What Does Gardnerella Vaginalis Treatment Consist Of? 

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Gardnerella vaginalis treatment typically consists of a short course of antibiotics used to treat bacterial vaginosis (BV). That’s because Gardnerella vaginalis (GV) is one of the many bacteria that can cause BV, which is the most common vaginal infection amongst pre-menopausal women. 

In small amounts, G. vaginalis (GV) is actually a normal inhabitant of the vaginal microbiome and doesn’t cause any symptoms. However, if it goes a bit rogue it can disturb the vaginal community leading to unpleasant symptoms like unusual vaginal discharge. 

Although it's easy to think that bacterial vaginosis and GV are one and the same, G. vaginalis is just one of the many bacteria involved in bacterial vaginosis.

Keep scrolling to learn more about G. vaginalis, how to treat it, and the best way to prevent bacterial vaginosis. 

What is Gardnerella vaginalis?

G. vaginalis is a strain of Gardnerella bacteria, a species often found in the vaginal microbiome. While it usually lives happily alongside other vaginal flora, sometimes it can overgrow, create a biofilm, and lead to bacterial vaginosis. 

When this happens, you might experience symptoms like abnormal vaginal discharge that is thin and gray with a strong “fishy” odor — the trademark symptoms of bacterial vaginosis. 

Researchers still don't know why Gardnerella vaginalis overgrows, but studies have found several risk factors for BV: 

Gardnerella vaginalis testing

To test for G. vaginalis, your healthcare provider will do a vaginal swab and examine your vaginal fluid (aka vaginal discharge) under a microscope to determine the relative amount of protective lactobacilli to other organisms like Gardnerella.  

You can test for Gardnerella vaginalis with Evvy's at-home vaginal microbiome test, too. Though it’s not a diagnostic test and shouldn’t replace your doctor's advice, it can help you uncover what strains are present and in what capacity to understand how they may contribute to any symptoms. Every Evvy test also comes with a custom plan of clear next steps, and if eligible, an Evvy-affiliated provider will develop a custom care program for you that may include both prescription medication and research-backed supplements to ensure that we don’t just fight the disruptive microbes, but regrow the protective ones as well.

Recurrent symptoms? Meet Evvy's at-home vaginal microbiome test, approved by leading OB-GYNs.
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How to treat Gardnerella vaginalis 

Let’s start with the good news: if you’re not experiencing symptoms, there’s no need to treat Gardnerella vaginalis! 

If it is causing symptoms, however, it’s important to keep the infection under control because untreated bacterial vaginosis is associated with an increased risk of:

First-line bacterial vaginosis treatment includes a short round of oral or intravaginal antibiotics prescribed by your healthcare provider. Frustratingly, the current treatments for bacterial vaginosis aren't always effective in providing long-term relief. 

While antibiotics can clear up as many as 85% of bacterial vaginosis cases within a month, the infection can return within just six months for over half of these patients. 

Antibiotics have varying effectiveness on different types of bacteria, and some can harm beneficial bacteria while others do not. When dealing with recurrent bacterial vaginosis, it can be helpful to know the specific bacteria present in your microbiome as this information can aid in selecting the most appropriate antibiotic.

Metronidazole 

Metronidazole is an antibiotic that can help to kill bacteria and other microbes that can cause infections. It's especially effective against anaerobic bacteria, which are bacteria that can survive without oxygen. This medication has been tested and found to be effective against a number of bacterial species that are associated with bacterial vaginosis, including Gardnerella vaginalis. 

In case your healthcare provider prescribes metronidazole to treat your bacterial vaginosis, they may recommend one of the following treatment options based on your unique medical history:

  • 500 mg pills of oral metronidazole taken twice a day for seven days
  • A full applicator of 0.75% metronidazole vaginal gel applied inside the vagina once daily for five days.

It's important to note that these are just common recommendations, and your healthcare provider will tailor the treatment specifically to your needs. Don't hesitate to ask your healthcare provider any questions you may have about the treatment, as they are there to help you through this process.

Tinidazole

Tinidazole is an oral medication that belongs to the same class of antibiotics as metronidazole and is effective against many of the bacteria that cause bacterial vaginosis, including Gardnerella vaginalis. 

Like metronidazole, tinidazole doesn't eliminate Lactobacillus, which are the protective bacteria in your vaginal microbiome. Additionally, researchers have found that it may cause fewer negative side effects on the GI tract, making it a desirable alternative to metronidazole in certain cases.

If you have bacterial vaginosis, your healthcare provider may prescribe tinidazole to be taken orally for two or five-day courses. While longer courses of treatment appear to be more effective against bacterial vaginosis than shorter ones, they may be less convenient. 

Clindamycin

Clindamycin is a commonly used antibiotic to treat bacterial vaginosis. It slows down and, at times, even stops the growth of bacteria. It has been proven to be effective against several bacterial species that can cause bacterial vaginosis, such as Gardnerella vaginalis, just like metronidazole.

You can take clindamycin as an oral pill or apply it intravaginally as a cream, with both treatments lasting for about a week. Alternatively, your healthcare provider may suggest using clindamycin "ovules", which are small pills that you insert into the vagina and let dissolve. This option is a little quicker and only requires a three-day course of treatment. 

How to prevent Gardnerella vaginalis overgrowth

BV has a nasty tendency to come back, even after treatment — but there are a few things you can do to look after your vaginal microbiome and prevent recurrence (to a certain extent):

  • Avoid douches! Your vagina is self-cleaning and douching can alter your vaginal pH and increase your risk of bacterial vaginosis. 
  • Use condoms or dental dams during sex. Although bacterial vaginosis isn’t an STI, having unprotected sex increases your chances of developing it.
  • Cover sex toys with a condom during partnered sex, and wash them after each use.
  • Change your period products within the recommended time frame based on your flow and the product’s absorbency.
  • Stop smoking 

FAQ

What is the best treatment for Gardnerella?

Antibiotics such as metronidazole, tinidazole, and clindamycin are the first-line treatment for infections caused by an overgrowth of Gardnerella, such as bacterial vaginosis. 

What happens if I test positive for Gardnerella?

Having Gardnerella present in your vagina isn’t always a cause for concern. When it’s coexisting along with other microbes, it’s just a healthy component of the vaginal flora. If your levels of Gardnerella are too high, your healthcare provider will recommend antibiotic treatment. 

Is Gardnerella vaginalis an STD?

No, G. vaginalis isn't a sexually transmitted disease (STD), but rather a type of bacteria. It's not a condition itself, but it can contribute to bacterial vaginosis (which isn't considered an STD, either). Even people who are not sexually active can have Gardnerella vaginalis in their vaginal flora without any issues. That said, sexual activity can increase the risk of developing bacterial vaginosis. 

How does a woman get Gardnerella?

Gardnerella vaginalis is a healthy component of the vaginal flora, rather than something you can catch. In many women it is a healthy component of the vaginal microbiome. However, sometimes the bacteria can start to multiply too quickly, which can lead to the development of bacterial vaginosis. It's unclear why G. vaginalis overgrows, but research shows that sex, smoking, chronic stress, and douching are all a potential risk factor for bacterial vaginosis.