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The Burden of Bacterial Vaginosis and Women’s Experiences with Clinical Care

The Burden of Bacterial Vaginosis: Women’s Experience of the Physical, Emotional, Sexual and Social Impact of Living with Recurrent Bacterial Vagin...
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  • Overview

    The Burden of Bacterial Vaginosis: Women’s Experience of the Physical, Emotional, Sexual and Social Impact of Living with Recurrent Bacterial Vaginosis

    Jade E. Bilardi, Sandra Walker, Meredith Temple-Smith, Ruth McNair, Julie Mooney-Somers, Clare Bellhouse, Christopher K. Fairley, Marcus Y. Chen, Catriona Bradshaw

    Bilardi JE, Walker S, Temple-Smith M, McNair R, Mooney-Somers J, et al. (2013) The Burden of Bacterial Vaginosis: Women’s Experience of the Physical, Emotional, Sexual and Social Impact of Living with Recurrent Bacterial Vaginosis. PLoS ONE 8(9): e74378. doi:10.1371/journal.pone.0074378

    Abstract

    Background
    Bacterial vaginosis is a common vaginal infection, causing an abnormal vaginal discharge and/or odour in up to 50% of sufferers. Recurrence is common following recommended treatment. There are limited data on women’s experience of bacterial vaginosis, and the impact on their self-esteem, sexual relationships and quality of life. The aim of this study was to explore the experiences and impact of recurrent bacterial vaginosis on women.

    Methods
    A social constructionist approach was chosen as the framework for the study. Thirty-five women with male and/or female partners participated in semi-structured interviews face-to-face or by telephone about their experience of recurrentbacterial vaginosis.

    Results
    Recurrent bacterial vaginosis impacted on women to varying degrees, with some women reporting it had little impact on their lives but most reporting it had a moderate to severe impact. The degree to which it impacted on women physically, emotionally, sexually and socially often depended on the frequency of episodes and severity of symptoms. Women commonly reported that symptoms of bacterial vaginosis made them feel embarrassed, ashamed, ‘dirty’ and very concerned others may detect their malodour and abnormal discharge. The biggest impact of recurrent bacterial vaginosis was on women’s self-esteem and sex lives, with women regularly avoiding sexual activity, in particular oral sex, as they were too embarrassed and self-conscious of their symptoms to engage in these activities. Women often felt confused about why they were experiencing recurrent bacterial vaginosis and frustrated at their lack of control over recurrence.

    Conclusion
    Women’s experience of recurrent bacterial vaginosis varied broadly and significantly in this study. Some women reported little impact on their lives but most reported a moderate to severe impact, mainly on their self-esteem and sex life. Further support and acknowledgement of these impacts are required when managing women with recurrent bacterial vaginosis.

    Women’s Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study

    Jade Bilardi, Sandra Walker, Ruth McNair, Julie Mooney-Somers, Meredith Temple-Smith, Clare Bellhouse, Christopher Fairley, Marcus Chen, Catriona Bradshaw

    Bilardi J, Walker S, McNair R, Mooney-Somers J, Temple-Smith M, Bellhouse C, et al. (2016) Women’s Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study. PLoS ONE 11(3): e0151794. doi:10.1371/journal.pone.0151794 

    Abstract

    Background
    Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women’s recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV.

    Methods
    A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews.

    Results
    The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women’s frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching.

    Conclusion
    In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinicalmanagement of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.

    Reviewed by:
    Caroline Mitchell, MD, MPH
    Assistant Professor of Obstetrics and Gynecology 
    Vincent Obstetrics and Gynecology Service
    Massachusetts General Hospital
    Boston, MA

    Commercial Support:
    This activity is supported by an independent educational grant from BD Life Sciences.

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