ABSTRACT – Bacterial vaginosis is a condition that occurs when there is imbalance in normal vaginal floral and it is the most common cause of vaginal discharge among the women of reproductive age. If the condition is ignored and left untreated it may increase the risk for sexually transmitted diseases like herpes, chlamydia, gonorrhoea and HIV. It may also increase the risk for PID and preterm delivery in pregnant women. This article aims at explaining bacterial vaginosis, the character of its discharge so that women can differentiate it with their normal vaginal discharge and various homoeopathic remedies which have been proved beneficial for this condition.
KEYWORDS – Vaginal flora, Lactobacillus
ABBREVIATION – Bacterial vaginosis (BV), Sexually transmitted diseases (STD), Human immunodeficiency virus (HIV), Species (spp.), World health organisation (W.H.O)
INTRODUCTION – Bacterial vaginosis is a condition caused by overgrowth of normal vaginal flora. Females have three periods in her life i.e. from birth to puberty, from puberty to menopause which is also known as reproductive age and the period after menopause. With each commencing period of her life the microbiota of vagina changes. Normally the vaginal microbiota is dominated by LACTOBACILLUS which lives in a glycogen rich vaginal environment and protects that area against pathogens by producing hydrogen peroxide, lactic acid, bacteriocins and maintaining the acidic pH of vagina.
According to W.H.O bacterial vaginosis is the most common cause of vaginal discharge among women of reproductive age.
DEFINITION – Bacterial vaginosis is a condition in which there is imbalance in normal vaginal flora resulting in increased vaginal discharge that has fish like odour.
ETIOLOGY –Several bacteria are associated with it. Many of these bacteria are normally found in the healthy vagina.
BV can occur from an overgrowth of pathogens such as Gardnerella spp., Prevotella spp., Mobilincus spp., Megaspahera spp., Sneathia spp. and mixed vaginal anaerobes species which replaces the lactobacilli which use to maintain the normal vaginal environment.
PATHOPHYSIOLOGY – Bacterial vaginosis is caused by an imbalance of the normal vaginal flora, characterized by decline in lactobacilli and increase in other anaerobes.
COMMON SYMPTOMS –
- Vaginal discharge which may be white, gray, thin
- Vaginal discharge has a strong fishy odour.
- There may be itching and irritation around the vagina.
- Burning during micturition.
DIAGNOSIS – Bacterial vaginosis can be diagnosed by laboratory test (most commonly Gram stain test) and clinical findings.
Bacterial Vaginosis can also be diagnosed based on the presence of the following 3 or more criteria (Ansel criteria):
- Presence of the white homogeneous vaginal discharge
- The vaginal discharge is often greyish, white, thin homogeneous and adherent to the vaginal wall.
- Ph greater than 4.5
- Presence of an amine odour in whiff test
- Presence of clue cells on microscopy of a wet mount of a sample of vaginal discharge.
COMPLICATION- Bacterial vaginosis is a common condition and usually there is no serious complication but if left untreated it may cause:
- Spontaneous abortion and Preterm delivery in pregnant women.
- Higher risk for STD, including HIV.
- Pelvic inflammatory disease.
DIFFERENTIAL DIAGNOSIS –
- Gonorrhoea
- Chlamydia
- Trichomoniasis
HOMOEOPATHIC MEDICINES
GRAPHITES- FOR WHITE, PROFUSE, GUSHING VAGINAL DISCHARGE
Discharge is gushing, pale, thin, profuse, white, excoriating with great weakness of the back. Like all carbons, this remedy is antipsoric of great power, especially active in patients who are rather stout, of fair complexion, with tendency to skin affection and constipation and takes cold easily.
ALUMIA –FOR ACRID, PROFUSE, TRANSPARENT VAGINAL DISCHARGE
Discharge is acrid, profuse, transparent, ropy, burning worse during daytime, and after menses. Relieved by cold washing.
PULSATILLA – FOR CREAMY, THIN BURNING OR THICK PAINLESS VAGINAL DISCHARGE
Pulsatilla is suited where there may be bland discharges, thin burning or thick painless discharges which aggravate during rest and in warmth.
SANICULA – FOR FISHY ODOUR VAGINAL DISCHARGES
In Sanicula, there is the odour of fish brine or old cheese in discharge. Vagina feels large.
CALCAREA CARB – DISCHARGE IS WHITE
In patients requiring calcarea carb, vaginal discharge is milky white but acrid. The typical constitution of calcarea carb patients is fair, fatty and flabby female who catches cold easily.
BORAX – VAGINAL DISCHARGE IS WHITE AS A MUCUS, PROFUSE AND ACRID
In borax the quantity of discharge is profuse, its character is albuminous, starchy, very much hot as if warm water were flowing, very much acrid and white as a mucus or like white of an egg.
HYDRASTIS – VAGINAL DISCHARGE IS ROPY, STRINGY, VISCID AND EXCORIATING
In hydrastis discharge is thick, yellowish, ropy, stringy and excoriating. There is burning pain in vagina with soreness. Aggravation after menses and coition.
SILICEA – VAGINAL DISCHARGE IS MILKY AND ACRID WITH ITCHING
Discharge is milky and acrid causing itching of the vulva and vagina which are very sensitive to touch.
KREOSOTUM – VAGINAL DISCHARGE IS VERY MUCH ACRID, OFFENSIVE AND STAINS THE LINEN YELLOW OR GRAY
Discharge is putrid, corrosive, causing swelling, burning, itching, and biting externally. Whey like milky, yellow, staining the linen yellow or may gray with weakness in legs.
CONCLUSION –
Bacterial vaginosis is a condition from which most women suffer and keep ignoring it for the time being. It may not be an emergency condition to deal with but if left untreated for a long time it has a risk of STD AND PID. In the cases of bacterial vaginosis homoeopathy works efficiently.
