| Bacterial vaginosis: what is physiological in vaginal bacteriology? An update and opinion. | |
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MedLine Citation:
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PMID: 21916857 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Bacterial vaginosis (BV) was originally described as a sexually transmitted infection caused by a single microbe. The prevailing concept describes BV as a polymicrobial coitus-associated disease of uncertain origin. In this overview the natural history of BV as a monobacterial and polymicrobial entity is examined with respect to the physiological concept of BV in relation to sexual behaviour before and after introduction of the hormonal contraceptive pill. Bacterial vaginosis, characterized by low vaginal acidity (elevated pH) and replacement of vaginal Lactobacillus by Gardnerella vaginalis flora, could be caused by unprotected intercourse when a low pH changes through the neutralizing power of male ejaculate, vaginal coital transudate and vaginal neurogenic transudate. A monobacterial form, Gardnerella vaginalis vaginitis, could be a physiological postcoital condition for protection of ejaculated spermatozoa, characterized by "pure" Gardnerella flora and elevated pH as an immediate result of an incidental unprotected coital act through neutralization of vaginal acid and replacement of Lactobacillus by Gardnerella flora. A polymicrobial form of BV could be autoinfection of the postcoital physiological Gardnerella vaginalis flora, characterized by a mixture of Gardnerella vaginalis, Mycoplasma hominis and anaerobic bacteria at lesser vaginal acidity, possibly resulting from suppression of normal vaginal acidity through repeated sexual acts, with a resultant higher pH and transfer of enteric bacteria from the perianal region. Monobacterial and polymicrobial auto-infectious forms of BV may be clinically distinct and share a common origin. The understanding of BV as a basic physiological entity could influence prophylaxis and treatment for the largely therapy-resistant polymicrobial BV. |
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Authors:
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Pentti A Leppäluoto |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-14 |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: - ISSN: 1600-0412 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology. |
Affiliation:
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Tampere, Finland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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