctor after examination and identification of its exact cause.

  As a rule, the gynecologist prescribes local preparations in the form of suppositories, ointments, vaginal tablets. In certain situations (for example, when a sexually transmitted infection is confirmed), systemic drugs taken orally (by mouth) are prescribed.

  Sexually transmitted infections are treated by a dermatovenereologist.

  Topical treatments for inflammatory vaginal diseases that may be accompanied by vaginal burning have several advantages due to the close proximity to the site of infection and inflammation, and the absence of systemic (affecting the whole body) side effects.

  Betadine® for the treatment of burning in the vagina

  Povidone-iodine suppositories are often used in the treatment of inflammatory diseases of the vulva and vagina – Betadine ^{® 10} . The active ingredient of the drug Betadine ^® (active iodine) promotes the destruction of gram-positive and gram-negative microorganisms, viruses, protozoa, fungi and spores. In view of these features Betadine ^® is suitable for the treatment of major vaginal diseases accompanied by burning (as part of complex therapy or on its own) ¹⁰ .

  Indications for prescribing suppositories Betadine ^® : acute or chronic vaginitis (inflammation of the vaginal mucosa), candidiasis (thrush) of the vagina and vulva, bacterial vaginosis, trichomoniasis, vaginal infections after antibacterial or hormonal therapy, as well as as a prophylaxis before operations and manipulations in gynecology .

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  In case of uncomplicated inflammation of the vaginal mucosa, it is necessary to apply one vaginal suppository into the vagina once a day for 1 week. In the presence of severe forms of the disease, treatment can be continued for another week (14 days in total) ¹⁰ .
  It must be remembered that the use of suppositories Betadine ^® is contraindicated during pregnancy and breastfeeding. Other restrictions on the use of suppositories Betadine ^® are diseases of the thyroid gland and allergic reactions to iodine ¹⁰ .

  Prevention of burning sensation in the vagina

  • Regular visits to the gynecologist (in the absence of complaints once a year)
  • Exclusion of self-medication )
  • Avoidance of casual sex and frequent change of sexual partners
  • Strengthening general immunity, control of chronic diseases
  • Proper intimate hygiene (special products with neutral or acidic pH)

  Frequently asked questions

  Burning without discharge from the genital tract.

  Could this be a symptom of an infection?

  Yes, of course. Many sexually transmitted infections can be asymptomatic or subacute (showing only one symptom, such as genital burning). The danger lies in the fact that an infection not cured in time can begin to spread, affecting the uterus, fallopian tubes, ovaries, and cells of the pelvic organs. In the long term, there is a risk of adhesions in the uterine appendages, which can lead to infertility or ectopic pregnancy.

  Worried about burning sensation in the perineum in the absence of pathology in a smear for flora.

  In this case, it is necessary to visit a gynecologist again to rule out sexually transmitted infections, atrophic processes of the vaginal and vulvar mucosa, an allergic reaction, and other causes. It is possible to conduct a more accurate PCR diagnosis.

  Can itching and burning in the vagina be cured at home?

  It is impossible to self-medicate, otherwise the process may spread upward to other organs of the small pelvis, which is fraught with the occurrence of complications, the transition of the disease to the chronic stage.

  Molchanov Oleg Leonidovich

  Gynecologist, reproductive specialist, doctor of medical sciences.

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  References

  1. Savelyeva G. M., Sukhikh G. T., Serov V. N., Radzinsky V. E. National guide “Gynecology” // GEOTAR-Media 2020, Moscow.
  2. Clinical guidelines “Inflammatory diseases of the cervix, vagina, vulva”// ROAG, 2021.
  3. Petersen E.E. Infections in obstetrics and gynecology // MEDpress inform, Moscow 2007.