Bacterial Vaginosis Infection (BV): Symptoms and Causes Explained

Bacterial vaginosis infection or (BV) is a common infection of the vagina that affects millions of women around the globe. BV is often misunderstood, with most women not even knowing that they have it despite its prevalence.

Reviewing the symptoms and causes of bacterial vaginosis becomes vital in managing the infection and preventing recurrence.

What is Bacterial Vaginosis Infection

Bacterial vaginosis is caused by an imbalance in the normal bacteria that live in the vagina. The vagina hosts many bacteria, the majority of which are Lactobacillus species.

These “good” bacteria maintain an acidic environment in the vagina to protect against infection. However, if the balance of bacteria becomes disturbed, the multiplication of harmful bacteria may develop symptoms and thus BV causes risks for other diseases.

BV is not classified as a sexually transmitted infection, although it is more common in sexually active women. It affects women of all ages. Although it is treatable, BV sometimes recurs.

Symptoms of Bacterial Vaginosis

Many women do not have symptoms of BV, or they have mild ones, making the infection hard to detect without a medical test. If symptoms occur, these may include:

• Unusual Vaginal Discharge: The most common symptom of BV is a thin, grayish-white vaginal discharge. It may have a “fishy” odor. After sexual activity or during your period, the discharge might be more noticeable.

• Smell: The fishy smell, sometimes described as unpleasant, is characteristic of BV. In most cases, the odor might be more pronounced after sex because of changes in the vaginal pH.

• Vaginal itching or irritation: While itching or irritation around the vagina may affect certain women, this symptom is experienced by a lesser number as compared to other symptoms such as odor and discharge.
• Burning Sensation: Some have experienced a burning sensation while urination or sexual intercourse, although infrequent in comparison with the occurrence of other symptoms.

Note that BV is different from other infections of the vagina, including yeast infection and trichomoniasis. Each has different symptoms. If you are experiencing any of the above symptoms, see your healthcare provider for a proper diagnosis and treatment.

Causes of Bacterial Vaginosis Infection

The exact cause of bacterial vaginosis infection is not fully understood, but a number of factors predispose individuals to the condition. Some of the known causes and risk factors that predispose individuals to BV include:

Imbalance in Vaginal Flora:

BV occurs when normal vaginal flora is disrupted. Usually, the lactobacillus bacteria dominate the vaginal environment.

These are outnumbered by bacteria such as Gardnerella vaginalis. This overgrowth of bacteria allows the bad bacteria to prosper and cause symptoms of BV.

Sexual Activity:

While BV is not considered an STI, sexual exposure does increase the risk for the condition. This includes multiple sexual partners or a new partner, as this can introduce new bacteria into the vagina.

The use of scented products, such as soaps or douching after sex, can also lead to an imbalance in the flora of the vagina.

Douching:

Douching, or washing the inside of the vagina with water or other liquids, can upset the natural balance of bacteria in the vagina. It can wash away beneficial bacteria and promote the growth of harmful bacteria. Health professionals recommend avoiding douching to prevent BV and other vaginal infections.

Antibiotics:

The use of antibiotics, while effective at treating bacterial infections, can alter the vaginal flora. Antibiotics may kill off beneficial bacteria along with harmful ones, making it easier for harmful bacteria to proliferate and cause BV.

Pregnancy:

The risk is high in pregnant women due to the change in hormonal balance and vaginal environment. In pregnant women, BV may increase the risk of delivering prematurely and with low birth weight if it is not treated.

Increased pH Levels:

Increased pH, less acidic in the vagina, would favor the overgrowth of pathogenic bacteria. These imbalances may also be due to factors such as menstruation, sexual intercourse, and menopause that may alter the pH to favor BV.

Weakened Immune System:

Any woman with weakened immunity-for instance suffers from HIV/AIDS or some form of immunosuppression at a greater possible risk for BV.

Hormonal Changes:

The hormonal balance, especially in pregnancy or menopause, may alter the vaginal environment and predispose it to infection with BV.

Diagnosis of Bacterial Vaginosis Infection

If you suspect you have BV, you should consult your doctor for an accurate diagnosis. The gynecologist or primary care physician will perform a pelvic examination and may collect a specimen of your vaginal discharge.

A sample is viewed under a microscope, and other tests, such as a pH test, are available to confirm the presence of BV. A culture or other laboratory tests may be done to rule out other infections.

