Tell Me About…Bacterial Vaginosis
By Adrienne Ton, NP
Chances are, you’re reading this because you started noticing something a little “off” in your underwear and wanted to know what it could be. Perhaps a different smell or a change in your vaginal discharge. Maybe you’ve even had a little vulvar or vaginal discomfort.
There are many possibilities that a change in vaginal discharge could be (check out this article to learn more). However, this could be caused by Bacterial Vaginosis, which is the most common cause of vaginal discharge in women ages 15-44 according to the CDC.
What is BV?
Bacterial Vaginosis (BV) is a common condition in people with vaginas. Normally, vaginas have plenty of bacteria. This is normal and healthy.
BV occurs when there is a change in the normal balance of the bacteria in the vagina - and one type of bacteria starts to grow too much. The most common bacteria that overgrows in this condition is called Gardnerella vaginalis. Other types of bacteria such as Prevotella, Mobiluncus, and A. vaginae can also cause this. This often causes a decrease in the amount of lactobacillus, one of the common healthy bacteria types in the vagina.
BV may be uncomfortable or frustrating, but it is usually not dangerous. However, people who are pregnant and/or may be getting a procedure, such as an abortion or hysterectomy, may experience complications if their BV is untreated. We also know that BV is associated with a higher risk for the transmission of sexually transmitted infections such as HIV, genital herpes, gonorrhea, and chlamydia (so it’s always good to get regular STI testing).
How Did I Get BV? Is BV a Sexually Transmitted Infection?
We don’t know exactly what causes this change in the bacterial balance, but we do know that there are certain things people do that are at higher risk for having BV.
BV is not commonly thought of as an STI, but it is a condition that is often associated with sex. One risk factor for BV is having new or multiple partners. Sometimes, a sex itself can lead to a change in the balance of your vagina, causing some bacteria to overgrow. Sometimes, BV can be transmitted by sex toys that are not cleaned, oral-genital contact, and fingers.
However, there are also episodes of BV that occur without sex. BV can also be associated with smoking and douching of the vagina.
What are the Symptoms of BV?
A lot of people with BV do not have any symptoms, or sometimes the symptoms are not noticeable.
One of the main symptoms includes a strong “fishy” scent in the vaginal discharge, sometimes this is more noticeable after sex.
Other symptoms might include a larger amount of thin white or gray vaginal discharge, irritation or itching in the vagina or around the vagina. Rarely, this can cause burning with urination, which may feel a little like a urinary tract infection (UTI).
Remember, all vaginas have a natural smell and that’s totally normal - when you notice a change in that typical smell or amount of discharge is when you may need to get medically evaluated.
Is BV Treatable?
Yes! Many people get better with treatment.
First, we recommend getting evaluated by a medical professional - this will likely involve a test of your vaginal discharge, which you may collect yourself or a clinician may help you collect this with a pelvic exam.
If you do have a confirmed infection, the two most common treatments include metronidazole or clindamycin. Both are prescription medications that are used for multiple days and come in a pill form that can be taken by mouth or in a gel/cream form that can be inserted into the vagina.
Unfortunately, a lot of people who experience BV will have this occur again within 1 year, which can be really frustrating. This can be treated in a similar way. If you have more than 3 confirmed BV episodes in a year, then it’s worth talking to your healthcare provider about a different treatment method.
How to Prevent BV?
Some key ways to help prevent BV:
- Avoid douching. Some people use a special solution to rinse their vagina and there are a lot of items on the market that encourage women to “clean” their vaginas or “restore balance” in their vaginas. This is NOT routinely needed and can actually further disrupt the normal balance in your vagina. Your vagina is a self-cleaning organ, so you don’t need any special products. If you want to clean, use a mild, gentle, unscented soap on the outside (vulva) instead. Let your vagina do its own self-cleaning.
- If you have a male partner, consider using a condom
- If you use sex toys, make sure to wash them after each use and even better - add a condom to help prevent BV.
Bottom Line: If you’re noticing weird vaginal discharge (especially thin, white, and fishy smelling discharge), it could be bacterial vaginosis. Get checked out by a medical professional to figure out a good treatment plan!
Resources & How to Learn More:
This article provides information about sexual health, healthcare and/or related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of TBD HEALTH INC.