What is bacterial vaginosis? Bacterial vaginosis (BV) is a type of vaginitis caused mainly by Gatnerella vaginalis and can be transmitted through sexual relations. Bacterial vaginosis is a disease caused by an increase in Gatnerella and anaerobic bacteria and a decrease in Lactobacillus and a change in the ecological balance system in the vagina. Among other things, Gatnerella parasitica is also found in the vagina of healthy women. BV is a mixed infection caused by a dysbiosis of the normal vaginal flora, a group of syndromes with a large number of bacteria in the vagina and a change in the nature of the vaginal discharge. The clinical and pathological features are not characterized by inflammatory changes. It occurs mostly in sexually active women. In normal women of childbearing age, under the influence of endocrine hormones, the epithelial cells of the vagina proliferate and their superficial cells are rich in glycogen, which is very favorable for the growth of parthenogenic lactobacilli, which account for more than 90% of the vagina. The presence of this bacterium in large numbers inhibits the growth of other pathogenic bacteria. A normal ecological balance is created in the vagina. How is bacterial vaginosis transmitted? BV is a common and frequent disease among women, accounting for 30% to 50% of vulvovaginal infections; the incidence of bacterial vaginosis in asymptomatic patients is 23%; the incidence of bacterial vaginosis in pregnant women is 6% to 32%; the prevalence of BV in women with IUDs is significantly higher than in those with other forms of contraception; the prevalence in non-white women is higher than in white women; and the prevalence of BV in women with a history of STDs, multiple sexual partners, and new sex is higher than in white women. A history of STDs, multiple sexual partners, new partners, frequent intercourse or vaginal irrigation can alkalize the vagina and are also associated with the disease. When the body’s estrogen level decreases, it leads to atrophy of the vaginal epithelium and a decrease in cellular glycogen, which is not conducive to the growth of Lactobacillus. Heavy use of antibiotics or excessive vaginal douching with alkaline fluids inhibits the growth of Lactobacillus. Sexual promiscuity and frequent sexual intercourse (due to semen pH 7.2-7.8) lead to the proliferation of pathogenic anaerobic bacteria and Gatnerella, causing an imbalance in the ecological balance of vaginal microorganisms. The reduction of aerobic lactobacilli eventually leads to bacterial vaginosis. What are the symptoms of bacterial vaginosis? 1. Vaginal secretions are grayish white, sticky, and uniformly pasty. The amine content of the discharge is particularly high and it has a strong fishy odor, which is often aggravated by the promotion of amine release during sexual intercourse or after activity. The ph value in vaginal secretions is increased, ph range 5.0-5.5, compared to 4.5-4.7 in normal people. 2. Since alkaline prostatic fluid can cause amine release, the odor is manifested as increased odor during or after intercourse; the vaginal ph value increases during menstruation, so the odor can also be increased during or after menstruation. The abnormal vaginal secretions are thin and homogeneous or thin paste, grayish white, grayish yellow or creamy yellow with a special fishy odor. Bacterial vaginitis patients have vulvar discomfort, including different degrees of vulvar itching and other symptoms, which are usually not obvious temporally, but the itchiness is more obvious at rest and under stressful conditions. Some patients have symptoms of painful intercourse. Very few patients have inflammatory symptoms such as pain in the lower abdomen, difficulty in sexual intercourse and abnormal urination. 5. Patients produce special odor and odor is especially obvious every time sexual intercourse activity occurs. The vaginal discharge is increased, off-white and sticky, but the inflammation of the vaginal wall is not obvious. Trans-clue cells can be detected in a wet smear of the vaginal discharge. What are the common dangers of bacterial vaginosis? 1. It can lead to female infertility: Generally, the vaginal flora is balanced and the pH is also balanced, which is suitable for sperm to stay and pass through temporarily, but with bacterial vaginosis, the pH of the vagina can exceed 4.5. The change of pH in the vaginal environment can inhibit the motility of sperm. Moreover, the germs also engulf the sperm, and the secretion inside the vagina increases a lot, and a large number of white blood cells appear, which prevents the sperm from becoming viable and reduces the number of sperm, causing infertility. 2. Affect the development of fetus: If the bacteria are seriously infected, it can affect the normal work and study of women. During pregnancy, it can also endanger the fetus – from fetal disturbance to miscarriage. Bacterial vaginosis during pregnancy is reported to be many times more common than in normal pregnancies, which can directly threaten the development and health of the fetus. 3. Inducing other diseases: The presence of vaginitis can cause genital infections, pelvic inflammatory disease and a series of other gynecological diseases. 4. Affects the quality of life of women and couples: Bacterial vaginosis, which causes itching of the vulva, can cause a lot of inconvenience and affect women’s life and work, and in serious cases, can affect the life of couples. 5. Bacterial vaginosis can lead to chorioamnionitis, premature rupture of membranes, preterm delivery, endometritis in non-pregnant women, pelvic inflammatory disease, and infection of the vaginal dissection after hysterectomy. What are the precautions for bacterial vaginosis? Sexual intercourse or condom use is prohibited during treatment. Wash the vulva daily, change underwear, and disinfect underwear and towels by boiling or soaking with disinfectant to eliminate pathogens and avoid repeated infections. Alcohol should be banned while taking medication. Husbands or sexual partners should be treated at the same time. How should bacterial vaginosis be treated? Systemic: Metronidazole 400mg 3 times daily for 7 days is 98.8% effective; Clindamycin 300mg twice daily for 7 days is 94% effective. Topical Tinidazole vaginal foam 200mg, placed in the vagina once a night for 7-14 days. Or metronidazole vaginal gel, 1 in the morning and 1 in the evening twice daily for 7-14 days. The medication should be used continuously for 3 menstrual cycles.