Unlike trichomoniasis, bacterial vaginosis (BV) is not sexually transmitted. Despite this fact, this infection is linked to sexual activities because being sexually active can contribute to contracting the condition. It is believed that sex may change the vagina’s bacterial environment. In its essence, bacterial vaginosis is a vaginal infection in which a bacterial imbalance occurs. This imbalance is a result of the overgrowth of normal bacteria that occupy the vagina.

Bacterial vaginosis does not cause itching or soreness, but the one telltale sign is abnormal vaginal discharge that is gray or off-white in color and emits a strong fishy smell. This infection is mostly found in women in reproductive years (15 to 44 years old). However, this does not rule out the possibility that other age groups will not be affected.

Risk factors of bacterial vaginosis

Although anyone with a vagina can get BV, this condition usually affects sexually-active women compared to those who have not had sex. The risks for bacterial vaginosis are particularly higher if you:

• Are pregnant
• Are sexually active
• Smoke
• Douche. Douching refers to the activity of cleaning and washing the vagina with a mix of substances (vinegar/baking soda/iodine) and water. Douching as well as the use of perfumed soaps can distress the natural balance of bacteria.
• Have multiple sexual partners. Although it is not clear why, females who engage in sexual activities with other females have higher risks of getting bacterial vaginosis.
• Have an intrauterine device (IUD). IUD is a contraceptive method where a T-shaped device is inserted into the uterus to prevent pregnancy. The incidence rate for getting BV among IUD users is 37%.
• Are not using condoms or dental dams

How is BV different from yeast infections and trichomoniasis?

Bacterial vaginosis, yeast infections and trichomoniasis are infections affecting the vagina that cause inflammation and discomfort. However, the three are by no means the same. While bacterial vaginosis is caused by bacteria that overgrows, yeast infections result from fungus (candida) and a protozoan parasite (Trichomonas vaginalis) is the culprit behind trichomoniasis.

Both bacterial vaginosis and yeast infections cause vaginal discharge and this can confuse people, but the one factor that tells if a person has bacterial vaginosis instead of trichomoniasis is the fishy odor. In yeast infections, vaginal discharge may have cottage cheese consistency but it does not smell. Another important note is the fact that bacterial vaginosis does not cause irritation or itchiness while yeast infections do.

Symptoms and diagnosis of bacterial vaginosis

• 50% of bacterial vaginosis cases show no symptoms, but when symptoms are present, the following might happen:
• Burning sensation during urination
• Gray or off-white vaginal discharge
• Fishy odor from the vaginal discharge that is usually the strongest after sex
• In very rare cases, itchiness or soreness may take place
• Fever

Diagnosing bacterial vaginosis is done by taking a sample of the vaginal fluid to be observed under the microscope or sent to the laboratory for more analysis. Your doctor or healthcare professionals may also inquire about your medical history, carry out a physical examination, conduct a pelvic exam, and review the vagina’s pH level.

Treatment for bacterial vaginosis

Although sometimes bacterial vaginosis can clear up on its own without the help of medications, women who have symptoms should consult a doctor. Bacterial vaginosis is usually treated with antibiotics (metronidazole, clindamycin, and tinidazole). Not limited to consuming the antibiotics orally, it can also take the form of a cream or gel which will need to be inserted into the vagina.

Most treatments normally last from 5 to 7 days. Even after the symptoms seem to subside or go away, any infected person should finish the antibiotic course. Not finishing the prescribed amount of antibiotics may mean that the infection will come back. No over-the-counter treatments are available to treat bacterial vaginosis. Treatment should be administered by healthcare professionals. Do consider seeing them when you notice something unusual with your vaginal discharge (change in color and consistency as well as strong fishy smell).

Bacterial vaginosis can come back even after treatment. As this infection can spread due to sex (female to female), abstaining from any sexual activities is imperative until the infection clears up. If recurrent bacterial vaginosis happens because of IUD, you might want to consider a different contraceptive method.

Bacterial vaginosis usually does not lead to other health problems. However, if left untreated, this infection may increase the likelihood for contracting chlamydia, herpes and gonorrhea. Besides risks for those diseases, BV can also heighten risks for pelvic inflammatory disease (PID) and infections in the uterus, fallopian tubes and ovaries. In pregnant women, bacterial vaginosis may cause complications such as early delivery or underweight newborns.

Preventing bacterial vaginosis

There are no sure ways to fully prevent bacterial vaginosis, but taking these steps might lower the risks:

1. Stay away from douching. As explained above, douching upsets the balance of bacteria. This also means avoiding perfumed soaps, bubble baths and other scented bath products.
2. Always use condoms or dental dams.
3. Anything that has touched your anus should never make contact with the vagina. This includes toilet paper and sex toys. It is imperative that every sex toy should be properly cleaned and stored after every use.
4. Wear underwear that is made of cotton instead of synthetic fabrics such as nylon or lycra. Bacteria flourish in moist environments. Wearing cotton underwear helps absorb moisture.
5. Be careful who you have sex with and know their sexual history
6. Always wipe from front to back to avoid the transfer of bacteria from the anus to the vagina
7. Get regularly tested to know your sexual health status if you are sexually active

One important way to make sure that you are sexually healthy is by getting regular STD testing. Shim Clinic is a STD clinic that provides  STD tests, diagnosis and STD treatments. We also carry STD prevention methods such as HIV PrEP, HIV PEP (best taken within 72 hours after a possible exposure) and HPV vaccination (Gardasil-9).