ABSTRACT
Bacterial vaginosis is not simply an alteration in the vaginal microflora but is the result of changes that occur continuously, likely on a daily basis. Studies of microflora in a healthy vaginal ecosystem revealed that there are transient shifts in bacterial dominance in women without vaginal infections, and the shifts appear to be associated with menses7-11. Schwebke and co-workers12 performed daily vaginal cultures of 60 patients over a 6-week period. These investigators found that 22% of the patients had a Lactobacillusdominant flora (normal flora) as graded according to Nugent’s score. Transient vaginal flora was common, and 6% of the patients had BV. Schwebke and co-workers also found that a history of BV, multiple sexual partners, and receptive oral sex were associated with an unstable flora.
