Doctors used to believe that bacterial vaginosis, while capable of causing irritating vaginal symptoms, was essentially harmless. However, evidence linked bacterial vaginosis to more serious conditions such as pelvic inflammatory disease, infection of the uterus (endometritis) after abortion or giving birth and complications with pregnancy. To avoid these complications you should promptly seek diagnosis and treatment if you suspect that you have bacterial vaginosis.
Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) encompasses any infection of the upper genital tract including the uterus, fallopian tubes and ovaries. The infections result from bacteria that migrate up the tract from the vagina or cervix. Normally your body resists this bacterial migration, but certain bacteria can circumvent your body’s defenses. Among those evasive bacteria are some agents that cause bacterial vaginosis, including Mycoplasma hominis and species of Peptostreptococci. According to “Primary Care for Women,” after one episode, pelvic inflammatory disease often recurs. In addition to acute symptoms of lower abdominal pain, painful urination and sexual intercourse, PID can cause long-term effects such as infertility and an increased risk for ectopic pregnancy (sometimes called tubal pregnancy).
One antibiotic used to treat PID, metronidazole, also commonly treats bacterial vaginosis, further highlighting the link between the two conditions.
Endometritis, infection of the inner lining of your uterus, can occur when harmful bacteria, such as those responsible for bacterial vaginosis, travel up the reproductive tract from the vagina. If you have bacterial vaginosis, then you will become especially vulnerable to endometritis following an abortion or delivery of a baby. Symptoms of endometritis include abnormal vaginal bleeding or discharge, fever and pelvic pain. Serious cases of endometritis can lead to infertility, formation of an abscess in your uterus or septic shock. Antibiotics cure endometritis. To prevent endometritis, your doctor might test you for bacterial vaginosis before an abortion and if the test is positive, she will prescribe antibiotics to cure your vaginosis before the procedure.
If you have bacterial vaginosis while you are pregnant, the harmful bacteria can cause several complications. You will become more likely to have premature rupture of the membranes surrounding the baby, which can cause infections in your uterus and can endanger the baby. Your risk for premature labor and premature birth also increase if you have bacterial vaginosis. During the first trimester, you can safely use the antibiotic vaginal gel metronidazole to treat bacterial vaginosis, although according to the Merck Manual, this has not been shown to lower the risk of pregnancy complications.