What's going on with the clear water flowing down there?

Women's vaginas are prone to inflammation, partly because the vaginal opening is exposed and therefore easily invaded by bacteria and viruses. In addition, sometimes the male penis may carry some bacteria and viruses, which can easily induce disease once they enter the female body. This is one of the reasons why many women suffer from gynecological diseases after marriage. So, what's going on with the clear water flowing down there?

In recent years, it is believed that the occurrence of bacterial vaginosis (BV) is due to the imbalance of vaginal flora. The reduction of lactobacilli leads to the massive reproduction of other pathogens such as Gardnerella, various anaerobic bacteria, and Vibrio campylobacter. BV is actually a mixed infection dominated by Gardnerella. Since it was reported in 1954, it has been called Haemophilus vaginitis, Corynebacterium vaginitis and nonspecific vaginitis due to unclear understanding of its pathogen. It was not until 1984 that it was officially named BV at a special international conference in Sweden.

Incidence

It mostly occurs in women between the ages of 15 and 44. The incidence rate varies in different populations, generally between 10-25%, but it is as high as 61% among sex workers, so it is considered one of the sexually transmitted diseases.

Causes

In recent years, it is believed that the occurrence of BV is due to the imbalance of vaginal flora and the reduction of lactobacilli, which leads to the massive reproduction of other pathogens such as Gardnerella, various anaerobic bacteria, and Vibrio campylobacter. BV is actually a mixed infection dominated by Gardnerella.

Clinical manifestations

symptom

About 10-50% of patients have no symptoms. Those with symptoms often complain of increased vaginal discharge with odor, which may be accompanied by mild vulvar itching or burning sensation.

Signs

Examination showed that the leucorrhea was uniform, large in amount, thin, and there was no inflammatory sign such as redness, swelling or congestion of the vaginal mucosa, and there was no Trichomonas, Candida or Gonorrhea infection. The cleanliness level is mostly I degree.

diagnosis

Asymptomatic people are easily overlooked. BV can be diagnosed if 3 of the following 4 items are met, among which positive clue cells are essential.

a. Vaginal discharge is a uniform, thin leucorrhea.

b. Vaginal pH>4.5 (due to ammonia production by anaerobic bacteria).

c. Ammonia test is positive: take a small amount of vaginal secretions and place them on a glass slide. Add 1-2 drops of 10% potassium hydroxide solution. If a rotten fish-like fishy smell is produced, it is positive.

d. Clue cells are positive, and more than 20% of clue cells can be seen under a high-power microscope using the hanging drop method. Cluecell is the superficial cell shed from the vagina with a large number of granular substances (such as Gardnerella) attached to its surface, making the cell edges unclear.

Disease treatment

Systemic medication

Metronidazole 500 mg, twice a day, for 7 days, the effective rate can reach 98.8%; clindamycin 300 mg, twice a day, for 7 days, the effective rate can reach 94%.

Topical medications

Metronidazole 200 mg, placed in the vagina, for 7 days; 2% clindamycin ointment 300 mg, applied to the vagina, for 7 days. The efficacy is slightly worse than oral administration.