A lab result indicating a “predominance of coccobacilli consistent with shift in vaginal flora” can raise questions. This medical phrase points to a change in the delicate balance of microorganisms within the vaginal environment. Understanding this finding, its implications, and how it is addressed can provide clarity.
Understanding the Lab Finding
The phrase “predominance of coccobacilli consistent with shift in vaginal flora” refers to Bacterial Vaginosis (BV). Vaginal flora describes the community of various microorganisms, primarily bacteria, that naturally reside in the vagina. In a healthy state, this flora is dominated by beneficial bacteria, mainly Lactobacillus species. These produce lactic acid, maintaining an acidic vaginal pH that discourages the growth of other, potentially harmful, bacteria.
A “shift” in this flora means a disruption in this natural balance. In the context of BV, this involves a significant decrease in the protective Lactobacillus bacteria and an overgrowth of other types of bacteria, particularly anaerobic bacteria and coccobacilli. Coccobacilli are bacteria with a shape intermediate between spheres and rods. One prominent coccobacillus associated with this shift is Gardnerella vaginalis, which is often found in higher numbers during BV and is believed to initiate a biofilm allowing other opportunistic bacteria to thrive.
Factors Leading to This Change
Several factors can disrupt the natural balance of vaginal flora, leading to the shift seen in Bacterial Vaginosis. Douching, for instance, can upset the vaginal ecosystem by flushing out beneficial bacteria and altering pH levels, making the environment more susceptible to bacterial overgrowth. Sexual activity also plays a role, as having new or multiple sexual partners can increase the risk of developing BV. While BV is not considered a sexually transmitted infection (STI), sexual contact can influence the vaginal microbiome.
The use of certain intrauterine devices (IUDs) has also been linked to an increased risk of BV, especially if irregular bleeding occurs. Additionally, hormonal fluctuations, such as those occurring during menstruation or pregnancy, can sometimes contribute to changes in vaginal pH and bacterial balance. These factors do not always lead to BV, but they can create conditions that favor the overgrowth of certain bacteria.
Recognising the Signs and When to Act
Bacterial Vaginosis can manifest through several signs and symptoms, though some individuals may experience no symptoms at all despite the presence of a flora shift. A common indicator is an unusual vaginal discharge, which might appear thin, grey, or white. Another frequent symptom is a strong, fishy odor, which often becomes more noticeable after sexual intercourse or during menstruation. Some individuals may also experience vaginal itching or a burning sensation during urination.
If any of these symptoms are present, particularly a persistent odor or unusual discharge, it is important to seek medical attention. Consultation with a healthcare provider is also recommended if the lab finding indicates a shift in flora, even without symptoms. This is particularly important for pregnant individuals, as BV has been associated with pregnancy complications, including premature rupture of membranes and preterm birth.
Approaches to Treatment
Treatment for Bacterial Vaginosis primarily involves the use of antibiotics to reduce the overgrowth of the problematic bacteria. These medications can be prescribed as oral pills or as vaginal gels or creams. Common antibiotics used for BV include metronidazole (available in oral tablet form or as a vaginal gel) and clindamycin (can be prescribed as a vaginal cream or ovules).
It is important to complete the entire course of treatment as prescribed by the healthcare provider, even if symptoms begin to improve or disappear before the medication is finished. Stopping treatment early can lead to the infection returning. For pregnant individuals, treatment is important to prevent potential complications, and specific antibiotic regimens are available that are considered safe during pregnancy. A healthcare provider will determine the most appropriate treatment based on individual circumstances.
Steps for Reducing Recurrence
After addressing a shift in vaginal flora, several practical steps can help reduce the likelihood of recurrence and support a healthy vaginal microbiome. Avoiding douching is a significant measure, as it can disrupt the natural balance of beneficial bacteria. Practicing safer sex, including consistent and correct condom use, can also help maintain vaginal health.
Additionally, it is advisable to avoid scented feminine hygiene products, such as scented tampons, pads, or sprays, as these can irritate the vaginal area and alter the microbial balance. Wearing breathable cotton underwear can promote air circulation and reduce moisture, creating a less hospitable environment for bacterial overgrowth. Maintaining good overall hygiene, without excessive washing or harsh soaps, also contributes to a balanced vaginal environment.
References
Bacterial Vaginosis. Centers for Disease Control and Prevention.
Vaginal Microbiome in Health and Disease. Frontiers in Cellular and Infection Microbiology.
Coccobacillus. Wikipedia.
Gardnerella vaginalis and Bacterial Vaginosis. Clinical Microbiology Reviews.
Intrauterine Devices and Bacterial Vaginosis. American Journal of Obstetrics & Gynecology.