BACTERIAL VAGINOSIS: WHEN THERE'S JUST SOMETHING UP WITH DOWN THERE

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What is it?

You know how you need the bacteria in your gut to be balanced? Well, your gut and vagina have this in common! It’s important to have the right “vag bugs” to keep everything healthy down there. Bacterial vaginosis is a condition that occurs when there is an imbalance of different types of bacteria in the vagina.

What causes it?

Bacterial vaginosis (BV) is a condition caused by a change in the balance of bacteria in the vagina. It’s unclear exactly how this happens, but it may be due to a shortage of a good bacteria called “lactobacilli”. Lactobacilli produce lactic acid, which keeps the normal vaginal pH balance of 3.5-4.5, which is slightly acidic (Bautista et al. 2016). This is important because an acidic environment helps your vag to fight off infections caused by bad bacteria (Hillier et al. 1993; Parma et al. 2014). A pH level of >4.5 may suggest BV.

There are some lifestyle factors that might increase BV risk for certain people. For example:

  • The use of scented soaps
  • Vaginal deodorants
  • Bubble baths
  • Douching
  • Strong laundry detergents
  • Not wiping front to back

(National Health Service, 2018).

There’s also a higher risk of developing BV if you’re sexually active and have frequent new partners (sorry to say). But the use of condoms can lower your risk (Fethers et al. 2008)!

If you've had BV before, you are at an increased risk of having more than one episode.

How do I know if I have it?

Symptoms often include unusual discharge that can be thin and watery, grey or white, and can have a “fishy” smell. However, BV can also be symptomless. #helpful.

Whilst BV doesn’t usually cause physical discomfort (National Health Service, 2018), some women do report itchiness, irritation, bleeding, pain during sex, abdominal cramps, and dry skin around the vulva during a BV episode (Bilardi et al. 2013).

Is it contagious?

Currently, there’s no evidence showing that the bacteria involved in BV affects the penis, but it can be passed between partners if both have vaginas (National Health Service, 2018).

Is it dangerous?

According to the CDC, if left untreated, it does increase your risk of getting STIs, HIV, and Pelvic Inflammatory Disease.  It can also increase your risk of infection if you need an operative gynecological procedure.

What can I do about it?

If you think you might have BV, check in with your practitioner. Sometimes BV can be diagnosed with a visual examination, but your practitioner may do a vaginal “wet mount” test – a swab will be done inside your vagina, and the cells will be looked at under a microscope. DNA testing (also collected with a swab) has been shown to be effective in accurately diagnosing BV (Brown et al. 2004).

If your practitioner is going to test you, know that having sex in the 24 hours prior to testing, or menstruating at the time of testing, could affect some of these test results.

The first line of treatment usually involves a short course of antibiotic tablets or an antibiotic gel that you use inside your vagina.

Birth Control + BV

If you get BV symptoms on the regular and you have an intra-uterine device (IUD), this might be the culprit. IUD users have been shown to have higher BV rates (Calzolari et al. 2000). Dr Eden Fromberg of Holistic Gynecology shares that she removes them from patients all the time for this reason.  But don’t panic, not all IUD users will get BV!

Do probiotics help?

There is some evidence that probiotics containing lactobacilli can help restore the balance of good bacteria, and reduce the recurrence of BV (Abad & Safdar, 2013; Parma et al. 2014). A treatment that combines probiotics and antibiotics has been recommended (Parma et al. 2014). This approach to treatment might also help reduce the long-term risks of antibiotics usage, as your vagina can become resistant to them – this means that BV will keep coming back!

What about herbal or alternative remedies?

The following have shown some promise, but always check in with your healthcare provider to go over risks and benefits before administering.

  • Vitamin C tablets (special ones administered vaginally!) can treat BV by improving vaginal pH levels and promoting good bacteria (Machado et al. 2016).
  • Tea tree oil, garlic and thymol, main ingredient in thyme oil. (Braga et al. 2010; Kessler et al. 2003).

BV in pregnancy

Unfortunately, having BV carries some additional risks during pregnancy, such as an increased chance of miscarriage or early delivery (Donders et al. 2014). Most people with BV will have no problems during pregnancy (National Health Service, 2018), but please speak to your healthcare provider if you’re worried. 
 

