Do you lose weight after abortion pill

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Bacterial vaginosis is characterised by large numbers of anaerobic bacteria in the vagina. However, the specific causative agents are unknown, and it may resolve spontaneously.

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We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of: different antibacterial regimens in non-pregnant women with symptomatic bacterial vaginosis on cure rates and symptom relief; antibacterial treatments in pregnant women to reduce adverse outcomes of pregnancy and prevent neonatal complications; treatments before gynaecological procedures?

Does treating male partners prevent recurrence? We searched: Medline, Do you lose weight after abortion pill, The Cochrane Library and other important databases up to June BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review. We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria.

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In this systematic review we present information relating to the effectiveness and safety of the following interventions: clindamycin, metronidazole, and oral or intravaginal antibacterial treatment.

Bacterial vaginosis is characterised by large numbers of anaerobic bacteria in the vagina, causing a grey, fishy smelling discharge in half of affected women.

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However, the specific causative agents are unknown and it may resolve spontaneously. Bacterial vaginosis is very common, especially in women using intrauterine contraceptive devices, with new or multiple partners and in lesbians.

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Bacterial vaginosis is associated with increased complications in pregnancy, endometritis, and increased risks of HIV infection. Antibiotic treatment with metronidazole and clindamycin increases cure rates compared with placebo in non-pregnant women.

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Intravaginal clindamycin may reduce systemic adverse effects, but has been associated with mild to severe colitis and vaginal candidiasis. We don't know which is the most effective antibiotic regimen, or what the long term effects of treatment might be.

In pregnant women with bacterial vaginosis, oral or vaginal antibiotics have not been shown overall to reduce complications of pregnancy, although studies have given conflicting results.

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Studies using higher doses of antibiotics, and where courses started earlier in pregnancy, are most likely to show a benefit. Treatment of women with clinically equivocal bacterial vaginosis may increase the risks of preterm birth and low birth weight.

Treating the woman's male sexual partner with metronidazole or clindamycin does not reduce the risk of recurrence in the woman.

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In women with bacterial vaginosis who are about to undergo surgical abortion, antibiotics may reduce the risk of subsequent pelvic inflammatory disease, but we don't know if they are beneficial before other procedures.

Bacterial vaginosis is a microbial disease characterised by a change in the bacterial flora of the vagina from mainly Lactobacillus species to high concentrations of anaerobic bacteria.

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Women with symptoms have an excessive white to grey, or malodorous vaginal discharge, or both; the odour may be particularly noticeable during sexual intercourse.

Commonly practised clinical diagnosis requires three out of four features: the presence of clue cells on microscopy; a homogenous discharge adherent to the vaginal walls; pH of vaginal fluid greater than 4.

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Some experts prefer other methods of diagnosis, e. Gram stain of vaginal secretionsparticularly in a research setting.

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Abnormal vaginal flora includes intermediate flora and bacterial vaginosis. Bacterial vaginosis is the most common infectious cause of vaginitis, being about twice as common as candidiasis.

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Bacterial vaginosis is particularly prevalent among lesbians. The cause of bacterial vaginosis is not fully understood.

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Risk factors include new or multiple sexual partners and early age of sexual intercourse, but no causative microorganism has been shown to be transmitted between partners. Use of an intrauterine contraceptive device and douching have also been reported as risk factors.

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Infection seems to be most common around the time of menstruation. The course of bacterial vaginosis varies and is poorly understood.

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Without treatment, symptoms may persist or resolve in both pregnant and non-pregnant women. Recurrence after treatment occurs in about a third of women.

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A history of bacterial vaginosis is associated with increased rates of complications in pregnancy: low birth weight; preterm birth pooled OR from 10 cohort studies: 1. Bacterial vaginosis can also increase the risk of HIV acquisition and transmission.

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To alleviate symptoms and to prevent complications relating to childbirth, termination of pregnancy, and gynaecological surgery, with minimal adverse effects; to reduce adverse neonatal outcomes.

