How to distinguish between bacterial vaginosis and trichomoniasis

Vaginitis is a common problem encountered in obstetrics and gynecology clinics, among which bacterial vaginosis, candidal vaginitis, and vaginal trichomoniasis account for more than 90%. The main causes of odor are bacteria and trichomoniasis. Bacterial infection usually has no other symptoms except for the smell and grayish white secretions. The secretions of trichomoniasis infection are more pus-like, yellow and thick.

The discharge from these two infections is sometimes similar, except that Trichomonas can also cause itching, pain during intercourse, and possibly painful urination, which is usually more severe after menstruation.

There is a big difference between the two in terms of the causes. Bacterial vaginosis is caused by the reduction of normal vaginal lactobacilli and the overgrowth of other bacteria. The exact cause is currently unknown, but it may be related to frequent sexual intercourse, increased vaginal pH, and weakened inhibition of lactobacilli. Trichomonas is almost always transmitted through sexual intercourse. Studies have shown that if the male partner is infected, the female infection rate is high. Moreover, women infected with Trichomonas are more likely to also suffer from gonorrhea.

In the past, it was believed that bacterial vaginosis had no sequelae, but now it has been found that it may cause amniotic fluid infection, premature birth, and postpartum fever in pregnant women. Gynecological surgery may also make infection or endometritis more likely. In recent years, it has also been found that it may be related to cervicitis or cell degeneration.

Similarly, trichomoniasis may also cause early water rupture in pregnant women, so if you have the symptoms mentioned above, you must check and treat them, and it is best to cure them before pregnancy. Usually when you go to the obstetrics and gynecology department for treatment, the doctor can distinguish these two diseases based on symptoms, secretions, amine tests, vaginal pH or microscopic examination.

The treatment of these two infections is somewhat similar. The antibiotic Metronidazole is effective for both of them and has a good therapeutic effect. It can be taken orally, as a suppository, or as a gel. However, Trichomonas infection is best treated orally because the bacteria often lurk in the urethra or nearby glands. Oral treatment is more complete to avoid recurrence. At the same time, male partners should also be treated to avoid a "ping-pong infection" caused by Trichomonas that is transmitted from you to me and from me to you. It should be noted that this antibiotic is best not to be used in the first three months of pregnancy.

These two infections often recur, and can usually be treated in the same way or with a longer course of treatment. As long as the male partner receives treatment, does not drink alcohol or eat spicy food during treatment, and maintains a simple sexual relationship, it is not difficult to cure Trichomonas infection. However, it is sometimes really impossible to find the cause of repeated recurrence of bacterial infections. Since we know that the protective ability of vaginal lactobacilli in these patients is reduced, there are now some suppositories made of lactobacilli, hoping to achieve the purpose of rebuilding a healthy vaginal environment. How effective it is remains to be verified by time.