The above terms refer to a condition that occurs when the
normal vaginal bacteria (lactobacilli) are displaced by anaerobic bacteria -
mainly by a bacterium called Gardnerella vaginalis. The cause is unknown and,
in fact , Gardnerella vaginalis can often be found on routine testing of women
who do not have any symptoms or signs of the condition. The normal pH (a
measure of the acidity in the vagina) is usually around 3 but in anaerobic
vaginosis this pH rises to 5 or 6. This is the opposite to the situation that
occurs in Thrush when the pH goes down to 2.
Although it is more common in women who are sexually
active, it is NOT considered a sexually transmitted condition and no real
benefit has ever been shown by treating the male partner.
Symptoms
Typically there is a
thin greyish discharge that occasionally has a fishy smell, particularly after
intercourse. It can be difficult to distinguish clinically from Thrush, but
there is usually less itching and irritation with anaerobic vaginosis than with
Thrush. It never causes an ascending infection (ie. An infection that ascends
up through the uterus and out to the fallopian tubes) so it is not a cause of
pelvic inflammatory disease and, even in recurrent cases, no long term damage
is done.
Diagnosis
The discharge can be examined under a
microscope and, if due to anaerobic vaginosis, "clue cells" (vaginal epithelial
cells covered with Gardnerella vaginalis bacteria) are seen.
Treatment
Treatment is simple. An antibiotic called
Metronidazole tablets (Flagyl) is given either as a single large dose (2 gram)
or, alternatively, as a twice a day dosage for one week. The tablets have to be
taken with food. Patients must not drink alcohol whilst on the course of
tablets. Recurrences may be helped by using a gel that lowers the vaginal pH (
Acigel).
Clindamycin (Dalacin C) vaginal cream and Metronidazole gel
(Zidoval) are alternative treatments, applied directly to the vagina. They are
as effective as Metronidazole tablets, and avoid the need for taking tablets.
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