Preterm delivery; other complications in pregnancy; puerperal and neonatal morbidity and mortality; clinical or microbiological cure rates, usually at weeks or 4 weeks after completing treatment; recurrence rates.

Clinical Evidence search do you lose weight after abortion pill appraisal March In addition, the authors used information obtained from drug manufacturers.

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The following databases were used to identify studies for this chapter - Medline to JuneEmbase to June and The Cochrane Library Issue two. Abstracts of the studies retrieved were assessed independently by two information specialists using pre-determined criteria to identify relevant studies. There was no minimum length of follow up.

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We have performed a GRADE evaluation of the quality of evidence for interventions included in this review see table. Consistency: similarity of results across studies Directness: generalisability of population or outcomes Effect size: based on relative risk or odds ratio.

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The information contained in this publication is intended for medical professionals. Categories presented in Clinical Evidence indicate a judgement about the strength of the evidence available to our contributors prior to publication and the relevant importance of benefit and harms.

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We rely on our contributors to confirm the accuracy of the information presented and to adhere to describe accepted practices. Readers should be aware that professionals in the field may have different opinions.

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Because of this and regular advances in medical research we strongly recommend that readers' independently verify specified treatments and drugs including manufacturers' guidance. Also, the categories do not indicate whether a particular treatment is generally appropriate or whether it is suitable for a particular individual. Ultimately it is the readers' responsibility to make their own professional judgements, so to appropriately advise and treat their patients.

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To the fullest extent permitted by law, BMJ Publishing Group Limited and its editors are not responsible for any losses, injury abortion pill damage caused to any person or property including under contract, by negligence, Dietas rapidas liability or otherwise whether they be direct or indirect, special, incidental or consequential, resulting from the application of the information in this publication.

CURE RATES Compared with placebo: Intravaginal antibacterial treatment with clindamycin cream or metronidazole gel is more effective at increasing cure rates at 25—39 days compared with placebo moderate-quality evidence. Intravaginal antibacterials compared with oral antibacterials: Intravaginal antibacterials clindamycin cream, metronidazole gel may be no more effective at increasing cure rates at 5—10 days or at 4 weeks compared with the oral antibacterial metronidazole very low-quality evidence.

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Twice-daily oral metronidazole regimen compared with single dose: A twice-daily regimen do you lose weight after abortion pill the oral antibacterial metronidazole is more effective at increasing cure rates at 7 days compared with a single dose high-quality evidence.

Oral clindamycin compared with metronidazole: Clindamycin may be no more effective at increasing cure rates at 7—10 days compared with metronidazole low-quality evidence. Once-daily intravaginal metronidazole gel compared with twice-daily dosing: Once-daily dosing of intravaginal metronidazole has a similar cure rate to twice-daily dosing in women with antibacterial vaginosis high-quality evidence.

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Three days' treatment with intravaginal clindamycin ovules compared with 7 days' treatment with intravaginal clindamycin cream: A 3-day course of intravaginal clindamycin ovules has a similar cure rate at 35 days to a 7-day course with intravaginal clindamycin cream high-quality evidence.

Intravaginal clindamycin has been associated with mild to severe colitis, and with vaginal candidiasis.

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Oral metronidazole has been associated with nausea and metallic taste. We found one systematic review search date4 RCTs, women comparing antibacterial treatment versus placebo. The relatively high cumulative cure rates with placebo treatment suggest that bacterial vaginosis often resolved spontaneously without treatment.

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We found one systematic review search date5 RCTs, women and one subsequent RCT comparing intravaginal versus oral formulations of metronidazole and clindamycin.

Three RCTs were conducted in symptomatic non-pregnant women and two were conducted in symptomatic and asymptomatic non-pregnant women.

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This conclusion remained the same when the review was updated. A quarter of women were lost to follow up.

