Author - Dr Kam Manak
Vaginal discharge is a normal part of female health, but changes in its consistency can often be a cause for concern. It's a common issue many women face, with changes in normal white or clear discharge primarily due to natural hormonal fluctuations throughout the menstrual cycle.
Among women of reproductive age, the most prevalent cause of altered discharge is Bacterial vaginosis (BV). This condition arises from an imbalance in the vaginal microbiome—a complex ecosystem of bacteria residing in the vagina. Central to our understanding of this ecosystem is the lactobacillus species, which maintains the vagina's acidic pH between 3.5 and 4.5 through the production of lactic acid. However, when the harmony of these microorganisms is disturbed, it can lead to an overgrowth of the wrong bacteria, such as Gardnerella vaginalis, the primary culprit in BV.
BV's prevalence varies widely, affecting an estimated 5% to 70% of women globally, with ethnicity being a significant factor. For instance, parts of Africa see higher incidences, whereas Asia and Europe report the lowest. In the United States, around 30% of women experience BV, with a higher incidence reported among non-white populations.
Many women with BV report a fishy odour, especially after sexual intercourse, accompanied by a watery clear or grey discharge. It's also possible to have BV without showing any symptoms.
A primary cause of BV is the use of soaps and feminine hygiene products in the vaginal area, which can upset the natural acidic balance. The vagina is self-cleansing, and plain water is all that's needed for hygiene. Other risk factors include:
Notably, having a female sexual partner can increase the risk of BV by 60%.
It's critical to understand that BV is not a sexually transmitted infection (STI). Nevertheless, Gardnerella has been found to produce a biofilm that may increase the susceptibility to STIs, such as chlamydia, gonorrhoea, and HIV.
While up to 30% of BV cases may resolve without intervention, antibiotics are commonly used for treatment. A small percentage of women might not respond to the initial treatment and may require further medical attention. Since BV is not an STI, treating sexual partners is not necessary, as current research, including a 2016 Cochrane review, indicates that partner treatment doesn't affect the clinical outcomes.
Although BV is often merely bothersome, it can lead to more severe complications during pregnancy, such as preterm delivery or low birthweight babies.
If you have concerns about vaginal discharge or suspect BV, it's prudent to speak with a healthcare professional. BV and other causes of vaginal discharge can be easily identified with simple swab tests.
Vaginal discharge, while common, can indicate an overgrowth of bacteria in the vagina, known as Bacterial vaginosis. If you're experiencing any changes or have concerns regarding vaginal health, don't hesitate to reach out.
Should you have any questions or concerns about vaginal discharge or wish to discuss your symptoms discreetly, we encourage you to book a consultation with our women's health experts. Our team is dedicated to providing comprehensive care and support for all aspects of female health.
