Dear Alice,

What is bacterial vaginosis? What are the signs and symptoms? And how can it be cured?

Dear Reader,                                                         

Vaginas play host to a variety of bacteria that help maintain a healthy environment. Some types of bacteria that normally live in the vagina in small numbers are called anaerobes (meaning they do not require oxygen to live). Bacterial vaginosis (BV, also called nonspecific vaginitis) occurs when these anaerobes become too numerous. Bacterial vaginosis is the most common type of vaginal infection and can be uncomfortable, but it tends to be pretty mild and easily treated.

Signs and symptoms of bacterial vaginosis can include:

  • Vaginal discharge that may appear watery and whitish-gray or milky
  • A change in the usual scent of the vagina, often described as a strong "fishy" odor
  • Itching or burning around the opening of the vagina
  • Burning during urination

Any or all of these symptoms may be more obvious after sexual intercourse. It's also possible to have the infection without any symptoms.

No one knows exactly why some women develop bacterial vaginosis. It doesn't seem to be sexually transmitted, because women who aren't sexually active can also develop BV. Some researchers think that anything that changes the balance of bacteria in the vagina could make some women more likely to develop the infection. This might include:

  • New or multiple sexual partners
  • Douching
  • Having an intrauterine device (IUD)
  • Natural lack of lactobacilli (good bacteria)

To test for BV, a health care provider may perform a pelvic exam and take a sample from vaginal secretions. Bacterial vaginosis can only be diagnosed by a health care provider and is easily treated with antibiotics (either in pill or topical form). If left untreated, it can cause more serious infections of the fallopian tubes and uterus, and can increase the chance of low birth weight and premature delivery in pregnant women. (If someone is pregnant or taking other medications, it's critical to let their provider know.) Women with BV are also at an increased risk of contracting sexually transmitted infections. Symptoms may get better before the condition is completely cured, so it's advised that any medications for bacterial vaginosis are used for the prescribed length of time. That being said, it is common for BV to recur within three to twelve months even after you've finished treatment for the first infection. Research is ongoing for recurrent infection treatment options. 

Although there are no 100 percent effective ways to prevent bacterial vaginosis, here are some tips for keeping the vagina healthy:

  • Wipe from front to back after urinating or having a bowel movement.
  • Avoid douching and using other chemical products (e.g., vaginal deodorant sprays, powders, perfumed soaps) in the vaginal area.
  • Bathe or shower regularly; try to keep the vaginal area clean and dry.
  • Wear cotton underwear and cotton-lined pantyhose; avoid extremely tight-fitting clothing; promptly change out of damp swimsuits and sweaty workout clothing.
  • Consider using condoms during sexual intercourse. Some practitioners believe that women who are prone to bacterial vaginosis have flares of trouble after intercourse, and avoiding sperm in the vagina may (or may not) help.
  • After intercourse, oral sex, or penetration, wash and dry the vulva carefully using a mild soap and warm water.

Again, if you think you might have bacterial vaginosis, it's best to make an appointment with your health care provider in order to get an accurate diagnosis and treatment.


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