Summary
Curious about what might be causing unusual vaginal symptoms? In her latest blog, Mary Cabell, MSN, APRN, FNP-C, dives into bacterial vaginosis (BV)—a common yet often misunderstood condition. Discover why BV isn’t an STI, learn about its telltale signs like discharge and odor, and explore effective treatments to help you feel like yourself again. If you’ve ever wondered about changes down there, this article is a must-read to get informed and take control of your health.
So, What’s the Deal with Bacterial Vaginosis (BV)?
Bacterial vaginosis, more commonly known as BV, is the most common cause of vaginitis in females of childbearing age and one of the most common complaints we see in the XXpressGyn Care clinic.
To answer the most common question I get—no, this is not an STI (Sexually Transmitted Infection)! There may be a sexual component, though, which we will discuss later.
BV is a condition where the balance of bacteria in the vagina changes, leading to an increase in vaginal pH. Normally, the vaginal pH is between 4 and 4.5, but it rises above 4.5 in BV cases.
What Causes BV and What Are the Symptoms?
In a healthy vaginal environment, the bacteria Lactobacillus helps keep things balanced. With BV, there’s a shift from Lactobacillus to a mix of other bacteria, which leads to a higher pH and symptoms.
Common symptoms of BV include a thin, grayish-white vaginal discharge and a fishy odor, which can become stronger with sexual activity or during menstruation. Some women may not have any symptoms at all.
What Are the Risk Factors?
While BV is not an STI, it can be associated with having multiple sex partners, a new sex partner, and not using condoms. Other risk factors include having
- STIs
- Douching
- Smoking
- High-fat diets
- Overweight or obese
BV can also increase the risk of complications during pregnancy and other gynecologic infections.
How Is BV Diagnosed?
To diagnose BV, we use the Amsel criteria, which involves checking for three out of four key indicators: a thin, grayish-white discharge, a higher-than-normal vaginal pH, a fishy smell, and the presence of clue cells in a sample. Clue cells are vaginal cells coated with bacteria, and their presence is a strong sign of BV.
When you come in with concerns about vaginal discharge, we’ll do a physical exam to check for other possible causes. At the Couri Center, we also take a swab during the exam and send it to the lab for testing. We’ll check for other conditions like yeast infections, trichomonas, gonorrhea, and chlamydia.
How Is BV Treated?
BV is usually treated with antibiotics. The most common treatments are either a vaginal or oral form of metronidazole. There are also newer options like Solosec, Clindesse, Xaciato, and Nuvessa, which are convenient because they only require one dose. Your healthcare provider will choose your best treatment based on your specific needs.
What If BV Keeps Coming Back?
BV can sometimes come back multiple times. If you have three or more episodes in a year, your provider might recommend a longer or different treatment plan to help manage it.
Can Boric Acid Help?
You might hear about using vaginal boric acid suppositories. They’re not just for initial treatment but can be used along with antibiotics and for some time after to help restore normal vaginal pH levels.
I hope this article clears up any confusion about bacterial vaginosis. If you have any questions or concerns, please contact your provider. We’re here to help.
Mary Cabell, MSN, APRN, FNP-C
DISCLAIMER: The information on this website is intended for general informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. The information provided is current as of the date of publication or last review, but medical knowledge is constantly evolving, and the information may become outdated over time.
References:
Occhipinti, S., Giosuè Giordano Incognito, & Palumbo, M. (2024). The influence of the vaginal ecosystem on vaginitis, bacterial vaginosis, and sexually transmitted diseases: an epidemiological study and literature review. Archives of Gynecology and Obstetrics. https://doi.org/10.1007/s00404-024-07626-8
Sobel, J. (2024, August 12). Bacterial vaginosis: Initial treatment. Uptodate.com. https://www.uptodate.com/contents/bacterial-vaginosis-initial-treatment?search=bacterial%20vaginosis&source=search_result&selectedTitle=4%7E92&usage_type=default&display_rank=4
Sobel, J., & Mitchell, C. (2024, July 24). Bacterial vaginosis: Clinical manifestations and diagnosis. Uptodate.com. https://www.uptodate.com/contents/bacterial-vaginosis-clinical-manifestations-and-diagnosis?search=bacterial%20vaginosis&source=search_result&selectedTitle=3%7E92&usage_type=default&display_rank=2