By now, you’ve likely heard about the importance of keeping your gut healthy, and the idea of the microbiome (aka the community of bacteria or “bugs”) that live in there. The very simplified general gist is that there are beneficial bacteria and not so beneficial bacteria that live in your community and the goal is to have a higher ratio of beneficial bugs to the not-so-helpful stuff. Hence the boom of probiotics- so that you can introduce more beneficial bacteria into the gut, in hopes of keeping that ratio in check.
What you may not have realized is that there is also a community of bacteria that live in the vagina! And, just as you need your gut to be balanced, the vagina wants balance too. Luckily, there are some things you can do to help you maintain that balance down below. We got you.
So what is B.V?
Bacterial vaginosis, or B.V for short, is a very common condition that occurs when there is an imbalance of “bugs” in the vagina. It’s actually the most common vaginal infection for those 15-44 years old (4).
There are many different factors that can throw the bacterial environment in the vagina outta whack. Some think it may be due to a shortage of a good bacteria called “lactobacilli”. Lactobacilli produce lactic acid, which is what helps keep the vaginal pH balance (or the vagina’s acidity level) in check. (7) A healthy vagina is slightly on the acidic side. This is important because an acidic environment helps the vag to fight off infections caused by those bad bacteria (18). A pH level of >4.5 may suggest something is going on down there, for those who have started menstruating and have not yet gone through menopause. (19).
B.V is not a STI.
Is it contagious?
Currently, there’s no evidence showing that the bacteria involved in BV affects the penis, but it can be passed between partners if both have vaginas (19).
Is it dangerous?
While B.V itself isn’t too harmful, leaving it untreated can be. According to the CDC, if left untreated, B.V does increase your risk of getting STIs, HIV, and Pelvic Inflammatory Disease. It can also increase your risk of infection if you need an operative gynecological procedure.
Unfortunately, having BV carries some additional risks during pregnancy, such as an increased chance of miscarriage or early delivery (13). Most people with BV will have no problems during pregnancy (19), but please speak to your healthcare provider if you’re worried.
How can I avoid getting it?
Here’s some good news- there are things you can do to help protect the vag and keep those ‘bugs’ in balance.
Wear cotton undies!
Wear 100% cotton underwear! (We love ODDOBODY because their underwear is made of 100% organic cotton fabrics and they don’t sag on your tush. Plus each pair comes with a super cute guide to get to know your bod better). Anywho, synthetic underwear, such as nylon and lycra, make it hard for the vagina to breathe. When the vag can’t get any air, heat and moisture gets trapped, creating a field day for bacteria growth. (1) Cotton, on the other hand (or cheek, hehe) is one of the softest fabrics for your oh so sensitive vulva and is breathable and absorbent. :High five:
Avoid strong soaps
Don’t douche, use vaginal deodorants or scented soaps. If you are already prone to infections, you may want to be careful with bubble baths and laundry detergents as well. (19). Soaps that are heavily perfumed can spur bacteria growth, which is exactly what we want to avoid! (3)
Use condoms. Annoyingly, the more sexually active you are, the higher risk you have of getting infections because you are essentially welcoming someone else’s bacteria into your community- and well, they may not get along. Using condoms (external and internal) can lower your risk (15).
Birth control and B.V
If you get BV symptoms on the regular and you have an intrauterine device (IUD), this might be the culprit. Remember, the idea here is that any time a foreign friend is introduced into “the community”, it may just not be a good fit. And an IUD counts as a new neighbor! IUD users have been shown to have higher BV rates (12). Dr Eden Fromberg of Holistic Gynecology shares that she removes them from patients all the time for this reason. But don’t panic, not all IUD users will get BV!
How do I know if I have it?
Symptoms often include unusual discharge that can be thin and watery, grey or white, and can have a “fishy” smell (yum!) However, BV can also be symptomless. #helpful.
Whilst BV doesn’t usually cause physical discomfort (19), some do report itchiness, irritation, bleeding, pain during sex, abdominal cramps, and dry skin around the vulva during a BV episode (8). P.S- cotton underwear can also help if you have sensitive skin!
What can I do about it?
If you think you might have BV, check in with your practitioner. Sometimes BV can be diagnosed with a visual examination, but your practitioner may do a vaginal “wet mount” test – a swab will be done inside your vagina, and the cells will be looked at under a microscope. DNA testing (also collected with a swab) has been shown to be effective in accurately diagnosing BV (11).
If your practitioner is going to test you, know that having sex in the 24 hours prior to testing, or menstruating at the time of testing, could affect some of these test results.
The first line of treatment usually involves a short course of antibiotic tablets or an antibiotic gel that you use inside your vagina.
Even if you don’t wear cotton underwear generally, iIt’s definitely a good idea to wear 100% cotton underwear while infected, for the reasons listed above.
Do probiotics help?
There is some evidence that probiotics containing lactobacilli can help restore the balance of good bacteria, and reduce the recurrence of BV (5). Combining probiotics and antibiotics might also help reduce the long-term risks of antibiotics usage, as the vagina can become resistant to them – which means that BV will keep coming back! (5)
What about herbal or alternative remedies?
The following have shown some promise, but always check in with your healthcare provider to go over risks and benefits before administering.
- Vitamin C tablets (special ones administered vaginally!) can treat BV by improving vaginal pH levels and promoting good bacteria (17).
- Tea tree oil, garlic and thymol (the main ingredient in thyme oil) (10).
And in conclusion...
B.V is super common, so if you feel a little embarrassed for things being a little er, off, down there, just remember you are not weird or strange and you did not do anything wrong! The vaginal ecosystem is delicate and even though there are defense systems in place to try and keep things even stevens (thanks vaginal discharge!), sometimes our bodies need a little SOS. Help your bod out by wearing cotton undies like ODDOBODY, avoiding strong smelling soaps of all kinds, and using protection during intimacy. If probiotics are appealing to you, have a chat with your health support team to find a good fit. If you think you may have B.V, get in touch with your practitioner ASAP so that it doesn’t stay around for too long. You got this!
Written by: Laura Hillier
Medically reviewed by: Danielle LeBlanc, RN
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
(1) “6 Contributors to Bacterial Vaginosis.” 6 contributors to bacterial vaginosis – Mayo Clinic Health System. Accessed September 11, 2019. https://mayoclinichealthsystem.org/hometown-health/speaking-of-health/6-contributors-to-bacterial-vaginosis.
(2) Rekstis, Emily. “8 Underwear Rules to Live by for a Healthy Vagina.” Healthline. Healthline Media, September 10, 2019. https://www.healthline.com/health/womens-health/underwear-hygiene#1.
(3) “STD Facts – Bacterial Vaginosis.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Accessed September 11, 2019. https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm.
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(14) Everyday Health (2016) https://www.everydayhealth.com/bacterial-vaginosis/guide/
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(16) Klebanoff, M. A., Nansel, T. R., Brotman, R. M., Zhang, J., Yu, K., Schwebke, J. R., & Andrews, W. W. (2011). Personal hygienic behaviors and bacterial vaginosis. Sexually Transmitted Diseases, 37(2), 94-99.
(17) Machado, D., Castro, J., Palmeira-de-Oliveira, A., Martinez-de-Oliveira, J., & Cerca, N. (2016). Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions. Frontiers in microbiology, 6, 1528.
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