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Aerobic Vaginitis (AV)

 

Aerobic Vaginitis (AV) is an imbalance of the vaginal flora (microbiome), with an increase in opportunistic aerobic bacteria and a reduction in protective lactic acid producing bacteria. 

Unlike Bacterial Vaginosis (BV), AV presents with inflammation of the vaginal tissues. The opportunistic bacteria commonly associated with AV include E.coli, Enterococcus, Klebsiella and Streptococcus species, all species native to the gut. 

AV is less common than BV, although it is estimated that its prevalence rate is 7-12% amongst women, so still fairly common.1 AV can co-occur with BV and vaginal thrush, mostly due to the lack of protective lactobacillus bacteria. 

Symptoms include: 

  • Unusual, thicker discharge, with a yellow / green tinge 
  • A change in odour (often described as a ‘rotten/foul’ smell)
  • Pain in the vagina and possibly on the external tissues (vulva) 
  • Red, sore skin on an examination
  • In some cases, small erosions or ulcerations are present

AV can increase a woman’s risk of a Urinary Tract Infection (UTI) given the vagina and urethra are so closely located, and the bacteria present in AV are common uropathogens. AV also been associated with painful intercourse, an increased risk of Sexually Transmitted Infections (STIs), newborn infection and preterm birth, and cervical dysplasia (abnormal cell growth on the surface of the cervix).1 

A healthcare practioner may perform a vaginal swab to help diagnose AV, and oral antibiotics are often given for treatment. Similarly to BV, its important to take oral probiotics designed for the vaginal canal, to support the colonies of protective bacteria, and reduce the risk of AV recurrence. 

Risk factors for developing AV include post partum and menopausal life stages (due to low oestrogen states), pregnancy, sexual intercourse, poor hygiene factors e.g. wiping back to front, constipation, a poor diet, poor gut health, poor immune status, and smoking. 

Desquamative Inflammatory Vaginitis (DIV) is a rare diagnosis often given to people with a severe form of AV. DIV involves the same opportunistic aerobic microbes as AV, but its characterised by severe vaginal inflammation, pain and burning. 

Reference

  1. Donders GGG, Bellen G, Grinceviciene S, Ruban K, Vieira-Baptista P. Aerobic vaginitis: no longer a stranger. Res Microbiol. 2017;168(9-10):845-858.

 

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