Bacterial vaginosis (BV) is a common vaginal infection characterized by an imbalance of natural vaginal bacteria. This condition can cause noticeable symptoms and often prompts questions about its timing in relation to the menstrual cycle.
Understanding Bacterial Vaginosis
Bacterial vaginosis occurs when there is an overgrowth of certain bacteria, leading to a disruption in the delicate balance of the vaginal microbiome. The healthy vagina maintains an acidic environment due to “good” bacteria, primarily lactobacilli. When “bad” bacteria, such as anaerobes, outnumber lactobacilli, the vaginal environment shifts, resulting in BV. This bacterial imbalance can manifest through various symptoms, though some may experience no noticeable signs. Common indicators include unusual vaginal discharge, a distinct odor, and sometimes irritation or burning.
The precise causes for this bacterial shift are not fully understood, but certain activities and conditions can disrupt the natural vaginal balance. Factors such as douching, unprotected sex, or having new or multiple sexual partners can increase the risk of developing BV. However, BV is not considered a sexually transmitted infection (STI), as it results from an imbalance of bacteria already present in the vagina.
Hormonal Fluctuations and BV
Hormonal changes throughout the menstrual cycle significantly influence the vaginal environment, making it more susceptible to conditions like bacterial vaginosis. The vagina’s natural acidity, typically between pH 3.8 and 4.5, is maintained by lactobacilli, which convert glycogen into lactic acid. Estrogen plays a role in increasing glycogen production in vaginal cells, which supports the growth of these beneficial lactobacilli.
Before and during menstruation, hormonal shifts can lead to an increase in vaginal pH, making the environment less acidic. Menstrual blood itself has a higher pH (around 7.4), and its presence can temporarily raise the vaginal pH. This less acidic environment favors the overgrowth of anaerobic bacteria associated with BV. Therefore, BV symptoms often appear or worsen around the time leading up to and during a period due to these natural physiological changes.
Recognizing and Treating BV
Recognizing the signs of bacterial vaginosis is important for seeking medical attention. The most common symptoms include a thin, gray, white, or greenish vaginal discharge. This discharge often presents with a strong, “fishy” odor, which may become more noticeable after sexual intercourse or during menstruation. Some individuals may also experience vaginal itching, irritation, or a burning sensation during urination.
A healthcare provider diagnoses BV through a pelvic exam, observing discharge and performing a “whiff test” for odor. A vaginal swab may be collected to examine vaginal fluid under a microscope for specific cells and bacteria, or to measure vaginal pH, often higher than 4.5 in BV cases. Treatment for BV involves antibiotics, available as oral pills or vaginal gels or creams. Common antibiotics prescribed include metronidazole, clindamycin, secnidazole, and tinidazole. Complete the entire course of medication as prescribed, even if symptoms resolve earlier, to ensure full treatment and reduce recurrence.
Reducing Your Risk of BV
While BV cannot always be prevented, several practices can help maintain vaginal health and lower the risk of infection. Avoiding douching is important, as it disrupts the natural balance and acidic environment, potentially leading to harmful bacterial overgrowth. The vagina is self-cleaning, and douching can push existing bacteria further into the reproductive tract.
Using mild, unscented soaps and avoiding scented products like feminine sprays, washes, and tampons can help prevent irritation and pH imbalance. Practicing safe sex, such as consistent condom use, and limiting sexual partners, can reduce the risk of BV. Wearing breathable cotton underwear and wiping from front to back after using the toilet can contribute to a healthier vaginal environment.