An imbalance of the bacteria normally found in the vagina can cause bacterial vaginosis, a type of vaginitis (inflammation of the vagina with abnormal discharge and pain or itching). To treat bacterial vaginosis, a doctor will prescribe medications to correct the imbalance of bacteria, such as metronidazole or clindamycin. To soothe the itching and irritation, antihistamines, ice packs or sitz baths, are also recommended remedies.
Cause
According to the Merck Manual, bacterial vaginosis is the most common infectious vaginitis. The normal vaginal bacteria (Lactobacilli) are over-run by bad bacteria, such as Peptostreptococci or Gardnerella vaginalis, causing a foul fishy odor, itching or pain, and gray watery vaginal discharge. Curing bacterial vaginosis requires that a woman re-establish the normal bacterial balance and pH of her vagina by killing off the bad bacteria.
Significance
Doctors used to believe that despite the discomfort it causes, bacterial vaginosis was not harmful. However, new evidence links bacterial vaginosis to a variety of complications, including pelvic inflammatory disease, endometritis, and premature labor or birth in women infected during pregnancy, according to the Merck Manual, so it is important to correctly diagnose and promptly treat bacterial vaginosis.
Treating Symptoms
A woman will need antibiotics to cure bacterial vaginosis, but she can treat the symptoms immediately. For pain, she can try a cold washcloth or an ice-pack. For itching, she can use cortisone cream on the outside of the vagina (never put it in the vagina). An anti-histamine might help the itch and also make a woman drowsy enough to sleep when the itch keeps her awake. A warm sitz bath with baking soda might help soothe the area. It is recommended not to try to treat the odor by douching, using a feminine deoderant or with extra washing, as this will probably irritate the vagina even more.
Medical Treatment
Once a doctor confirms that a woman has bacterial vaginosis, she will prescribe an antibiotic cream, gel or pills to correct the bacterial imbalance in the vagina. According to the Merck Manual, the best treatments are 0.75 percent metronidazole gel (for example Flagyl) for five days or 2 percent clindamycin vaginal cream (for example Cleocin) for five days because these topical treatments cause fewer side effects than taking antibiotic pills. Metronidazole kills bacteria by breaking its DNA strands while clindamycin prevents bacteria from making proteins. With either treatment, a woman should feel better within two days.
Warning
Clindamycin cream weakens latex. If a woman is using clindamycin cream to treat bacterial vaginosis, she should not use latex products like condoms or diaphragms for birth control because there is a risk that they will break.