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We found no systematic review but found two RCTs. The second RCT women compared 3 day treatment with intravaginal clindamycin ovules versus 7 day treatment with intravaginal clindamycin cream.

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The review gave no information on adverse effects. The RCT found no significant difference in the frequency of adverse effects between intravaginal clindamycin and oral metronidazole Rates of vaginal candidiasis were similar between the two do you lose weight after abortion pill groups 3. Intravaginal clindamycin has been associated, rarely, with mild to severe colitis and vaginal candidiasis vaginal candidiasis with 7 day treatment: The review gave no information on adverse effects of 7 day or single dose oral metronidazole.

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The second RCT found that the proportion of people experiencing adverse effects was similar between 3 day clindamycin ovules and 7 day clindamycin cream, except for vaginal pain 3. Intravaginal administration reduces systemic absorption and systemic adverse effects.

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Some women may prefer oral medication because it is more convenient. Most of the RCTs followed women for a short period of time about 4 weekstherefore it is not possible to fully evaluate long term adverse effects and recurrence rates.

We found one RCT 61 women, 19 withdrew that followed up women who had been treated for bacterial vaginosis with either clindamycin vaginal cream or oral metronidazole. NOTE Treatment of pregnant women who have equivocal bacterial vaginosis may increase the risk of preterm birth and of low birth weight.

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We found one systematic review search date10 RCTs, women comparing antibacterial treatment versus placebo, and two subsequent RCTs. The review performed separate analyses of any antibiotic, oral antibiotics, or intravaginal antibiotics versus placebo or no treatment; none found a significant difference in outcomes between antibacterial treatment and placebo or no treatment.

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  • Bacterial vaginosis is characterised by large numbers of anaerobic bacteria in the vagina. However, the specific causative agents are unknown, and it may resolve spontaneously.
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The second RCT did not analyze the results according to whether the women were at high risk previous preterm birth. Overall, the systematic review found that adverse effects of antibiotics were uncommon although not all of the included RCTs gave information on adverse effects.

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It found no significant difference between any antibiotic and placebo or no treatment in the risk of adverse effects adverse effects sufficient to stop treatment, 2 RCTs, women: OR 1. However, one large RCT women included in the review found significantly more adverse effects with oral metronidazole compared with placebo, particularly gastrointestinal symptoms The average quality of the RCTs in the do you lose weight after abortion pill review was good.

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The review found two different clusters of results for oral treatment of bacterial vaginosis among high risk women. Different effects may be because of differences in dose and type of treatment regimen or in the timing of treatment.

The subsequent RCT, which also found a benefit from treatment, used oral clindamycin, which has broader activity compared with metronidazole against bacterial vaginosis organisms especially Mobiluncus species.

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Differences in timing of treatment early v late gestational age may also have contributed to different results among RCTs. The two included RCTs that found no reduction in preterm birth initiated antibiotic treatment at about 24 weeks of gestation, but the subsequent RCT, which found a reduction in preterm birth, initiated antibiotic treatment earlier in the pregnancy at about 16 weeks.

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Unlike severely disturbed flora, intermediate flora is not considered altered sufficiently enough to be a microbiological diagnosis for bacterial vaginosis. To a lesser degree, differences in study population symptomatic v asymptomatic and diagnosis of bacterial vaginosis clinical v Gram stain diagnosis may also have contributed to the differing results.

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Bacterial vaginosis is a condition of altered vaginal flora. There is a continuum of degrees of alteration of vaginal flora that women may have, and bacterial vaginosis may be defined differently according to the diagnostic criteria being used.

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Given this uncertainty, screening for bacterial vaginosis may result in the treatment of some women who do not have bacterial vaginosis. Thus, it is important to evaluate the harms of treatment among women who have equivocal bacterial vaginosis. Subgroup analyses of RCTs suggest that likely harms of antibiotics in this group include an increase in preterm birth and low birth weight.

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