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Bacterial vaginosis, a common vaginal infection that is often being misdiagnosed

Although it is one of the most common vaginal infections out there, you are probably unlikely to have heard of bacterial vaginosis.

An infection that is not often talked about, it is often mistaken for a yeast infection, even though there are some differences in the symptoms.

So, what is bacterial vaginosis?

It is a type of inflammation due to an overproliferation of bad bacteria in the vagina, causing a disruption in the natural balance of good and bad bacteria there.

Women of any age can contract bacterial vaginosis, and it carries a risk of miscarriage or premature birth for pregnant women.

If you smoke, douche or use overly-scented bath soaps, you are more likely to get bacterial vaginosis.

It can also be transmitted sexually, even though it is not officially classified as a sexually-transmitted disease (STD).

When to be worried

The symptoms of bacterial vaginosis include:

  • A stale, fishy odour around the vaginal area
  • Itchiness at the vaginal area
  • A burning sensation when urinating
  • Smelly vaginal discharge
  • You should see a doctor if:
  • You have self-treated for a yeast infection and the symptoms persist.
  • Your discharge has an unusually strong odour.
  • You are sexually active with more than one partner during the same period of time, and you’re unsure of their sexual health.

In a diagnosis, your doctor will ask about your medical history, to learn about past infections or STDs.

A pelvic exam follows next to check for physical symptoms of an infection, both outside and inside your vaginal tube.

Sample vaginal secretions are taken for microscopic analysis to confirm the overgrowth of bad bacteria, and pH testing is conducted.

If your pH is 4.5 or higher, that’s an indication of bacterial vaginosis.

Yoghurt is a natural probiotic, which can help restore the bacterial balance in your vagina, when eaten once a day. — Photos: AFPYoghurt is a natural probiotic, which can help restore the bacterial balance in your vagina, when eaten once a day. — Photos: AFP


There are pharmaceutical medications, as well as home remedies, to treat bacterial vaginosis.

For medication, you may be prescribed one of these:

  • Clindamycin – This is a cream that is applied to the inside walls of the vagina. Note that clindamycin cream has been known to weaken latex condoms during treatment and for at least three days after.
  • Metronidazole – This medicine is taken orally. It is also available as a topical gel. It’s best to stop drinking alcohol to reduce stomach upset, abdominal pain or nausea, when using this medication.
  • Tinidazole – This oral medication also carries the same potential for stomach upset and nausea as oral metronidazole does.

Now, let’s discuss some common and safe home remedies.

While these treatments won’t be as effective as prescribed medications, home remedies come without the side effects of pharmaceutical solutions.

  • Probiotics – Taking probiotic supplements, either in the form of pills or liquids, can help to prevent bacterial vaginosis. Adding a supplement may prevent future recurrences of bacterial vaginosis.
  • Yoghurt – Yoghurt is a natural probiotic, which contains lots of healthy bacteria that can help to restore the balance in your vaginal bacterial ecosystem. To reap the full benefits, eat at least one serving of yoghurt per day.
  • Tea tree oil – Tea tree oil is known to have antifungal and antibacterial qualities. It can be diluted with a carrier oil like coconut or olive oil. Try adding five to 10 drops of high quality tea tree oil to one ounce of carrier oil. Soak a tampon with the diluted oil and insert it into your vagina to treat bacterial vaginosis. But if you are allergic to tea tree or a carrier oil, this method isn’t recommended.
  • Garlic – In many cultures, garlic features prominently as a healing food, known for its antibiotic properties. If you dislike the taste of raw or fresh garlic, a supplement may be an option.
  • Boric acid – In treatments involving boric acid, pessaries are inserted into the vagina for between seven to 14 days. It’s often used in cases of chronic bacterial vaginosis, where a patient’s condition recurs more than three times a year. Boric acid is considered safe and almost as effective as pharmaceuticals, but they are poisonous if taken orally – the only safe method of administering it is via suppositories.

Good hygiene is key

Keeping up with good hygiene includes changing underwear regularly, and taking care not to expose your delicate vagina to external bacteria.

When you wipe or wash, cultivate the habit of starting from front to back, in order to avoid faecal matter from entering the vaginal tube.

Change tampons or pads at least once a day, or more if you’re prone to heavy flow.

Thoroughly clean anything that you insert inside the vagina, whether it’s a menstrual cup or sex toys.

Practising good hygiene not only clears bacterial vaginosis, but helps to prevent recurrence as well.

However, one very out-of-date practice in vaginal hygiene is the act of douching.

Many women have been misled, either by commercial products or cultural beliefs, that douching is necessary for women’s health.

Douching is unnecessary and is actually harmful to the health and pH of your vagina. When the pH balance is disrupted, that paves the way to the increased likelihood of infections.

If you currently believe in douching, stop that practice and focus instead on cleansing daily with mild, fragrance-free soap.

The fit, material and even design of your underwear can play a role in preventing bacterial vaginosis.

Spandex tends to be less breathable than cotton, and a fit that is too tight causes oxygen and blood flow constriction.

Wear undies that promote better airflow and aren’t uncomfortably tight, to avoid trapping too much moisture down there.

When you starve bacteria of an environment that allows them to thrive, the problem will clear more quickly.

Tight pants and leggings should also be avoided when you have bacterial vaginosis.

Bacterial vaginosis tends to recur within three to 12 months, even after it’s been treated.

If you have tried home remedies, but still experience recurrence, seek out a doctor or gynaecologist for further treatment.

Make an appointment on days when you don’t have your period so that the samples you provide for testing will give the right picture.

Don’t wait for your symptoms to get worse.


By Datuk Dr Nor Ashikin Mokhtar
Published in Star Newspaper, Novamber 25, 2019