Vaginal squamous cell with normal vaginal flora versus bacterial vaginosis on Pap stain. Normal vaginal flora (left) is predominantly rod-shaped Lactobacilli whereas in bacterial vaginosis (right) there is an overgrowth of bacteria which can be of multiple species.
BV is caused by an imbalance of the naturally occurring bacteria in the vagina.[4][5] There is a change in the most common type of bacteria and a hundred to thousandfold increase in total numbers of bacteria present.[6] Typically, bacteria other than Lactobacilli become more common.[15] Risk factors include douching, new or multiple sex partners, antibiotics, and using an intrauterine device, among others.[5] However, it is not considered a sexually transmitted infection and, unlike gonorrhoea and chlamydia, sexual partners are not treated.[16] Diagnosis is suspected based on the symptoms, and may be verified by testing the vaginal discharge and finding a higher than normal vaginal pH, and large numbers of bacteria.[6] BV is often confused with a vaginal yeast infection or infection with Trichomonas.[7]
Usually treatment is with an antibiotic, such as clindamycin or metronidazole.[9][6] These medications may also be used in the second or third trimesters of pregnancy.[6] The antisepticboric acid can also be effective.[10] BV often recurs following treatment.[6]Probiotics may help prevent re-occurrence.[6][8] It is unclear if the use of probiotics or antibiotics affects pregnancy outcomes.[6][17]
BV is the most common vaginal infection in women of reproductive age.[5] The percentage of women affected at any given time varies between 5% and 70%.[11] BV is most common in parts of Africa and least common in Asia and Europe.[11] In the United States about 30% of women between the ages of 14 and 49 are affected.[18] Rates vary considerably between ethnic groups within a country.[11] While BV-like symptoms have been described for much of recorded history, the first clearly documented case occurred in 1894.[1]
^ abQueena JT, Spong CY, Lockwood CJ, eds. (2012). Queenan's management of high-risk pregnancy: an evidence-based approach (6th ed.). Chichester, West Sussex: Willey-Blackwell. p. 262. ISBN9780470655764.
^ abBennett J (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN9781455748013.
^ abFaught BM, Reyes S (September 2019). "Characterization and Treatment of Recurrent Bacterial Vaginosis". J Womens Health (Larchmt). 28 (9): 1218–1226. doi:10.1089/jwh.2018.7383. PMID31403349.
^ abCite error: The named reference LærkeholmMüllerDamstedPetersenSaunte2024 was invoked but never defined (see the help page).
^ abcdeKenyon C, Colebunders R, Crucitti T (December 2013). "The global epidemiology of bacterial vaginosis: a systematic review". American Journal of Obstetrics and Gynecology. 209 (6): 505–23. doi:10.1016/j.ajog.2013.05.006. PMID23659989.