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Gardnerella vaginalis infection – Bacterial Vaginosis

Bacterial vaginosis is an infection by Gardnerella vaginalis and other different bacteria that produces a fishy odor and maybe complications.

This article will discuss what is bacterial vaginosis, how does it happen, and everything in relation to it. We will also be seeing into what are its symptoms and signs and whether it is a sexually transmitted disease or not.

Continue reading this article to be informed on the importance of preventing bacterial vaginosis and the treatments available in case of catching the disease, all of this directly from a doctor.

What is bacterial vaginosis?

Bacterial vaginosis is an infection that occurs in the vagina by different types of bacteria. Doctors do not call this disease vaginitis since it does not produce inflammation itself, although it is an infection.

The most common bacteria that causes it is Gardnerella vaginalis. This microorganism is an anaerobic bacteria, which means it doesn’t need oxygen to survive. But many others infect the vagina as well and are as crucial in the development of the disease. Therefore, this disease is a polymicrobial infection, an important fact to know when treatment is given to the patient. 

The average healthy vagina of an adult has a pH of 4.5, which means it is an acidic tissue regularly. It has epithelial cells in contact with the exterior, and over them, there is the normal vaginal flora.

This vaginal microbiome or vaginal microflora consists of different bacterial species that cover the vaginal epithelium. The most important one of these vaginal specimens is the lactobacillus species, specifically the vaginal lactobacilli.

The lactobacillus is the one that keeps the vagina with the proper pH. So, it ensures no other bacteria will cause an infection, as they cannot survive and take its place. Sometimes, for diverse reasons, there is an unbalance in the different bacteria within the tissue. This situation is what leads to a vaginal infection since other bacteria colonize the tissue and are harmful.

Some bacteria associated with the disease besides Gardnerella vaginalis are Prevotella bivia, Mycoplasma hominis, Mobiluncus, and many others. This was proven since, in an experiment, applying Gardnerella vaginalis directly to a healthy vagina did not cause any infection or symptoms. But by using a vaginal fluid of a female with the disease to a healthy one did cause infection and symptoms.

How does Gardnerella cause bacterial vaginosis?

For G vaginalis to cause bacterial vaginosis, there needs to be a change in the normal pH of the vagina. Usually, as part of the vaginal flora, the lactobacillus maintains an acidic pH through hydrogen peroxide production. This keeps the pH low and prevents other bacteria from infecting the vagina, but, in some cases, these changes.

There are several mechanisms through which the pH can change and allow other bacteria to colonize the vagina.

Furthermore, If the female is using antibiotics, there is a chance it affects the vaginal flora, specifically the lactobacillus. When there is a drop of these facultative anaerobe bacteria, there is a reduction of hydrogen peroxide production. Also, if the patient uses vaginal douching products, it causes a pH change of the vagina as well.

Another way Gardnerella vaginalis can lead to infection is through sexual practices that increase the chances of transmission. For example, simply having a new sexual partner or having a rise in the number of sexual partners recently.

Females who wear an intrauterine device may not use barrier protection methods such as condoms, expanding the transmission. All of this causes an augmentation of the chances of contracting the disease. 

Gardnerella vaginalis has an exceptional quality that sometimes makes bacterial vaginosis or nonspecific vaginitis hard to treat; it produces biofilm. This a matrix made of various materials in which different kinds of bacteria live. Biofilm production provides the bacteria living in that environment several advantages: 

  • Drug resistance
  • Cellular communication between them
  • Nutritional resources
  • Physical protection to the exterior
  • Cohesiveness and adhesion. 

They can appear in several places like the mouth, airways, and in this case, the vagina.

What are the symptoms of the infection by Gardnerella vaginalis?

Bacterial vaginosis (BV), some of the times, especially at the beginning of the disease, presents little to no symptoms.

Symptomatic BV shows vaginal symptoms since it’s a vaginal infection, but it can affect the vulva and the urinary tract. The vulva consists of the external female genitalia, such as the labia, the clitoris, and the urinary tract and vaginal opening. It is not common for the vulva to showcase symptoms but if it does is usually irritation.

As we can also see, the urinary tract opening is susceptible to an infection as well. It presents itself as a burning sensation or discomfort while peeing, and doctors call it a urinary tract infection.

The main symptoms of females are in the vagina, and the first one to mention is Gardnerella’s very characteristic. Vaginal odor is the main reason patients with this disease attend to the doctor; in this case, a gynecologist.

