APPENDIX:

Pregnancy Related

• Preterm Labor
• Low birth-weight
• Intra-amniotic fluid infection
• Premature rupture of the membranes
• Postpartum endometritis

Unrelated to Pregnancy

• Pelvic Inflammatory Disease
• Cervicitis
• Urinary Tract Infection
• Sexually Transmitted diseases including HIV
• Cervical dysplasia
• Postoperative infection

Medical Conditions

• Diabetes
• Sjogren’s Syndrome
• Cancer

Low-Estrogen Conditions

• Endometriosis
• Menopause
• Cancer
• Radiation
• Psychological (see below)

Chemical

• Douches
• Perfumes
• Soaps
• Bath or body products

Infectious Conditions

• Bacterial Vaginosis
• Yeast infections
• Sexually transmitted diseases (STDs)

Psychological

• Hypophalamic amenorrhea, stress
• Prior miscarriage
• Sexual assault, abuse
• Depression
• Trauma

Recommended Treatment for Bacterial Vaginosis (BV)

Antibiotic Treatment

• Metronidazole 500 mg orally twice daily x 7 days (2 g orally in single dose works slightly less effectively) or
• Metronidazole gel 0.75%, one full applicator (5 g) intravaginally daily x 5 days or
• Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime x 7 days (300 mg orally twice daily x 7 days or 100 g intravaginal ovules at bedtime x 3 days works slightly less effectively)

Follow-up treatment

• RepHresh Vaginal Gel every 3 days for at least 6 weeks to prevent re-infection.
• It is important also that the patient avoids douching, as this doubles the risk (Brown D. J Reprod Med.2004;49:781-86)

References

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