Bacterial vaginosis… what is it? “The imbalance of good and bad bacteria within your vagina” I’m sure we’ve all heard that before, but what exactly does this mean and how can I stop it from recurring?
A Healthy Vagina:
The vagina is full of microorganisms, it’s the perfect environment for it! The human body is known as a holobiont, this means we have mutualistic symbiotic relationships with bacteria. They provide us with things like antimicrobial and anti-inflammatory factors while we provide a moist and warm habitat for them to thrive. Data from 110 persons of reproductive age revealed that the vagina contains 10(^10)–10(^11) bacteria.(^2) While the bacteria within the vagina mostly consists of Lactobacillus, there is a lot of diversity which can fluctuate depending on which phase of the menstrual cycle you’re in. While menstruating, the number of Lactobacillus can decrease by about 60%, this is due to either vaginal pH rising or hormone changes. The specific amount can all depend on sexual activity, race, douching, stress, and other factors, but for the majority, the vagina has a decrease in Lactobacillus bacteria while actively menstruating. This is all very normal and considered healthy.(^1)
Bacterial Vaginosis (BV):
As we’ve established, a healthy vagina loses much of the Lactobacillus bacteria while on your period. So, what is bacterial vaginosis? When there is a sharp and drastic decrease in Lactobacillus bacteria and a sharp increase in “other” bacteria, this is considered BV.(^1) Many things can cause it, and it really depends on the individual, some vague examples are hormonal status, age, immune system, antibiotics, infections, and environmental exposure (oral sex is a big contender for this example).(^3) Some symptoms are milk–like vaginal fluid/discharge, fishy odor, and itching like crazy, some individuals can be asymptomatic and thus unaware of this dysbiosis. Don’t worry, you’re not alone, it afflicts 23%–29% of women worldwide, and has an incredibly high recurrence rate of 50-67%.(^1) This number is probably much larger than gathered due to the underwhelming amount of research focused on women’s health and specifically the vaginal microbiome.
Treatments:
So you think you have BV and/or it continues to occur. How can it help be prevented? First, make a doctor's appointment and get the diagnosis, it is always important to have these issues examined by a professional to solidify that the issue is BV and not something more sinister. If already done, you probably have antibiotics, take the ENTIRE amount prescribed for the appropriate time period. Since BV has such a prevalent recurrence rate, you’re more likely to deal with this again, so just take the doctor’s orders seriously to help prevent this. If already done so, and now you’re kinda like “What the heck do I do now?” here are some tips that can help that you don’t need a prescription for.
Take a daily probiotic:
I specifically take one for women’s health, but any probiotic with Lactobacillus will do. It can take up to 2 weeks before you see any effect, but this genuinely helped me and I hope it does for you as well. If you do not want to take a probiotic every day, consider adding Greek yogurt into your daily life as it contains the same healthy and wanted bacteria.
Wear only cotton underwear:
To sleep, while working out, while just doing random daily things, cotton underwear is it. Cotton thongs, briefs, cheekys, etc. are a gateway to preventing BV. This is due to the material being “breathable” and thus preventing the build-up of heat.
Be cautious of who your sex partner is:
Not only can BV be spread through oral sex, but this goes for any type of sex including things like fingering or just touching. Have a talk with your partner about your concerns for your health.
While menstruating, change products often:
Changing products often helps to remove any buildup of bacterial growth, also remember to wash your hands thoroughly before applying products!! Also, do not wear any sort of scented menstrual product.
Change your clothing detergent:
This may not apply to all, but any heavily scented detergent should not be used on your underwear. This can cause vaginal irritation and thus a snowball effect of recurrent BV.
Change your underwear often:
Changing your underwear often prevents the buildup of bacteria, when I am going through a BV event, sometimes I change my underwear 2-3 times a day. It can depend on the weather outside/stress which can lead to excessive sweating and foul odor.
Showering every day:
Again, to remove any unwanted bacteria accumulated throughout the day, washing your body daily will help.
Good luck on your journey, there is not much research on bacterial vaginosis, but with all of our experienced knowledge pulled together we can help one another. Thank you for taking the time to read this blog post!
-Bridget Baber, Education Officer in the Women’s Health Advocacy Organization at the University of Oklahoma.
Sources:
Chen, Xiaodi et al. “The Female Vaginal Microbiome in Health and Bacterial Vaginosis.” Frontiers in cellular and infection microbiology vol. 11 631972. 7 Apr. 2021, doi:10.3389/fcimb.2021.631972
Chen, C., Song, X., Wei, W. et al. The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases. Nat Commun 8, 875 (2017). https://doi.org/10.1038/s41467-017-00901-0