Hygienic vulvo-vaginal habits, contraceptive use, and bacterial vaginosis

Abstract

Dear Editor: Bacterial vaginosis is a common health problem leading to millions of worldwide medical consultations yearly (Morales, 2015). It is characterized by the presence of abundant and malodorous vaginal discharge and in some cases, is accompanied by itching, dysuria, and dyspareunia (Hakakha et al., 2002). This condition is associated with an imbalance in the vaginal bacterial flora (reduction in Lactobacilli and predominance of Gardnerella vaginalis and other anaerobic bacteria). One concerning aspect of this condition is that approximately 75% of the patients who undergo gynecological consultations present some alterations in their vaginal flora, and between 10% and 31% of such patients are diagnosed with bacterial vaginosis (Gonzalez et al., 2006; Abreu et al., 2023). In healthy women, vaginal fluid has a pH of 4.5 (Spiegel et al, 1980) and is mainly composed of lactic acid in addition to volatile aliphatic acids (acetic, propanoic, methylpropanoic, butanoic, methyl butanoic, and methylpentanoic acids), which vary in percentages throughout the menstrual cycle (Michael et al., 1974; Preti and Huggins, 1975). Acetic acid, along with lactic acid, is present in higher amounts. On the other hand, in women diagnosed with bacterial vaginosis, several amines produced by G. vaginalis are responsible for the foul odor associated with the problem have been identified. These amines include isobutylamine, 2-phenylethanamine, putrescine, cadaverine, and 4-(2-aminoethyl) phenol (Wolrath et al., 2001; Jokipii et al., 1986).