What is BV? How to Stop the Cycle of Bacterial Vaginosis

Bacterial vaginosis (BV) is an inflammatory condition resulting from an overgrowth of "bad" bacteria in the vagina. In some cases, it comes with a telltale odor, but in others, there may be no symptoms at all. If you think you have BV, remember that you aren't doing anything wrong, and you’re not alone. In fact, BV is the most common vaginal condition in women ages 15-44⁽²⁾.

In this article, we’ll break down the symptoms, causes, and solutions to BV to support you in understanding the condition.

What is BV?

Bacterial vaginosis (BV) is an infection that can occur when there is an imbalance within the vaginal microbiome. A healthy vaginal microbiome is dominated by bacteria called lactobacillus. This good bacteria works to regulate healthy vaginal pH levels⁽³⁾.

If there is a rise in pH, this can allow for an overgrowth of "bad" bacteria. A common strain of the "bad" bacteria that causes BV is Gardnerella vaginalis, or G. vaginalis⁽⁴⁾. BV can develop in females of any age, but tends to be more common during reproductive years⁽⁵⁾.

What causes BV?

Bacterial vaginosis (BV) is caused by an overgrowth of anaerobic bacteria, replacing the normal lactobacilli and causing an increase in vaginal pH⁽⁴⁾.

A change in your vaginal pH can occur in a variety of ways including diet, sexual activity, and exposure to irritants like fragrances^(5,6).

Antibiotics for UTI treatment can also disrupt the vaginal microbiome. Antibiotics work to kill bacteria (good and bad) in turn causing the vaginal pH to rise, potentially causing BV⁽⁷⁾.

What are the symptoms of bacterial vaginosis?

BV can feel very uncomfortable and can impact your day to day life. Remember to take care of your mental health during this time and get support – we know it can feel tough to experience this cycle of infections. BV symptoms may include abnormal vaginal discharge, pain, itching, burning in or around the outside of the vagina, a strong vaginal odor, or burning during urination⁽⁵⁾. 

However, around 84% of women with BV are asymptomatic⁽²⁾. While asymptomatic BV may not be causing you apparent discomfort with noticeable symptoms, you may find yourself struggling with recurrent urinary tract infections. It's possible the two are connected and may be a great discussion to have with your doctor if you suspect this could be a factor in your journey⁽⁸⁾. 

If you do experience any of the above symptoms, it’s important to seek medical advice for appropriate diagnosis, as BV is sometimes mistaken for other infections. For example, BV and yeast infections cause similar symptoms, but they are different conditions with varied risks and treatment plans. 

BV can be tested using a vaginal swab analysis that is administered by your doctor. We explain more about this connection below.

What are the risks of BV?

Aside from the uncomfortable symptoms, studies have shown that those with BV have an increased risk of developing a UTI⁽⁸⁾. 

This correlation likely begins with an increase in the pH of the vaginal microbiome due to the decline of lactobacilli bacteria. Maintaining a healthy vaginal microbiome is crucial for urinary health. If it’s thrown off, additional issues can develop⁽³⁾.

How do I stop getting BV?

The cycle of BV can be frustrating and challenging to break.  

Doctors typically recommend antibiotics, such as oral metronidazole and clindamycin, tinidazole, metronidazole gel, or clindamycin gel for treating BV⁽¹⁾.

Luckily, these treatments will often bring swift relief.

However, breaking the ongoing cycle of BV and reducing the likelihood of future infection, may require a proactive approach:

1. Practice vaginal hygiene

We know you’ve heard it before – but it’s an important reminder to support you in getting proactive! For those that are more prone to infection, it is helpful to be as proactive as possible. There’s a lot of mixed opinions out there about vaginal washes because the vagina is self-cleansing. Our take? If you feel like you don’t need a wash or wipes, then skip it! But if you’re looking for a wash or wipes we recommend finding gentle, fragrance-free options to use after intimacy, workouts, or during your period when there is a possibility of bacteria being introduced.

Make sure to avoid scented or harsh soaps and opt for hypoallergenic, paraben-free, and unscented mild options⁽³⁾.

Some people have even commented that switching to hypoallergenic detergent has helped them avoid potential irritation, and being mindful of their underwear and lubricant choices.

2. Balance the vaginal microbiome

Steer clear of douching, as it can quickly upset the harmony between the beneficial and harmful bacteria in your vagina. It's best to let your body's natural processes maintain the right balance⁽³⁾.

3. Be mindful of your diet

Certain foods can affect the body’s pH levels. Some foods that are known to cause irritation include sugar, processed foods, and alcohol. 

Dr. Payal Bhandari considers eating foods that are rich in probiotics and prebiotics to be supportive! Foods that are rich in probiotics include garlic, onions, asparagus, and apples, and foods rich in prebiotics, such as berries, salmon, leafy greens, and broccoli.

Is it normal to develop bacterial vaginosis after having sex with someone new?

The short answer: yes. While the link between sex and BV requires further research, recent studies show that BV develops more often when people have a new sex partner⁽⁹⁾.

Is BV a sexually transmitted infection?

BV is not a sexually transmitted infection (STI), but it does develop more often in people who are sexually active. It’s important to note that BV could possibly increase your risk of getting an STI⁽⁹⁾. 

Final Thoughts

As studies have shown, the vaginal microbiome is directly correlated to urinary health. 

If you’re struggling with BV, remember that you’re not alone! This common vaginal issue can be frustrating, to say the least, but it’s treatable and you can consider taking a proactive approach to find ways to balance your vaginal microbiome. 

Note: references to "female", “women”, “male”, and “men” in this article refer to sex assigned at birth, not gender.

This article does not replace medical advice. We recommend you seek treatment if you think you are experiencing a UTI.