Gardnerella or Bacterial Vaginosis

Gardnerella or Bacterial Vaginosis (BV) Treatment in Nottingham

Serving: Nottingham, Derby, Leicester, Mansfield, Sheffield and the wider Midlands area

What is Bacterial Vaginosis?

Bacterial vaginosis (BV) is a common vaginal condition that occurs when the normal balance of bacteria in the vagina is disrupted, leading to an overgrowth of certain bacteria, primarily Gardnerella vaginalis. The diagnosis of BV has become increasingly common over the past decade, with approximately 97,000 women per year being seen in GUM clinics in the UK, and many more being treated in other healthcare settings.

BV is not classified as a sexually transmitted infection (STI), though it is more common in sexually active women. The condition represents a change in the vaginal ecosystem where the normal, protective lactobacilli are replaced by an overgrowth of anaerobic bacteria. During this process, the normal vaginal pH level, which is usually around 3.8-4.5, rises to 5 or 6, creating an environment that favours the growth of potentially harmful bacteria.

Causes and Risk Factors

The exact cause of bacterial vaginosis remains unclear, but several factors can increase the risk of developing this condition:

Multiple sexual partners: Having multiple or new sexual partners may increase the risk, although BV can occur in women who are not sexually active.
Douching: Regular douching disrupts the natural balance of vaginal bacteria.
Lack of lactobacilli: A reduction in the number of ‘good’ lactobacilli bacteria that normally keep the vagina slightly acidic.
Intrauterine devices (IUDs): Some studies suggest a potential link between IUDs and BV.
Smoking: Research indicates that women who smoke are at higher risk.
Genetic factors: Some women may be genetically predisposed to BV.
Hormonal changes: Changes during menstruation or pregnancy can alter vaginal pH.
Certain hygiene practices: Using perfumed products or washing with antiseptic solutions in the genital area.

While BV can affect anyone with a vagina, it is more common in women of reproductive age.

Symptoms of Bacterial Vaginosis

Many women with BV (approximately 50%) do not experience any symptoms. When symptoms do occur, they typically include:

A thin, white, grey, or yellowish vaginal discharge with a watery consistency
A distinctive and unpleasant ‘fishy’ odour, particularly after sexual intercourse
Mild irritation or discomfort in the vaginal area
Occasionally, a burning sensation during urination

Unlike other vaginal infections such as thrush (candidiasis) or trichomoniasis, BV is usually not associated with significant itching, soreness, or pain.

Diagnosis

If you suspect you have bacterial vaginosis, it’s important to seek proper diagnosis from a healthcare professional. The diagnosis typically involves:

Clinical Examination

A pelvic examination to check for signs of infection
Collection of vaginal discharge samples for testing

Laboratory Tests

Microscopic examination: Vaginal discharge is examined under a microscope to check for “clue cells” (vaginal cells coated with bacteria), which are a characteristic sign of BV
pH testing: The pH level of vaginal discharge is measured; a pH above 4.5 supports a diagnosis of BV
Whiff test: A sample of discharge is mixed with a solution, and the production of a fishy odour is indicative of BV
Molecular testing: PCR (polymerase chain reaction) tests to detect the DNA of Gardnerella vaginalis and other bacteria associated with BV

At Park Private Clinic, we offer confidential testing for bacterial vaginosis with results typically available within 24-48 hours.

Treatment Options

Bacterial vaginosis is treatable with antibiotics, and most women respond well to treatment. The most common treatments include:

Prescription Medications

Metronidazole: This is the most commonly prescribed antibiotic for BV. It can be taken orally as tablets (either as a single large dose or as a twice-daily dose for 5-7 days) or applied directly to the vagina as a gel.
Clindamycin: Available as a cream that is applied inside the vagina or as oral capsules. This is an alternative for those who cannot take metronidazole.
Tinidazole: An alternative oral antibiotic that may be used in cases where metronidazole is not suitable.

Important Treatment Considerations

Alcohol: It’s essential to avoid alcohol consumption during treatment with metronidazole or tinidazole and for at least 48 hours afterwards, as combining these medications with alcohol can cause severe nausea, vomiting, flushing, and headaches.
Complete the course: Even if symptoms improve, it’s important to complete the full course of antibiotics as prescribed to ensure the infection is fully cleared.
Sexual activity: Avoid sexual intercourse during treatment, or use condoms if abstinence is not possible.
Follow-up care: A follow-up appointment may be recommended to confirm that the infection has cleared, especially if symptoms persist.

Recurrent Bacterial Vaginosis

For women who experience recurrent BV, longer courses of antibiotics or a maintenance regimen may be recommended. Additionally, vaginal pH-regulating products such as gels or pessaries may help prevent recurrence by maintaining the normal acidic environment of the vagina.

Prevention Strategies

While it’s not always possible to prevent bacterial vaginosis, certain measures may help reduce the risk:

Maintain good vaginal hygiene: Wash the genital area with mild, unscented soap and water.
Avoid douching: Douching can disrupt the natural balance of bacteria in the vagina.
Use barrier methods: Consider using condoms during sexual intercourse.
Limit the number of sexual partners: Having multiple sexual partners increases the risk of BV.
Wear breathable underwear: Choose cotton underwear and avoid tight-fitting clothing that can create a warm, moist environment conducive to bacterial growth.
Avoid irritants: Refrain from using scented products such as bubble baths, vaginal deodorants, or perfumed sanitary products.
Consider probiotics: Some studies suggest that probiotic supplements containing Lactobacillus may help maintain a healthy vaginal flora, though more research is needed in this area.

During Pregnancy

Untreated BV during pregnancy has been associated with:

Premature birth: Women with BV are more likely to deliver prematurely.
Low birth weight: Babies born to mothers with BV may have lower than average birth weights.
Premature rupture of membranes: BV increases the risk of the amniotic sac breaking before labour begins.
Postpartum endometritis: Infection of the uterine lining following delivery.
Miscarriage: Some studies suggest a potential link between BV and pregnancy loss.

When to Seek Medical Advice

You should consult a healthcare provider if:

You notice an unusual vaginal discharge, particularly if it has a strong, unpleasant odour
You experience vaginal irritation or discomfort
You have pain during urination or sexual intercourse
You develop symptoms of BV during pregnancy
Your symptoms persist or recur despite treatment
You are planning to undergo a gynaecological procedure and suspect you might have BV

Book Your Confidential Consultation Today

At Park Private Clinic, we offer confidential consultations for bacterial vaginosis and other sexual health concerns. Our healthcare professionals provide discreet, non-judgemental care and can advise on the most appropriate testing and treatment options for your specific situation.

Remember that many women with bacterial vaginosis have no symptoms but can still experience complications or transmit the infection. Regular sexual health check-ups are advisable for sexually active individuals, even in the absence of symptoms.