Bacterial vaginosis (BV) is an infection that is one of the most common vaginal health issues for women. According to some studies, over 30% of all American women in the age group of 14 to 49 will get at least one BV outbreak per year. It is not a sexually transmitted infection (STI) and only about 15% of women with BV will notice symptoms. Subsequently, the vast majority of cases usually develop and disappear before any symptoms manifest. BV’s rate of occurrence often depends on a woman’s ethnic background. In the U.S. African American women face the highest risk of BV infection.
BV is caused by an imbalance of “good” and “bad” bacteria inside the vagina: if there are fewer good bacteria, the bad bacteria will take over and produce a thick mucus layer and discharge that often carries a foul, fishy odor. This unpleasant discharge — which has a gray or white color — is the only major symptom of BV and, as mentioned, only 15% of women with BV will have this symptom.
The good bacteria are called lactobacilli because they produce lactic acid, which protects your vagina from bad bacteria. The blance of lactobacilli can be disrupted by overly aggressive vaginal hygiene, including douching and using scented soaps or wipes, as well as by sexual activity which can bring foreign bacteria in from the outside. Other risk factors include smoking, hormonal changes during pregnancy or after menopause, and the use of intrauterine devices (IUD) if they aren’t properly cleaned.
BV tends to disappear on its own after about 5-8 days. Once the lactobacilli have recovered control and wiped out most of the bad bacteria, the natural balance of your vaginal flora is restored. In persistent BV cases or if you are pregnant or otherwise considered an at risk group, your doctor may decide to put you on antibiotics, like metronidazole (Flagyl) or clindamycin (Dalacin gel), to support your recovery. For a stronger effect, these antibiotics also are available as vaginal suppositories. The antibiotic treatment period typically lasts for one week.
If you belong to a high-risk group, or if you have BV with symptoms lasting longer than five days, it’s a good idea to get it checked out by a doctor. In rare cases BV can cause a range of health issues, and in pregnant women, it can induce preterm birth. Having active BV also raises your risk of contracting an STI during unprotected sexual intercourse, by making it easier for viruses to take hold.
What to do about the unpleasant BV odor?
Usually, the simple answer is to wait it out and avoid further upsetting the bacterial environment in your vagina. The faster the bacterial balance is restored, the quicker the smell goes away. Embarrassed by the smell, some women may use scented soaps and vaginal deodorants to cover it up. But that’s exactly the wrong thing to do; it only makes things worse as it keeps depleting the good bacteria. This is often responsible for the high relapse rate of BV. After successful antibiotic treatment, women go back to using the same hygiene products as before, placing them at high risk of recurrence. Up to 50% of first-time BV patients will suffer a relapse of BV within a year, and 25% will be reinfected after a period of three months.
To speed up the recovery of your ongoing BV (and thereby get rid of the bad smell), and to prevent BV from reappearing, consider the following suggestions for vaginal hygiene:
To learn more about BV prevention talk to your gynecologist or primary doctor.