Talk:Bacterial vaginosis

"Diagnosis" section

The Diagnosis section appears to be written more for a clinical student or research assistant than for the general public. We need a more general explanation of the diagnosis. Anyone know of a source where we could get such information, or of an expert who might know?

Deleted /* Symptoms and signs */ because it's redundant, yet not accurate or complete.

If we want to keep the clinical diagnostic minutiae, I think it needs to be formatted into some sort of chart or table. Carolfrog 00:40, 22 February 2007 (UTC)

Thanks to Alanmccleod for adding the patient-friendly diagnosis information. It's much more useful to the casual reader now. And I now think the clinical stuff is readable enough for professionals without needing to format it into a chart or anything . . . unless someone wanted to do that for fun.  :) —Carolfrog 08:50, 4 March 2007 (UTC)

I have restored the 'for health professionals' section of the entry - the reason I wrote (most of) this section is that I tried looking on wikipedia for it as it was available nowhere else in one place. Students of a variety of sciences will find this data useful, up to date and hard to access in other forums - I do honestly believe it to be a valid part of the usefulness of this article - maybe it should be moved to the bottom under the heading of 'current research'? - what do people think? Alanmcleod 08:13, 6 May 2007 (UTC)

I'm glad you fixed it. I didn't notice when that anonymous IP removed it; I'm not sure why they did. I think it works where it is. The idea of "current research" might be harder to keep sourced with current citations, and might be a magnet for unsourced information to creep in. I dunno, though. ≈≈Carolfrog≈≈♦тос♦ 23:50, 6 May 2007 (UTC)

Current research was removed because of multiple inaccuracies and bias.

Keep Amsel criteria, BUT needs to be shown alongside Nugent scoring.

Diagnostic test for sialidase (BV blue) is a good clinical test not mentioned. — Preceding unsigned comment added by 75.130.213.57 (talk) 05:00, 9 September 2011 (UTC)

"Symptoms" section

In the "Symptoms" section, there is currently one symptom (smelly abnormal discharge) and the statement that "nearly half of all women with BV don't notice any symptoms." If there are no noticeable symptoms, then why is it an "infection?" Are there initially mild symptoms that develop into something worse? How bad can it get? Why do we care? … Just wondering.  :) Any help would be appreciated. Carolfrog 00:46, 22 February 2007 (UTC)

Thanks to the anonymous user on 27 February 2007 who clarified the noticeable symptoms of BV. It makes more sense now that many women don't notice any symptoms, but there could still be a bacterial imbalance. —Carolfrog 08:53, 4 March 2007 (UTC)

Clean-up tag?

I might just have been wikifying too many poorly formatted articles, but this one seems fine to me. Why the clean-up tag? Lottie 15:37, 30 April 2007 (UTC)

~TREATMENT~ Antibiotic treatment for bacterial vaginosis can lead to vaginal yeast infections because the medications change the balance of organisms in the vagina, allowing an excess of yeast to grow. You might be able to avoid this by eating yogurt daily with active Lactobacillus acidophilus culture or taking L. acidophilus dietary supplements.

Because bacterial vaginosis is not caused by sexually transmitted organisms, treating your sex partner will not help cure you. User:HoooahUSArmyWife 13:00, 11 May 2007 (UTC)

There was some junk written under "Treatments" and I deleted it. It was some nonsense about it's bad for your heart and turns your toes purple, can be treated by increasing your number of sexual partners, etc. Clearly, someone was trying to be funny. I'm not a member and was actually just looking at this page for information, so I apologize if I skipped some proper editing/permission procedure. Just wanted to delete that nonsense. ~Mel 4-21-08 —Preceding unsigned comment added by 138.238.41.24 (talk) 18:54, 21 April 2008 (UTC)

As an expert in the field I can confirm that nonsense keeps cropping up in the article. — Preceding unsigned comment added by 128.252.210.21 (talk) 16:38, 2 December 2011 (UTC)

Fact and Citation Check

(Part of the WikiProject Medicine effort)

BV = bacterial vaginosis throughout this section.

Introduction

I recommend adding a reference for the first statement because I think that many women assume that yeast infections are the most common vaginal infections.

