Bacterial Vaginosis (BV) is a common vaginal infection that occurs when the naturally balanced environment of the vagina is disrupted. This disruption involves a decrease in beneficial Lactobacilli bacteria, allowing an overgrowth of other anaerobic bacteria. While BV is known primarily for symptoms like abnormal discharge and odor, the question of whether it causes bleeding is a frequent concern. Understanding this relationship helps determine if the symptom is related to the infection or signals a different health matter.
Answering the Bleeding Question
Bacterial Vaginosis is not considered a direct cause of heavy vaginal bleeding. The infection does not affect the uterine lining or the menstrual cycle to cause substantial blood loss. However, BV can lead to inflammation and irritation of the vaginal and cervical tissues. This localized irritation may result in mild spotting, especially following friction from sexual intercourse or wiping. The inflamed tissue is more prone to minor trauma, which can manifest as light, pink, or reddish-brown discharge. If bleeding is significant, prolonged, or accompanied by pain, it warrants immediate medical evaluation.
Primary Symptoms of Bacterial Vaginosis
The primary indicators of Bacterial Vaginosis are changes in the quantity and quality of vaginal discharge. This discharge is often thin, watery, and grayish-white or greenish, and is typically homogenous, unlike the thick, clumpy discharge associated with a yeast infection. The most distinctive symptom is a strong, unpleasant, “fishy” odor. This malodor is caused by volatile amines produced by the overgrowing anaerobic bacteria. The odor frequently becomes more noticeable after sexual intercourse or during menstruation. Some individuals may also experience mild irritation, itching, or a burning sensation during urination, though many people with BV experience no noticeable symptoms at all.
Other Reasons for Unexpected Bleeding
Since BV is an unlikely cause of anything beyond very light spotting, any unexplained or heavier vaginal bleeding should prompt a medical consultation. Unexpected bleeding has numerous possible causes not related to a bacterial imbalance. Hormonal fluctuations, particularly those caused by starting or changing hormonal contraceptives, are a common source of breakthrough bleeding or spotting. Structural issues within the reproductive tract, such as benign growths like cervical polyps or uterine fibroids, can also cause irregular bleeding. Bleeding can also be linked to other infections, including sexually transmitted infections (STIs) such as Chlamydia or Gonorrhea, which cause inflammation of the cervix. Pregnancy-related events, including implantation bleeding or complications like ectopic pregnancy, must also be considered. Postmenopausal bleeding, in particular, should always be investigated promptly by a healthcare provider.
Diagnosis and Treatment
Diagnosing Bacterial Vaginosis relies on a clinical examination and analysis of vaginal discharge, often using the Amsel criteria. A healthcare provider typically performs a pelvic exam and takes a sample to confirm the diagnosis.
Diagnostic Methods
Diagnosis involves several steps. The vaginal pH is measured, which is usually elevated above 4.5 due to bacterial overgrowth. The provider may also perform a “whiff test,” where potassium hydroxide solution is added to the sample; a strong, fishy odor confirms the presence of volatile amines. Microscopic examination of the sample reveals “clue cells,” which are vaginal epithelial cells coated in bacteria.
Treatment
Treatment for BV is straightforward, typically involving a course of prescription antibiotics, such as metronidazole or clindamycin, administered orally or as a vaginal gel or cream. It is important to complete the entire course of medication as prescribed, even if symptoms improve quickly, to minimize the high risk of BV recurrence.