- Bacterial Vaginosis is the most common vaginal infection that affects nearly 21M women every year in the United States. It’s nothing to worry about.
- There are two theories as to how Bacterial Vaginosis occurs. The first is that the pH of the vaginal flora changes causing colonies of hydrogen peroxide-producing Lactobacillus (good bacteria) begin to die within the vaginal flora and harmful bacteria (anaerobes) begin to thrive. The second is that because Lactobacillus die off for other reasons, pH changes, allowing anaerobic bacteria to colonize the vagina.
- Common symptoms of Bacterial Vaginosis(BV) includes discharge, an unusual or foul odor, itch and a change in vaginal pH.
- Because lactobacillus colonize begin to decrease, there is less lactic acid and hydrogen peroxide being produces, which means Bacterial Vaginosis can lead to an increase in catching sexually transmitted diseases (STD’s).
- Natural remedies, such as Probiotics, Prebiotics and Cranberries aim to treat the symptoms of BV, UTIs, and yeast infections while minimizing re-occurrences.
Here at Happy V, we believe that accessibility to great educational resources and high-quality products is critical to helping you achieve your health goals and reduce your chances of experiencing BV.
Our sole purpose for existing is to create a world where humans have a solution to treating the symptoms of Bacterial Vaginosis, Yeast Infections, and UTIs; we all know that properly crafting solutions are only half the battle. The other half? Ensuring that you have the right information you need to combat future occurrences and set your feminine health on the right track.
So we decided to create this ultimate guide to understanding BV. It’s always important to see a doctor, but our guide is a great start to understanding what might be going on.
Bacterial Vaginosis has been best described by The Review of Obstetrics and Gynaecology as “loss of the normal bacterial population of the vagina and their replacement by other species.”
Some may call is a dysbiosis and others being out of balance.
Simply put, Bacterial Vaginosis is an anaerobic infection that occurs when harmful bacteria outnumbers good bacteria.
Simple enough, right? Now let’s dive in and learn about what causes BV, what the symptoms of Bacterial Vaginosis are, and what to do if you find yourself with this common infection.
What is the Vaginal Flora?
You’ve probably heard from your primary physicians or OB/GYN or read it before on other health pages; your vagina is a delicate ecosystem, and, keeping the natural vaginal flora balanced is crucial for feminine health. Well, although your body has defense mechanisms, such as the microbiome and immune system, the actions we take every day can either benefit or compromise our vaginal flora, and keeping it “in balance” is essential for our feminine wellness.
Let’s start by breaking down the Vaginal Flora so we can understand what causes BV.
When you hear “ecosystem,” think about what we were taught in elementary school: a biological community of organisms living together in their ideal climate and physical environment in order to survive and reproduce.
The vaginal flora is similar to the ecosystems on earth as it contains a variety of species, landscapes, and climates (as does every organ of your body)!
Just like the earth has a population of humans, our bodies have a population of living organisms that thrive in specific landscapes and climates. The organism that we consider to be crucial for gut health and digestion, a properly working immune system, and also maintaining the health of your vaginal flora are known as good bacteria or probiotics! The most commonly found probiotic in the vagina, which is also the most essential, is known as Lactobacilli.
Lactobacilli are incredible microorganisms that are essential for maintaining the vaginal flora in the right range of acidity or “climate” within the vagina. Probiotics such as lactobacilli consume prebiotics, natural fibers and glucose found in ingredients like BiAloe®, in order to produce hydrogen peroxide and lactic acid as a natural defense against foreign bacteria. When lactobacilli are prominent, and the vaginal pH level is in an acidic state, your vaginal flora is in its ideal state.
One of the most critical drivers of life is climate. On Earth, animals tend to thrive in better environments that allow for vegetation to grow and have habitable conditions. The same can be said for the vagina.
However, whereas we may say a place is dry or humid, we measure the environment of the vagina using a pH scale (short for the potential of Hydrogen). To explain pH, think of an orange (acidic) as having low pH and a potato (alkalized also known as basic) as having high pH. Understanding the pH scale is going to be very important, so make sure you fully understand before continuing to read.
Now that we understand the prominent species (lactobacillus), the climate (acid pH) and landscape (vagina), or the vaginal flora. Let’s now take a look at how BV occurs
How BV Occurs
When the pH in the vagina changes, which could have been caused by many factors (more on this later), the opportunity for harmful bacteria known as anaerobes to overtake the vaginal flora increases. These anaerobes cause the symptoms of Bacterial Vaginosis to occur, which may include; unusual or foul odor, vaginal discharge, and vaginal itching. In some cases, the harmful bacteria can be aerobic as well.