• Possible reference for this line: The new Harvard guide to women's health by Karen J. Carlson, Stephanie A. Eisenstat, Terra Diane Ziporyn, p 74 (http://books.google.com/books?id=Qt4QYzrGyvMC&lpg=PA74&dq=bacterial%20vaginosis&lr=lang_en&as_drrb_is=q&as_minm_is=0&as_miny_is&as_maxm_is=0&as_maxy_is&num=100&as_brr=3&pg=PA74#v=onepage&q=bacterial%20vaginosis&f=false).

The statement about BV not being sexually transmitted isn’t mentioned in the citation listed. Additionally, there is a debate in the literature about whether or not BV is a sexually transmitted disease, so this statement should be changed to reflect the debate. It might also be better to move this sentence later in the article (“Causes section”) to avoid a controversial statement in the introduction. Agreed--These comments on sexual transmission hardly deserve to be the first thing mentioned about BV. — Preceding unsigned comment added by 128.252.210.21 (talk) 16:40, 2 December 2011 (UTC)

It is inappropriate to use the second and third sentences to talk about a correlation with sexual activity. BV is also correlated with being black. Do we want to get into that in the second sentence rather than talk about the essential features of the microbial imbalance? I have tried to change this multiple times, but somebody keeps inserting these statements about sex and sexual transmission. Perhaps the virgins with BV would be interested in hearing about these theories. This is the third time I have tried to fix this. Two other experts have weighed in on this above. Can we agree to move these statements to "causes"? Alternatively, we can get rid of them. 75.130.213.57 (talk) 01:13, 15 December 2011 (UTC)

• Possible reference for the debate and possible STD status for BV: Sexual Risk Factors and Bacterial Vaginosis: A Systematic Review and Meta-Analysis, Clinical Infectious Diseases (2008). 47:1426–1435.

The very first sentence states that BV is a disease, when it is in fact an infection. Unfortunately there is no way to edit the introduction. — Preceding unsigned comment added by 24.87.95.6 (talk) 19:22, 28 September 2014 (UTC) a link to Mayo Clinic explains the difference between the two. http://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289

Symptoms and signs

The list of symptoms is incomplete and unreferenced. The Harvard guide to women's health (citation above) or the Merck site (below) have more detailed descriptions of the symptoms.

I think the second paragraph is meant to distinguish BV symptoms from regular vaginal discharge, but the current wording of this section is confusing. Also, the current reference is a university health center fact sheet, and I think a stronger source should be listed. Finally, the reference for this paragraph should be moved to end of the last sentence because all topics are included in the same reference.

• Alternative reference: http://www.merck.com/mmpe/sec18/ch246/ch246b.html has a good description of normal versus BV discharge symptoms.

Diagnosis

The two references listed in this section are primary research articles and should be replaced with a secondary source.

• Source for the diagnostic criteria from the American Academy of Family Physicians: http://www.aafp.org/afp/20000901/1095.html

A citation should be added for the differential diagnosis of BV. The same citation as above could be used, and the citation could be added at the end of the section.

The primary Amsel et al., 1983 paper is cited again in the first sentence, but this is an appropriate use of a primary citation because this is the publication in which the Amsel diagnostic criteria were put forth. The same is true for the next two references for the Hay/Ison and Nugent criteria. The article appropriately adds a reference to a secondary source, the National Guideline Clearinghouse.

The section starting with “The standards for research…” is a description of the Nugent criteria, and the only citation is the original paper that introduced these criteria. A secondary source is necessary to support the claims about the effectiveness of the Nugent criteria.

• The following review article discusses that various diagnostics and has evaluations of their strengths and weaknesses, but I could not find a secondary source to support the statement about interobserver reliability. Urban Forsum et al. (2005). Bacterial vaginosis – a laboratory and clinical diagnostics enigma. APMIS 113(3): 153-161.

The concluding paragraph of this section is currently a summary of a primary source describing a new diagnostic test for BV. A secondary source that supports the use of this diagnostic should be added. I did not tag this section as requiring a non-primary source because the text is a re-statement of the original paper rather than an interpretation, but a secondary source would strengthen the statement.

• Suggested reference: Jane Mashburn (2006). Etiology, Diagnosis, and Management of Vaginitis. Journal of Midwifery and Women’s Health 51(6): 423-430.

Causes

A source should be added for the first paragraph.

