Bacterial vaginosis: a critical analysis of current knowledge

Bacterial vaginosis (BV), the change from a Lactobacillus‐dominant vaginal microbiota to an anaerobic and facultative bacterial dominance, is associated with pathological sequelae. In many BV‐positive women their microbiota is in fact normal and unrelated to pathology. Whether or not the dominance of BV‐associated bacteria persists depends upon interactions between host and bacterial factors. Inconsistencies in diagnosis and erroneous associations with pathology may be due to a failure to differentiate between sub‐populations of women. It is only in those women with a BV diagnosis in which the identified bacteria are atypical and persist that BV may be a clinical problem requiring intervention. Tweetable Improved diagnosis of bacterial vaginosis is needed to accurately determine its role in pathology. Tweetable Improved diagnosis of bacterial vaginosis is needed to accurately determine its role in pathology.