Bacterial Vaginosis
How common are STDs in pregnant women
in the United States?

STDs                          Estimated Number of
              Pregnant  Women
Bacterial vaginosis       1,080,000
Herpes SV 2                      880,000
Chlamydia                         100,000
Trichomoniasis                 124,000
Gonorrhea                           13,200
Hepatitis B                           16,000
HIV                                         6,400
Syphilis                               <1 ,000
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Bacterial vaginosis (BV) is the name of a condition in women where the normal balance
of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria.  It
is sometimes accompanied by discharge, odor, pain, itching, or burning. Bacterial
vaginosis (BV) is the most common vaginal infection in women of childbearing age.  In the
United States, BV is common in pregnant women.

Causes The cause of bacterial vaginosis is not fully understood. Bacterial vaginosis is
associated with an imbalance in the bacteria that are normally found in a woman's vagina.
The vagina normally contains mostly "good" bacteria, and fewer "harmful" bacteria.
Bacterial vaginosis develops when there is an increase in harmful bacteria.

Not much is known about how women get bacterial vaginosis. There are many
unanswered questions about the role that harmful bacteria play in causing bacterial
vaginosis. Any woman can get bacterial vaginosis. However, some activities or behaviors
can upset the normal balance of bacteria in the vagina and put women at increased risk

* Having a new sex partner or multiple sex partners,
* Douching

It is not clear what role sexual activity plays in the development of bacterial vaginosis.
Women do not get bacterial vaginosis from toilet seats, bedding, swimming pools, or from
touching objects around them. Women who have never had sexual intercourse may also
be affected.

Signs and Symptoms Women with vacterial vaginosis may have an abnormal vaginal
discharge with an unpleasant odor. Some women report a strong fish-like odor, especially
after intercourse. Discharge, if present, is usually white or gray; it can be thin. Women with
BV may also have burning during urination or itching around the outside of the vagina, or
both. However, most women with bacterial vaginosis report no signs or symptoms at all.

Dangers of Bacterial Vaginosis In most cases, bacterial vaginosis causes no
complications. But there are some serious risks from bacterial vaginosis including:

Having bacterial vaginosis can increase a woman's susceptibility to HIV infection if she is
exposed to the HIV virus.

Having bacterial vaginosis increases the chances that an HIV-infected woman can pass
HIV to her sex partner.

Having bacterial vaginosis has been associated with an increase in the development of an
infection following surgical procedures such as a hysterectomy or an abortion.

Having bacterial vaginosis while pregnant may put a woman at increased risk for some
complications of pregnancy, such as preterm delivery.

Bacterial vaginosis can increase a woman's susceptibility to other STDs, such as
herpes simplex virus (HSV), chlamydia and gonorrhea.

Pregnant women with bacterial vaginosis more often have babies who are born premature
or with low birth weight (low birth weight is less than 5.5 pounds).

The bacteria that cause Bacterial vaginosis can sometimes infect the uterus (womb) and
fallopian tubes (tubes that carry eggs from the ovaries to the uterus). This type of infection
is called pelvic inflammatory disease (PID). PID can cause infertility or damage the
fallopian tubes enough to increase the future risk of ectopic pregnancy and infertility.
Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside
the uterus, usually in a fallopian tube which can rupture.

A health care provider must examine the vagina for signs of vacterial vaginosis and
perform laboratory tests on a sample of vaginal fluid to look for bacteria associated with
bacterial vaginosis.

Treatment Although bacterial vaginosis will sometimes clear up without treatment, all
women with symptoms of bacterial vaginosis should be treated to avoid complications.
Male partners generally do not need to be treated. However, bacterial vaginosis may
spread between female sex partners.

Treatment is especially important for pregnant women. All pregnant women who have ever
had a premature delivery or low birth weight baby should be considered for a bacterial
vaginosis examination, regardless of symptoms, and should be treated if they have
bacterial vaginosis. All pregnant women who have symptoms of bacterial vaginosis should
be checked and treated.

Some physicians recommend that all women undergoing a hysterectomy or abortion be
treated for bacterial vaginosis prior to the procedure, regardless of symptoms, to reduce
their risk of developing an infection.

Bacterial vaginosis is treatable with antibiotics prescribed by a health care provider. Two
different antibiotics are recommended as treatment for bacterial vaginosis: metronidazole
or clindamycin. Either can be used with non-pregnant or pregnant women, but the
recommended dosages differ. Women with Bacterial Vaginosis who are HIV-positive
should receive the same treatment as those who are HIV-negative.

Bacterial vaginosis can recur after treatment.

Bacterial vaginosis is not completely understood by scientists, and the best ways to
prevent it are unknown. However, it is known that BV is associated with having a new sex
partner or having multiple sex partners.

Prevention The following basic prevention steps can help reduce the risk of upsetting the
natural balance of bacteria in the vagina and developing BV:

Be abstinent.
Limit the number of sex partners.
Do not douche.

Use all of the medicine prescribed for treatment of, even if the signs and symptoms go