Social Media Discussion of Bacterial Vaginosis Often Misleading
Key findings
- This study examined how well discussions of bacterial vaginosis symptoms on social media compare with clinical data
- 112 posts about bacterial vaginosis on Instagram, Facebook, X, or YouTube were compared with symptom questionnaires completed by 140 clinic patients, including 23 diagnosed with bacterial vaginosis
- 97% and 96% of social media posts about bacterial vaginosis mentioned malodor and vaginal discharge, respectively, but only 39% and 29% of patients with the diagnosis reported those symptoms as being moderate to severe
- 45% of social media comments about bacterial vaginosis mentioned itching and burning, but in the clinical population, those symptoms were as frequent in patients with yeast infections or vulvodynia as in those with bacterial vaginosis
- Social media overemphasizes the ability of symptoms to allow self-diagnosis of vaginitis
Many people attempt to self-diagnose and self-manage vaginal symptoms, whether because of social stigma or lack of access to care. Often, this effort involves seeking health information online.
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Andriana H. Velmahos, a medical student at Boston University; Caroline M. Mitchell, MD, MPH, director of the Vulvovaginal Disorders Program in the Department of Obstetrics and Gynecology at Massachusetts General Hospital; and a colleague recently determined that online discussions of bacterial vaginosis (BV) symptoms don't match well with clinical reality. Their report appears in Frontiers in Reproductive Health.
Comparing Two Sources of Data
The research team compared BV symptoms mentioned in social media with symptoms reported by patients who presented to the Mass General Gynecology or Vulvovaginal Disorders Clinic. 112 English-language posts on Instagram, Facebook, X, or YouTube were collected between August 5 and 9, 2024; comments made before 2014 were excluded.
The clinic patients presented for an annual examination or were diagnosed with BV, vulvodynia, or yeast infection by vaginal fluid Gram stain between August 2014 and August 2017. All patients completed a questionnaire about symptoms in the past 4 weeks: vulvar itch, burning, and pain and vaginal itch, burning, pain, discharge, and odor. 140 patients were selected for this study because they reported at least one moderate to severe symptom, including 23 who were diagnosed with BV.
Social Media Mischaracterized Symptoms
Symptoms mentioned in social media posts about BV did not match well with the symptoms reported in the clinic:
- Discharge—96% of posts about BV vs. 39% of patients diagnosed with BV (P<0.001)
- Malodor—97% vs. 29% (P<0.001)
- Itching—45% vs. 22% (P=0.04)
- Burning—45% vs. 30% (statistically similar)
- Pain—23% vs. 22% (statistically similar)
There were no significant differences in the frequency of moderate–severe symptoms reported by patients with BV versus those with yeast infections or vulvodynia. The only distinguishing symptom was pain, reported by 51% of patients with vulvodynia, 22% of those with BV, and 19% of those with yeast infections (P=0.007).
Counseling Patients
The discrepancies between online commentary and patient self-reports emphasize the need for more accurate online information. The public needs to know that the cause of vaginitis cannot be inferred simply from the type of symptoms or the appearance of discharge.
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