What’s bacterial vaginosis (BV)?
Bacterial vaginosis (BV) is a vaginal infection that’s one of the most common vaginal health issues for women in most countries. 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’s not a sexually transmitted infection (STI) and only about 15% of women with BV will notice symptoms. In contrast, the vast majority of cases usually develop and disappear unnoticed as there aren’t any symptoms or only weak ones. 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 getting BV.
What are the causes of BV?
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 an ongoing BV actually get it.
The good bacteria are called lactobacilli because they produce lactic acid, which is protecting your vagina from bad bacteria entering it. The presence of lactobacilli can be upset by overly aggressive vaginal hygiene, which includes douching and using scented soaps or wipes, as well as by sexual activity bringing too many bad bacteria in from the outside. Other risk factors that make such a bacterial imbalance more likely are hormonal changes during pregnancy or after menopause and the use of intrauterine devices (IUD) if they aren’t properly cleaned. Smoking also is thought to be a risk factor.
Does BV disappear on its own?
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 vagina is restored. In persistent BV cases or if you are pregnant or otherwise considered a risk group, your doctor may decide to put you on antibiotics, like metronidazole (Zidoval tablets) and clindamycin (Dalacin gel), to support your recovery. For a stronger effect, these antibiotics also are available as vaginal suppositories that are placed directly into the vagina. The antibiotic treatment period typically lasts for one week.
If you belong to a risk group or if a BV with symptoms has lasted longer than five days, it’s a good idea to get it checked out by a doctor. Because in rare cases a BV can cause a range of health issues and in pregnant women, it can induce preterm birth. Having an active BV also raises the risk of catching an STI during unprotected sexual intercourse, as the BV makes it easier for viruses to take hold inside your vagina.
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 irritating the good bacteria. This is often also why the chances of a BV relapse are so high. After a successful antibiotic treatment, women go back to using the same hygiene products as before, continue to use douches or don’t pay enough attention to sexual hygiene. Therefore, up to 50% of first-time BV patients will likely suffer a new BV outbreak within a year; some 25% already after a period of three months.
So, to speed up the recovery of your ongoing BV (and thereby get rid of the bad smell) and to prevent a BV from reappearing, consider the following suggestions for vaginal hygiene:
- Don’t use douches; they do more harm than good
- Only use mild, unscented soaps or, better yet, no soap at all
- Don’t use vaginal wipes or deodorants
- Use condoms and/or reduce your sexual activity during a BV
- Keep on using condoms for several months after a BV was cured to prevent recurrence
- Wear loosely-fitted cotton underwear and avoid thongs
To learn more about BV prevention, talk to your gynecologist or usual doctor.
References
- Menard, Jean-Pierre. “Antibacterial Treatment of Bacterial Vaginosis: Current and Emerging Therapies.” International Journal of Women’s Health, Aug. 2011, p. 295, 10.2147/ijwh.s23814. Accessed 18 May 2020.
- Koumans, Emilia H., et al. “The Prevalence of Bacterial Vaginosis in the United States, 2001???2004; Associations With Symptoms, Sexual Behaviors, and Reproductive Health.” Sexually Transmitted Diseases, vol. 34, no. 11, Nov. 2007, pp. 864–869, journals.lww.com/stdjournal/pages/articleviewer.aspx?year=2007&issue=11000&article=00006&type=fulltext, 10.1097/olq.0b013e318074e565. Accessed 18 May 2020.
- Wilson, J. “Managing Recurrent Bacterial Vaginosis.” Sexually Transmitted Infections, vol. 80, no. 1, 1 Feb. 2004, pp. 8–11, 10.1136/sti.2002.002733. Accessed 18 May 2020.
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