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Causes of Bacterial vaginosis

Bacterial vaginosis Causes: Book Excerpts

• Differential Diagnosis - Vaginal Discharge
• Differential Diagnosis - Vaginal Discharge
• Medical causes - Vaginal discharge
• Medical causes - Vaginal discharge
• Differential Overview - Vaginal Discharge
• Medical causes - Vaginal discharge
• Principal Causes of Vaginal Discharge - Vaginal Discharge
• Medical causes - Vaginal discharge

Bacterial vaginosis as a symptom:

Conditions listing Bacterial vaginosis as a symptom may also be potential underlying causes of Bacterial vaginosis. Our database lists the following as having Bacterial vaginosis as a symptom of that condition:

• HIV/AIDS

What causes Bacterial vaginosis?

Causes: Bacterial vaginosis: The cause of BV is not fully understood. BV is associated with an imbalance in the bacteria that are normally found in a woman's vagina. The vagina normally contains mostly "good" bacteria, and fewer "harmful" bacteria. BV develops when there is a change in the environment of the vagina that causes an increase in harmful bacteria. (Source: excerpt from Bacterial Vaginosis (BV): DSTD)
Article excerpts about the causes of Bacterial vaginosis:

Bacterial Vaginosis (BV): DSTD (Excerpt)

Not much is known about how women get BV. Women who have a new sex partner or who have had multiple sex partners are more likely to develop BV. Women who have never had sexual intercourse are rarely affected. It is not clear what role sexual activity plays in the development of BV, and there are many unanswered questions about the role that harmful bacteria play in causing BV. Women do not get BV from toilet seats, bedding, swimming pools, or from touching objects around them. (Source: excerpt from Bacterial Vaginosis (BV): DSTD)

Vaginitis Due to Vaginal Infections, NIAID Fact Sheet: NIAID (Excerpt)

BV reflects a change in the vaginal ecosystem. This imbalance, including pH changes, occurs when different types of bacteria outnumber the normal ones. Instead of Lactobacillus bacteria being the most numerous, increased numbers of organisms such as Gardnerella vaginalis, Bacteroides, Mobiluncus, and Mycoplasma hominis are found in the vaginas of women with BV. Investigators are studying the role that each of these microbes may play in causing BV, but they do not yet understand the role of sexual activity in developing BV. A change in sexual partners and douching may increase the risk of acquiring bacterial vaginosis. (Source: excerpt from Vaginitis Due to Vaginal Infections, NIAID Fact Sheet: NIAID)

Vaginal Infections & Vaginitis: NWHIC (Excerpt)

BV is due to a change in the balance among different types of bacteria in the vagina. Instead of the normal predominance of Lactobacillus bacteria, increased numbers of organisms such as Gardnerella vaginalis, Bacteroides, Mobiluncus, and Mycoplasma hominis are found in the vagina in women with BV. Investigators are studying the role that each of these microbes may play in causing BV. (Source: excerpt from Vaginal Infections & Vaginitis: NWHIC)

Related information on causes of Bacterial vaginosis:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Bacterial vaginosis may be found in:

• Risk factors for Bacterial vaginosis
• Genetics of Bacterial vaginosis
• Hidden causes of Bacterial vaginosis

Causes of Bacterial vaginosis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Bacterial vaginosis.

Vaginal Discharge: Differential Diagnosis
(In a Page: Signs and Symptoms)

• Physiologic
  –Many women will have a consistent, slightly clear, non-odor-producing discharge, either midcycle or premenstrually, particularly if they are on oral contraceptives
  –A change in odor, consistency, or color of discharge may signify that evaluation is necessary
  –Increased discharge is associated with pregnancy
• Sexually transmitted disease
  –Trichomonas vaginalis: “Strawberry cervix” with punctate erythema, flagellated oval organisms on wet mount
  –Gonorrhea/Chlamydia may be associated with pelvic pain/dysmenorrhea and dyspareunia
• Bacterial vaginosis
  –Various organisms and changes in normal flora with a characteristic fishy odor
  –Not considered an STD
  –Increases the risk of preterm delivery in pregnant women

• Alteration of normal vaginal flora and/or inflammatory response
  –Candida albicans overgrowth is more common with recent antibiotic use, poorly controlled diabetes, and/or pregnancy; presents with intensely pruritic, inflamed, and erythematous introitus
  –Doderlein's cytolysis (caused by an overgrowth of lactobacilli)

• Atrophic vaginitis
  –Common in postmenopausal women, especially those not on HRT
  –Poor coital lubrication, dyspareunia
  –Dysuria due to atrophic urethral tissue
• Foreign body vaginitis (e.g., retained tampon)
• Noninfectious irritant/allergic contact vaginitis (e.g., soaps, feminine pads, perfumes)
• Cervicitis (usually due to gonorrhea or Chlamydia)
• Cervical dysplasia, cancer, or polyps
• Vaginal or vulvar trauma or cancer

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Vaginal Discharge: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

