The medical director, Genius Touch Health Care Group, Dr. Oyetola Samuel Omomurewa, discusses the causes, symptoms and treatment of bacterial vaginosis in this interview with OPEYEMI ADEFEMI
What is bacteria vaginosis?
Bacteria vaginosis is a bacterial infection that is common among women of childbearing age. It occurs when there is an imbalance in the beneficial and harmful bacteria population in the vagina. It is important to note that every part of the human body has bacteria. Bacterium is one type of microorganism that humans can never do without. It’s on the skin, in the throat, in your mouth, on the palm and everywhere else on the body. The good thing, however, is that there are beneficial bacteria, apart from the ones that are harmful to the health of humans. Bacteria vaginosis generally occurs because of the imbalance in the spectrum of bacteria present in the vagina.
Do bacteria vaginosis affect only women of childbearing age?
Yes, it is typically an infection that affects women of childbearing age. It is commoner in women with multiple sexual partners or a woman who changes sexual partners. Though BV is not classed as a sexually transmitted infection, it can be contracted through sexual activities. If a man sits on a toilet bowl and is exposed to a certain type of bacteria; he can introduce the bacteria into a woman’s body during sexual intercourse. Where this changes or alters the vagina’s PH, the woman runs the risk of coming down with bacteria vaginosis.
What bacteria are responsible for bacteria vaginosis?
It’s not just one type of bacteria. That is why it is important that when you notice symptoms, you just don’t go over the counter to buy drugs. It is very important to see a doctor who would recommend a laboratory test, to know the exact type of bacteria causing bacteria vaginosis. Doing this will be a guide on the best treatment approach. Some of the bacteria that cause bacterial vaginosis include Staphylococcus aureus and E. coli. Certain bacteria are supposed to prevent those bacteria. An example is Lactobacillus. But if the Lactobacillus population is low, it will give room for other harmful bacteria to come in and cause harm.
What are the symptoms of bacteria vaginosis?
Its symptoms include itching of the vagina, having a characteristic smell from the vagina and sometimes having very strange vagina discharge. The next commonest symptoms are pain during urination and pain during sex, but these symptoms are also found in some sexually transmitted infections. So, the best thing is to go to the hospital for a proper diagnosis.
Can bacteria vaginosis cause infertility?
Yes. When a woman has bacteria vaginosis that is left untreated for a long period of time it can cause infection and inflammation of the upper genitalia tract, resulting in an infection called Pelvic Inflammation Disease. Again, if BV is left untreated, it can also cause the fallopian tube in the woman’s reproductive system to be blocked, which will definitely make conception difficult for the woman. In fact, if a woman has untreated bacteria vaginosis, her chances of getting a good result from an assisted reproduction process like IVF, are slim. I must also mention that untreated bacteria vaginosis exposes a woman to the risk of contracting sexually transmitted infections.
What are the possible complications of bacteria vaginosis in a pregnant woman?
It can lead to miscarriage or the baby being born preterm. It can also predispose the child to cerebral palsy. Those are the risk associated with a pregnant woman having bacteria vaginosis.
Are there safe treatment options for a pregnant with bacteria vaginosis?
There are antibiotics that pregnant women can use. If a pregnant woman has BV she should see her doctor who will evaluate and do a risk analysis to know the right antibiotics that will work for her and the duration of use. It is possible to treat bacterial vaginosis during pregnancy, it just depends on the timing
Is bacteria vaginosis sexually transmitted?
No, it is not sexually transmitted but it can increase the risk of getting an STI, such as chlamydia.
What are the risk factors for bacteria vaginosis in women?
There are hygiene practices that can predispose a woman to bacterial vaginosis. Hygiene practices like douching or washing the vagina with soap can cause an imbalance in the PH of the vagina and this predisposes a woman to bacterial vaginosis. Some soaps are highly alkaline and they alter the PH of the vagina, thereby wiping out the normal bacteria population that protects the vagina against harmful or infectious bacteria. So, using douches and soaps can expose a woman to bacteria vaginosis.
