Bacterial Vaginosis: The Lowdown

First of all let’s talk about what BV is and what it isn’t.

BV is NOT a sexually transmitted disease. BV is an overgrowth of certain types of bacteria in the vagina. Your vagina has what is called a normal flora. If you remember from biology that is the environment where different microorganisms, in this case, bacteria and fungi naturally occur. When this environment is disrupted in the vagina, it can cause Bacterial Vaginosis. BV is characterized by malodorous discharge often described as fishy, vaginal irritation, and loose watery discharge.

So what disrupts the normal flora of the vagina, you ask? What doesn’t??! There are soooooo many things that could cause a disruption. Chronic BV sufferers are just more sensitive to those changes than others. This article could help you find your triggers, so you can get to the bottom of your reoccurrences. Is it that nightly glass or two of wine? Or is it that new vanilla scented soap?

Let’s get into the things that cause the disruption and what we can do about it!

1.) Penetration– of any kind, this includes your toys. Make sure that you are washing them with soap and warm water after every use. Penile sex can cause a disruption with or without condoms. If you get BV after sex there are a few things you can do to try to help.

If you’re having sex without a condom, you could:

-use condoms (I have to give you the lowdown lol)

-make sure that your partner takes a shower before sex.

-use use the withdrawal method to prevent semen from entering the vagina.

-insert a boric acid suppositories after sex to reset and balance the vaginal flora. 1 boric acid suppository into the vagina after intercourse may help prevent BV from occurring, you could do a couple more nights if possible.* Please please avoid having oral or penetrative sex for 24-48 hours after insertion.

If you are having sex with condoms, you could:

-Try a different brand of condoms

-Use the boric acid method as described above

*Also watch for lubricants that throw you off, water based is the preferred lubricant.

2.) Diet: A healthy diet does the body good! And the vagina is no exception. Drinking lots of water. Staying away from excess sugar and alcohol. I mean it! Often times, when a patient comes back with recurrent vaginal infections I check an A1c, which is a blood test for blood sugar levels and Diabetes. Often times the level is elevated. Both yeast and bacteria love sugar! Alcohol disrupts the vaginal microbiome directly and weakens the immune response, not to mention all the sugar in some of your favorite wines. Put the sweets down and watch your vagina thrive! Remember even too much of natural sugars from fruits can have the same effect.

*If you have a family history of Diabetes, and recurrent vaginal infections, you should have an A1C drawn.

3.) Hormones -Hormones that are out of whack can directly affect the growth of bacteria. And you’re like what can I do about this??? Sometimes getting on birth control might be the answer to regulate your hormones in such a way that recurrent infections stop. Sometimes getting off of a certain birth control could help stop recurrent infections, everyone’s body reacts differently to certain birth controls. DIM is a natural hormone modulator that might help. Pregnancy also increases your risk of recurrent vaginal infection due to the obvious hormonal changes.

4.) Your menstrual cycle – This could have to do with the hormonal changes from your menstrual cycle and/or the blood from your cycle can disrupts your normal flora. Boric acid suppositories nightly after your cycle could also help prevent BV by restoring you pH. Your vagina is acidic & blood is slightly basic. Think back to chemistry class, finally that knowledge comes in handy lol. You may even be able to take a birth control in a continuous manner, so that you don’t have a menstrual cycles.

4.) Hygiene – Self explanatory. Wash it. Put clean underwear on it & repeat.

5.) Stress – Some women find this as a surprise, but emotional stress is bad for your health! Studies have shown that depressed individuals report bacterial vaginosis more frequently because chronic stress alters your immune response! Find ways to relieve stress and promote your wellbeing could also help keep your vagina happy!

6.) Tight, restrictive clothing – Let your vagina breathe! Tight clothing can reduce airflow to the vagina and promote overgrowth of bad bacteria.

7.) Soaps – My thoughts on soap is to do what works best for you. I’ve heard providers tell women not to wash with soap down there. All though it is not necessary, I don’t think its a bad idea to use soap. Washing with soap should help eliminate sweat, buildup, and mustiness . If soaps irritates your vulva, then switch to unscented soap, as perfumes can cause irritation and changes in flora. However, the inside of the vagina and its opening are self-cleaning, so do not use soap inside and absolutely no douching!

8.) Infidelity – I’ve been asked this question so many times, is my man cheating on me if I have BV or keep getting BV? Let’s put it like this….he could be, but the BV isn’t proof of that. You might get recurrent BV with a specific partner and not another, why? It could be that guy is carrying a BV causing bacteria OR his semen composition disrupts your vaginal peace. Although not routinely done, consider treating your partner with oral antibiotics! Or find a new man lololol

JUST FYI

Improper use or repetitive use of antifungals may promote the growth of bacteria in the vagina by killing the yeast that keeps it in check.

There are several different prescription regimens for BV – Trying a different medication to treat BV might help. The most commonly used medication is metronidazole, but there are others. Whatever you take, take it as prescribed by your provider!

Again, consider treating your partner with oral antibiotics after multiple recurrences.

Natural support

Probiotics can help promote normal flora. Vaginal probiotics could also be of benefit.

Oral garlic daily – garlic is a natural antibiotic.

Oral vitamin C to boost your immune system and help promote the acidity of the vagina. Vitamin C can also be used vaginally, if you can tolerate it.

DIM for hormonal support as previously stated.

Boric acid suppositories nightly for 2 weeks can help reset the vaginal flora.

I understand that Bacterial Vaginosis can be sooo frustrating especially if it is recurrent, and I hope this article gives you the tools to keep you balanced and healthy.

Stay Fresh my friends!

G’vanni Whyte, DNP