Bacterial Vaginosis
Bacterial vaginosis is a vaginal microbiome syndrome causing thin, grey-white, fishy-smelling discharge with little inflammation; diagnosis is clinical or microscopy-supported, and current UK care prioritises symptomatic treatment, pregnancy assessment, STI exclusion and specialist management of recurrence.
Definition
Bacterial vaginosis is a clinical syndrome associated with reduced lactobacilli and overgrowth of mixed anaerobic vaginal flora. It typically causes a thin, homogeneous, malodorous discharge with vaginal pH above 4.5 and little inflammation. It is not classed as a sexually transmitted infection, although sexual activity can trigger or pass associated bacteria between partners.
First principles
A change in vaginal ecology rather than a single pathogen
Bacterial vaginosis is associated with a reduction in protective lactobacilli and an increase in mixed anaerobic flora. It is not classed as a sexually transmitted infection, but sexual activity, a new partner, vaginal products and an intrauterine device can be associated with episodes, and BV-associated bacteria can be shared between partners.
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