Bacterial vaginosis (BV) happens when there is an imbalance between good and bad bacteria in the vagina. This can lead to symptoms like vaginal itchiness, an unusual discharge, and a distinct odor.
Sometimes, the body can clear up BV on its own. However, if it is not treated, it can lead to other health problems. It’s important to talk to a doctor if you think you have BV to avoid discomfort and prevent complications.
Symptoms
Bacterial vaginosis (BV) is a common vaginal condition among women of childbearing age. Many individuals with BV do not experience any symptoms. When symptoms do occur, they typically include changes in vaginal discharge, such as a thin, watery consistency, or a white or gray color. The discharge may also have a strong, unpleasant odor, often reported as fishy.
In addition to changes in discharge, BV can cause a burning, itching, and irritation in the vaginal area. Some people may also experience a burning sensation when urinating. While itching around the outside of the vagina and a burning sensation during urination are possible symptoms, they are less common.
Complications
BV itself is not life-threatening, but it can increase the chance of other health issues.
General Health Complications
BV can raise the risk of developing sexually transmitted infections (STIs) such as human papillomavirus (HPV), herpes, gonorrhea, chlamydia, and HIV, as it increases susceptibility to the virus. Additionally, it can lead to a postsurgical infection, especially after procedures like a hysterectomy.
Pregnancy Complications
During pregnancy, BV can lead to complications such as preterm or early delivery, pregnancy loss, premature rupture of the amniotic sac, postpartum endometritis (inflammation of the uterine lining after delivery), and chorioamnionitis (inflammation of the fetal membrane). Chorioamnionitis mainly increases the risks of an early delivery and, if the newborn survives, raises the chance of cerebral palsy.
Fertility Complications
BV may straightly increase the chances of difficulties in conceiving and raise the chance of health complications that can influence fertility. These include tubal factor infertility, which is infertility caused by harm to the fallopian tubes, and pelvic inflammatory disease, an inflammation and infection of the upper female genital tract that can lead to severe effects along with infertility. BV can also reduce the success rate of in vitro fertilization (IVF) treatments.
Causes
BV happens when there’s a mix-up in the good and bad bacteria that normally exist in the vagina.
This mix-up can happen because of different reasons, like:
- Having sex with someone new.
- Having sex with more than one person.
- Cleaning the vagina with douches.
- Not using protection like condoms during sex.
- Being pregnant.
- Taking antibiotics recently.
BV often shows up after having sex with someone new. It’s not a sexually transmitted infection (STI), but having BV can make it more likely to get one.
Risk factors
BV can develop in anyone with a vagina, and several factors can increase the likelihood of experiencing it. These include using certain feminine hygiene products like douches and vaginal deodorants, indulging in perfumed bubble baths or using scented soaps, bathing in water containing antiseptic liquids, cleaning underwear with strong detergents, practicing sex with someone new or multiple partners, and smoking. However, it’s important to note that BV cannot be acquired from common surfaces like toilet seats, bedding, or swimming pools.
Home remedies
There’s a natural way that might help with BV called probiotics. These are good bacteria that can help balance out the bad ones in your body. Probiotics can also include some helpful yeasts.
Studies from 2021 and 2022 have shown that probiotics might be useful in treating and preventing BV. They could even work alongside antibiotics to help treat BV better. But we still need more research to be sure.
What we do know is that certain probiotics, like oral Lactobacillus acidophilus or specific types put directly into the vagina, can increase the number of helpful bacteria in the vagina. This can help bring back the natural balance. But we’re still figuring out the best ways to use them, like how much to take and how often.
Remember, if you have symptoms of BV, it’s essential to see a doctor for proper treatment. But you can also talk to them about using probiotics to see if it might help you.
Treatment
Sometimes BV goes away on its own, but its symptoms can be similar to other health problems like trichomoniasis or gonorrhea. If left untreated, BV can cause complications, especially if you’re pregnant.
That’s why it’s important to see a doctor to make sure you get the right treatment.
BV might also increase the chances of having problems after a hysterectomy or certain types of abortion. Some healthcare providers suggest giving treatment to everyone having these processes, even if they don’t have BV symptoms.
Usually, male partners don’t need treatment. But BV can spread from a man to many female partners.
Let’s take a look at some treatment options for BV.
Antibiotic Medication
Antibiotics can be helpful in treating BV, working in about 90% of cases. However, BV often returns within a few weeks even after treatment.
Below, you’ll find some antibiotics that doctors might prescribe for BV.
Metronidazole
Metronidazole is the most common antibiotic used for BV treatment. It comes in different forms:
- Oral Tablets: These are taken twice daily for a week. Tablets are considered the most effective treatment, especially for pregnant or breastfeeding individuals.
- Single Dose: In 2017, the FDA approved secnidazole (Solosec) for BV treatment. It’s a single-dose oral treatment that you sprinkle onto food.
- Gel: Applied into the vagina once daily for 5 days.
It’s crucial to avoid alcohol while taking metronidazole as it can cause severe side effects like vomiting and nausea.
Clindamycin
Clindamycin is another antibiotic used when metronidazole isn’t effective or if BV returns. It comes in various forms:
- Cream: Applied inside the vagina at bedtime for a week.
- Tablets: Taken twice daily for a week.
- Ovules: Inserted into the vagina at bedtime for 3 days.
Clindamycin cream and ovules can weaken latex, so they might reduce the effectiveness of barrier methods like diaphragms, condoms, or cervical caps.
Tinidazole
Tinidazole is another antibiotic option if metronidazole doesn’t work or if BV recurs. It’s taken as a single 2-gram oral dose once a day for 2 days, or as a 1-gram dose once a day for 5 days.
If you’re using tinidazole, avoid alcohol and take your doses with food to reduce the chance of gastrointestinal side effects.
Diagnosis
A doctor can diagnose BV by listening to what symptoms you’re experiencing and by checking you during a physical exam.
During the exam, the doctor might take a small sample of your vaginal discharge and send it to a lab for testing. They might also check the acidity level of your vagina by measuring its pH balance.
If you’re sexually active and there’s a chance you might have a sexually transmitted infection (STI), the doctor might suggest some additional tests. These could involve using a swab or a small plastic loop to collect cells from your vaginal wall for further examination.
Prevention Tips
While there’s no surefire way to prevent BV since its exact causes are still uncertain, there are strategies that might help lower the risk:
Using a barrier method like a condom during sex can reduce the chances of getting BV.
Avoiding douching, as it can disturb the natural balance of bacteria in the vagina, leading to BV.
Steering clear of perfumed bubble baths, scented soaps, and vaginal deodorants, as these products can irritate the vagina and increase the risk of BV.
Washing underwear with gentle detergents instead of harsh ones can help maintain vaginal health.
Taking a daily oral probiotic might also be beneficial, as it can support the growth of healthy bacteria in the body, including those in the vagina.
Summary
BV, or bacterial vaginosis, is a common condition resulting from an imbalance of vaginal bacteria. Symptoms include discharge, itching, and odor. Risk factors include multiple sex partners and certain hygiene practices. Treatment typically involves antibiotics, while probiotics may offer relief. Diagnosis involves a physical exam and possibly lab tests. Prevention tips include barrier protection during sex and avoiding douching and scented products.
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