OpenHealth Q&A

Get answered by medical professionals

Does a Pap Smear Indicating Bacterial Vaginosis Require Treatment if Asymptomatic?

7/7/2025, 1:20:20 AMMale25-34

* Age: 29 * Gender: Female * Height: 5 feet 11 inches * Weight: 210 pounds * Current Medications: Spironolactone 100mg daily for acne; Mirena IUD * Smoking Status: Non-smoker Hello! I recently underwent a Pap smear, and I’m relieved to report that the results were clear regarding any cervical abnormalities or cancerous changes. However, the test did suggest a disturbance in my vaginal flora points towards bacterial vaginosis. I don’t currently have any noticeable symptoms, but I do have a Mirena IUD, which has caused me some ongoing bleeding and spotting—I've heard that this could raise my risk for bacterial vaginosis. Is treatment necessary in my case, or should I wait until I develop symptoms?

Drug AllergiesAllergy & ImmunologyDermatology

Answers (1)

Cony

7/7/2025, 1:20:39 AM

OpenHealth AI

It's great to hear that your Pap smear results were clear! When it comes to the finding of bacterial vaginosis (BV) in an asymptomatic individual, the treatment approach can vary.

In general, treatment for bacterial vaginosis is usually recommended only if you are experiencing symptoms like unusual vaginal discharge, odor, or irritation. Since you are currently asymptomatic, immediate treatment may not be necessary. However, one important consideration is your Mirena IUD, which may be associated with increased vaginal flora imbalances.

Here’s a structured approach for you:

Explanation

Bacterial vaginosis occurs when there is an imbalance in the normal bacteria found in the vagina. Many women with BV do not experience symptoms, but the condition can sometimes lead to symptoms or increase the risk of other issues, especially during pregnancy or with certain gynecological procedures. Since you are asymptomatic and have no other risk factors besides the Mirena IUD, the need for treatment depends on your situation.

Next Steps

  1. Monitor for Symptoms: Keep an eye on any developments that may arise, such as changes in discharge (color or odor), irritation, or notable discomfort.

  2. Maintain Hygiene: Practice good genital hygiene. Gently wash with mild soap and water, and avoid douching, which can disrupt the natural flora.

  3. Discuss with Your Gynecologist: Although treatment isn't necessarily needed right now, it might be beneficial to have a discussion with your healthcare provider about your results and the IUD. They can provide guidance on whether follow-up testing or treatment is advisable in the future.

  4. Consider Probiotics: Some studies suggest that probiotics may help maintain vaginal flora balance. You could consider incorporating a probiotic supplement into your routine, but you should discuss this with your healthcare provider first.

If you start experiencing symptoms or have any concerns, be sure to reach out to your healthcare provider for personalized advice. Take care!

Related Questions

Am I Misunderstanding My Allergist – Should I Seek a New One?

I’m a 31-year-old woman, standing at 5 feet 1 inch and weighing 206 pounds. My current medications include Contrave (80 mg), Slynd (4 mg), and Valsartan/HCTZ (160 mg/25 mg). A little background: recently, I experienced my first mosquito bite in several years while celebrating the 4th of July. In the past, I rarely attracted these pests, but that has changed since I became pregnant. Shortly after being bitten, I noticed the affected area became swollen, and hives erupted all over my body. This reaction was accompanied by a racing heart and an overwhelming feeling of malaise. Being a stay-at-home mom, I decided to visit urgent care after struggling with these symptoms for three days. I was prescribed a prednisone dose of 20 mg, which alleviated the hives and other issues momentarily, but they returned once I completed the steroid course. Fortunately, my primary care doctor was available during my baby’s appointment and provided me with another steroid pack while also referring me to an allergist for further evaluation. Today was my consultation with the allergist. I answered all her questions and expressed my eagerness to undergo generic allergy testing to identify and gauge the severity of my allergies, as I had never been tested before. However, the allergist claimed that "hives are not indicative of an allergy" and suggested that "most individuals are unaware of what constitutes an allergic reaction." She prescribed an antihistamine, despite my assertion that it hadn’t helped any of my symptoms, and insisted that I must take them for four weeks without improvement before they would reconsider my case. When I tried to show her images of my rash and elaborate on my symptoms, she continuously interrupted me, insisting I didn’t recognize what allergies truly looked like. Feeling belittled and frustrated by her dismissive attitude, I questioned the necessity of my visit. To my dismay, she replied that "people don’t understand antihistamines," which I found to be quite condescending, especially considering I had just disclosed that my husband is a pharmacist and I have substantial knowledge about medications myself. I also requested testing to confirm my long-suspected allergy to strawberries, to which she replied with an unhelpful suggestion to "simply eat them and see what happens"—despite my longstanding awareness of my allergy since childhood. Yet, she was ready to prescribe me an EpiPen for my bee allergy, noting that they generally do not conduct testing for it, a stance I find concerning given I might be prescribed medication for a potential allergy I may not be in danger of experiencing. Overall, I walked away feeling unheard and as though my time had been wasted. After taking my dog outside later that evening while utilizing precautions, I suffered from another bite and am now experiencing the same distressing symptoms again, putting me right back at square one. Am I being unreasonable? Is this typical behavior for allergists? I came in with hopes of receiving help and treatment, but instead, I feel as though I am once more stuck in limbo.

