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Gardnerella vaginalis is a bacterium that coexists, in a delicate balance, with other bacteria in the vagina to keep it free from infection. — Filepic

This helpful bacterium can also be responsible for vaginal infections

Gardnerella vaginalis is a mouthful to say, but it’s important to know. Gardnerella vaginalis is the scientific name for a bacterium that lives in your body.

In addition to trillions of other microorganisms, Gardnerella vaginalis also helps keep your vaginal flora (the bacteria normally living in and around your genitals) balanced and prevent infections. A common reproductive health condition called bacterial vaginosis (BV) is caused by Gardnerella going rogue and multiplying too fast.

Premenopausal women are around 30% likely to develop BV at some point, and some are unfortunate enough to contract it repeatedly. BV doesn’t technically qualify as a sexually transmitted infection (STI), but it shares some symptoms and risk factors with STIs (more on that later).

Fortunately, because of its prevalence, BV can be diagnosed and treated fairly easily. Before we assume that Gardnerella vaginalis is bad for our lady health, let’s learn a bit more about what it is.

It is present in the normal vaginal makeup, and in limited quantities, Gardnerella plays a valuable role in maintaining a balanced pH level – that’s the measure of acidic versus alkaline in your vaginal tract – that keeps bad bacteria out.

It is possible for Gardnerella vaginalis to disrupt your vaginal pH level and cause vaginal infections such as BV instead of protecting against it when it grows abnormally. For many years since mid-1950s, researchers believed Gardnerella was the sole cause of BV.

Scientific thinking has changed over the past 70 years. Now BV is believed to be caused by a wide variety of bacteria, not just one. Researchers have found that bacteria like Atopobium, Mobiluncus and Prevotella, among others, can also cause BV.

Gardnerella vaginalis used to be commonly referred to as BV. Nowadays, you will hear Gardnerella vaginalis referred to as one of many bacteria that can cause this infection. You can treat BV if your vagina is overgrown with bad bacteria.

There is no specific condition called Gardnerella vaginalis, but rather it is a bacteria species that can contribute to the development of this disease. Gardnerella is already present in small amounts in your body, but when it multiplies, it disrupts your vaginal microbiome.

This can result in symptoms of BV such as pain itching, and abnormal discharge. Simply put: Gardnerella vaginalis is a bacterium, and BV is a condition that may result from this bacterium.

Symptoms of BV

Around 84% of women are totally asymptomatic when they get infected. If you do have symptoms of BV, look out for these. The most common sign of this infection is a thin, grayish vaginal discharge with a strong “fishy” odour.

As well as causing itching and discomfort around the opening of your vulva, BV can also make your vulva smell stronger after sexual activity and after menstruation. While BV is not officially considered an STI, sexual activity does increase your risk, particularly with a new partner or multiple partners.

Women who have intercourse are more likely to get BV because semen make the vagina more alkaline, raising the pH, which increases their vulnerability to BV. Experts don’t fully understand why some women get BV and others don’t.

Men don’t show symptoms and don’t need treatment, but BV can spread to women. If you are dating a new or non-monogamous partner, you can reduce your risk of contracting the disease by using condoms.

BV is distinguished from other vaginal conditions such as yeast infections or STIs by its odour, itching, or bloody discharge. Patients should be evaluated if they have any of these symptoms.

Effective treatment

The treatment for BV involves taking antibiotics for five to seven days, either orally or vaginally. Two popular antibiotics are metronidazole and clindamycin, available in 150mg, 300mg, or 500mg tablets.

Tinidazole can be used as an alternative to metronidazole or clindamycin. Recurrent infections can also be treated with boric acid. A vaginal application, such as a cream or gel applied to the vagina, has fewer side effects than an oral version.

Oral antibiotics may cause upset stomach, diarrhoea, and metallic mouth taste. Pregnant women aren’t advised to take these medications. Certain blood dyscrasias and central nervous system diseases are also contraindicated.

Douching temporarily removes malodorous secretions, but it does not cure the infection (in fact, it may increase the likelihood of recurrence). If someone has had at least three documented episodes of BV, you will need to consider a longer and more aggressive treatment plan called suppressive therapy.

The treatment lasts for more than five days – usually seven to 10 days of the medication, followed by one to two nights a week over the next four to six months. The vaginal flora will be reset so the normal bacteria can take over and prevent BV from recurring in future.

Preventing an infection

Although BV cannot be completely prevented, here are some tips to reduce your risk:

  • Limit your number of sexual partners, and always use condoms.
  • >void scented tampons and vaginal deodorant in the shower and use gentle, pH-balanced products.
  • There is no need to “clean” your vagina with any additional fluid, since the vagina cleans and regulates itself; doing so would only result in an imbalance in your microbiome.
  • Wear breathable underwear and change it every day.

By Datuk Dr Nor Ashikin Mokhtar
Published in Star Newspaper, 03 Apr 2023

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