Male partners may be colonised with Gardnerella vaginalis, and some organisms causing vaginosis have also been found in the rectum suggesting that this may provide a reservoir for vaginal infection.
The initial change in the pathogenesis is probably an increase in vaginal pH from pH 4.0 to pH 5.5. This is probably due to the production of amines by Gardnerella and and Prevotella.
It is unclear why only some women are susceptible.
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