What Should You Do If You Get Bacterial Vaginosis During Pregnancy
Getting BV during pregnancy is related to pregnancy risks such as miscarriage, preterm birth, and low birth weight. According to a 2018 study, a connection between BV and miscarriage does exist, but more research is required before reaching a definitive conclusion.
Research shows that BV can be treated during pregnancy. If you think you have BV and youre pregnant or trying to conceive, its important to consult with your healthcare provider.
Risks Associated With Asymptomatic Bacterial Vaginosis In Pregnancy
Bacterial vaginosis has been associated with an increased risk of preterm birth , with a review of casecontrol and cohort studies finding that women with bacterial vaginosis were 1.85 times more likely to give birth preterm than women without . The higher risk of preterm birth remains in women diagnosed with bacterial vaginosis early in pregnancy, even if the bacterial vaginosis spontaneously resolves later in pregnancy .
How Can I Lower My Risk Of Bacterial Vaginosis
Because bacterial vaginosis isnt fully understood, there are no foolproof ways of avoiding it. These steps may reduce your risk:
- Avoid douching. It changes the natural balance of bacteria in your vagina. Instead, practice healthy vaginal and vulvar care.
- Avoid vaginal contact with anything that has touched your anus. Things like toilet paper and sex toys could transfer bacteria found in your poop to your vagina. Make sure sexual toys are properly cleaned after every use.
- Limit your number of sex partners. Research shows youre more likely to get BV if you have multiple sex partners.
- Use latex condoms or dental dams. Although its unclear why, research indicates that sexual activity is associated with BV.
- Wear cotton or cotton-lined underwear. Bacteria thrive in moist environments. Cotton helps wick away moisture.
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Whats The Deal With Bacterial Vaginosis And Fertility
BV is known to be more common in people with infertility than people without fertility issues three times more common. Dr. Eduardo Hariton, an OB-GYN and fertility fellow at the University of California in San Francisco, explains: “These studies show that bacterial vaginosis is more common in women with infertility, but not yet proven to be a cause of infertility. At this point, we should not assume causality.”
And while the extent that BV directly affects fertility is still unclear, a 2016 study found a connection between the presence of BV and the presence of pelvic inflammatory disease , an infection that causes fertility issues by spreading into the fallopian tubes.
Dr. Eva Luo, MD, an OB-GYN and one of Modern Fertilitys medical advisors, adds that STDs, IUDs, pregnancy, and surgical procedures can throw off the bodys vaginal flora, leaving the vagina more susceptible to BV. For some, even periods and sex seem to be correlated with BV. All of these various causes make studying the link between fertility and BV more difficult.
To recap: The occurrence of BV in people with fertility issues doesnt mean the BV is causing fertility issues but its difficult to know exactly what the connection between the two issues might be, or if there are any drivers of infertility that may increase the likelihood of BV.
Sexual Health Clinics Can Help With Bacterial Vaginosis
Sexual health clinics treat problems with the genitals and urinary system.
Many sexual health clinics offer a walk-in service, where you do not need an appointment.
They’ll often get test results quicker than GP practices.
During coronavirus, call a sexual health clinic if you need help or advice. Only go to a clinic if you’ve been told to.
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Is There Anything Else I Can Do To Lower My Risk Of Bv
To lower your risk of BV you should avoid douching. Douching removes some of the bacteria that are normally present in your vagina, which protect you from infection.2
You can keep your vaginal bacteria in balance by washing your external genitalia daily with mild soap and wearing cotton or cotton-lined underpants.2 Avoiding tight pants and pantyhose, especially in the summer when you are perspiring more, will also lower your risk.
Bacterial Vaginosis During Pregnancy Third Trimester
Bacterial vaginosis during last trimester is risky. It can cause premature labor and infections in the vagina.
BV during pregnancy third trimester needs immediate medical attention.
During the third trimester of pregnancy, water leak occurs. When the water breaks, the membranes begin rupturing. It can lead to bacterial vaginosis spreading to other places.
BV during third pregnancy trimester can even cause premature rupture of membranes.
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What Is The Treatment For Persistent Bacterial Vaginosis
If you have persistent BV then your doctor may want to take further vaginal swabs to check whether there is another cause for the discharge. They will usually suggest that you use the seven-day course of metronidazole if you have not had this before.
Another treatment which may be tried is using metronidazole gel twice a week for up to six months.
If you have a persistent BV infection which does not respond to treatment, and you have an intrauterine contraceptive device then your doctor may advise removing the device until things settle down, as there is some evidence that IUCDs can contribute to persistent BV.
If you have persistent BV and a same-sex partner then treating both of you at the same time is likely to be helpful in preventing persistence and recurrence – even if your partner does not have symptoms.
Infections In Pregnancy: Bacterial Vaginosis
What Is Bacterial Vaginosis?
Bacterial vaginosis is an infection in the vagina caused by bacteria. The vagina naturally has good bacteria called lactobacilli and a few bad bacteria called anaerobes. Normally, theres a careful balance between lactobacilli and anaerobes. When that balance is disrupted, however, anaerobes can increase in number and cause BV.
