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Client Handout for Bacterial Vaginosis

BACTERIAL VAGINOSIS - Updated 12/99
(also called Gardnerella vaginitis or Hemophilus Vaginalis)
by Daphne Singingtree, CPM, LM,

Bacterial vaginosis or BV is the most common infection of the vagina. It is due to an overgrowth of several kinds of bacteria that are normally present in the vagina in small amounts. These organisms are usually harmless and exist in the vagina without causing any problems. When they are present in excessive numbers they may cause symptoms.

BV is diagnosed by a KOH/wet mount, which is a small sample of vaginal discharge examined under a microscope. Other tests and cultures can also pick it up during your first visit.

BV is not considered a sexually transmitted disease because it may be acquired without having sex. However, women with multiple sex partners or other STDs are more prone to BV.  While it can be caused by poor vaginal hygiene, for example, not wiping from front to back when you go to the bathroom, it also may be present with good hygiene. A low fiber diet causing messy stools or constipation will contribute to the problem. In addition, using non cotton underwear, nylons, or tight lycra shorts can cause a buildup of moisture which promotes bacterial growth. Vaginal deodorant sprays, or bubble baths can cause irritation which can contribute to BV.

Symptoms are: a change in vaginal odor, which may be especially pronounced after intercourse, increase in the amount of discharge, a yellow colored discharge, vaginal itching or irritation. Many women do not have any symptoms.

Even if you do not have symptoms, if you're pregnant, we recommend to treat it because there is an increased risk of preterm labor, low birth weight, early rupture of membranes and postpartum infection for those women with BV. Usually the partner is not treated.

Many of the women we see want to try alternative or non-pharmaceutical treatments first before using the medication.  Whatever treatment you use you will need to get a follow-up test to make sure it is gone.

Hydrogen peroxide treatment for BV

1. Take an additional 1000 mg of vitamin C (in addition to your prenatal) per day during the course of your treatment and 500mg a day for the week following your treatment. Also increase your water or clear fluid intake, and really pay attention to your diet, emphasizing whole foods, with  lots of fresh vegetables. If you have a persistent case we may have you take Echinacea internally as well.

 2. Hydrogen peroxide vaginal wash: Fill a 30-cc syringe (without the needle) with hydrogen peroxide, insert just the tip of the syringe in your vagina, about an inch with your hips elevated and very gently push the fluid in.  Let it sit for three minutes then sit up and let it drain out.

Medical Treatment You may choose to see our referral physician who can give you a prescription of either: 1. Oral clindamycin 300 mg twice daily for seven days.  OR 2. Single dose metronidazole, 2 GM orally or oral metronidazole 500 mg twice daily for seven days.

To prevent re-infection use good hygiene, during your pregnancy your partner should wash his genitals after sex with a mild antibacterial soap (like Dial). By working towards optimal health by maintaining excellent nutrition, lots of water, exercise, and lowering stress you will boost your body's immune system.