Bacterial Vaginosis (BV) is a common vaginal condition affecting many individuals. This article clarifies what BV is, its causes, and its connection to sexual activity. Understanding these aspects is important for recognizing the condition and seeking appropriate care.
Understanding Bacterial Vaginosis
Bacterial Vaginosis is characterized by an imbalance in the naturally occurring bacteria within the vagina. A healthy vagina maintains a balanced environment where beneficial bacteria, primarily Lactobacilli, are abundant. These Lactobacilli produce lactic acid, which keeps the vaginal pH acidic, inhibiting the growth of harmful bacteria.
When this delicate balance is disrupted, an overgrowth of other bacteria, known as anaerobes, leads to BV. While BV is not a sexually transmitted infection (STI), it is linked to sexual activity. The condition involves a shift in the vaginal microbiome rather than the acquisition of a new pathogen.
Factors Influencing BV Development
Several factors can disrupt the vaginal bacterial balance, increasing the likelihood of BV developing. Douching, for instance, involves rinsing the vagina with solutions, which can upset the natural pH and bacterial composition. This practice removes beneficial Lactobacilli, allowing other bacteria to overgrow. Similarly, using perfumed products in the genital area can alter the vaginal environment.
Certain types of contraception, such as intrauterine devices (IUDs), have been associated with changes in the vaginal microbiome that may contribute to BV risk. Hormonal fluctuations during menstruation, pregnancy, or menopause can also influence the vaginal environment and acidity, potentially leading to an imbalance. Psychosocial stress has also been linked to an increased risk of BV.
Sexual Activity and BV Risk
Sexual activity can influence the vaginal environment, increasing the risk of BV. While men do not contract BV, sexual contact can introduce new bacteria or alter the vaginal pH, making a woman more susceptible to an imbalance. The presence of semen, for example, has a higher pH than the vagina, and its introduction can temporarily raise vaginal pH, which may encourage the growth of anaerobic bacteria.
Having a new sexual partner or multiple partners is a known risk factor for BV. This is not due to direct transmission from the man, but rather because new partners introduce different microbial environments that can disrupt the existing vaginal balance. Bacteria associated with BV can be carried on the penis, and studies show that treating both female and male partners can reduce BV recurrence in women. Thus, the “cheating” aspect relates to new sexual partners introducing new microbial exposures that can shift the vaginal ecosystem, not direct transmission from the man.
Recognizing Symptoms and Seeking Treatment
Recognizing the symptoms of BV is an important step toward seeking appropriate care. Common indicators include an unusual vaginal discharge that may be off-white, gray, or greenish, often accompanied by a “fishy” odor, which can become more noticeable after sex. Some individuals may also experience vaginal itching or a burning sensation during urination.
Up to 84% of individuals with BV may not experience any symptoms. However, if symptoms are present, treatment is recommended, as BV typically does not resolve on its own and can lead to complications if left untreated. Untreated BV can increase the risk of acquiring sexually transmitted infections, pelvic inflammatory disease, and may lead to complications during pregnancy. Treatment commonly involves antibiotics, prescribed as oral pills or as a gel or cream inserted into the vagina.