Amsel’s criteria – BV diagnostics

Diagnosis of bacterial vaginosis (BV) has two main methods: Amsel’s criteria and Nugent score.

Amsel’s criteria is much cheaper than Nugent scoring, despite Nugent scoring having been considered the gold standard – it requires expensive lab equipment and takes a lot of time.

Amsel’s criteria, however, has been found to be just as effective as Nugent scoring in the diagnosis of BV. Amsel’s criteria, however, can be done in your doctor’s office.

Amsel’s criteria – three out of four criteria must be met for a diagnosis of BV

  • Vaginal discharge is homogenous – that is, all looks the same, with colour and amount varying, can be grey or off-white
  • Fishy odour when potassium hydroxide (KOH) is added to the vaginal secretions (the whiff test)
  • Clue cells make up more than 20 per cent of cells in the sample when examined under a microscope
  • Vaginal pH over 4.5 (normal vaginal pH is 3.8 – 4.5)

References

  • Mohammadzadeh F, Dolatian M, Jorjani M, Alavi Majd H. Diagnostic value of Amsel’s clinical criteria for diagnosis of bacterial vaginosis. Glob J Health Sci. 2014;7(3):8–14. Published 2014 Oct 28. doi:10.5539/gjhs.v7n3p8
  • Evaluation of Spiegel’s and Nugent’s criteria of interpreting vaginal gram stain for the diagnosis of bacterial vaginosis in pregnant women, Agarwal, V.A. et al. Journal of Clinical Epidemiology , Volume 52 , 24S


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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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