Treatment

The therapy of bacterial vaginosis includes the use of various antibiotics that fight the bacteria. Therapy must always be carried out to prevent complications such as ascending infections. A distinction is made between systemic and local therapy.

For systemic therapy, the active ingredients clindamycin or metronidazole are suitable. The active substance clindamycin is taken in a dose of 300 mg three times a day for seven days. Metronidazole is taken once a day, most likely in the evening, in a dose of one gram also for seven days.

Vaginal creams or suppositories can be used as an alternative to systemic antibiotic therapy. For local therapy the active substances clindamycin or metronidazole are also used. Apart from antibiotic therapy, there are other supportive measures for the treatment of bacterial vaginosis.

As the vaginal pH value plays a very important role for the healthy vaginal flora, it is recommended to acidify the vagina. Vaginal suppositories containing lactic acid bacteria are suitable for this. They are inserted deep into the vagina for about seven days before going to bed.

The use of unsweetened natural yoghurt is sometimes discussed as a therapeutic approach. Natural yoghurt also contains lactic acid bacteria and can be applied deep into the vagina by hand or with a syringe. Both vaginal sprays and vaginal tablets with disinfecting agents are available for disinfecting the vagina.

It is not necessary to treat the partner as well in the case of bacterial vaginosis. Although the partner is usually also found to have guardnerella, which can be detected in the urine, sperm or in the urethral swab, this has no disease value. Co-treatment leads to the elimination of the bacteria, but cannot prevent a relapse (recurrence) in the woman. Studies have therefore not been able to show any results that would speak in favour of co-treating the partner. The use of antibiotics should always be considered in terms of its benefits, as uncontrolled antibiotic use can lead to the development of resistance to germs.

Duration

Bacterial vaginosis can usually be treated very well within a few days by using antibiotics. Below that the symptoms also improve quickly, so that healing occurs after 7 days at the latest. Unfortunately, relapses (recurrences) are frequent, which is why women who have already experienced bacterial vaginosis usually suffer from further bacterial vaginosis. Untreated, bacterial vaginosis can take a chronic course and cause discomfort for several weeks or months. Frequently, the symptoms are not continuous, so that after the symptoms have subsided in the meantime, the symptoms can flare up again spontaneously.

Possible complications

Bacterial vaginosis is usually easily treatable and heals without consequences. However, they can also be accompanied by certain complications. If left untreated, so-called ascending infections of the female reproductive organs can occur.

These are infections of the internal genital organs, such as ovarian and uterine inflammation, caused by ascending germs from the vagina. In the worst case, such infections can even lead to sterility. Therefore, bacterial vaginosis is always treated with antibiotics.

Especially after operations and procedures, such as scraping or the insertion of a coil, the risk of an ascending infection caused by bacterial vaginosis is increased. Therefore, bacterial vaginosis should always be ruled out before such treatments. The imbalance in the vaginal flora also increases the likelihood of sexually transmitted diseases such as HIV. The non-intact vagina is less able to fight off infections in this state, which is why unprotected sexual intercourse in such a situation is associated with an even higher risk of infection than usual. Bacterial vaginosis can also lead to specific complications during pregnancy (see section on pregnancy).