BV is the most common vaginal infection in women between ages 15 and 44. Its also one of the most common infections in women who are pregnant, affecting approximately pregnant women each year. BV is typically a mild infection and is easily treatable with medication. When left untreated, however, the infection can increase your risk for sexually transmitted infections and complications during pregnancy.
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Treatments What To Do And Not Do
Antibiotics such as metronidazole , clindamycin, and tinidazole are often prescribed and will destroy some of the bacteria that cause symptoms of bacterial vaginosis. But, it is well-known that antibiotics kill off the good bacteria along with the infection-causing bacteria, which has potentially dire long-term impact on vaginal health. In a groundbreaking study published in Nature, Martin Blaser of New York Universitys Langone Medical Center maintains that antibiotics impact on friendly bacteria is permanent.1 Blaser argues that the consequences of this are so serious that antibiotic prescriptions should not be given to pregnant women and young children.
Since vaginal health correlates to the presence of good bacteria, antibiotics must be used only when absolutely necessary. Killing off the good bacteria along with the bad can lead to vaginal imbalance and recurring instances of BV. Studies have shown that more than 50 percent of women treated for BV will experience a recurrence within 12 months.2 BV is most typically recurrent following a course of antibiotics.
Cause Of Bacterial Vaginosis
The cause of bacterial vaginosis is not fully understood. But it happens when the type of bacteria in your vagina changes.
In your vagina you have a mixture of bacteria. This includes ‘friendly’ or ‘good’ bacteria called lactobacilli.
If the friendly bacteria die off, other types of bacteria begin to grow. These are called anaerobic bacteria.
This change in bacteria upsets the acid balance of your vagina. This can cause more ‘unfriendly’ anaerobic bacteria to grow and cause BV.
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Bacterial Vaginosis And Fertility
Bacterial Vaginosis or BV is the most common genital tract disorder in reproductive-aged women. It is characterized by a shift from a healthy vaginal microbiome one dominated by acid-producing bacteria to a vagina dominated by unhealthy bacteria. The most prominent and often the most disconcerting symptom of BV is a strong fishy vaginal odor, but some women with BV also see increased amounts of discharge that is gray in color. A burning sensation when you urinate, itching in the vulvovaginal area and pain during sex are other symptoms of Bacterial Vaginosis
Lets explore how Bacterial Vaginosis affects fertility.
How Is Bacterial Vaginosis Treated
Antibiotics like metronidazole and Clindamycin taken in pill form or placed vaginally in cream form are standard treatments for bacterial vaginosis. Still, only 65% to 85% of people with BV are completely cured after taking standard antibiotics. The thing is, while antibiotics work to kill off the harmful bacteria in your vaginal area, they also kill off the healthy bacteria which is less than ideal.
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How Is Bv Treated
BV is treated with antibiotics prescribed by your doctor.
If you get BV, your male sex partner won’t need to be treated. But, if you are female and have a female sex partner, she might also have BV. If your current partner is female, she needs to see her doctor. She may also need treatment.
It is also possible to get BV again. Learn how to lower your risk for BV.
BV and vaginal yeast infections are treated differently. BV is treated with antibiotics prescribed by your doctor. Yeast infections can be treated with over-the-counter medicines. But you cannot treat BV with over-the-counter yeast infection medicine.
How Can I Avoid Getting Bv From Sex
Although BV is not always transmitted sexually, the only way to avoid the sexual transmission of BV is to practice abstinence. If you decide to engage in sex, steps that will minimize your risk of developing BV include2:
- Limiting the number of sexual partners that you have
- Using condoms consistently
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What Are The Preventive Measures That Can Be Done To Prevent Bv Transmission From A Man To A Woman
- Always use a condom. Having protected sexual intercourse will help lessen the possibility of getting BV.
- Limit sexual partners. Women who have multiple sex partners have a higher risk of getting BV.
- Do not practice anal-to-vagina sexual intercourse it can cause bacteria from the anus to infect the vagina even when using a condom
- Uncircumcised men have a higher risk of carrying bacteria that can cause BV.
What Causes Bacterial Vaginosis
Women with BV have reduced levels of amylase in the vagina, an enzyme that breaks up big carbohydrates into smaller carbohydrates called glycogen that healthy bacteria eat. Without this preferred food source, the friendly lactobacillus bacteria cant grow and thrive. Women with BV also have reduced levels of antimicrobial peptides that can fight off invading bacteria. In healthy vaginas, vaginal mucosal cells normally make AMPs. It is not transmitted sexually, but it is associated with having vaginal sex. Therefore, it may be listed under sexually transmitted diseases when you research it.
Youre at increased risk if you:
- Have new sex partners
- Are African-American. BV is twice as common in African-American women than in white women.
- Used an intrauterine device
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Antibiotics For Bacterial Vaginosis
Oral antibiotics are the first-choice treatment in pregnant women with BV.
Metronidazole tabletsA full course of metronidazole tablets is the common treatment. Metronidazole is an antibiotic. This clears BV in most cases. It is important to read the leaflet that comes with these tablets for the full list of possible side-effects and cautions. The main points to note about metronidazole include:
- The usual dose is 400-500 mg twice a day for 5-7 days. A single dose of 2 grams of metronidazole is an alternative, although this may be less effective and may cause more side-effects. It is important to finish the course you have been prescribed, and not to miss any tablets.
