SEX, THRUSH AND BACTERIAL VAGINOSIS

Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of childbearing age. Ln some women it shows a relapsing and remitting course with apparently spontaneous onset and resolution. The re are intermediate patterns of vaginal flora in which lactobacilli an d other species co-exist. We asked women with recurrent BV to prepare vaginal smears daily, and to record symptoms, time of menstruation sex ual activity and use of douches or medication. We Gram-stained the sme ars and assigned a Nugent score for BV, and noted the presence of cand ida, pus cells, sperm and blood. Eighteen women collected daily vagina l smears for up to 10 months. Forty months of slides were collected in total. Bacterial vaginosis arose spontaneously on 23 occasions. We sa w candida arise 11 times. Bacterial vaginosis appeared after candida o n 9 of these 11 episodes. We saw BV regress spontaneously 13 times. Ni ne of these resolutions occurred within 48 h of unprotected sexual int ercourse: BV only arose on one occasion within 48 h of unprotected int ercourse. The intermediate pattern was seen for up to 10 days, and occ urred as BV began or resolved in some women, and sometimes resolved wi thout developing into BV. Bacterial vaginosis arose most often in the first 7 days of a menstrual cycle, and resolved spontaneously most oft en in mid-cycle. In women with recurrent BV, BV arises most often arou nd the time of menstruation and resolves spontaneously in mid-cycle. R ecurrences often follow an episode of candidiasis, and BV often regres ses after unprotected sexual intercourse.