Oral or topical metronidazole is usually very effective for treating bacterial vaginosis. Bacterial vaginosis is a vaginal infection seen frequently in women and is normally caused by overgrowth of an anaerobic organism, Gardnerella vaginalis. The use of metronidazole, both topically and orally, has shown good results in eradicating the condition.
The bacterial flora in the vagina is a finely maintained balance of anaerobic and Lactobacillus bacteria. The exact cause of vaginosis is not established, but it seems that a number of factors can affect the balance. It is thought that some practices may increase a woman's risk of developing this condition, including douching and unprotected sexual intercourse. It does not, however, only occur in sexually active women. It does commonly recur, however, causing some medical practitioners to treat sexual partners, although this is controversial.
While bacterial vaginosis may be asymptomatic and, in these cases, probably doesn't need treatment, it usually presents with vaginal discharge, a "fishy" odor, and pain during intercourse. Should these symptoms occur, medical help should be sought. Bacterial vaginosis usually doesn't have any complications but may increase a women's risk of getting a sexually transmitted disease (STD) and, in pregnant women, may increase the risk of premature labor.
Metronidazole is the most well-recognized treatment for bacterial vaginosis. It is known by different trade names in different countries, by manufacturer, and is usually available by prescription only. It is important that the prescribed dose is taken and the full course is completed, even if symptoms subside. Stopping taking the drug before the course is finished may increase the chances of recurrence and make treatment more difficult.
The usual dose of oral metronidazole for bacterial vaginosis is a daily or twice daily dose for seven days. If used topically, metronidazole is inserted intra-vaginally at bedtime every night for five nights. It is important for a woman who is pregnant, trying to get pregnant, or breastfeeding discuss this with the prescribing medical professional before beginning treatment.
As with any medication, metronidazole may interact with other drugs, including over-the-counter, homeopathic and complementary medicines, and they should be discussed with the prescribing healthcare professional. Alcohol should be avoided completely while taking this drug, as it may cause a disulfiram-like reaction that can cause flushing, abdominal cramps, and severe nausea and vomiting. Side effects include headache and gastrointestinal problems, such as diarrhea, nausea, and vomiting. Patients who experience severe side effects should seek medical attention.