The vagina of a sexually active woman is populated with many bacteria that are in a balanced ratio. This is of utmost importance in order to provide an environment in which the reproduction of pathogenic bacteria is difficult. A major part of the bacterial fund of the vagina is lactobacilli. Due to their main function – fermentation of carbohydrates to lactic acid, they are also referred to as lactic acid bacteria. These bacteria ensure the vagina maintains an acidic environment with a pH below 4.5. Bacterial vaginosis is a disease in which the balance between the microorganisms inhabiting the vagina is disturbed. The amount of lactobacilli is greatly reduced. Other bacteria such as – Gardnerella vaginalis, Mobiluncus, Ureaplasma urealyticum have increased growth. The main causative agent that is isolated in over 90% of women with bacterial vaginosis is Gardnerella vaginalis. It is a gram-negative microorganism whose growth is the most elevated. Gardnerella vaginalis causes a change in the vagina by alkalizing its environment. Due to the change in the environment, the development of other pathogenic microorganisms is also promoted. Complaints in women with bacterial vaginosis The disease is a vulvo-vaginal infection. Its course is associated with increased vaginal discharge. Characteristic of bacterial vaginosis is the specific smell of the discharge of “rotten fish”. This symptomatology is most clearly expressed after sexual contact, which can occur with pain and discomfort. Development of bacterial vaginosis The disease is characteristic of women of sexual maturity. In pregnant women, the frequency of this condition can reach up to 20-25%, because during the period of pregnancy the woman’s local defense mechanisms decrease and susceptibility to bacterial infections increases. Other predisposing factors are taking antibiotics and changing sexual partners frequently. NEWS_MORE_BOX Making the diagnosis of bacterial vaginosis The diagnosis of the disease is made on the basis of the woman’s complaints and the performed gynecological examination. During the gynecological examination, redness of the vagina and increased vaginal discharge may be detected. The main clinical criteria that support the diagnosis are four. Increased vaginal discharge has a grayish color. The vaginal environment is alkaline and the pH is above 4.5. This state is reached due to a decrease in lactobacilli and an increased amount of pathogenic microorganisms. Specific odor of vaginal discharge. The proof can be done by a drop test on a potassium base. A microbiological study that proves the presence of pathological microorganisms. The presence of Gardnerella vaginalis is predominantly detected. In order to make the diagnosis, in addition to the specific complaints of the woman, it is necessary that three of the four criteria are present. Treatment of bacterial vaginosis Bacterial vaginosis is a polymicrobial infection – caused by more than one microorganism.For its treatment, the use of antibiotics to which the established causative agents are sensitive is undertaken. The treatment is carried out by taking medication, a frequently used preparation is metronidazole. In addition to systemic administration of drugs, preparations for local use can also be used. Despite the lack of pronounced complaints on the part of the woman, upon diagnosis of bacterial vaginosis, it is necessary to undertake treatment, since the disease is unfavorable during pregnancy. In addition to the woman, the treatment can also be carried out with the partner in the case of repeated episodes of bacterial vaginosis.