Generally, good bacteria — such as Lactobacilli — are responsible for maintaining pH and the acidic environment of the vaginal flora. Think of them as moderators making sure everything is running smoothly by stopping the growth of harmful bacteria while preventing vaginal infections.
There are many opportunities for BV to be triggered, but the process is pretty much identical in all of them.
Whether its due to sex, diet, or lifestyle choices, when lactobacillus decrease in the vaginal flora, new harmful bacteria enter the body or pH increases on its own. The competition between the lactobacillus and anaerobes increases.
If there is a decrease of lactobacilli in the vaginal flora, then new anaerobes (bad bacteria) have entered, and the good bacteria hasn’t been restored. This can be due to the use of scented products or antibiotics that killed all the good bacteria. Then anaerobes have an advantage in consuming precious prebiotics and creating by-products such as toxins, which leads to a higher vaginal pH. This makes the vaginal flora even more basic, allowing for anaerobes to thrive and cause the symptoms of Bacterial Vaginosis.
If the vagina is moving towards a higher pH, not because of the quantity of good or bad bacteria has changed, lactobacillus becomes less efficient, cannot thrive in the vaginal flora, and allows anaerobes to colonize better and create their toxins.
So whether its because you aren’t eating enough yogurt or have just spent too much time in damp clothing after Orangetheory (yes, staying in damp clothes can cause BV), the result is always the same: Bad bacteria have the advantage to consume prebiotics, lactobacillus numbers begin to dwindle, and pH begins to rise, leading to the symptoms of BV.
What Causes BV?
There can be many things that can trigger BV, here are the top five remember and to take seriously:
- Your Diet. Even though diets might sound boring, remember what they are, opportunities for you to replenish your body with the nutrients they need to function well. That includes probiotics in the form of yogurt, prebiotics in the form of fibrous foods, and antioxidants in the form of healthy fruits. Your diet is essential to a well-maintained microbiome.
- Your Clothes. Have you ever come out of a Bootcamp or spinning class only to start your day with errands? Not the best move as staying in damp clothes changes the pH as well and is one of the easiest ways of getting BV. After exercise, time at the pool or beach or just because you sweat outside, make sure to clean up and dry up.
- Your Personal Care Products. Speaking of cleaning up, your personal care products, such as your soaps, rubs, or creams, can have chemicals and fragrances that can change the pH of your vaginal flora. Make sure to read the labels of the products you use and go as far as asking the company for information regarding the pH in their products.
- Your Sex Partners & Sex Toys. Did you know that semen has a pH higher than seven, and not cleaning your sex toys properly can lead to bacterial growth? Have the conversation with your sex partner or partners on maintaining good hygiene and make sure to clean your sex toys properly.
- Your Menstrual Cycle. Heres a great one as it’s something you will face every month. Your menstrual blood can have a pH over nine, and using tampons ensures that the blood collects and stays in the same place for hours at a time. Make sure to change your tampons or pads frequently!
What kind of Bacteria can cause BV?
Many types of harmful bacteria are capable of causing infections. Still, Gardnerella Vaginalis is the most common type of anaerobic bacteria in your vagina, and it is the one that must be dealt with to tame the symptoms of BV.
Gardnerella is shown to be sexually transmitted in some scenarios as the bacteria is common in men, however many studies have shown that women who have not had sexual intercourse can still experience BV. It’s believed that this bacteria can be the root cause of Bacterial Vaginosis amongst sexually active women, but other bacteria such as Prevotella, Peptostreptococcus, and Bacteroides can cause BV in other ways.
Gardnerella Vaginalis is capable of adhering to the vaginal mucosa, creating a biofilm, and competing with lactobacillus in order to dominate the vaginal flora. The species may also build symbiotic relationships with dormant vaginal anaerobes and cause other complications. For example, one study found that G. vaginalis may activate dormant E.coli bacteria leading to an increased risk of UTIs.
While there are biological factors that may cause Bacterial Vaginosis, specific habits or lifestyle choices may also increase your chances of getting BV. We cover some of these potentially harmful habits later on in the guide.
Who can get Bacterial Vaginosis?
Because there is such a range of ways that you can get Bacterial Vaginosis, most are at risk. Let’s remember, whether it’s because of diet, sex, wearing synthetic underwear, your menstrual cycle, or because of menopause, you can be at risk of experiencing Bacterial Vaginosis.
According to the Center for Disease Control and Prevention, nearly 21.2 million women will be affected by this recurring vaginal infection in the U.S. every year, making BV the most common anaerobic vaginal infection.
