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Bacterial Vaginosis; Diagnosis.

With many negative outcomes now linked to bacterial vaginosis (BV), it is important that women get tested and treated. Yet surveys find that the majority of health care professionals don't routinely test for or treat BV. And yet BV is responsible for a significant number of vaginitis-related office visits, specifically, 17 to 19 percent in family planning or student health clinic visits, 24 to 37 percent in sexually transmitted disease clinics, and 10 to 35 percent among pregnant women.

The most common symptoms include a discharge and an unpleasant odor in the vagina. Women may easily mistake BV for a yeast infection, which is caused by the overgrowth of fungi called Candida albicans and has similar symptoms. However, BV requires a different treatment, so it is important you get an accurate diagnosis. Additionally, you may have more than one type of vaginitis at the same time, so having a "yeast infection" doesn't mean you don't have BV.

Fortunately, a trained health care professional can easily diagnose BV. All it takes is a test to check the level of acidity, or pH, in the vagina. A vaginal pH greater than 4.5 is one sign that you may have BV.

Your health care professional also will take a vaginal discharge specimen for examination under a microscope to look for "clue cells"--cells from the vaginal lining that are covered with bacteria. It is important not to douche or use deodorant sprays before a medical exam because these products can make it more difficult to diagnose BV.

In addition to checking the vaginal pH and checking for clue cells, your health care professional may place a drop of 10 percent potassium hydroxide on a vaginal fluid specimen and check the odor. Several commercial tests also are available to diagnose BV. Cultures for Gardnerella vaginalis and cervical Pap tests are not accurate methods for diagnosing BV.

The most common symptom of BV is a vaginal discharge similar in consistency and appearance to skim milk. The discharge caused by the infection often has a strong "fishy" odor that may become worse after sex because semen changes the acidic level of vaginal fluids. BV also may cause vaginal itching and irritation. About 50 to 75 percent of all women with BV experience no symptoms.

References

Bacterial Vaginosis. National Women's Health Information Center. http://www.4woman.gov. Updated May 2005. Accessed September 2005.

STD Facts: Vaginitis (Most Common Causes: Yeast Infection, Trichomonas, Bacterial Vaginosis)." Minnesota Department of Health. 2004. Centers for Disease Control and Prevention National Prevention Information Network (NPIN). http://www.cdcnpin.org. Accessed September 2005.

"Bacterial Vaginosis." Feminist Women's Health Center. 2002. http://www.fwhc.org. Accessed September 2005.

Lactobacillus Organisms and Bacterial Vaginosis. Saint Joseph Mercy Health System. Updated May 19, 2004. http://www.sjmercyhealth.org. Accessed September 2005.

Secor, R. Mimi. "Bacterial Vaginosis." Clinician Reviews. 11(11):59-68, 2001.

Yen, Sophia, et al. "Bacterial Vaginosis in Sexually Experienced and Non-Sexually Experienced Young Women Entering the Military." Obstetrics & Gynecology. 102(5):927, November 2003.

Rakel, Robert, and Edward Bope, eds. Conn's Current Therapy 2004: Latest Approved Methods of Treatment for the Practicing Physician. 56th edition. St. Louis: Saunders, 2004. Page 119.

Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR 2002;51(No. RR-6)

"Vaginitis Due to Vaginal Infections." National Institute of Allergy and Infectious Diseases. Health Matters. October 2004. http://www.niaid.nih.gov. Accessed September 2005.

Connett, H. What you need to know about bacterial vaginosis. STD Advisor, 1999; Vol. 2. Insert.

The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Institute of Medicine. Washington, D.C. National Academy Press, 1997.

Bacterial Vaginosis--CDC Fact Sheet. Centers for Disease Control and Prevention. http://www.cdc.gov. Last updated: May 2004. Accessed September 2005.

Bacterial Vaginosis. American Family Physician, March 15, 1998. http://www.aafp.org. Accessed September 2005.

Bacterial vaginosis and preterm birth: a comprehensive review of the literature. J Nurse Midwifery. 43(2):83-9, Mar-Apr 1998.

Urinary Tract Infections in Adults. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). NIH Publication 04-2097. November 2003. http://kidney.niddk.nih.gov. Accessed September 2005.

Keywords: bacterial vaginosis, bv, yeast infection, symptoms, discharge, vaginal discharge
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Publication:NWHRC Health Center - Bacterial Vaginosis
Geographic Code:1USA
Date:Mar 14, 2006
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