Bacterial vaginosis

Diagnosis

To diagnose a case of bacterial vaginosis, the doctor can do the following:

Ask questions about your medical history. The doctor may ask about previous vaginal infections or sexually transmitted infections.
Perform a pelvic exam. During a pelvic exam, the doctor visually examines the vagina for signs of infection and inserts two fingers into the vagina while pressing the abdomen with the other hand to check the organs of the pelvis and detect signs that may indicate the disease.
Take a sample of vaginal secretions. This can be done in order to detect an overgrowth of anaerobic bacteria in the vaginal flora. The doctor can examine vaginal secretions under a microscope for "key cells," vaginal cells covered with bacteria that indicate a sign of bacterial vaginosis.
Evaluate the pH of the vagina. The doctor can check the acidity of the vagina by placing a pH test strip in the vagina. A vaginal pH of 4.5 or more is a sign of bacterial vaginosis
Treatment
To treat bacterial vaginosis, your doctor may prescribe one of the following medications:

Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine can be taken as pills (orally). Metronidazole is also available as a topical gel that you put into the vagina. To reduce the risk of upset stomach, abdominal pain, or nausea when taking this medication, avoid consuming alcohol during treatment and for at least one day after completing treatment. Read the instructions for the product.
Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that is inserted into the vagina. Clindamycin cream can weaken the latex of condoms during treatment and for at least 3 days after stopping the use of the cream.
Tinidazole (Tindamax). This medicine is taken orally. Tinidazole has the same potential to cause upset stomach and nausea as metronidazole, so avoid drinking alcohol during treatment and for at least one day after completing treatment.
It is usually not necessary to treat the male partner of an infected woman, but bacterial vaginosis can be transmitted between female sex partners. Female partners should see a doctor for analysis and may need treatment. In particular, it is important that pregnant women with symptoms are treated to decrease the risk of premature birth or low birth weight.

Take the medication or use the cream or gel for as long as the doctor tells you, even if the symptoms go away. Early suspension of treatment may increase the risk of recurrence.

Reappearance
Bacterial vaginosis often reappears within 3 to 12 months, despite treatment. Researchers explore treatments for recurrent bacterial vaginosis. If your symptoms come back right after treatment, talk with your doctor about other treatments. One option could be extended therapy with metronidazole.

A self-help approach consists of therapy by colonization by lactobacilli - which attempts to increase the number of good bacteria in the vagina and restore a balanced vaginal environment - possibly accompanied by certain types of yogurt or other foods containing lactobacilli. While current research shows that probiotic therapy may have some benefit, more research is needed on the subject.

Preparation for the consultation
Try to coordinate a consultation for a date when you are not menstruating. In this way, the primary care physician or gynecologist can observe and evaluate the vaginal discharge without interposing menstruation. Avoid using tampons and deodorants vaginal spray, do not use douching or have sex 24 hours before the consultation.

What can you do
To make the most of the consultation time with the doctor and not forget any important question:

Make a list of the symptoms you experience. Include all the symptoms, even if you do not think they are related.
Make a list of all medications, vitamins, herbs or other supplements that you take. Include how often you take them and at what does.
Take a notepad or electronic device. Record important information during the consultation.
Make a list of questions for the doctor. First write down the most important ones, in case you do not have time to ask everything.
In the case of bacterial vaginitis, some of the basic questions for the doctor are:

Is there anything I can do to prevent bacterial vaginitis?
What signs and symptoms should I watch out for?
Do I need to take any medication?
Should my partner also have an analysis or receive treatment?
Is there any special instruction to take the medication?
Is there an over-the-counter product that treats my condition?
What can I do if the symptoms come back after treatment?
Do not be afraid to ask questions during the consultation if you do not understand something.

Questions that the doctor can ask you:
Be prepared to answer questions the doctor may ask, for example:

What symptoms do you have?
How long have you had the symptoms?
Do you notice that you have a strong vaginal odor?
Have you ever received treatment for a vaginal infection?
Have you used an over-the-counter product to treat the condition?
Have you taken, in the last time, antibiotics for some reason?
Are you sexually active?
You are pregnant?
Do you use soap or bath foam with perfume?
Do you wash your vagina or use feminine hygiene sprays?