For the women who will experience this infection, only 50% will notice symptoms. That’s why it’s essential to have your regular checkups with your gynecologist or primary physician.
Now, if you’re worried about these numbers, don’t be! You should feel more comfortable that Bacterial Vaginosis is an infection that can go away naturally while minimizing future occurrences when addressed properly.
No, Bacterial Vaginosis is not a sexually transmitted disease, according to the Center for Disease Control. Nor should we consider it an STD even when BV occurs due to the high pH in semen or because of a transfer of G. vaginalis.
In fact, Bacterial Vaginosis is an anaerobic infection that occurs when harmful bacteria outnumber the good bacteria in your vaginal flora. There are so many reasons why bad bacteria can outnumber good bacteria that it would be considered irresponsible and not scientifically sound to call BV an STD.
Studies have shown, that because there is less naturally occurring lactic acid and hydrogen peroxide present in the vagina, having sex while experiencing Bacterial Vaginosis may increase your chances of getting a sexually transmitted infection (STI) or sexually transmitted disease (STD). This includes herpes, chlamydia, and gonorrhea.
The symptoms of BV can differ from person to person, but here are some general signs to look out for. Some women may experience no symptoms at all, meaning that they are asymptomatic. Other women experience mild symptoms of BV, whereas others may have multiple symptoms at the same time. The most identifiable BV symptoms include:
- An unusual or unfamiliar odor
- Substantial amounts of discharge, especially when you’re sexually active
- Vaginal discharge, which is thin and grayish in color
- Burning and itching while urinating
The biggest issue regarding these symptoms? They can easily be misdiagnosed for a different infection that displays similar symptoms. It’s vital that you are able to tell the difference between infections such as Bacterial Vaginosis, Vaginal Yeast Infection, Urinary Tract Infections, and Trichomoniasis.
In the end, you know your body best, so be conscience!
Make an appointment to see your doctor and/or Gynecologist if:
- You notice a new vaginal discharge or vaginal discharge that’s associated with an odor, discharge, vaginal itching, or burning sensation.
- You’ve had vaginal infections before, but this occurrence comes with new symptoms, such as odor, discharge, vaginal itching, or burning sensation.
- You have new or multiple sex partners or past partners who have had bacterial infections.
- Over-the-counter or home remedies are not treating the symptoms.
Ask your doctor for medical advice and what you can do.
What are the complications if BV is left untreated?
Bacterial Vaginosis is a treatable infection when appropriately diagnosed. However, until adequately treated, or if not treated at all, Bacterial Vaginosis is potentially harmful. The anaerobes that are present during the infection are capable of producing a dense biofilm, or a collection of bacterial mass, known as epithelium that hides and nurtures the harmful bacteria under it, making them less exposed to antibiotics, antimicrobials, and natural remedies. This makes BV hard to get rid of altogether.
While Bacterial Vaginosis doesn’t generally cause complications. Having Bacterial Vaginosis may lead to:
Pregnancy complications. In a 2006 study on pregnant women, Bacterial Vaginosis was associated with small birth weight and small size, but not with spontaneous preterm birth.
Sexually transmitted infections. According to the Center for Disease Control, having BV can increase your chances of acquiring an STD such as HIV, herpes simplex virus, chlamydia, or gonorrhea while also increasing the odds that you’ll pass the virus on to your partner.
Infection risk after gynecologic surgery. According to an article published by Mayo Clinic, having Bacterial Vaginosis may increase the risk of developing a post-surgical infection after procedures such as a hysterectomy or dilation and curettage (D&C).
Pelvic Inflammatory Disease (PID). PID is an infection of the female organs such as the uterus and the fallopian tubes. When this disease occurs, it can lead to an increased risk of infertility. Bacterial Vaginosis and other vaginal infections can lead to PID.
How is Bacterial Vaginosis diagnosed?
If you notice any changes in vaginal discharge or odor, see your doctor. They will determine whether or not you have BV based on four clinical criteria:
- Vaginal discharge was homogeneous;
- The vaginal discharge had a pH greater than or equal to 4.7;
- The vaginal discharge had an amine-like odor when mixed with 10% potassium hydroxide;
- Vaginal discharge contained clue cells representing greater than or equal to 20% of vaginal epithelial cells.
However, your visit to your primary physician or gynecologist may also include:
- Physical examination
- An assessment of your hygiene routine
- Assessment of your medical history
- Pelvic examination
- Swab test sample so that they can rule out other sexually transmitted infections such as gonorrhea or trichomoniasis
If you’re diagnosed with BV, don’t worry! The good news is that you can work with your doctor to ensure the right steps are taken so that it can be properly treated and managed.
