Bacterial Vaginosis (BV) is the most common cause of vaginal infection among women of reproductive age. It results from an upset in the naturally occurring microbial community inside the vagina, where beneficial bacteria are significantly reduced, allowing other types of bacteria to overgrow. A common concern is whether routine hygiene products, specifically antibacterial soaps, contribute to this imbalance. These cleansing products are designed to kill microorganisms indiscriminately, raising questions about their effect on the delicate vaginal ecosystem. This article investigates the link between antibacterial soap use and the development of BV.
What is Bacterial Vaginosis
Bacterial Vaginosis is a state of microbial imbalance, or dysbiosis, within the vagina. It occurs when the diverse community of microorganisms shifts away from its healthy, protective state. Although not classified as a sexually transmitted infection, sexual activity can influence the risk of developing it.
Common symptoms include a thin, gray, or off-white vaginal discharge and a strong, unpleasant “fishy” odor, often noticeable after intercourse or during menstruation. While some people experience itching or irritation, up to 84% of those with BV may experience no symptoms at all.
The Essential Role of the Vaginal Microbiome
The vagina maintains a self-regulating environment, primarily protected by its unique microbial community, known as the vaginal microbiome. This ecosystem is typically dominated by beneficial bacteria, most notably Lactobacilli species. These protective bacteria keep the vaginal environment in a healthy state.
Lactobacilli maintain a highly acidic environment by processing glycogen into lactic acid. This results in a low pH level, typically ranging from 3.5 to 4.5. This low pH acts as a chemical barrier, inhibiting the growth of most harmful bacteria and pathogens.
BV develops when the population of Lactobacilli declines and the protective acidic environment is lost. When the pH rises above 4.5, it allows other, less beneficial anaerobic bacteria to multiply and become dominant. This shift is the biological basis of BV.
How Antibacterial Soap Disrupts Natural Balance
The use of antibacterial soap in the genital area disrupts the delicate balance of the vaginal microbiome. Most conventional soaps, especially antibacterial varieties, are inherently alkaline, possessing a pH level significantly higher than the vagina’s natural acidity. Introducing an alkaline substance to the vulva can neutralize the protective lactic acid film, causing the pH to rise.
This rise in pH is detrimental to Lactobacilli, which require acidic conditions to thrive. Furthermore, antibacterial soaps contain active antimicrobial chemicals, such as triclosan, designed to kill bacteria indiscriminately. These chemicals cannot differentiate between harmful bacteria and the beneficial Lactobacilli that provide protection.
The combined effect of high alkalinity and bactericidal chemicals eliminates the protective Lactobacilli population. This dysbiosis removes the natural defense mechanism, allowing BV-associated bacteria to proliferate unchecked. Studies show that harsh soaps used on the vulva are associated with an increased risk of developing Bacterial Vaginosis.
Recommendations for Genital Hygiene
The general recommendation for maintaining genital health is to allow the vagina to clean itself naturally through its normal secretions. For external cleansing of the vulva, using only plain warm water during a shower is usually sufficient to remove sweat and normal discharge.
If a cleansing agent is desired, it should be a mild, non-perfumed, and non-antibacterial soap. Scented or harsh products can irritate the sensitive vulvar skin and increase the risk of upsetting the microbial balance. No soap, whether antibacterial or regular, should ever be used to wash inside the vagina.
Practices like douching, which involves rinsing the inside of the vagina, are strongly advised against. Douching forcibly removes the Lactobacilli and washes away the protective acidic environment, making the development of BV much more likely. Hygiene should focus on gentle, external cleaning to avoid disrupting the body’s natural defense system.