• Physiologic leukorrhea
  –In newborns for 2–3 weeks, due to maternal estrogen effect, and in pubertal girls
  –Discharge typically clear to white, sticky, and nonirritating
  –Newborns may have withdrawal bleeding

• Infections
  –Bacterial vaginosis: Previously known as nonspecific vaginitis; polymicrobial in etiology (coliforms, streptococci, Gardnerella); discharge may be gray and malodorous (fishy smell) but generally nonirritating
  –Candida: Discharge may be cheesy and white with erythematous, pruritic, irritated vulva; typical discharge is rarely seen in prepubertal children; discharge typically has no odor
  –Trichomonas: Discharge may be frothy, malodorous, creamy, green, bloody, or pruritic (or asymptomatic)
  –Chlamydia: Commonly asymptomatic or a nonspecific discharge
  –Gonorrhea: Infection is commonly asymptomatic or has a gray-white, thick, purulent discharge
  –Group A β-hemolytic streptococci: Discharge may be bloody
  –Shigella: Discharge may be bloody

• Irritation/hygiene
  –Due to bubble baths and other chemical irritants, tight clothing, obesity, poor wiping
• Foreign body
  –Commonly includes toilet paper, forgotten tampon
  –Discharge is often bloody and malodorous
• Anatomic
  –Ectopic urethra
  –Rectovaginal fistula
  –Urethral prolapse
• Urinary tract infection
• Masturbation
• Sarcoma botyroides
• Oral contraceptives (estrogen effect)

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Vaginal discharge: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Atrophic vaginitis

With atrophic vaginitis, a thin, scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial vaginosis

Bacterial vaginosis (formerly called Gardnerella vaginalis and Haemophilus vaginalis) results from an ecozogic disturbance of the vaginal flora. Causing a thin, foul-smelling, green or gray-white discharge, it adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other signs of vaginal irritation may occur but are usually minimal.

Candidiasis

Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine, red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chancroid

Chancroid — a rare but highly contagious sexually transmitted disease — produces a mucopurulent, foul-smelling discharge and vulvar lesions that are initially erythematous and later ulcerated. Within 2 to 3 weeks, inguinal lymph nodes (usually unilateral) may become tender and enlarged, with pruritus, suppuration, and spontaneous drainage of nodes. Headache, malaise, and fever to 102.2° F (39° C) are common.

Chlamydial infection

Chlamydial infection causes a yellow, mucopurulent, odorless, or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially following menses. Many women remain asymptomatic.

Endometritis

A scant, serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, lower back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts

Genital warts are mosaic, papular vulvar lesions that can cause a profuse, mucopurulent vaginal discharge, which may be foul-smelling if the warts are infected. Patients frequently complain of burning or paresthesia in the vaginal introitus.

Gonorrhea

Although 80% of women with gonorrhea are asymptomatic, others have a yellow or green, foul-smelling discharge that can be expressed from Bartholin’s or Skene’s ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer

Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul-smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital)

A copious mucoid discharge results from herpes simplex, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis

Trichomoniasis can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; a red, inflamed vagina with tiny petechiae; dysuria and urinary frequency; and dyspareunia, postcoital spotting, menorrhagia, or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies

Contraceptive creams and jellies can increase vaginal secretions.

Drugs

Drugs that contain estrogen, including hormonal contraceptives, can cause increased mucoid vaginal discharge. Antibiotics, such as tetracycline, may increase the risk of a candidal vaginal infection and discharge.

Radiation therapy

Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Vaginal discharge: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Atrophic vaginitis

In this disorder, a scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial Vaginosis

This infection, caused by Gardnerella vaginalis (formerly called Haemophilus vaginalis), results from an ecozogic disturbance of the vaginal flora. It produces a thin, foul-smelling, green or gray-white discharge that adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other mild signs of vaginal irritation may also occur.

Candidiasis

Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chancroid

This rare but highly contagious sexually transmitted disease produces a mucopurulent, foul-smelling discharge and vulvar lesions that are initially erythematous and later ulcerated. Within 2 to 3 weeks, inguinal lymph nodes (usually unilateral) may become tender and enlarged, with pruritus, suppuration, and spontaneous drainage of nodes. Headache, malaise, and a fever as high as 102.2° F (39° C) are common.

Chlamydial infection

This infection causes a yellow, mucopurulent, odorless or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially after menses. Many women, however, remain asymptomatic.

Endometritis

A scant serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, low back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts

These mosaic, papular vulvar lesions can cause a profuse mucopurulent vaginal discharge, which may be foul smelling if the warts are infected. Patients commonly complain of burning or paresthesia in the vaginal introitus.

Gonorrhea

Although 80% of women with gonorrhea are asymptomatic, others have a foul-smelling yellow or green discharge that can be expressed from Bartholin’s or Skene’s ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer

Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital)

A copious mucoid discharge results from this disorder, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis

This infection can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; an inflamed, erythematous vagina with tiny petechiae; dysuria and urinary frequency; dyspareunia; postcoital spotting; and menorrhagia or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies

These products can increase vaginal secretions.