How does a doctor treat Bacterial Vaginosis?
Typically, when your OB/GYN diagnoses you with Bacterial Vaginosis, they prescribe antibiotics as the treatment. Antibiotics are an antimicrobial that is used by medical professionals to fight off bacterial infections. This is accomplished by killing off and inhibiting the growth of bacteria.
Now we aren’t fans of antibiotics because of their effects on beneficial bacterial colonies. However, it’s essential that you know what doctors may prescribe you for BV.
Metronidazole (vaginal cream, vaginal gel, and pills) is one of the most commonly prescribed antibiotics for this condition. The second option is Clindamycin vaginal suppositories. Both of these conventional treatment strategies can be helpful, but they are not 100% fool-proof. This is because:
Conventional medicine is not capable of preventing recurrence of the infection. Nearly 60% of women who have been diagnosed with Bacterial Vaginosis will get experience it again, even after treatment.
Antibiotics may destroy the good bacteria as well, leaving you susceptible to other infections such as a yeast infection.
So here is where we get to the good stuff, how to address your current battle with Bacterial Vaginosis while minimizing future occurrences. So if you’re like us and you’d prefer not to take antibiotics or other prescribed medicine altogether, there are natural remedies you can experiment with.
Happy V Probiotic
This is your foundation! Happy V Probiotics are packed with six specific strains that introduce good bacteria to optimize the pH level of your vaginal flora.Shop Now
Vaginal probiotics are vital! They provide healthy strains of bacteria to your vaginal flora so that you can continue to produce the natural defenses the vaginal flora needs to be balanced. A great habit you can start right away is taking a probiotic supplement in order to introduce new lactobacilli to the body. If you want to do more than just take a supplement, you can also pair it by adding probiotic-rich foods into your diet. These foods include yogurt, kefir, and fermented foods such as kimchi.
Prebiotics have been a hot topic as of late. With eveyone know understanding the importance of consuming probiotics they are wondering how to take their microbe game up a notch. That’s where prebiotics come in! Prebiotics are the dietary fibers and glucose that probiotics consume in order to make lactic acid and hydrogen peroxide. By adding prebiotics to your vaginal wellness routine, you ensure that probitoics are constantly feasting in order to function properly!
Cranberries are filled with amazing antioxidants known as proanthocyanadins, or PACs. These compounds keep your vaginal wellness optimal by not allowing bacteria to stick the urinary tract and create biofilm. What this means is that when you consume cranberry extract, like Pacran found in Happy V Immune Boost, you begin the process of flushing bacteria out of your body. So, next time when you’re ordering a fresh juice try opting for a cranberry juice or you can also have them as supplements – like in our happy V daily Pack!
How to Prevent Bacterial Vaginosis
If you’re perfectly healthy and your vagina is living its best life, then keep doing you!
Now, if you want to take your vaginal wellness to the next level and prevent future occurrences, we hope the list below will help you do so.
Lifestyle Choices for Minimizing BV
We believe in safe sex! However, certain chemicals in condoms, vaginal lubricants, and spermicides may cause irritation in some people. The chemicals in these products can disrupt your vaginal pH and encourage bad bacteria to grow. If you have an adverse reaction to a particular condom, try a new brand!
Don’t wear tight underwear — especially those that are made of synthetic fibers. Your vagina needs to breathe!
Avoid douching, please! Douching washes away the harmful bacteria, but it also removes the good bacteria and replaces it with scented chemicals that could change your vagina’s pH. All that this is going to do is once again throw your vaginal ecosystem off balance. Your vagina is perfectly capable of cleaning itself, and introducing chemicals to feel “fresh” does the opposite — literally! Instead, washing your vulva with mild, unscented soap, or just plain water is the healthiest way to clean.
Avoid foods that have high amounts of sugars. Bad bacteria love glucose, the broken-down substance within sugary foods and drinks. So either reduce the amount of added sugars in your diet or remove it altogether. That means alcoholic beverages with sugary mixes as well.
During your menstrual cycle, make sure to change your tampons, pads, or menstrual cups. The pH of blood is higher than that of the vaginal flora. Having too much blood in the same area for a prolonged period of time can increase pH levels.
Staying in wet clothes after a swim or exercise session creates the optimal conditions for vaginal infections. Bacteria love warm, moist, and humid environments. So don’t just sit around in wet clothes, change and keep your vaginal area as dry as possible.
