Bacterial Vaginosis (BV) is a common condition involving a shift in the balance of bacteria within the vagina. This imbalance often prompts questions about its effects on the body, particularly concerning urinary habits. This article explores the connection between BV and the sensation of needing to urinate frequently or with urgency.
What is Bacterial Vaginosis
Bacterial vaginosis is characterized by a disruption in the vaginal microbiome, resulting in an overgrowth of certain anaerobic bacteria. This shift involves a decrease in protective Lactobacilli bacteria, which normally maintain the vagina’s healthy acidic environment. The resulting environment becomes less acidic, often exhibiting a vaginal pH higher than 4.5.
The most recognized symptoms of BV involve the vagina itself. A thin, gray or whitish discharge is common, often accompanied by a distinct, fishy odor. This odor may become more noticeable after sexual intercourse or during menstruation. However, up to half of all people who have BV may not experience any noticeable symptoms.
Explaining BV’s Effect on Urinary Urgency
Although bacterial vaginosis is a vaginal infection and not a urinary tract infection, it can influence urinary symptoms, including the feeling of needing to urinate frequently. The anatomical structures of the female pelvis place the vagina in close proximity to the urethra and the bladder. The inflammation and irritation caused by the bacterial overgrowth can spread to and irritate the nearby urinary opening and surrounding tissues.
This localized irritation can cause symptoms like burning during urination and a heightened sense of urinary urgency or frequency, mimicking a urinary tract infection (UTI). Research also suggests that bacteria associated with BV, such as Gardnerella vaginalis, may produce compounds that affect the bladder muscle. These compounds can cause the bladder to contract unnecessarily, creating a frequent urge to urinate. Studies show that women with BV have greater odds of experiencing urgency urinary incontinence than those without the condition.
Other Factors Leading to Frequent Urination
Frequent urination is a symptom associated with many different conditions, not just bacterial vaginosis. The most common alternative cause is a urinary tract infection (UTI), which causes a persistent, strong urge to urinate, often with pain or burning. Certain dietary choices can also increase urinary frequency because they act as diuretics, including excessive consumption of caffeine, alcohol, or highly acidic beverages.
Other underlying health issues can also contribute to this symptom. These include uncontrolled diabetes, where the body attempts to flush out excess glucose through the urine. Conditions like interstitial cystitis, which causes chronic bladder wall irritation, or an overactive bladder (OAB) syndrome can also result in persistent urgency and frequency. Additionally, some medications, such as diuretics, are designed to increase the output of urine.
Medical Diagnosis and Treatment
If you are experiencing frequent urination alongside other vaginal symptoms, seek a professional diagnosis from a healthcare provider. Diagnosis typically begins with a pelvic examination and a review of your medical history. The provider will take a sample of vaginal discharge to test its acidity, as a vaginal pH of 4.5 or higher often indicates BV.
The discharge sample may also be examined under a microscope for the presence of “clue cells,” which are vaginal cells coated in bacteria. The standard treatment for bacterial vaginosis involves prescription antibiotics to restore the normal balance of vaginal flora. These medications are prescribed as either oral tablets (e.g., metronidazole) or as topical gels or creams inserted into the vagina (e.g., clindamycin). Effectively treating the BV infection alleviates associated inflammatory symptoms, including urinary frequency and urgency.