vaginose

Vaginose, or vaginosis, is a condition characterized by an imbalance of the vaginal ecosystem, most commonly due to bacterial overgrowth rather than an infection with a specific pathogen. The term bacterial vaginosis (BV) is the most frequent form of vaginosis and results from a decrease in lactobacilli and an increase in anaerobic bacteria such as Gardnerella vaginalis and Atopobium vaginae.

Symptoms vary; some people have thin, grayish-white discharge with a fishy odor, while others experience itching or burning. Many individuals, however, may be asymptomatic. Diagnosis is typically based on clinical criteria, including discharge characteristics, vaginal pH, a positive whiff test, and the presence of clue cells, or by microscopic scoring systems such as Nugent scoring.

Treatment involves antibiotics, most commonly metronidazole (oral or vaginal gel) or clindamycin (cream or oral). Women should avoid alcohol while taking metronidazole. Partner treatment is not routinely recommended, as BV is not classified as a sexually transmitted infection, though sexual activity can influence risk. Recurrence after treatment is common.

In pregnancy, BV is associated with higher risks of adverse outcomes such as preterm birth and low birth weight, and treatment may be considered when diagnosed. Prevention strategies focus on avoiding vaginal irritants such as douching, maintaining vaginal health, and addressing modifiable risk factors. BV remains the most common cause of vaginitis among reproductive-age women, with prevalence influenced by population and behavioral factors.