Is bacterial vaginosis contagious? Diagnosis, treatment

Is bacterial vaginosis contagious?

Although bacterial vaginosis is not considered to be a contagious condition, the role of transmissibility of bacteria among individuals is not fully understood. Since having multiple or new sexual partners increases a woman's risk of developing bacterial vaginosis, this suggests that spread of bacteria among individuals may alter the balance of bacteria in the vagina and potentially predispose to bacterial vaginosis. However, since bacterial vaginosis also occurs in celibate women, other causative factors must also play a role in its development.

How is bacterial vaginosis diagnosed?

When a woman reports an unusual vaginal discharge, the doctor will ask her a series of routine questions to help distinguish mild from more serious conditions. Additional issues that might indicate the presence of a more serious condition include fever, pelvic pain, new or multiple sexual partners (especially with unprotected intercourse), and a history of sexually-transmitted infections(STDs).

In addition to these questions, the doctor will perform a pelvic exam. During the exam, the doctor notes the appearance of the vaginal lining and cervix. The doctor will also perform a manual exam of the ovaries and uterus. The cervix is examined for tenderness, which might indicate a more serious infection. The doctor may collect samples to check for chlamydia or gonorrhea infection.

Examining the vaginal discharge under the microscope can help distinguish bacterial vaginosis from yeast vaginitis (vaginal yeast infection, Candidiasis) and trichomoniasis(a type of sexually-transmitted infection). A sign of bacterial vaginosis under the microscope is a vaginal cell called a clue cell. Clue cells are vaginal cells covered with bacteria and are believed to be the most reliable diagnostic sign of bacterial vaginosis. In addition to clue cells, women with bacterial vaginosis have fewer of the normal vaginal bacteria, called lactobacilli. A vaginal pH greater than 4.5 is also suggestive of bacterial vaginosis. Cultures of bacteria are generally not useful in establishing the diagnosis of bacterial vaginosis.

Finally, the doctor may perform a "whiff test" with potassium hydroxide (KOH) liquid. When a drop of KOH testing liquid used in the "whiff test" contacts a drop of the discharge from a woman with bacterial vaginosis, a certain fishy odor can result.

What is the treatment for bacterial vaginosis?

Treatment for bacterial vaginosis consists of antibiotics. A few antibiotic remedies are routinely used. Metronidazole (Flagyl) taken by either oral (pill) form or by vaginalmetronidazole gel (Metrogel) is an effective cure. Also available is the vaginal clindamycin cream (Cleocin). The oral metronidazole can cause some minor but unpleasant side effects, but is believed to be the most effective treatment. The gels do not typically cause side effects, although yeast vaginitis can occur as a side effect of the medication.

Tinidazole (Tindamax) is an antibiotic that appears to have fewer side effects than metronidazole and is also effective in treating bacterial vaginosis.

Recurrence of bacterial vaginosis is possible even after successful treatment. More than half of those treated experience recurrent symptoms within 12 months. It is unclear why so many recurrent infections develop. With recurrent symptoms, a second course of antibiotics is generally prescribed