I recently had a Pap smear that came back showing some bacteria present. The doctor's office said it was nothing to be concerned with, and the test was negative for cancer. What could be the cause of the bacteria? Is it normal to have some bacteria?

--Karen

The vagina is full of bacteria -- about 1 billion per milliliter of vaginal fluid! The number of different bacterial species is between 17 and 29. Lactobacillus is one of the most common; strep, staph and Gardnerella vaginalis are other commonly found bacteria. Yeast are also normally present in the vagina in small amounts. The proper mix of bacteria is what keeps the vaginal environment normal and the vagina healthy; an imbalance in the normal vaginal ecosystem often leads to infection.

Bacteria that are considered normal in small amounts may be considered abnormal and cause symptoms in large amounts. Yeast are a good example of this, as is Gardnerella. In small amounts, yeast are unnoticeable, while in large amounts -- made possible, for example, when antibiotics destroy the normal bacteria and leave the yeast to grew unchecked -- yeast cause a white, curdy, itchy discharge. Large concentrations of Gardnerella produce a grayish discharge with a fishy odor.

If your Pap smear was negative for dysplasia (abnormal cells), and you are not experiencing a bad-smelling, itchy or heavy discharge, then the presence of bacteria on your Pap smear is of no concern. If you do have symptoms, mention them to your doctor. A quick look at the discharge under a microscope or a culture will be done to make a diagnosis and then appropriate treatment can be started.