Bacterial Vaginosis in Women

Bacterial vaginosis (BV) is one of the most common infections in women. Symptoms of BV may include a watery, white or grey discharge instead of normal vaginal secretions, and a strong or unusual odor from the vagina, often described as a 'fishy' odor. The condition is characterized by a shift in the composition of vaginal microbial communities from the normal healthy bacteria - in particular lactic acid-producing lactobacilli - which become replaced by an overgrowth of various other bacteria, notably strict anaerobes, and an elevation in vaginal pH (i.e., an increase in alkalinity of the vaginal fluid).

Bacterial vaginosis is sexually transmitted, as shown by an Australian meta-analysis [Fethers et al., 2008]. This systematic review and meta-analysis showed that the epidemiology of bacterial vaginosis appeared to be similar to that of established STIs [Fethers et al., 2008].

A longitudinal study in Pittsburg of 773 women without BV at enrolment found that over one year, those whose partners were uncircumcised were twice as likely to have BV [Cherpes et al., 2008]. Two small US studies, thus having limited power, were unable to find an association, however [Zenilman et al.; Schwebke & Desmond, 2005]. The 'gold standard' in epidemiology is, nevertheless, the randomized controlled trial, and one of these, in Uganda, found that bacterial vaginosis of any type was 40% lower, and severe bacterial vaginosis was 61% lower in the wives of men in the circumcised arm of the trial [Gray et al., 2009a].

The foreskin of males could facilitate survival of BV organisms, such as gram-negative anerobic bacteria, and make an uncircumcised male amore efficient and more prolonged transmitter of infection [Fethers et al., 2008; Gray et al., 2009a]. The much higher prevalence of such anaerobic bacteria under the foreskin of men prior to circumcision was established in an analysis of the microbiome of men from a large randomized controlled trial, and the authors highlighted the fact that these have been associated with bacterial vaginosis [[Tobian et al., 2010].

Bacterial vaginosis is associated with cervical intraepithelial neoplasia, the precurser to cervical cancer [Nam et al., 2009].

For more see systematic reviews [Grund et al., 2017; Morris et al., 2019b].





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Circumcision Info

What is circumcision?
Who in the world gets circumised?
The circumcision debate.
Circumcision history and recent trends.
Position statements by national pediatric bodies.
Why the foreskin increases infection risk.
Circumcision - 'shapshot' of health benefits + reviews.
Different specialists see different things.
Circumcision - benefits outweigh the risks.
Pain and memory.
Penile hygiene.
What motivates parents to baby boy circumcision.
Rates of circumcision.
Physical problems.
Inflammatory dermatoses.
Urinary tract infections.
Sexually transmitted infections.
Cancer of the penis.
Prostate cancer.
Cervical cancer in female partners of uncircumcised men.
Breast cancer in female partners of uncircumcised men.
Herpes simplex type 2 virus in women.
Chlamydia in women.
Trichomonas in women.
Bacterial vaginosis in women.
HIV: the AIDS virus.
Circumcision Socio-sexual aspects.
Circumcision - sensitivity, sensation & sexual function.
Circumcision - societal class distinction.
Circumcision prevents infibulation.
Circumcision procedure.
Circumcision & Anesthesia.
Cost of the Circumcision procedure.
Cost benefit of Circumcision.
Circumcision - how do I find someone to do it?.
Circumcision - whose responsibility?...legal
Risks in infants.
Circumcision - risks in adults & older boys.
Circumcision - breastfeeding outcomes and cognitive ability.
Circumcision, does it affect penis length?
Circumcision - why are human males born with a foreskin?
Circumcision - best not to delay til later.
Circumcision - what caused many cultures to ritually remove the foreskin?
Summary
SUMMARY
Conclusion
CONCLUSION
References
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Brochures
Brochures, circumcision information guide.
Anti Circumcision
Anti-circumcision lobby groups.
Links & Resources
Circumcision websites & online discussion groups.
BOOK: "In Favour of Circumcision".
About the Author - Professor Emeritus Brian J. Morris.
Adult circumcision stories - testimonials and more.
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