A Guide to

Bacterial VaginosisTraining Guide

What is Bacterial Vaginosis (BV)?The normal vaginal flora contains anaerobic and aerobic bacteria, dominated by the Lactobacillus species (95%). Lactobacilli can provide defense against infections, mostly by maintaining an acidic vaginal pH.1

Bacterial vaginosis is a polymicrobial syndrome resulting in a decreased concentration of Lactobacilli and an increase in pathogenic bacteria in the vaginal flora.1 It is the most common lower genital tract disorder among women of reproductive age, and the most prevalent cause of vaginal discharge and odour.1

Bacterial Vaginosis

BV is the most common lower genital tract disorder1 However, there is low awareness of BV among women. In a survey of 100 women with BV, only 29% were aware of the condition.2

WHAT ARE THE RISK FACTORS? Different factors can affect vaginal pH, such as:

Smoking3,4

The practice of regular douching or use of intravaginal products1,3,4

Use of an intrauterine device4

More common among women who are sexually active1,3,4

29%awareness

DIFFERENTIAL DIAGNOSIS OF VAGINAL DISCHARGE5

Symptoms

pH

Itch

Vaginal discharge

Odour

Inflammation

-

Grey or milky, thin, copious

+ (fishy)

-

> 4.5

+

White, clumpy,& curdy

-

+

< 4.5 (normal)

+

Frothy, off-white or yellow

+

+

> 4.5

Bacterial Vaginosis (BV)

Candidiasis (VYI)

Trichomoniasis(TV)

About CanesBalance®

CanesBalance® is a clear gel containing lactic acid that restores the pH balance within the vaginal environment. It has been clinically shown to help effectively relieve and prevent the symptoms of bacterial vaginosis.

PRODUCT BENEFITSRestores pH balance

Helps relieve unpleasant odour and abnormal discharge

Helps support healthy vaginal flora by restoring vaginal pH

HOW IT WORKS • CanesBalance® contains lactic acid, which effectively relieves abnormal vaginal discharge and restores vaginal pH to relieve odour

• Maintains normal vaginal pH

CANESBALANCE® DOSING For relief of BV symptoms: Use 1 tube daily for 7 days.

For prevention: Use 1 tube daily for 3 days after menstruation.

Use at bedtime. Twist off the end tab, sit or lie in a comfortable position and gently insert the neck of the applicator into the vagina as far as it will comfortably go. Gently squeeze the applicator to release the contents. Remove the tube, still squeezing, and discard.

It may be helpful to wear a panty liner as it is common to notice slight leakage. This does not mean the treatment has not worked. Use only as directed.

Known Adverse Reactions• May cause some stinging during vaginal

fungal (yeast) infections or when there are small cracks in the vaginal tissue. If you are concerned, seek medical advice.

Contraindications• Do not use as a contraceptive.

• Do not use if you are allergic to shellfish.

Cautions and Warnings• Keep out of the reach of children.

• Avoid using CanesBalance® if you are trying to conceive.

• Consult your doctor if you think you may have a vaginal infection during pregnancy.

• Contact your doctor if your symptoms worsen or do not cease, if you experience pain, or if your discharge is blood-stained.

• If you experience no symptom relief after using CanesBalance® as instructed, you should contact your doctor for further advice.

• Do not use if tab end is broken off.

1. van Schalkwyk J and Yudin MH. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. J Obstet Gynaecol Can. 205;37(3):266-274.

2. Ipsos Marketing. (December 2016). Bacterial Vaginosis U&A. Unpublished market research study. December 2016.

3. Bautista CT, Wurapa E, Sateren WB, et al. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res. 2016;3-4.

4. Hainer BL, Gibson MV. Vaginitis: Diagnosis and Treatment. Am Fam Physician. 2011;83:807-815.

5. 5. Canadian Pharmacists Association. Sexually Transmitted Infections. 2017 ed. Ottawa, Ontario; 2017. Chapter 116, Compendium of Therapeutic Choices.

References

PLEASE ADVISE YOUR PATIENTS ON THE FOLLOWING WARNINGS:

Always direct the patient to read the label. See Warnings, Cautions, and Directions of Use at https://health-products.canada.ca/lnhpd-bdpsnh/index-eng.jsp for information to assist in benefit-risk assessment. Also available upon request from 1-800-714-4449.

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