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WHAT ARE BACTERIAL VAGINOSIS TREATMENT Options?
* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.
Bacterial Vaginosis is most commonly treated with one of the following:
A. Metronidazole (Flagyl) 500 mg 2 x / day for 7 days
B. Clindamycin 300 mg 2 x / day for 7 days
Bacterial Vaginosis is less commonly treated with:
A. Metronidazole Gel 0.75% (5 Grams) 1 x /night for 5 days (Intravaginally)
B. Clindamycin Gel 2% Vaginal suppositories 1 x / night for 3 days (intravaginally)
C. Clindamycin bioadhesive cream (Clindesse) 2% one 5 grams of cream containing 100 mg of Clindamycin 1 x / night ONCE (intravaginally)
Less Common treatments:
A. Tinidazole (orally)
B. Secnidzole (orally)
CAUTION:
1. Bacterial Vaginosis symptoms are very similar to Trichomoniasis (an STD), and the treatment although similar is not exactly the same. They both have a gray, yellow, or green discharge with a fishy smell.
2. Bacterial Vaginosis does not always respond well to treatment. BV sometimes needs to be retreated or treated with a different medication.
3. Vaginal creams that treat bacterial vaginosis may cause damage to condoms during intercourse.
4. All medication, including all oral antibiotics and all medications that come in lotions, ointment, and creams have a risk of side effects.
5. Possible Mild side effects are nausea, vomiting, diarrhea, itching, and light to moderate skin rash.
6. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.
7. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.
Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.
WHAT ARE THE SYMPTOMS OF BACTERIAL VAGINOSIS (also called BV)?
The main symptoms of bacterial vaginosis are a thin gray, white, or green vaginal discharge that smells like fish. The smell may be more noticeable during or after vaginal intercourse. There may also be a vaginal itching and a burning that occurs during urination.
WHAT IS THE CAUSE OF BACTERIAL VAGINOSIS (BV) ?
The exact cause of Bacterial Vaginosis (BV) is complex. BV occurs because of the both the undergrowth of normal vaginal bacteria, and overgrowth of normal vaginal bacteria; and there are many different normal vaginal bacteria. Bacterial Vaginosis usually occurs when the complex balance of these bacteria becomes unbalanced. There are at least three types of bacteria that are usually involved. Lactobacillus bacteria usually decreases in number, while Gardnerella bacteria and group B streptococcus bacteria usually increase. This imbalance of the normal vaginal bacteria causes the symptoms of Bacterial Vaginosis.
HOW IS BACTERIAL VAGINOSIS (BV) DIAGNOSED?
Ideally bacterial vaginosis will be diagnosed by taking a careful history, by physical exam of the vagina, and by examining a small drop of the vaginal discharge under a microscope. However, there is a relatively new product that is quicker and less invasive, called VS-SENSE™. This product only requires a vaginal swab of the discharge to be tested. It can be done in a few minutes, is about 90% accurate, and does not require a pelvic exam. But, this product is only available in clinics, doctor offices, and hospitals.