In most situations, this odor gets strong enough for the person to smell it after having sexual intercourse. A reaction happens within the vagina between the alkaline pH of semen and the acidic pH of the vagina. This also affects the patient’s day to day life as it damages their sexual activity.

Moreover, there could be a vaginal discharge too. Vaginal discharge is a normal fluid every woman produces daily; it’s transparent, thick, and sticky, and doesn’t usually smell bad.

When the disease is present, this fluid gets greyish, thinner, and adheres to the vaginal walls, often described with a fishy smell. Some patients may notice this first because of stains in their underwear and noting the difference in consistency and smell.

Is Gardnerella vaginalis an STD?

Doctors do not consider Gardnerella vaginalis or other bacteria that cause bacterial vaginosis, a sexually transmitted disease. Although this disease can pass from partner to partner through sexual intercourse, treating the other partner isn’t a prevention method.

Males can have bacteria, but they do not show any specific disease symptoms, affecting only women. The disease also can pass through sexual relationships between women by fluids with the bacteria. 

An important thing to consider is that patients with this disease can have an actual sexually transmitted disease. This is because some of the risk factors, like having multiple sexual partners, are risk factors for STDs.

When this disease is present, tests must be done for STDs like HIV, Syphilis, and Chlamydia. Also, the change of pH in the vagina makes it easier for an STD to infect the tissue since it lost a natural body barrier.

What does Gardnerella smell like?

Gardnerella vaginalis has a very characteristic fishy smell that differentiates it from other vaginal infections. If we compare it to other diseases that affect the vagina, we can see many dissimilarities all around.

For example, Chlamydia is another sexually transmitted infection, but abdominal pain and intermenstrual bleeding are in this case. The vaginal discharge is more abundant but does not take a particular smell. In Gonorrhea, the vaginal fluid is excessive, as the bleeding, and it takes a green/yellow color and thick consistency.

Additionally, Trichomonas vaginalis has a musty odor and a pale green fluid. It is crucial for most sexually transmitted diseases to treat the patient’s partner; if not, the disease might come back. There are also many other characteristics, especially in specific tests, that remarks on each particular disease’s singularities. 

What happens if Gardnerella is left untreated?

If this disease is not treated or is not treated properly, it can present some consequences. First of all, we would have a case of recurrent BV in which the disease comes back after it “ceases.”

The constant treatment done ineffectively can lead to bacterial resistance. This is when bacteria learn to defend themselves against antibiotics, which makes a disease harder to treat.

If the woman is pregnant and gives birth to her child in a more serious turn of events, it can cause a neonatal infection. These are infections that are pass on to the child before, during, or shortly after birth.

In this case, the bacteria infect the child by vaginal discharge when they go through the birth canal. This disease can cause respiratory problems and even lead to death if there are complications present.

Should I be worried about bacterial vaginosis? What are the complications of Gardnerella?

Most bacterial vaginosis infections appear with very mild symptoms that many times women do not notice it. At other times, the infection may clear up without the need for treatment.

Some women recover from this condition without knowing they ever had it. But Gardnerella infections don’t always go away on their own and can cause serious damage in your uterus.

For this reason, you should visit the doctor if you think you have bacterial vaginosis. It is also essential to take all of your medications, even if the symptoms disappear early.

Patients with Gardnerella vaginalis usually do not have complications, but this infection can appear in association with different conditions.

Certain studies show that women with bacterial vaginosis are more susceptible to Sexual Transmitted Diseases or infection. These infections may include herpes simplex virus, chlamydia, or gonorrhea, and HIV.

It can also increase the odds of getting post-surgical infections after a hysterectomy, cesarean section, or another surgical procedure. Other conditions like miscarriage or premature births in pregnant women can also appear due to this disease.

Having bacterial vaginosis can cause Pelvic Inflammatory Disease (PID). This is an important infection of women’s reproductive organs, including the uterus and fallopian tubes. This disease can increase the risk of infertility, the difficulty, or the impossibility of having children.

What are the types of Gardnerella tests?

During the physical exam, doctors may perform a pelvic exam, including the use of the speculum. This instrument helps them to separate the walls of the vagina. With this exam, they could look for signs of inflammation and infections such as erythema, the redness of the tissue, and the presence of a milky homogeneous vaginal fluid.