• Good book with description of microbiology of BV: Vaginitis: differential diagnosis and management, by Sebastian Faro (http://books.google.com/books?id=tYZ6IDPvIsIC&lpg=PA25&dq=bacterial%20vaginosis&lr=lang_en&as_drrb_is=q&as_minm_is=0&as_miny_is&as_maxm_is=0&as_maxy_is&num=100&as_brr=3&pg=PA26#v=onepage&q=bacterial%20vaginosis&f=false).

I tagged the second paragraph of this section for clarification because the topics are unorganized, and the section is difficult to follow. Consider dividing this into several sections.

The sentence “It is possible for virgins to get infected with bacterial vaginosis” should be moved to the following paragraph where BV in girls is discussed, and a source should be added.

• Suggested source: Primary Care for Women (2004) Leppert and Peipert. (http://books.google.com/books?id=PiiD0iUNhlIC&lpg=PA77&ots=tKNtPu7kiu&dq=bacterial%20vaginosis%20prepubescent%20girls&pg=PA77#v=onepage&q=bacterial%20vaginosis%20prepubescent%20girls&f=false).

There is some debate in the literature about whether BV is sexually transmitted, so this debate should be mentioned and referenced (see note and reference above). Also, the current reference is a primary source, so a secondary source is important here due to the potential controversy.

The sentence “Rather, BV is a disordering of the chemical and biological balance of the normal flora” does not fit in this section. Consider removing. ^^This (or something like it) should be the second sentence in introduction. 01:17, 15 December 2011 (UTC)

Several reviews discussing the risk factors for BV should be added to this paragraph. There are several primary sources included, so it is important to add secondary sources to summarize the consensus about BV risk factors.

• Suggested reference: Jane Mashburn (2006). Etiology, Diagnosis, and Management of Vaginitis. Journal of Midwifery and Women’s Health 51(6): 423-430.
• Suggested reference: Sexual Risk Factors and Bacterial Vaginosis: A Systematic Review and Meta-Analysis, Clinical Infectious Diseases (2008). 47:1426–1435.

I couldn't find evidence that thong underwear causes BV. There was just in Feb 2010 a study for the first time looking at underwear type, and they only looked at cotton vs. nylon. A search of pubmed for finds no research on BV that includes the word thong.

COMPLICATIONS: Complications of BV include things such as burning when urination, irritation, discharge, fishy odors...etc. You can carry this disease for years and it can come back over and over again. It does not complicate birthing experiences

-- Spermicides have been implicated in bacterial vaginosis. If someone would like to write a paragraph with the journal articles below, it would be much appreciated. "However, even after adjustment for colonization status at baseline and for race, an increase in nonoxynol-9 exposure was associated with a statistically significant increase in colonization by anaerobic gram-negative rods, H2O2-negative lactobacilli, and bacterial vaginosis." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380307/ http://www.ncbi.nlm.nih.gov/pubmed/1316413 — Preceding unsigned comment added by Cobgenius (talk • contribs) 17:16, 22 February 2013 (UTC)

Treatment

Added citation to 2016 Cochrane review under "Prevention" and edited text to reflect new findings--Archie.west (talk) 06:53, 25 October 2016 (UTC)

Antibiotics

clindamyacin

sulfameth

Epidemiology

The three sources in this section are not appropriate. The first two link to the main site of two webpages, and I could not verify the referenced information. The third site is an individual’s blog site.

• Suggested reference: Allsworth and Peipert (2007) Prevalence of bacterial vaginosis: 2001-2004 National Health and Nutrition Examination Survey data. Obstet Gynecol 109(1): 114-120.

This section could be expanded for completeness. Factcheck101 23:23, May 4, 2010 Reference is a good one 75.130.213.57 (talk) 01:19, 15 December 2011 (UTC)

Should use a review article --Doc James (talk · contribs · email) 01:26, 15 December 2011 (UTC)

Book

This is not a terribly good book [1] thus removed it. Doc James (talk · contribs · email) 11:19, 24 June 2015 (UTC)

Review

Of microbiome doi:10.1128/CMR.00075-15 JFW | T@lk 22:40, 16 March 2016 (UTC)

Good information but medical article content should only be review articles, not single studies. Best Regards, Barbara (WVS) (talk) 22:41, 2 July 2016 (UTC)