Patient's question:
Nighttime itching is unbearable, excessive discharge.Doctor's answer:
Bacterial Vaginosis (BV) is a syndrome caused by a mixed infection of Gardnerella vaginalis and anaerobic bacteria, leading to an imbalance in the vaginal microecological equilibrium, resulting in increased vaginal discharge, fishy odor in leukorrhea, and pruritus or burning sensation of the external genitalia. It can be classified into Haemophilus vaginalis vaginitis, Corynebacterium vaginitis, anaerobic vaginosis, Gardnerella vaginitis, etc. This condition can also be transmitted through sexual contact and has a higher incidence rate among individuals with promiscuous sexual relationships. Examination of the discharge smear can reveal a large number of pus cells and identify the pathogenic bacteria.### Etiology
Indirect Contact Infection
Contact with bacteria-contaminated public toilet seats, bathtubs, hot tub benches, or towels, as well as the use of unhygienic toilet paper, can all lead to infection.
Sexual Transmission
Sexual transmission is one of the causes of the disease, with at least 10% of male partners of symptomatic women suffering from bacterial urethritis.
Excessive Use of Antibiotics
Antibiotics alter the vaginal microenvironment, allowing pathogenic bacteria to proliferate extensively, leading to local bacterial vaginosis.
Excessive Hygiene Practices
Some women, in an effort to maintain hygiene, frequently use medicated douches, which can easily disrupt the vaginal acid-base environment and increase susceptibility to bacterial vaginosis.
### Treatment
1. General Treatment
- Maintain cleanliness and dryness of the external genitalia, avoiding scratching.
- Avoid spicy or irritating foods.
- Change underwear frequently, wash with warm water, and avoid washing with other clothes to prevent cross-infection.
2. Medication Treatment
(1) Metronidazole – Currently considered to have reliable efficacy, taken twice daily for 7 days.
(2) Miconazole – Taken for 3 days.
(3) Trimethoprim – Effective against a variety of Gram-negative and Gram-positive bacteria, as well as having good efficacy against anaerobic bacterial growth.
(4) Clindamycin and Ampicillin can also be used. In recent years, it has been recommended that asymptomatic individuals do not require treatment.
3. Local Therapy
- Topical medications such as metronidazole suppositories can be used, administered once nightly for 7 days.
4. Treatment of Complications
- If other pathogens are detected, targeted treatment should be administered to avoid the indiscriminate use of antibiotics.
- Pay attention to the patient's overall condition and may provide supportive and immunotherapeutic treatments simultaneously.
- Monitor for adverse drug reactions.
5. Treatment of Sexual Partners
- Male sexual partners should also be treated simultaneously.