Gardnerella vaginalis is a bacterium commonly found in the vaginal microbiome. Its presence often leads to confusion regarding its classification as a sexually transmitted infection (STI). This article clarifies the role of Gardnerella vaginalis, its association with Bacterial Vaginosis (BV), and its implications for vaginal health.
Is Gardnerella Vaginalis a Sexually Transmitted Infection?
Gardnerella vaginalis is not considered a sexually transmitted infection (STI) in the traditional sense, unlike conditions such as chlamydia or gonorrhea. This bacterium is a natural inhabitant of the vaginal flora. However, an overgrowth of Gardnerella vaginalis is strongly associated with Bacterial Vaginosis (BV), a common vaginal infection.
While BV is not classified as an STI because it results from an imbalance of naturally occurring bacteria rather than being solely transmitted through sexual contact, sexual activity can influence the vaginal microbiome and increase the risk of developing BV. This association often leads to the misunderstanding that Gardnerella vaginalis or BV is an STI. Gardnerella vaginalis is a bacterium, and BV is a condition arising from its overgrowth. Sexual activity can be a trigger for BV, and certain practices like having new or multiple sexual partners can increase the risk.
Understanding Bacterial Vaginosis
Bacterial Vaginosis (BV) is a common vaginal condition characterized by an imbalance in the vaginal microbiome. In a healthy vagina, beneficial Lactobacillus species typically dominate, producing lactic acid that maintains a low, acidic pH, which inhibits the growth of harmful bacteria. In cases of BV, there is a decrease in these protective Lactobacillus species, allowing other bacteria, including Gardnerella vaginalis, to overgrow.
Gardnerella vaginalis is frequently the most prevalent bacterium found in cases of BV, and it often contributes to the formation of a biofilm that can further support the proliferation of other opportunistic bacteria. This disruption of the natural balance shifts the vaginal environment from a healthy acidic state to a more alkaline one, leading to the symptoms associated with BV. The exact causes for this microbial shift are not always clear, but factors like douching, unprotected sex, and hormonal changes can contribute to the imbalance.
Recognizing Symptoms and Getting a Diagnosis
Recognizing the symptoms of Bacterial Vaginosis is important, though approximately 50% to 84% of individuals with BV may not experience any symptoms. When symptoms do occur, they commonly include an unusual vaginal discharge that is typically thin, grayish-white, or greenish. A notable characteristic is a “fishy” odor, which often becomes more pronounced after sexual intercourse or during menstruation.
Other potential symptoms include vaginal itching, irritation, or a burning sensation during urination. Diagnosis of BV by a healthcare provider typically involves a physical examination and an assessment of vaginal discharge. Diagnostic tests can include measuring the vaginal pH, which is usually elevated (above 4.5) in BV, performing a “whiff test” where a fishy odor is detected after adding a chemical to the discharge, and microscopic examination of vaginal fluid to look for “clue cells” (vaginal cells coated with bacteria).
Treatment Options and Prevention Strategies
Treatment for Bacterial Vaginosis primarily involves antibiotics, which can be prescribed as oral medications or as vaginal gels or creams. Common antibiotics used include metronidazole and clindamycin. It is important to complete the full course of antibiotics as prescribed, even if symptoms improve or disappear, to reduce the likelihood of recurrence. Recurrence is common, with 50% to 80% of individuals experiencing BV again within 6 to 12 months after treatment.
Prevention strategies can help maintain a healthy vaginal microbiome and reduce the risk of recurrence. These include avoiding douching, which can disrupt the natural bacterial balance and pH of the vagina. Using mild, unscented soaps for external cleaning and wearing cotton underwear can also contribute to vaginal health. Practicing safe sex, such as consistent condom use, and limiting the number of sexual partners may also help, as sexual activity can influence the vaginal environment.