Bacterial Vaginosis Infection Treatment

Fortunately, bacterial vaginosis is curable using antibiotics. Antibiotics prescribed for BV usually come in oral medication or topical creams and gels. Some of the most commonly prescribed antibiotics for BV are as follows:

• Metronidazole (Flagyl): It comes both as an oral and topical (gel) version, although metronidazole is among the most effective therapies against BV.

• Clindamycin: This is available in oral and topical formulations and has a similar mode of action to metronidazole.

The course of antibiotics should be taken as prescribed, even if symptoms resolve before the treatment course is completed. Failure to complete the course can result in recurrence of the infection or the development of antibiotic resistance.

Prevention of Bacterial Vaginosis Infection

While BV can be treated, it may also recur. To prevent getting BV again, the following preventive measures can be taken:

• Do not douche: Douching will upset the normal balance of bacteria in the vagina and increase your risk for BV. It is wise to avoid douching.

• Practice safe sex: Condoms may lower your risk for BV by reducing the contact with bacteria that may cause the infection during sexual activities.

• Limit Sexual Partners: The risk of BV increases with multiple sexual partners due to the introduction of new bacteria. This risk is reduced when there are fewer partners.

• Maintain Good Hygiene: Although personal hygiene in the genital area is essential, harsh soaps or scented products irritate the vagina. The outer genital area should be cleaned with mild, unscented soap.

• Probiotics: The consumption of probiotics through foods such as yogurt or in supplement form may help restore the normal balance of vaginal bacteria and, in turn, prevent recurrence.

What is Bacterial Vaginosis Yeast Infection

A yeast infection, also known as vaginal candidiasis, is a type of infection caused by the overgrowth of Candida fungi, which naturally exist in small amounts within the vagina.

The most common species that causes yeast infection is Candida albicans. Ordinarily, yeast infections occur when there is an alteration in the normal balance of yeast and bacteria in the vagina. This can be from:

• Use of antibiotics, which kill off friendly bacteria that would usually keep the yeast population under control.

• Hormonal shifts, such as those that occur during pregnancy or menopause.

• High blood sugar levels may promote the growth of yeast in diabetic women.

• Wearing tight, non-breathing clothing creates a warm, moist environment for yeast growth.
• Weakened immunity-a typical result of HIV or immunosuppressive therapy.

The typical symptoms of a yeast infection include:

• Itching or irritation in and around the vagina

• Thick, white, cottage cheese-like discharge, often odorless

• Burning during urination or intercourse

• Redness and swelling of the vaginal lips

Is BV Infection Dangerous?

Infections (STIs):

The most severe risk of BV is the increased vulnerability to sexually transmitted diseases. The disturbed balance of bacteria in the vagina promotes the infection of the vaginal tissues by harmful pathogens like Chlamydia, Gonorrhea, and HIV.

Since the protective barrier of Lactobacillus bacteria is disrupted, women with BV are more susceptible to the acquisition of STIs; their vaginal environment is more suitable for the development of certain harmful bacteria and viruses.

Pelvic Inflammatory Disease:

In the absence of treatment, BV can result in a condition whereby bacteria travel upwards from the vagina to the upper reproductive organs, and is known as pelvic inflammatory disease.

PID involves infection of the uterus, fallopian tubes, and ovaries, including long-term complications such as chronic pelvic pain, infertility, and a predisposition toward ectopic pregnancy.

Pregnancy Complications:

BV can be particularly dangerous during pregnancy. Studies have shown that pregnant women with BV are at a higher risk for the following complications:

1. Preterm birth: BV is associated with a higher risk of preterm delivery, which may also lead to complications in the baby, such as low birth weight.

2. Miscarriage: There is some evidence suggesting BV may increase the risk for early pregnancy loss.
3. Infections after delivery: With BV, there is a possibility that women may run a higher risk of developing infections after childbirth, such as uterine infections, which could delay the healing process.

4. Low birth weight: Babies born to mothers with untreated BV are at a higher risk of having low birth weight and may further develop other health problems.

5. Increased risk of postoperative infections: If you plan to undergo any surgical operation such as a hysterectomy or any other kind of gynecological surgery, untreated BV will make you more susceptible to infection after the surgery. The bacteria can spread from the vagina to the surgical site and complicate recovery.

Conclusion

Bacterial vaginosis is an infection of the vagina that results from an imbalance of bacteria inside the vagina. Many women never show symptoms, but the condition can cause discomfort and odors.

Knowing the causes and symptoms, ways of prevention, and treatment options will help women take specific measures to keep their vaginas healthy to avoid recurrence. If you believe that you might have BV, seek diagnosis and then treatment from a healthcare provider.