Vol 38, (6) 394-397
Bacterial vaginosis - More questions than answers
Marie Pirotta MBBS, FRACGP, DipRANZOCG, MMed (WomHlth), PhD, is a general practitioner and Senior Research Fellow, Primary Care Research Unit, Department of General Practice, University of Melbourne, Victoria.
Kath A Fethers MBBS, MM, FAChSHM, is a sexual health physician, Melbourne Sexual Health Centre, Victoria.
Catriona S Bradshaw MBBS(Hons), FAChSHM, PhD, is a sexual health physician and NHMRC Research Fellow, Department of Epidemiology and Preventive Medicine, Monash University and Melbourne Sexual Health Centre, The Alfred Hospital, Victoria.
BACKGROUND Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age and is associated with serious pregnancy related sequelae and increased transmission of sexually transmissible infections, including HIV. The aetiology, pathology, microbiology and transmission of bacterial vaginosis remain poorly understood.
OBJECTIVE This article discusses the prevalence, clinical features and possible complications of bacterial vaginosis. It summarises what is known about the aetiology, pathophysiology and treatment of the condition and highlights directions for further research.
DISCUSSION Bacterial vaginosis is characterised by a complex disturbance of the normal vaginal flora with an overgrowth of anaerobic and other micro-organisms and a corresponding decrease in important lactobacillus species. The cause is not known, but observational evidence suggests the possibility of sexual transmission. Bacterial vaginosis is diagnosed by the Amsel or the Nugent method. Recommended treatment is with 7 days of oral metronidazole or vaginal clindamycin. More than 50% of women will experience recurrence of bacterial vaginosis within 6 months. It is not known whether this represents relapse or re-infection. Further research is needed into the aetiology, pathogenesis and optimal treatment of this condition.
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AFP Audio: Interview with Dr Catriona Bradshaw
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