“Haemophilus vaginalis” is an older name for Gardnerella vaginalis, a bacterium initially described in the 1950s. Gardnerella vaginalis is a natural inhabitant of the vaginal environment for many individuals. Its primary association is with Bacterial Vaginosis (BV), a widespread condition involving an imbalance of the vaginal flora.
Understanding Gardnerella vaginalis and Bacterial Vaginosis
Gardnerella vaginalis is a facultative anaerobic bacterium, meaning it can thrive both with and without oxygen. It is a normal component of the vaginal microbiome, the complex community of microorganisms that naturally reside in the vagina. In a healthy vaginal environment, beneficial bacteria, primarily various species of Lactobacillus, are abundant and help maintain an acidic pH. This acidic environment typically inhibits the overgrowth of other bacteria.
Bacterial Vaginosis (BV) develops when this delicate balance is disrupted, leading to a decrease in protective Lactobacillus bacteria and an overgrowth of other anaerobic bacteria, including Gardnerella vaginalis. While Gardnerella vaginalis is a major species often present in BV, it is not considered the sole cause, but rather a “signal organism” indicating a shift in the microbial ecology. Many other bacterial species contribute to the polymicrobial nature of BV.
BV is a very common vaginal condition, affecting millions of women globally. It is the most frequent cause of abnormal vaginal discharge in women of reproductive age. The exact reasons for the imbalance leading to BV are not fully understood, but various factors can influence the vaginal microbiome, making some individuals more susceptible.
Recognizing Bacterial Vaginosis
BV often presents with noticeable symptoms, though some individuals may have it without experiencing any. A hallmark symptom is an unusual vaginal discharge, which can appear thin, white, or gray in color. The consistency may be watery, and the volume can vary.
Another common symptom is a strong “fishy” odor, which tends to become more pronounced after sexual intercourse or during menstruation. This odor is a result of volatile amines produced by the overgrowing bacteria. Some individuals may also experience vaginal itching or a burning sensation during urination.
Diagnosis of BV involves a healthcare professional evaluating the symptoms and conducting a physical examination. A microscopic examination of vaginal fluid, known as a wet mount, is often performed. During this test, the presence of “clue cells”—vaginal epithelial cells coated with bacteria—is a strong indicator of BV. Additionally, the vaginal pH is usually tested; a pH greater than 4.5 is commonly associated with BV due to the reduction in acid-producing Lactobacillus species.
Managing and Preventing Bacterial Vaginosis
Treatment for BV primarily involves antibiotics, which can be prescribed as oral medication or as a topical gel or cream applied directly to the vagina. Common oral antibiotics include metronidazole or tinidazole, while topical options often feature metronidazole gel or clindamycin cream. It is important to complete the entire course of medication as prescribed by a healthcare provider, even if symptoms improve before the medication is finished, to ensure full resolution of the infection and reduce the likelihood of recurrence.
Preventing BV involves several practical measures aimed at maintaining a healthy vaginal environment. Avoiding douching is a significant preventive step, as douching can disrupt the natural balance of vaginal bacteria and increase the risk of BV. Practicing good genital hygiene, such as wiping from front to back after using the toilet, can help prevent the introduction of bacteria from the anal area to the vagina.
Using condoms consistently and correctly during sexual activity can also help in prevention, as semen can alter vaginal pH and potentially contribute to an imbalance. Wearing breathable underwear made from cotton helps to keep the genital area dry and prevent moisture buildup, which can create a favorable environment for bacterial overgrowth. Limiting the number of sexual partners and avoiding fragranced feminine products are additional strategies that may help reduce the risk of BV.
Common Questions and Misconceptions
A common misunderstanding is whether BV is considered a sexually transmitted infection (STI). While BV is not classified as an STI in the traditional sense, as it can occur in individuals who are not sexually active, sexual activity can influence the vaginal microbiome and increase the risk of developing BV. It is more accurately described as an imbalance of naturally occurring vaginal bacteria.
If left untreated, BV can lead to several potential complications. It can increase an individual’s susceptibility to acquiring other sexually transmitted infections, including HIV, herpes simplex virus (HSV), and human papillomavirus (HPV). For pregnant individuals, untreated BV can pose risks such as premature birth or low birth weight.