Symptoms of Gardnerella vaginalis in Men & Women
Gardnerella vaginalis is a normal bacterium in the vagina, and its presence alone does not indicate infection. Symptoms only arise when it overgrows, causing bacterial vaginosis (BV) in women, while men are typically asymptomatic carriers. For residents of Hong Kong, understanding the distinct and often misunderstood signs of a Gardnerella-related imbalance is crucial for seeking the right care and avoiding confusion with other common infections.
What is Gardnerella vaginalis? The Key is Balance
First, it's essential to clarify a major point of confusion: Gardnerella vaginalis is not a sexually transmitted infection (STI), and simply having this bacterium is normal for women1. It is a natural part of the healthy vaginal microbiome, which is a delicate ecosystem of various bacteria.
Problems occur when the vaginal environment becomes unbalanced. A decline in protective Lactobacillus bacteria allows Gardnerella vaginalis and other anaerobic bacteria to overgrow. This shift leads to a condition called bacterial vaginosis (BV), which is characterized by a set of specific symptoms. It's the overgrowth and imbalance—not the mere presence of the bacteria—that cause issues.
Symptoms in Women: Recognizing Bacterial Vaginosis (BV)
For women, symptoms are directly linked to BV. Notably, up to 50% of women with BV may experience no symptoms at all2. When symptoms do occur, they are distinct from other vaginal infections like yeast infections.
The primary symptoms of BV include:
- A thin, watery, greyish-white vaginal discharge.
- A strong, unpleasant "fishy" odour, which is often more noticeable after sexual intercourse or during menstruation.
- Itching or burning is not a primary symptom of BV. Significant itching typically suggests a different condition.
Differentiating BV from Other Common Infections
It's easy to mistake BV for a yeast infection. The following table clarifies the key differences:
| Feature | Bacterial Vaginosis (BV) | Vaginal Yeast Infection | Trichomoniasis (STI) |
|---|---|---|---|
| Primary Cause | Bacterial imbalance (overgrowth of Gardnerella and others) | Overgrowth of Candida fungus | Parasite (Trichomonas vaginalis) |
| Discharge | Thin, greyish-white, homogenous | Thick, white, clumpy (like cottage cheese) | Frothy, yellow-green, often copious |
| Odour | Strong fishy smell | Usually odourless or yeasty | Strong, unpleasant smell |
| Itching/Burning | Uncommon (mild if present) | Very common, often severe | Common, can be significant |
| Vaginal pH | Elevated (usually >4.5) | Normal (usually <4.5) | Elevated (usually >4.5) |
Symptoms in Men: Typically Silent Carriers
The situation for men is markedly different. Men do not have a natural genital microbiome that includes Gardnerella vaginalis. However, the bacteria can be transiently present on the penis after sexual contact with a partner who has BV.
Crucially, men almost never develop symptoms or an infection from Gardnerella vaginalis. It does not cause urethritis (inflammation of the urethra) or other male-specific conditions. In extremely rare cases, some sources suggest it might contribute to mild balanitis (inflammation of the head of the penis), but this is not typical.
A man who tests positive for Gardnerella is generally considered an asymptomatic carrier, not a patient requiring treatment for his own health. The main clinical significance is his potential role in the "ping-pong" effect, where he might unknowingly pass the bacteria back to his female partner, contributing to her recurrent BV.
When to Seek Medical Advice in Hong Kong
Use the following flowchart to guide your decision on seeking medical care in Hong Kong:
- For Women: If you experience the characteristic fishy odour or abnormal discharge, you should consult a healthcare provider for an accurate diagnosis. In Hong Kong, you can visit a general practitioner (GP), a gynecologist, or a government Social Hygiene Clinic. Avoid self-treating with over-the-counter yeast infection creams, as they are ineffective against BV.
- For Men: Men do not need to seek testing or treatment for Gardnerella for their own health. However, if a female partner suffers from frequent, recurrent BV, it can be beneficial for both partners to consult a doctor together to discuss strategies to break the cycle of reinfection.
Diagnosis and Treatment Pathways in Hong Kong
Diagnosis for women follows established medical guidelines. In addition to the clinical Amsel criteria, Hong Kong clinics may use advanced Nucleic Acid Amplification Tests (NAATs), GV DNA Test. These molecular tests can rapidly and accurately detect Gardnerella vaginalis and other BV-associated bacteria from a vaginal swab, often providing results within 24 hours.
Treatment for symptomatic BV requires prescription antibiotics. It is critical to complete the entire course of antibiotics, even if symptoms improve quickly, to prevent early recurrence.
Conclusion
Understanding Gardnerella vaginalis means understanding balance. For women, symptoms like a fishy odour and thin grey discharge signal an imbalance (BV), not the simple presence of the bacteria. For men, carrying the bacterium is typically inconsequential to their own health. Recognising these distinct symptoms empowers individuals in Hong Kong to seek appropriate, effective medical care and avoid the frustration of misdiagnosis. If you suspect BV, consult a local healthcare provider for a proper diagnosis and safe, effective treatment.
Ref:
(Text Only)
