Stress and the link to vaginal health

BV is a vaginal infection which is characterised by the release of a milky or greyish discharge that is accompanied by a strong 'fishy' odour[ii]. Although relatively little is known about BV, ongoing research suggests that stress has a role to play in the development of this vaginal infection 1,[iii].

"Stress is a risk factor for the development of BV," said Dr Sumayya Ebrahim, a practising gynaecologist at the Park Lane Clinic in Johannesburg. In fact, according to Dr Ebrahim, women who suffer from significant stress make up one of the three most at risk groups for developing BV - along with women of child-bearing age and women who are sexually active.[iv], [v]

Stress undermines the body's ability to combat illnesses and infections

Because stress lowers the immune system, it undermines the body's ability to fight off illness and infection.[vi]. Said Dr Ebrahim: "This creates hormonal changes which may alter the pH environment of the vagina. The vagina's normally acidic pH environment then becomes more alkaline, disturbing the necessary community of beneficial bacteria such as lactobacilli. The altered pH of the vagina allows unfriendly or harmful bacteria to multiply and an infection or BV may then develop."[vii]

According to Dr Ebrahim, those suffering from BV should be treated using medication. This can be in the form of over the counter antibiotic creams or prescription creams and oral medication. In addition, emphasis should also be placed on ensuring that stress levels are appropriately managed.

Dr Ebrahim said that while BV is relatively simple to self-diagnose, it is often misdiagnosed and mistreated because women are uninformed and may be embarrassed about the symptoms. "When diagnosing BV, there are two factors to consider: firstly, whether inflammation is present and secondly, the characteristics of the vaginal discharge. Unlike two other common vaginal infections - candidiasis and trichomoniasis - BV usually does not result in inflammation."
The discharge is also usually white or grey, with a 'fishy' odour that becomes stronger after washing with soap or having sex.[viii].

Have it treated - Now!

BV can have serious consequences, particularly if undiagnosed and untreated.[ix]. For example, pregnant women who have BV are at greater risk of miscarrying or going into early labour and are more likely to develop an infection after giving birth.[x].

"BV has a high rate of recurrence within the first seven months of an infection," said Dr Ebrahim. "If the patient has had failed treatment, a lack of response to treatment or recurrent infections, you would look more closely at stress and other factors in order to get to the root cause for that individual," she said. If you suffer from these symptoms, consult your local pharmacist who can recommend an effective treatment plan.

According to Dr Ebrahim, following the basic suggestions below will help reduce a woman's risk of developing BV:

• Supplement courses of antibiotics with probiotics;
  
• Don't douche;
  
• Don't smoke;
  
• Limit the amount of alcohol you consume;
  
• Manage your stress levels and do not allow stress to go unchecked in your life. Seek professional help if necessary.

For further information on BV go to www.health24.com/vaginaldischarge.asp.

[i] Nansel TR, Riggs MA, Yu KF, Andrews WW, Schwebke JR, Klebanoff MA. The Association of Psychosocial Stress and Bacterial Vaginosis in a Longitudinal Cohort. American Journal of Obstetrics and Gynecology 2006; 194 (2): 381-6.
[ii] Owen MK, Clenney TL. Management of vaginitis. Am Fam Physician 2004; 70: 2125-2132.
[iii] Harville EW, Hatch MC, Zhang J. Perceived Life Stress and Bacterial Vaginosis. Journal of Women's Health 2005; 14 (7): 627-33.
[iv] Centres for Disease Control and Prevention. Bacterial Vaginosis: CDC Fact Sheet. CDC. www.cdc.gov. 13 July 2010.
[v] Smart S, Singal A, Mindel A. Social and sexual risk factors for bacterial vaginosis. Sexually Transmitted Infections 2004; 80 (1): 58-62.
[vi] Burchfield SR. Stress: psychological and physiological interactions. Hemisphere Publishing Corporation. Washington. 2008.
[vii] Faro S. Vaginitis: Differential Diagnosis and Management. Parthenon Publishing, New York. 2003. 37.
[viii] Eds. Merck Manual of Medical Information. Home Edition. Merck Research Laboratories. Whitehouse Station. 1997. 1081.
[ix] Livengood C. Bacterial Vaginosis: An overview for 2009. Reviews in Obstetrics & Gynecology 2009; 2 (1): 28-37.
[x] Mashburn J. Etiology, Diagnosis, and Management of Vaginitis. Journal of Midwifery and Women's Health 2006; 51 (6): 423-430.