Bacterial vaginosis (BV) is a common vaginal condition caused by an imbalance in the natural bacteria present in the vagina. This article explores BV and its relationship with oral sex.
Understanding Bacterial Vaginosis
Bacterial vaginosis (BV) is a common vaginal infection characterized by an overgrowth of certain bacteria, such as Gardnerella vaginalis, and a reduction in beneficial bacteria, like Lactobacillus species. This shift creates an imbalance in the vaginal microbiome, leading to symptoms. While BV is the most common vaginal condition, it is not considered a sexually transmitted infection (STI) in the traditional sense.
The healthy vaginal environment is typically acidic, maintained by Lactobacillus bacteria. When these beneficial bacteria decline, the vagina becomes less acidic, allowing other bacteria to proliferate. This imbalance is the underlying cause of BV, affecting approximately 29% of women in the United States. Although the exact cause of this imbalance is not fully understood, it is associated with sexual activity and can increase the risk of acquiring other STIs.
The Link Between Oral Sex and BV
The question of whether oral sex can cause bacterial vaginosis is a common one, and current scientific understanding suggests a nuanced relationship rather than a direct cause-and-effect. While BV is not classified as an STI, sexual activities, including oral sex, can influence the delicate balance of the vaginal microbiome. The introduction of new bacteria or changes in vaginal pH due to saliva during oral sex could potentially disrupt this balance, creating an environment conducive to BV development.
Research indicates that bacteria commonly found in the mouth, such as Fusobacterium nucleatum and Prevotella species, can increase the risk of BV if introduced into the vaginal environment. F. nucleatum can promote the growth of Gardnerella vaginalis, a major bacterium associated with BV. Saliva itself has a different pH level compared to the natural acidic environment of the vagina, and its introduction can disrupt this balance, making the vagina more susceptible to infections.
Studies have observed a strong association between receptive cunnilingus and BV, with some research indicating a significantly higher prevalence of BV in women who practice it. The exact mechanisms are still under investigation, but the transfer of oral microbes and the alteration of the vaginal environment appear to play a role. Individual susceptibility varies, and while oral sex can be a risk factor, it does not guarantee BV.
Common Factors Affecting Vaginal Balance
Beyond oral sex, several other factors can disrupt the vaginal microbiome and increase the likelihood of developing bacterial vaginosis. Douching, for instance, can significantly upset the vagina’s natural bacterial balance and acidity, making it more prone to infections and increasing the risk of BV.
Scented feminine products, including pads, tampons, and washes, can also irritate vaginal tissues and disrupt the delicate pH balance, potentially leading to BV. Sexual activity in general, particularly with new or multiple partners, is also linked to an increased risk of BV, as it can introduce new microbes and alter the vaginal environment.
Certain types of lubricants can impact vaginal pH, and while not a direct cause, they may contribute to an imbalance. Hormonal changes, such as those occurring during menstruation, can also influence vaginal susceptibility to BV. The presence of an intrauterine device (IUD) has also been associated with an increased risk of BV, possibly due to increased menstrual bleeding or the IUD acting as a foreign body.
Symptoms and Next Steps for BV
Bacterial vaginosis often presents with noticeable symptoms, though some individuals experience none. The most common signs include a thin, white or gray vaginal discharge, which often has a strong, “fishy” odor that may become more pronounced after sex or during menstruation. Other symptoms can include vaginal itching and a burning sensation during urination.
If you experience any of these symptoms, seek medical attention for an accurate diagnosis. A healthcare professional can perform a pelvic exam, take a sample of vaginal discharge for testing, and check the vaginal pH. Prompt diagnosis is important because BV can increase the risk of acquiring sexually transmitted infections and may lead to complications during pregnancy.
Treatment for BV typically involves antibiotics, prescribed as oral pills or as a gel or cream inserted into the vagina. Complete the entire course of medication as prescribed, even if symptoms improve, to ensure the infection is fully treated and reduce recurrence. Self-diagnosis and self-treatment are not recommended, as symptoms can mimic other vaginal conditions like yeast infections, requiring different treatments.