Drug AllergiesHivesAllergy & Immunology
Male25-34
1 hour ago

Determining Kidney Infection or UTI: My Experience

A week ago, I began experiencing a persistent urge to urinate, prompting me to seek medical attention. I underwent two urine tests to assess my condition with results indicating some similarities on both occasions, apart from the bacterial count. Despite these tests, the urgency remains, and I've recently noticed slight discomfort in my middle to left side of the back. While the pain is manageable and I’ve taken Tylenol to alleviate it, I generally feel alright otherwise. Here are my vital signs: - Temperature: 99.8°F - Blood Pressure: 98/82 mmHg - Oxygen Saturation: 98% - Heart Rate: 83 bpm Given these symptoms, I’m concerned about whether this could indicate a kidney infection or just a urinary tract infection (UTI). The nagging urge to urinate is worrisome and I’m reluctant to visit the hospital. For context, I am a 28-year-old woman, weighing around 75 kg, and typically enjoy good health, with no previous history of UTIs. I’m currently awaiting the results of a urine culture from my second test, hoping for clarity soon.

Allergy & ImmunologyPulmonology
Male25-34
1 hour ago

Should I (24F) Get Checked for a Possible Concussion?

Earlier today, I (24F) experienced a minor car accident. While stopped at a red light, another vehicle unexpectedly accelerated and collided with mine. The impact resulted in a split in my bumper, but thankfully, the car isn’t severely damaged. I felt my head bounce against the headrest, although that was the extent of it. Naturally, my head felt somewhat off afterwards, which I assume is expected given the circumstances. After the incident, I continued driving to a nearby store and then made the 15-minute journey back home. Currently, I’m feeling a bit tense, and there’s a slight soreness at the back of my head, but overall, I believe I’m okay. Should I consider getting a medical evaluation for potential concussion symptoms?

Allergy & ImmunologyDermatology
Male25-34
1 hour ago

Do We Need to Consider Rabies Vaccination?

My cat has been unwell for some time, dealing with a urinary tract infection and potentially some kidney problems. Recently, he accidentally bit my daughter while she was feeding him, mistaking her finger for food. The bite caused some bleeding, so we cleaned it with soap and put her on antibiotics. I contacted the veterinarian to confirm that my cat's vaccinations were current, and they assured me that he is up to date. Lately, he has been excessively drinking water, has experienced weight loss, and feels cool to the touch. Fortunately, there are no signs of foaming at the mouth or aggression; however, I have noticed some tearing in his eyes. Despite these issues, he remains affectionate and calm. It's been over ten days since he began showing signs of illness, while it's only been four days since the incident with my daughter. He cohabits with two other indoor cats, both of whom appear to be completely healthy, although they are overdue for their rabies vaccinations by several months. While he is managing to hang on, I'm uncertain if he will pull through for ten more days. Should we go ahead and get my daughter vaccinated against rabies, and what does the doctor recommend in such situations? Thank you!

Drug AllergiesPet AllergiesAllergy & Immunology
Male25-34
1 hour ago

Understanding My Prolactin Level of 2466 mIU/L: Seeking Guidance

At 33 years old, I'm a white female residing in the UK. My lifestyle includes occasional alcohol consumption, but I don’t smoke and don’t take any regular medications. For quite some time, I've been feeling persistently unwell. After finally seeking medical advice, I underwent blood tests around eight weeks ago. The initial results indicated elevated prolactin levels, prompting my doctor to request further testing. In the past eight weeks, my health has deteriorated significantly; I'm constantly fatigued, feel mentally sluggish, and lack energy. Additionally, I’ve been experiencing a notable drop in my mental well-being alongside severe headaches and discomfort behind my right eye—symptoms I haven’t encountered before. The headaches consistently affect the right side of my head. One alarming incident occurred while I was in the park reading; I lost vision momentarily and could only see unusual colors in my peripheral view, leaving me unable to move or navigate home for roughly 20 minutes. Despite the seriousness of my condition, I have yet to hear from my doctor regarding my test results, and attempts to schedule an appointment have proven futile, leaving me uncertain about what this all signifies or whether it’s something to be concerned about. Below is a summary of my previous and recent blood tests: |**Test**|**Results (8 Weeks Ago)**|**Results (Most Recent)**|**Normal Reference Range**| |:-|:-|:-|:-| |**Vitamin B12**|227 ng/L|216 ng/L|197–771 ng/L| |**Folate**|**2.9 µg/L** *(deficient)*|**15.8 µg/L** *(normal)*|3.9–26.8 µg/L| |**TSH**|3.8 mIU/L|**6.2 mIU/L** *(high)*|0.27–4.2 mIU/L| |**Prolactin**|**1252 mIU/L** *(high)*|**2466 mIU/L** *(very high)*|102–496 mIU/L| While I believe these results are particularly pertinent, I have more data available if needed, and I would greatly appreciate any insights or guidance as I am in urgent need of assistance.

Skin AllergiesAllergy & ImmunologyPulmonology
Male25-34
2 hours ago