Bacterial vaginosis (BV) is the most common cause of abnormal
vaginal discharge in women of childbearing age. It is a syndrome
of unknown cause characterized by depletion of the normal
Lactobacillus population and an overgrowth of vaginal
anaerobes, accompanied by loss of the usual vaginal acidity. In
1983 the term ‘bacterial vaginosis’ replaced the older term
‘Gardnerella vaginitis’. This recognized the fact that many
anaerobic or facultative anaerobic bacteria are present and that
classical signs of inflammation are absent.1
Women with symptomatic bacterial vaginosis report an offensive,
fishy-smelling discharge that is most noticeable after unprotected
intercourse or at the time of menstruation. The diagnosis can
be confirmed by microscopy with or without additional tests.
About 50% of cases are asymptomatic. Bacterial vaginosis is
associated with infective complications in pregnancy and
following gynaecological surgery, and is a risk factor for the
acquisition of sexually transmitted infections (STIs) including HIV.