Bacterial Vaginosis: Causes, Symptoms & Treatment Options

Sexual health deserves to be taken seriously, so it's worth seeing your doctor and starting treatment as soon as infection symptoms show up.

This guide covers everything you need to know about bacterial vaginosis, so you can get back to passionate sex and stop worrying!

What Is Bacterial Vaginosis?

Bacterial vaginosis, in plain terms, means a bacterial infection of the vagina — but before your symptoms or a diagnosis send you into a panic, there's some helpful context to know. Bacterial vaginosis, or BV for short, is remarkably common. In fact, the CDC calls it the most common vaginal condition among women aged 15 to 44 [1].

A bacterial infection in the vagina simply means your bacterial levels have fallen out of balance. The vagina naturally hosts healthy bacteria, but the introduction of unwanted bacteria — especially in large amounts — can trigger BV.

BV often gets lumped in with STIs, and while sex can cause it, it's not always sexually transmitted. Plenty of other factors can lead to it, and you can be diagnosed with BV even without any sexual activity. A few common causes and contributing factors:

• Sex toy use
• Non-breathable/synthetic underwear material
• Douching
• A new partner
• Multiple partners
• IUDs
• Smoking
• Antibiotic use
• Switching laundry detergent or personal soap
• Partners with uncircumcised penises (more tips on that here)

The CDC acknowledges that the exact cause behind any individual case of BV often isn't clear, though a positive diagnosis is generally neither serious nor life-threatening.

You can lower your odds of developing BV by sticking to cotton underwear, washing only the outside of your vagina with water, cleaning sex toys thoroughly before and after use, thinking twice before using household items as makeshift toys, and using condoms with all partners, especially multiple partners. These habits support good sexual health overall, but they're no guarantee against BV, particularly if you've had it before.

What Are The Symptoms Of BV?

Bacterial vaginosis shares several symptoms with other STIs, and also with yeast infections. More information here.

You might be dealing with a vaginal infection if you notice any of the following:

• Thick discharge, usually white or gray
• A strong fishy odor, more noticeable after sex. Normal vaginas shouldn't have a strong smell. 7 treatments for getting rid of vaginal odor.
• Discomfort, itching, or burning
• Burning during urination
• Painful sex

Several of these overlap with other sexually transmitted infections — particularly Trichomoniasis, HPV, Chlamydia, and Gonorrhea — and BV is often mistaken for a yeast infection. That's exactly why seeing your doctor at the first sign of symptoms matters so much.

That said, it's entirely possible to have BV with no symptoms at all. Your doctor can confirm a diagnosis through a vaginal exam and lab testing.

How Is BV Treated?

Typically, your OBGYN or general physician will prescribe a round of antibiotics.

It's important to finish the full course, even once symptoms disappear. Like most infections, BV can linger even after visible signs fade. Cut the antibiotics short, and the infection may come roaring back later. BV is also notorious for recurring in women regardless of a completed antibiotic course — MedicineNet reports that more than half of women treated for BV see symptoms return within a year. Source.

Commonly prescribed antibiotics include metronidazole (Flagyl) and tinidazole (Tindamax), both taken orally, though tinidazole tends to carry fewer side effects. Your doctor might also prescribe a vaginal cream or gel — Metrogel and Cleocin are both effective options for clearing vaginal bacterial infections.

BV can sometimes resolve on its own, but the CDC strongly urges pregnant women to seek treatment regardless. Source.

Beyond the risk of recurrence, BV can also make you more susceptible to other STIs, including HIV, herpes, Chlamydia, and gonorrhea — and having a bacterial infection can even raise the odds of transmitting HIV to a partner. Source. Using condoms while dealing with BV is a smart move — we've got the full rundown on condoms in this post.

Are There Natural Treatment Options?

While the CDC and Planned Parenthood both recommend antibiotics, some people prefer to treat BV without relying on chemicals, which the body can eventually build resistance to. The CDC notes that each round of antibiotics can make future rounds less effective. Source.

Fortunately, there are several alternative approaches worth trying, most of them cheaper than a doctor's visit and prescription. Here are a few home remedies and treatments for BV.

Hydrogen Peroxide

In one small study, women who douched daily with 30 milliliters of hydrogen peroxide for a week saw symptom relief in 89% of cases. Doctors caution against such a high vaginal dose, though, since it can irritate the sensitive tissue in and around the vagina. Metrogel is generally the safer recommendation instead. Source.

Boric Acid

Boric acid, a mild acid sometimes used as an antiseptic, has shown effectiveness as a vaginal douche for treating bacterial vaginosis thanks to its alkalinity. Boric acid suppositories also work well against yeast infections, so having some on hand is handy when you're not sure which infection you're dealing with. According to the CDC, boric acid capsules inserted vaginally are particularly effective against BV. You can pair boric acid with antibiotics, or try it alone to see if it helps.

Vaginal Probiotics

Just as you can buy probiotics to balance gut bacteria, similar products exist to balance vaginal bacteria and pH. These can be used preventatively, or once infection symptoms appear. RepHresh (a gel) and Enzymatic Therapy (vaginal pearls containing lactoferrin) are two options worth knowing about, with the latter potentially helping treat BV directly.

Medical professionals often recommend lactobacillus-based products to help keep vaginal bacteria balanced, available as vaginal capsules, powders, juice concentrates, or chewable tablets. Lactobacillus and Nature's Way Primadophilus Optima Women's are two of many brands you'll find at pharmacies and vitamin stores.

Milk naturally contains lactobacilli, so some people dip a tampon in chilled milk and insert it for up to two hours, or drink a warm mixture of milk with a teaspoon of turmeric as an oral remedy.

Whatever remedy you're considering, check with your doctor first.

Other Home Remedies For BV

If recurring infections resist everything above, a few more options exist. Adding 1 to 2 cups of apple cider vinegar to your bathwater may help combat BV, and tea tree oil — a well-known natural antiseptic — can be added to bathwater the same way.

You can also soak a cotton pad in plain yogurt and apply it to the affected area for 30 minutes, up to three times a day. The healthy bacteria in yogurt can ease BV symptoms. If eating it appeals more, try mixing in a teaspoon of fenugreek daily for a week or until symptoms clear.

Finally, some people crush three to four garlic cloves, apply the paste to the vulva or vagina for 20 minutes, then rinse off. As an alternative to direct application, wrap a small clove in gauze and insert it vaginally for up to 30 minutes daily until symptoms resolve. Garlic is a longstanding home remedy for infections generally, particularly in the mouth — it offers pain relief, and one recent study found it effective against MRSA when used in an ancient recipe. Source.

Bacterial infections are never pleasant, but BV is fortunately very treatable and considerably less risky than some other vaginal infections. One last note on BV and any remedy: always check with your doctor before trying anything new, to make sure it's both safe and genuinely effective.

November 15, 2020