Bacterial Vaginosis: Symptoms, Treatment, and Prevention

Bacterial vaginosis

Hello Doctor: Recently, I noticed abnormal vaginal discharge during urination, with clumps that feel like what is expelled during menstruation.
The color is somewhat between milky white and translucent, and it has a sour (fishy?) odor.
When touched, it feels a bit sticky but does not stretch.
I consulted a gynecologist who diagnosed it as a bacterial infection.
I underwent vaginal irrigation and was prescribed oral antibiotics for five days.
The amount of discharge decreased, and the odor improved, so I did not return for a follow-up.
However, the day after stopping the medication, the discharge increased again, and every three to four days, I experience clumps similar to the initial symptoms.
Since I want to start trying to conceive after the New Year, the recurring vaginitis is concerning.
I would like to ask the doctor: 1.
How long does treatment for bacterial vaginitis typically last? 2.
Given the frequent recurrence, should I undergo bacterial culture or testing? 3.
Is it more effective to use oral antibiotics and vaginal suppositories simultaneously? 4.
If I only take oral antibiotics, can I use over-the-counter vaginal cleansing products like feminine washes? 5.
Can excessive use of oral antibiotics and vaginal suppositories lead to antibiotic resistance? 6.
The gynecologist advised me during my follow-up not to take too many antibiotics and suggested wearing loose, breathable clothing.
Could this be related to not taking enough antibiotics to effectively eliminate the bacteria? I apologize for the many questions; I just hope to improve my vaginal inflammation symptoms quickly and conceive a healthy baby soon.

Ms. Chen, 30~39 year old female. Ask Date: 2021/01/17

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the general treatment takes about a week.
If there are recurrent infections, a culture can be performed.
If there are any issues, it is important to see a physician.
Of course, it is also necessary to monitor one's own immune response.
Wishing you good health.

Reply Date: 2021/01/17

More Info

Bacterial vaginosis (BV) is a common condition that arises from an imbalance in the normal bacteria found in the vagina. It can lead to symptoms such as unusual discharge, a fishy odor, and irritation. Your description of the discharge being white, somewhat translucent, and having a distinct odor aligns with typical BV symptoms. It’s important to understand the nature of this condition, its treatment options, and preventive measures to manage it effectively, especially if you are considering pregnancy.

1. Duration of Treatment: Treatment for bacterial vaginosis typically lasts about 5 to 7 days, depending on the antibiotic prescribed. Common antibiotics include metronidazole or clindamycin, which can be administered orally or as a vaginal gel. If symptoms persist after completing the course of antibiotics, it may indicate a need for further evaluation or a different treatment approach.

2. Need for Cultures: If you experience recurrent BV, it may be beneficial to conduct a bacterial culture or other tests to identify specific pathogens. This can help tailor treatment more effectively. Recurrent infections may suggest an underlying issue, such as a compromised immune system or other health conditions that need to be addressed.

3. Combination Therapy: Using both oral antibiotics and vaginal treatments can sometimes enhance effectiveness, especially in persistent cases. However, it’s crucial to follow your healthcare provider’s recommendations regarding the use of these medications to avoid potential side effects or complications.

4. Use of Over-the-Counter Products: While some women may consider using over-the-counter feminine hygiene products, it’s essential to approach this cautiously. Many commercial products can disrupt the natural flora of the vagina and may exacerbate symptoms. It’s advisable to consult your healthcare provider before using any such products.

5. Antibiotic Resistance: Overuse of antibiotics, whether oral or topical, can lead to antibiotic resistance. This means that the bacteria may become less susceptible to treatment over time. It’s crucial to use antibiotics only as prescribed and to complete the entire course of treatment, even if symptoms improve before finishing the medication.

6. Lifestyle Recommendations: Your healthcare provider's advice regarding wearing breathable clothing and avoiding excessive antibiotic use is sound. Tight clothing can trap moisture and create an environment conducive to bacterial growth. Maintaining good hygiene, avoiding douching, and using unscented products can also help prevent BV.

In summary, managing bacterial vaginosis effectively involves a combination of appropriate medical treatment and lifestyle adjustments. If you continue to experience symptoms or have concerns about recurrent infections, it’s essential to maintain open communication with your healthcare provider. They can help you navigate treatment options and ensure that any underlying issues are addressed, ultimately supporting your goal of a healthy pregnancy. Remember, while BV is not typically a serious condition, it can significantly impact your quality of life and reproductive health, so proactive management is key.

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