- Some people feel sick or may be sick when they take metronidazole. This is less likely to occur if you take the tablets straight after food. A metallic taste is also a common side-effect.
- Do not drink any alcohol while taking metronidazole, nor for 48 hours after stopping treatment. The interaction of metronidazole with alcohol can cause severe sickness and vomiting, and may also cause flushing and an increased pulse rate.
- Metronidazole can get into breast milk in small amounts but will not harm your baby, although it may make the milk taste different. The manufacturer recommends that if you are breastfeeding you should take the 5- to 7-day lower dose course of metronidazole rather than the single large dose.
At What Point Should You See A Doctor Or Other Healthcare Provider
Although BV infections are often mild with some cases resolving on their own, its still a good idea to see a healthcare professional if you notice any symptoms.
This is especially true if youre pregnant, as theres a small risk of the infection causing complications.
A healthcare provider will be able to examine your vagina and test any fluid or discharge.
And if your BV recurs, they can help you identify any triggers and tweak the antibiotic treatment.
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Are There Diseases Or Conditions Associated With Bv
BV can increase the risk of acquiring certain diseases and conditions, including1,2:
- Chlamydia, gonorrhea, herpes, HIV/AIDS, and other sexually transmitted diseases from an infected partner
- Infections following certain types of surgery, such as hysterectomy, abortion, and caesarean delivery
- Pelvic inflammatory disease
If a woman is infected with HIV and has BV, there is an increased risk of passing HIV/AIDS to her partner and possibly to her child if she is pregnant2,3,4.
Whats The Difference Between Bacterial Vaginosis And A Yeast Infection
Both bacterial vaginosis and yeast infections are vaginal infections that increase discharge. Heres how you can tell the difference:
- Discharge: The hallmark sign of BV is discharge with a fishy smell. Discharge from yeast infections doesnt usually have a strong smell but may look like cottage cheese.
- Vaginal irritation: Typically, BV doesnt cause vaginal irritation or itchiness. Yeast infections do.
- Over-the-counter treatment: You can treat yeast infections with over-the-counter medications. Youll need to see your healthcare provider to get antibiotics for BV.
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Diagnosis Of Bacterial Vaginosis
If you notice a change in the colour or smell of your vaginal discharge, talk to your GP, obstetrician or midwife.
They may ask you some questions about the discharge. They may also examine you by looking at your vagina. A vaginal swab is often the best way to confirm bacterial vaginosis.
A vaginal swab looks like a long cotton bud . It is inserted into your vagina and wiped against any discharge or the inside of your vagina.
Most GPs, GP practice nurses and midwives use a speculum to take the swab. This is a small plastic device that is inserted into your vagina and opened gently.
Once they take the swab, it will be sent to the nearest microbiology lab for analysis.
Vaginal swabs do not usually hurt, but they may be a little uncomfortable. They do not harm your baby.
Should My Partner Be Treated For Bacterial Vaginosis
There is no evidence that treating a male sexual partner prevents his female sexual partner from developing BV. One small trial looked at whether using a sterilising alcohol gel on the penis protected their partners against BV – but the gel appeared to make BV more, rather than less, common in the women.
If you have a female partner then it does appear that treating her for BV at the same time as you – even if she doesn’t have symptoms – will prevent recurrence .
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What Are The Possible Complications Of Bacterial Vaginosis
When left untreated, BV can cause serious complications and health risks. These include:
- Pregnancy complications: Pregnant women with BV are more likely to have an early delivery or low birth weight baby. They also have a greater chance of developing another type of infection after delivery.
- Sexually transmitted infections: BV increases your risk of getting sexually transmitted infections, including the herpes simplex virus, chlamydia, and HIV.
- Pelvic inflammatory disease: In some cases, BV may lead to pelvic inflammatory disease, an infection of the reproductive organs in women. This condition can increase the risk of infertility.
- Infections after surgery: BV puts you at a higher risk for infections after surgeries affecting the reproductive system. These include hysterectomies, abortions, and cesarean deliveries.
Can Sperm And Eggs Survive Bacterial Vaginosis
Bacterial Vaginosis is three times more common in infertile women than fertile women. BV, and other infections in general, can decrease fertility in a number of ways:
- Increasing inflammation and immune system activity, making a toxic environment for reproduction
- Causing damage to sperm and vaginal cells
- Interfering with the production of healthy cervical mucus during ovulation
- Blocking the fallopian tubes through scar tissue damage from infections, so that sperm and egg cant meet
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Bacterial Vaginosis And Miscarriage
Some studies indicate a link between BV and preterm labor or miscarriage, and if the infection is really nasty and not treated, it can progress to become pelvic inflammatory disease, which can cause infertility.
BV during pregnancy can also cause problems like premature labor, late miscarriage, and premature rupture of membranes although these occurrences are also rare. If you’re getting prenatal care, your doctor or midwife will be looking for signs and symptoms of infection.
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