Another risk factor is washing the female underwear with strong detergent, with a high level of alkalinity. So, a woman’s attempt to maintain vaginal hygiene can actually be injurious. I don’t know why some women think the vagina is not clean enough. It has its own cleaning system, so, they only need to wash it with just water.
Women are also advised to avoid things like vagina sweeteners and all that stuff they use. If you introduce such things and they change the PH scale of the vagina, you might end up with bacteria vaginosis.
Also, wiping or washing from back to front after using the toilet or defeacating can expose a woman to the risk of bacterial vaginosis. A woman should wipe from front to back, to prevent introducing bacteria from the anus to the vagina area.
Why is recurrence common with bacteria vaginosis after treatment?
If a woman got bacteria vaginosis as a result of douching or by washing her panties with a strong detergent and she goes to the hospital to get treated, if, after treatment, she goes back to repeat the same thing, there is a high chance of having that infection again. Another reason for recurrence is failure to properly treat the condition, for instance, if the appropriate or specific antibiotics are not used. So, getting proper treatment is important and that is predicated on running a laboratory test to determine the exact bacteria responsible for bacteria vaginosis. Although the commonest cause of BV is Gardnerella vaginalis, it is not safe to just assume or conclude without first running a lab test. So, it is quite expedient to visit the hospital to get a proper diagnosis and treatment.
How is bacterial vaginosis treated?
It is treated with antibiotics to get rid of the bacteria. But it is best to use specific antibiotics after a laboratory test to prevent antibiotic resistance. But in some cases, the normally harmless bacteria in the vagina will wipe out or overpower the harmful bacteria responsible for BV without drug intervention. It is possible that without treatment, the problem is resolved.
Is it possible to permanently cure bacteria vaginosis?
Of course, it is. I have treated a lot of patients with BV and they don’t have it again. But there will be recurrence if the patient goes back to doing those things that can make it reoccur, such as washing the vagina with soap or chemicals.
There is a suggestion that there is a link between low-quality pads and bacteria vaginosis. Is this true?
I have heard some women claim that certain brands of pads gave them bacteria vaginosis, but, presently, there is no scientific evidence that backs such a claim. There is no medical evidence yet. The only thing I know and have heard from patients is that they react to particular types of pads and that reaction might just be due to the kind of materials used to produce certain types of pads.
For a women who has just got treated for bacteria vaginosis, will they have to discard their undies and get new ones in order to prevent recurrence?
They can still go on to use the underwear they used before. We prescribe that women use 100 per cent cotton underwear because that is safer to use. And if you do not want to change underwear after treating BV, wash them properly with mild soap. It is very important to dry the panties in the sun or expose them to heat by ironing them. This can prevent them from fungi. Fungus is another type of microorganism that thrives in moist environments. If you wash and don’t dry undies, you can be predisposed to fungal infections.
What are some of the common misconceptions about bacteria vaginosis among public members?
The commonest misconception is that it is got from the toilet or that it is a toilet infection. Some people also believe that taking over-the-counter drugs can cure it permanently; some think when there are no symptoms the infection is not there. The fact that you are not seeing symptoms does not mean it is not there. Until you run a test you can’t tell if you have it or not.
Another misconception is that some people think it is not treatable. It is very treatable. Consult a physician for treatment and use the prescribed medication.
Are there certain foods that can help balance the PH level of the vagina?
Yes, there are. First is the fermented unsweetened yoghurt. It helps to regulate the PH scale of the vagina a lot. Combining it with the prescribed drugs can help a lot. Other food items that can balance the PH scale of the vagina are citrus, such as oranges, lemons, and the like. Any food that contains probiotic substances, such as garlic can also help but it is important to note that garlic should be consumed in controlled proportions because it can reduce blood pressure beyond a limit. When we say certain foods can help, it doesn’t mean that such foods should be consumed in excess.
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