Gardnerella vaginalis is a normal bacterium in the vaginal microbiome, a community of diverse bacteria like Lactobacillus species. A balanced flora maintains an acidic environment, helping prevent infections.
An “abnormal” state of Gardnerella vaginalis signifies an overgrowth or imbalance within this ecosystem. This shift disrupts the delicate balance, leading to bacterial vaginosis (BV).
When Gardnerella Vaginalis Becomes Abnormal
This overgrowth contributes to bacterial vaginosis (BV), characterized by a decrease in protective Lactobacillus species and an increase in other anaerobic bacteria, including Gardnerella vaginalis. This shift results in the vaginal pH becoming less acidic, typically rising to 4.5 or higher, creating an environment where Gardnerella and other associated bacteria can thrive. Gardnerella vaginalis is present in approximately 98% of women with symptomatic BV. This imbalance, rather than Gardnerella vaginalis alone, is the underlying cause of BV.
Recognizing the Indicators
An overgrowth of Gardnerella vaginalis, manifesting as BV, often presents with recognizable signs. A common indicator is unusual vaginal discharge, which may appear thin and have a grayish-white color. A strong, fishy odor is another frequent symptom, often becoming more noticeable after sexual intercourse or during menstruation. Some individuals may also experience vaginal itching or irritation, along with a burning sensation during urination. About 50% of women with BV may not experience any symptoms.
Factors Contributing to Imbalance
Several factors can disrupt the natural balance of the vaginal microbiome, leading to an overgrowth of Gardnerella vaginalis and the development of BV. Douching is a significant factor, as it can alter the vaginal pH and eliminate beneficial bacteria. Unprotected sexual activity, particularly with new or multiple partners, is also linked to an increased risk of BV, although BV is not classified as a sexually transmitted infection. The use of certain hygiene products, such as perfumed soaps, can irritate the vaginal environment and contribute to imbalance. Hormonal changes, such as those occurring during pregnancy or menstruation, can also influence the vaginal flora and increase susceptibility to Gardnerella vaginalis overgrowth.
Diagnosis and Treatment Approaches
Diagnosis of an abnormal Gardnerella vaginalis overgrowth, or BV, involves a clinical assessment and laboratory tests. A healthcare provider might conduct a pelvic exam and examine vaginal fluid under a microscope to look for “clue cells,” which are epithelial cells covered in bacteria. Vaginal pH testing is performed, with a pH of 4.5 or higher often indicating BV.
Treatment for BV involves antibiotics, which can be prescribed as oral medications or vaginal gels/creams. Common antibiotics include metronidazole and clindamycin. Complete the full course of medication, even if symptoms improve, to ensure effectiveness and prevent recurrence. Recurrence is common, with approximately 80% of women experiencing BV again within three months of treatment.
Implications of Untreated Imbalance
Leaving an abnormal Gardnerella vaginalis overgrowth untreated can lead to health complications. It increases susceptibility to acquiring sexually transmitted infections (STIs), including HIV. The altered vaginal environment can make it easier for other pathogens to establish themselves. Untreated BV can also increase the risk of pelvic inflammatory disease (PID), a condition that can affect the uterus, fallopian tubes, and ovaries. For pregnant individuals, untreated BV can lead to complications such as preterm birth, low birth weight, and premature rupture of membranes.