Drugs

Drugs that contain estrogen, including hormonal contraceptives, can cause a mucoid vaginal discharge. Antibiotics such as tetracycline may increase the risk of a candidal vaginal infection and associated discharge.

Radiation therapy

Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Vaginal Discharge: Differential Overview
(Field Guide to Bedside Diagnosis)

❑ Physiologic discharge

❑ Candida vulvovaginitis

❑ Bacterial vaginosis

❑ Trichomonas vaginitis

❑ Atrophic vaginitis

❑ Irritant dermatitis

❑ Gonorrheal cervicitis

❑ Chlamydial cervicitis

❑ Herpes simplex

❑ Cervical cancer

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007

Vaginal discharge: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Atrophic vaginitis

With atrophic vaginitis, a thin, scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial vaginosis

Bacterial vaginosis results in a thin, foul-smelling, green or gray-white discharge that adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other signs of vaginal irritation may occur but are usually minimal.

Candidiasis

Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine, red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chlamydial infection

A chlamydial infection causes a yellow, mucopurulent, odorless, or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially following menses. Many women remain asymptomatic.

Endometritis

A scant, serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, lower back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts

Genital warts are mosaic, papular vulvar lesions that can cause a profuse, mucopurulent vaginal discharge, which may be foul-smelling if the warts are infected. Patients with genital warts frequently complain of burning or paresthesia in the vaginal introitus.

Gonorrhea

Although 80% of women with gonorrhea are asymptomatic, others have a yellow or green, foul-smelling discharge that can be expressed from Bartholin’s or Skene’s ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer

Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul-smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital)

A copious mucoid discharge results from genital herpes, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis

Trichomoniasis can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; a red, inflamed vagina with tiny petechiae; dysuria and urinary frequency; and dyspareunia, postcoital spotting, menorrhagia, or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies

These products can increase vaginal secretions.

Drugs

Drugs that contain estrogen, including hormonal contraceptives, can cause increased mucoid vaginal discharge. Antibiotics, such as tetracycline, may increase the risk of a candidal vaginal infection and discharge.

Radiation therapy

Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Vaginal Discharge: Principal Causes of Vaginal Discharge
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)

1. Prepubertalonset
   1. Physiologicleukorrhea
   2. Vulvovaginitis
      1. Nonspecificcauses
      2. Specific infections
   3. Foreign body
2. Pubertal and postpubertal onset
   1. Physiologicleukorrhea
   2. Vulvovaginitis
      1. Nonspecificcauses
      2. Specific infections
         1. Bacterialvaginosis
         2. Candida species
         3. Trichomonas vaginalis
         4. Herpes simplex virus
   3. Cervicitis
      1. Chlamydia trachomatis
      2. Neisseria gonorrhoeae
   4. Pelvic inflammatory disease
   5. Foreign body

» READ BOOK EXCERPT ONLINE »

Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006

Vaginal discharge: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Atrophic vaginitis.With atrophic vaginitis, a thin, scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial vaginosis.Bacterial vaginosis causes a thin, foul-smelling, green or gray-white discharge, it adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other signs of vaginal irritation may occur but are usually minimal.

Candidiasis.Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine, red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chancroid.Chancroid produces a mucopurulent, foul-smelling discharge and vulvar lesions that are initially erythematous and later ulcerated. Within 2 to 3 weeks, inguinal lymph nodes (usually unilateral) may become tender and enlarged, with pruritus, suppuration, and spontaneous drainage of nodes. Headache, malaise, and fever to 102.2° F (39° C) are common.

Chlamydial infection.Chlamydial infection causes a yellow, mucopurulent, odorless, or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially following menses. Many women remain asymptomatic.

Endometritis.A scant, serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, lower back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts.Genital warts are mosaic, papular vulvar lesions that can cause a profuse, mucopurulent vaginal discharge, which may be foul-smelling if the warts are infected. Patients frequently complain of burning or paresthesia in the vaginal introitus.

Gonorrhea.Although 80% of women with gonorrhea are asymptomatic, others have a yellow or green, foul-smelling discharge that can be expressed from Bartholin's or Skene's ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer.Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul-smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital).A copious mucoid discharge results from genital herpes simplex, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis.Trichomoniasis can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; a red, inflamed vagina with tiny petechiae; dysuria and urinary frequency; and dyspareunia, postcoital spotting, menorrhagia, or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies.Contraceptive creams and jellies increase vaginal secretions.

Drugs.Drugs that contain estrogen, including hormonal contraceptives, can cause increased mucoid vaginal discharge. Antibiotics, such as tetracycline, may increase the risk of a candidal vaginal infection and discharge.

Radiation therapy.Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

 » Next page: Risk Factors for Bacterial vaginosis

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