Written By: Laura Hillier, Feminist, Book-lover and Writer, Bristol, UK

**Disclaimer** This post is intended as informational only, and should not be treated as medical advice.

 

Sources

Abad, C. L., & Safdar, N. (2009). The role of lactobacillus probiotics in the treatment or prevention of urogenital infections–a systematic review. Journal of Chemotherapy, 21(3), 243-252.

Allsworth, J. E. & Peipert, J. F. (2007). Prevalence of bacterial vaginosis: 2001-2004 National Health and Nutrition Examination Survey data. Obstetrics & Gynecology, 109(1), 114-120.

Bautista, C. T., Wurapa, E., Sateren, W. B., Morris, S., Hollingsworth, B., & Sanchez, J. L. (2016). Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Military Medical Research, 3(1), 4.

Bilardi, J. E., Walker, S. M., Temple-Smith, M. J., McNair, R. P., Mooney-Somers, J., Vodstrcil, L. A., Bellhouse, C. E., Fairley, C. K., & Bradshaw, C. S. (2017). Women view key sexual behaviours as the trigger for the onset and recurrence of bacterial vaginosis. PloS one, 12(3), e0173637.

Bilardi, J. E., Walker, S., Temple-Smith, M., McNair, R., Mooney-Somers, J., Bellhouse, C., ... & Bradshaw, C. (2013). The burden of bacterial vaginosis: women’s experience of the physical, emotional, sexual and social impact of living with recurrent bacterial vaginosis. PloS one, 8(9), e74378.

Braga, P. C., Dal Sasso, M., Culici, M., & Spallino, A. (2010). Inhibitory activity of thymol on native and mature Gardnerella vaginalis biofilms: in vitro study. Arzneimittelforschung, 60(11), 675-681.

Brown, H. L., Fuller, D. D., Jasper, L. T., Davis, T. E., & Wright, J. D. (2004). Clinical evaluation of Affirm VPIII in the detection and identification of Trichomonas vaginalis, Gardnerella vaginalis, and Candida species in vaginitis/vaginosis. Infectious Diseases in Obstetrics and Gynecology, 12(1), 17-21.

Calzolari, E., Masciangelo, R., Milite, V., & Vertaramo, R. (2000). Bacterial vaginosis and contraceptive methods. International Journal of Gynecology & Obstetrics, 70(3), 341-346.

Donders, G. G., Zodzika, J., & Rezeberga, D. (2014). Treatment of bacterial vaginosis: what we have and what we miss. Expert opinion on pharmacotherapy, 15(5), 645-657.

Everyday Health (2016) https://www.everydayhealth.com/bacterial-vaginosis/guide/

Fethers, K. A., Fairley, C. K., Hocking, J. S., Gurrin, L. C., & Bradshaw, C. S. (2008). Sexual risk factors and bacterial vaginosis: a systematic review and meta-analysis. Clinical Infectious Diseases, 47(11), 1426-1435.

Klebanoff, M. A., Nansel, T. R., Brotman, R. M., Zhang, J., Yu, K., Schwebke, J. R., & Andrews, W. W. (2011). Personal hygienic behaviors and bacterial vaginosis. Sexually Transmitted Diseases, 37(2), 94-99.

Machado, D., Castro, J., Palmeira-de-Oliveira, A., Martinez-de-Oliveira, J., & Cerca, N. (2016). Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions. Frontiers in microbiology, 6, 1528.

Parma, M., Vanni, V. S., Bertini, M., & Candiani, M. (2014). Probiotics in the prevention of recurrences of bacterial vaginosis. Alternative therapies in health and medicine, 20, 52.

National Health Service (2018). Bacterial Vaginosis. Retrieved from https://www.nhs.uk/conditions/bacterial-vaginosis/

Van Kessel, K., Assefi, N., Marrazzo, J., & Eckert, L. (2003). Common complementary and alternative therapies for yeast vaginitis and bacterial vaginosis: a systematic review. Obstetrical & gynecological survey, 58(5), 351-358.

WebMD (2018). Vaginal Wet Mount. Retrieved from https://www.webmd.com/women/vaginal-wet-mount#1