Many years ago physicians described an infectious gynecologic condition in women in which there was no microorganism consistently responsible, and they termed it non-specific vaginitis. Today the condition involves an imbalance of the beneficial microbes in the woman’s vagina and harmful microorganisms. Normal inhabitants of the female vagina include Lactobacillus species which produce hydrogen peroxide.
When harmful anaerobic and fastidious microorganisms dominate the microbial flora of a woman’s reproductive tract, they replace lactobacilli and lead to infection. Fastidious microorganisms have complex nutritional requirements. This condition, which physicians now call bacterial vaginosis, is the most common vaginal infection in women of childbearing age. Though sexual transmission may have a role in its occurrence, physicians do not really understand its cause (Centers for Disease Control, 2010).
In the United States, bacterial vaginosis is especially common in pregnant women. Medical treatment for them is essential because the condition during pregnancy may lead to premature or low birth weight babies. Consequently, whenever a woman gives birth to a premature or low birth weight baby, she should have an evaluation for the presence of bacterial vaginosis.
The rates of bacterial vaginosis are higher in African-American and Mexican-American women than in Caucasians.
Risk Factors
This disease appears in the medical literature under sexually transmitted diseases; however, it may occur in women regardless of whether they are sexually active. And unlike most other sexually transmitted infections, there is no need to treat the male partner when a physician confirms that a woman has bacterial vaginosis. Nevertheless, women who have sex with women can transmit bacterial vaginosis to each other and therefore require clinical evaluation and treatment.
Despite the lack of clarity over the role of sexual transmission in this condition, physicians know that women who have new or multiple male sexual partners will be at risk for bacterial vaginosis.
It does not spread through toilet seats, bedding, swimming pools, or contact with inanimate objects in the home or environment. Most women who acquire bacterial vaginosis do not have any symptoms; therefore, in order to detect its presence, women need regular health screening.
Many women douche, but this appears to push microorganisms into the upper part of the female reproductive tract. It clearly predisposes to bacterial vaginosis.
Bacterial Vaginosis and HIV
Like several other sexually transmitted diseases, bacterial vaginosis predisposes a woman to the acquisition of human immunodeficiency virus infection and other sexually transmitted diseases should she encounter exposure to any of those other microbes because of the inflammation and damage to tissue and mucosa.
Conversely, women with bacterial vaginosis and human immunodeficiency virus infection are more likely to transmit HIV to their partner than when they have HIV without bacterial vaginosis or any other sexually transmitted infection.
Bacterial vaginosis may lead to pelvic inflammatory disease. Moreover, the occurrence of bacterial vaginosis does not confer any immunity upon a woman who acquires the disease; hence, she can get the infection numerous times.
Sources
- Centers for Disease Control. (2010). Bacterial vaginosis. Retrieved November 1, 2011.
- U.S. Department of Health and Human Services. (2008). Bacterial vaginosis fact sheet. Retrieved November 1, 2011.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.
Michael Koger - Dr. Koger obtained his medical education at Meharry Medical College and specialized in Internal Medicine.
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