Usually, there isn’t much inflammation present unless the person has recently had sexual relationships or other diseases present. Since the discharge is very sticky, it adheres to the vaginal walls and does not pool in the vaginal fornix. This is the last part of the vagina, and it relates directly to the uterus.

They can also take vaginal samples with a sterile swab of fluid for further evaluation under a microscope. In this test, doctors can find clue cells, vaginal epithelial cells covered with bacteria, one of the most important criteria.

Then they could use the Gram stain. This is a method by which they can paint and classify the bacteria present in vaginal fluid. With this, they differentiate the type of bacteria by the colors their cellular walls take.

Doctors also may check your vagina’s acidity using paper strips and placing them in the wall of the vagina. Results above 4.5 could be a sign of bacterial vaginosis.

Another is the release of an amine or fishy odor immediately after KOH’s addition in the vaginal fluid. This takes the name of the “Whiff test” as the person who does the test has to smell the upcoming odor. 

What is the treatment for Gardnerella?

If your doctor makes the diagnosis of bacterial vaginosis, they will prescribe a lot of different antibiotics. They may include ampicillin, penicillin, and metronidazole. The latter being the most common drug of choice.

They come in different forms, as pills to take by mouth, or as creams or ovules, like clindamycin, to put in the vagina. If the doctor prescribes you antibiotics like metronidazole, avoid drinking alcohol while treatment lasts, because it can cause general symptoms such as nausea and vomiting.

Sometimes, doctors may suggest using probiotics, like Lactobacillus, due to their role in the inhibition of growth of damaging microbes. You could take it orally, or you could use it locally.

Remember taking your treatment only as your doctor tells you. It is important to say that your male sex partners won’t need to receive treatment if you get bacterial vaginosis. Most of the time, they don’t show signs or symptoms. Conversely, if you have female sex partners, they need to visit the doctor for evaluation and treatment.

How can I lower my risk of bacterial vaginosis?

You could lower the risk of suffering bacterial vaginosis with proper vulvar and vaginal care. That means keeping this area dry, clean, and free from irritant substances.

It is important to highlight that the vagina does not require deep and prolonged cleaning sessions. A normal bath is ideal. It is unnecessary to use douche because it can modify the balance of bacteria of the vagina. 

Secondary, to prevent or reduce vaginal irritation, you should use mild soaps and avoid deodorant and scented tampons or pads. You should use the least amount of detergent possible to wash your underwear and rinse it well.

Because there are studies that show that having multiple sexual partners increases the risk of bacterial vaginosis, it is recommendable to limit your sexual partner’s numbers—even avoiding having sex. By doing this, you would also decrease the risk of contracting sexually transmitted infections. It would be desirable that your male sex partner uses latex condoms.

Hot and humid environments promote the growth of microorganisms. For that reason, some doctors would recommend wearing cotton underwear instead of nylon fabrics. This action would help keep the area dry.

What are the differences between bacterial vaginosis and yeast infections?

Much like Bacterial Vaginosis, yeast infections are a very common vaginal infection in women.

Yeast infections are due to the overgrowth of Candida. This fungus is normally present in the vagina, but some factors cause them to grow in greater numbers. These factors may include antibiotics, women with diabetes without optimal control, and taking contraceptive pills with estrogen.

Both diseases can appear with vaginal discharge. In bacterial vaginosis, this discharge is usually thin, gray, or yellow. While in a yeast infection, this fluid is usually thicker and white. Another hallmark is the fishy odor that is characteristic in bacterial vaginosis, unlike candida infections, where it does not seem.

Yeast infections also cause itching, whereas bacterial vaginosis does not. Doctors generally prescribe antibiotics for the treatment of Gardnerella vaginalis. For candida infections, antifungal creams are generally sufficient to eliminate the symptoms.

However, you may need to take an antifungal such as fluconazole by mouth in more severe or recurring cases. 

It is important to bear in mind that sometimes these pathologies may appear in an association, or their symptoms may be undifferentiated.

Gardnerella vaginalis infections could emerge in the presence of polymicrobial infections in adult patients. Other occasions when a physician cannot identify the agents that cause vaginitis, nonspecific vaginitis, it is commonly due to contact allergies. That is why you should visit the doctor for proper diagnosis and treatment.

Are you having symptoms of bacterial vaginosis?

This tool is a Bacterial Vaginosis Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for developing this infection. Therefore, it would help anybody who uses it to determine if their symptoms are because of bacterial vaginosis. Importantly, it is free and to use it would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.

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