Bacterial vaginosis (BV) commonly affects women of reproductive age due to an overgrowth of bacteria in the vagina, which disrupts the natural balance of bacterial flora. Although not classified as a sexually transmitted infection, BV can cause discomfort. This article will explore the symptoms, causes, and treatments for bacterial vaginosis.
What is BV or Bacterial Vaginosis?
Bacterial vaginosis, commonly known as BV, occurs when there is an imbalance in the pH level of the bacteria in the vagina. The vagina is home to beneficial bacteria called lactobacilli, which maintain its health by producing lactic acid, keeping the environment acidic.
However, if the vaginal environment becomes alkaline, often due to factors like menstruation or sexual activity, the lactobacilli decrease, allowing other bacteria to thrive. This overgrowth of suppressed bacteria leads to the development of BV.
Causes of Bacterial Vaginosis
A healthy vagina maintains a natural balance of bacteria, with lactobacilli playing a vital role in keeping the environment acidic (pH <4.5) to inhibit the growth of harmful bacteria.
Bacterial vaginosis (BV) occurs when the vaginal pH rises above 4.5, reaching up to 6.0, creating an ideal condition for anaerobic bacteria to thrive. The most common culprits include Gardnerella vaginalis, Prevotella species, and Mycoplasma hominis.
While the exact cause of BV remains unclear, certain risk factors can increase the likelihood of infection:
- Sexual activity, including receptive cunnilingus (oral sex), recent changes in sexual partners, multiple partners, and not using condoms.
- Cleansing the inside of the vagina, known as douching.
- The presence of a concurrent STI (like chlamydia).
- BV is more common during or after menstruation.
- Smoking.
The exact cause of BV remains unclear, but an imbalance in the vaginal microbiome plays a predominant role. The vagina typically maintains a balance of various bacteria, including lactobacilli, which help keep the vaginal pH acidic and inhibit harmful bacteria. Harmful bacteria can proliferate when this balance is disturbed, leading to BV.
Symptoms of Bacterial Vaginosis
BV symptoms can differ from woman to woman. While some women might not notice any symptoms, others may experience the following:
- Strong, fishy odour, particularly after sexual intercourse
- Burning or itching sensation around the vagina
- Thin, white or grey vaginal discharge
- Vaginal irritation or redness
- Pain during urination
The most common symptom is vaginal discharge, often carrying a fishy or unpleasant odour. Unlike thrush, BV usually does not cause itching, though some women may experience mild vaginal discomfort.
Symptoms of BV tend to worsen after sex or a period, as semen and blood are alkaline, creating an environment that promotes the growth of BV organisms.
Bacterial Vaginosis Diagnosis
If you suspect BV, obtaining an accurate diagnosis is crucial. A private Gynaecologist in London will typically begin with a physical examination and may take a vaginal swab to identify the types of bacteria present. This step is essential to rule out other conditions like a yeast infection, which can have similar symptoms. It is important to note that bacteria levels can fluctuate, so a negative test may only sometimes provide a definitive result.
Bacterial Vaginosis Treatment in London
For bacterial vaginosis treatment in London, doctors typically prescribe antibiotics, which you should take orally or applied directly to the vagina. To help prevent the recurrence of BV, women can take several proactive measures, including:
- Taking high-concentration probiotics and consuming probiotic-rich foods such as kefir
- Maintaining good hygiene by washing the genital area with mild soap and water
- Eating a healthy diet and limiting sugar and refined carbohydrates
- Using condoms during sexual activity
- Avoiding douching
Antibiotics
For Bacterial Vaginosis Treatment in London, antibiotics like metronidazole or clindamycin are commonly prescribed, either orally or as topical vaginal gels or creams. Ensure you complete the entire course of antibiotics, even if your symptoms start to improve.
Pregnancy Considerations
Pregnant women should seek specialised advice immediately for appropriate care.
Recurrent BV
Recurrent BV is not clearly defined but is a common concern for many women. Some report only a partial response to antibiotics, while others experience a full recovery followed by a return of symptoms within days or weeks. Treatment options are debated, including whether treating sexual partners might be beneficial.
Prophylactic Antibiotics
Women experiencing frequent recurrences might find relief through regular oral antibiotics or topical metronidazole twice a week.
Probiotics
Evidence suggests that probiotics can help lower the chances of recurrent BV.
Lactic Acid Treatments
Although trial-based evidence is limited, some women find lactic acid products helpful to prevent further episodes after antibiotic treatment.
Newer Therapies
Specialists are now exploring newer therapies, which may be worth discussing with a specialist in the field.
My Final Thoughts
While bacterial vaginosis is not usually considered a severe health risk, it can cause significant concern. Understanding its causes, symptoms, and treatment options is essential for maintaining vaginal health and overall well-being. If you suspect BV or experience ongoing vaginal symptoms, book an appointment for a proper diagnosis and treatment plan.
Frequently Asked Questions (FAQs)
Q1) Is BV considered to be an STD?
No, BV is not classified as a sexually transmitted infection, though some women notice it after changing sexual partners. While the exact reasons are not fully understood, experts believe that new and unfamiliar bacteria introduced during sex can disrupt the vaginal microbiome, leading to the growth of BV organisms.
Q2) What happens if BV is left untreated?
If over-the-counter remedies have not cleared your BV, you may be at risk of contracting STIs such as chlamydia, gonorrhoea, or HIV. For pregnant women, untreated BV can lead to premature birth.
Additionally, untreated BV may increase your susceptibility to pelvic inflammatory disease (PID), an adverse condition that can also affect fertility and elevate the risk of premature delivery during pregnancy.
Q3) Is it good to have sex If I have BV?
While it is unlikely to pass BV to a male partner, your symptoms might make intercourse uncomfortable. However, female-to-female transmission is possible, so if your partner is female, check if she has the infection if you have developed BV.
Q4) Can I have treatment for BV if I’m expecting a baby?
During pregnancy, your physician can provide you with medication that is safe for use. It’s crucial to get treated, whether you have symptoms or not, to prevent complications like low birth weight and premature delivery, which are associated with untreated BV.
Q5) How can you treat BV over the counter?
You can treat BV with antibiotics, but several over-the-counter options are equally effective. Products like Relactagel, Canes Balance, and Balance Activ are lactic acid treatments that you insert into the vagina to prevent and treat BV. You can also reduce the risk of BV by avoiding scented bath products and prolonged soaking in baths, as these can disrupt the vaginal environment.
Q6) Can BV go away without antibiotics?
Yes, bacterial vaginosis (BV) can resolve by itself as the normal lactobacilli re-establish themselves, often eliminating the need for treatment.
