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GYN CHRONICLES Bacterial Vaginosis Dr. Maureen Owiti P enning my column piece post filing deadline is a very stressful situation with the publisher all over my head! So I thought I’d write about an equally stressful condition, Bacterial Vaginosis or BV as we call it. What is Bacterial Vaginosis (BV )? Ever had a discharge with a fishy smell that gets worse after intercourse? Well if you haven’t just praise the Lord. Those of you who have had this nasty experience kindly share the article especially with your friends you may just save a relationship and above all restore your friend’s self-esteem. To answer the question it is easier to outline what Bacterial Vaginosis is not. For the normal woman in reproductive age there is a wonderful bacteria that lives in the vagina and we call it lactobacillus. What is great about Mr. Lactobacillus is that its presence makes the vagina to be slightly more acidic making it a hostile environment for other bad bacteria to flourish. Bacterial Vaginosis is a shift in the normal flora or dysbacteriosis. In simple terms it’s when there is an imbalance in terms of the expected micro- organisms that should live in the vagina or a disruption of the micro-environment in the vagina. The vagina like all other epithelium has microorganisms such as bacteria, fungi or viruses that live there and their role is to protect it. The common epithelium would be the skin, inner lining of the nose and respiratory system or even the lining of the stomach and digestive tract. They each would have a defense mechanism and most have a special bacteria that plays that role and in the case of the vagina it is lactobacillus. The challenge with many diseases is that Risk factors that may predispose patients to Bacterial Vaginosis include recent an- tibiotic use, decreased estrogen produc- tion of the host, wearing an intrauterine device (IUD), douching, tub bathing es- pecially with scented gels and soaps, use of over the counter intra-vaginal hygiene products, sexual activity that could lead to transmission (e.g. having a new sexual partner or a recent increase in the num- ber of sexual partners). 22 MAL32/19 ISSUE they can be asymptomatic meaning they have no outright symptoms. However when symptoms are present, they are very distressing as normal women do not enjoy having an offensive odour coming from their private parts. Other symptoms may include a vaginal discharge, irritation of the vulvar and in rare instances pain or burning sensation when taking a pee - dysuria, or even pain during sexual intercourse - dyspareunia. Yikes nothing here sounds like anything one wants to go through. These symptoms may also cause sexual dysfunction as the woman will not have confidence and feel desirable to her partner. Risk factors that may predispose patients to BV include recent antibiotic use, decreased estrogen production of the host, wearing an intrauterine device (IUD), douching, tub bathing especially with scented gels and soaps, use of over the counter intra- vaginal hygiene products, sexual activity that could lead to transmission (e.g. having a new sexual partner or a recent increase in the number of sexual partners). Mitigation So you have an offensive odour coming from the V area or any of the aforementioned symptoms what should you do. VISIT YOUR GYNAECOLOGIST!!! I wrote this in Caps as I feel the best person to manage such issues is obviously a gynae. In the event that you don’t have one or you are unable to, at least see a doctor and they should be able to help. It has been found that patients are generally very poor at self-diagnosis and the worst one is Dr Google!