Just as scented tampons or pads can irritate your skin, products such as soap, laundry detergents, and scented or colored toilet paper can also make you more susceptible to vaginal infections.
We need to discuss the other place where germs naturally occur – your anus. The proximity between your vagina and anus matters. If those germs manage to get near or into your vagina, the likelihood of infection increases.
Always remember to wipe carefully after using the bathroom. Use different toilet paper between your vagina and anus – the same paper should not be used interchangeably!
And remember – try a great supplement routine that gives you the right dose of clinically proven ingredients that were made for vaginal wellness, Like Happy V’s Over the Counter BV Treatment. We made it for one reason only – Optimizing Total Vaginal Wellness.
Sex-based risk factors
Just like any infection, transmission during sexual intercourse, or physical contact from one individual to another is possible. Knowing how to keep sex-based risk low is essential.
We know that unprotected sex can impose a serious threat to overall health, but did you know that it can also lead to BV even if both partners are free of disease and infection? This is because semen tends to have a higher pH than that of the vagina, potentially leading to Bacterial Vaginosis.
New or Multiple Sex Partners
Because semen can change the pH of the Vagina, it is easy to understand that having new or multiple partners will make you susceptible to BV due to the difference in the body’s chemistry from person to person.
Always ? Clean ? Your ? Toys! ? Make sure to clean your toys properly after each use — as not cleaning was shown to have an association with BV. Infections can occur if sex toys are not properly cleaned.
Excessive usage of certain medications and devices can cause an imbalance in your vaginal flora, too.
- Antibiotics are used to treat infections caused by bad bacteria but can also kill off the good bacteria. This makes you susceptible to other types of infections.
- Studies show that having an IUD (contraceptive device) can increase your chances of getting Bacterial Vaginosis. If you have had an IUD, make sure to inform your doctor when seeking treatment.
We know navigating vaginal health can seem overwhelming, that’s why we’re here to help! We hope that this guide has been informative and has given you a sense of what BV is, how it can be treated, and the best means for prevention.
If you believe you have BV, ask your doctor about Bacterial Vaginosis for more information.
You can let us know if you have any questions by asking here.
“Bacterial Vaginosis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 July 2017, www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279.
“Bacterial Vaginosis and Contraceptive Methods.” NeuroImage, Academic Press, 25 Aug. 2000, www.sciencedirect.com/science/article/pii/S0020729200002174.
“CDC – Bacterial Vaginosis Statistics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/std/bv/stats.htm.
“CEArticle.” An Updated Review to Discourage Bacterial Vaginosis | Article | NursingCenter, www.nursingcenter.com/cearticle?an=00005721-201003000-00008&Journal_ID=54021&Issue_ID=984108#P76.
Eschenbach, D A, et al. “Diagnosis and Clinical Manifestations of Bacterial Vaginosis.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Apr. 1988, www.ncbi.nlm.nih.gov/pubmed/3259075.
Hill, G B. “The Microbiology of Bacterial Vaginosis.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Aug. 1993, www.ncbi.nlm.nih.gov/pubmed/8357043.
Marrazzo, J M, et al. “Characterization of Vaginal Flora and Bacterial Vaginosis in Women Who Have Sex with Women.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 1 May 2002, www.ncbi.nlm.nih.gov/pubmed/12001048.
Mijac, V D, et al. “Hydrogen Peroxide Producing Lactobacilli in Women with Vaginal Infections.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Nov. 2006, www.ncbi.nlm.nih.gov/pubmed/16814920.
Patterson, Jennifer, et al. “Analysis of Adherence, Biofilm Formation and Cytotoxicity Suggests a Greater Virulence Potential of Gardnerella Vaginalis Relative to Other Bacterial-Vaginosis-Associated Anaerobes. – Semantic Scholar.” Undefined, 1 Jan. 1970, www.semanticscholar.org/paper/Analysis-of-adherence,-biofilm-formation-and-a-of-Patterson-Stull-Lane/1d7a202f4442b090076d96216f094171a934dff0.
Thorsen, P, et al. “Bacterial Vaginosis in Early Pregnancy Is Associated with Low Birth Weight and Small for Gestational Age, but Not with Spontaneous Preterm Birth: a Population-Based Study on Danish Women.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Jan. 2006, www.ncbi.nlm.nih.gov/pubmed/16492583.
Wiesenfeld, et al. “Bacterial Vaginosis Is a Strong Predictor of Neisseria Gonorrhoeae and Chlamydia Trachomatis Infection.” OUP Academic, Oxford University Press, 1 Mar. 2003, academic.oup.com/cid/article/36/5/663/456379.