Okay, let's just get this out of the way: vagina. You'll be running across that word a lot in this article, and if it makes you uneasy, you'll have to try to get past it. There's no need for discomfort, anyway; the vagina is a beautiful, functional, pleasure-giving thing. Unless, of course, you have bacterial vaginosis. In that case, you may understandably be uncomfortable with your vagina. Bacterial vaginosis, or BV for short, is the most common vaginal infection—yes, even ahead of yeast infections—and is especially prevalent among pregnant women. Many women with bacterial vaginosis never even know they have it because it doesn't always cause noticeable symptoms. But women who do notice when they have BV usually describe highly unfriendly symptoms that include itching, burning, gray or white vaginal discharge, and a fishy odor that may be more potent after sex.
Because bacterial vaginosis occurs in so many women with such different habits and lifestyles, scientists have been unable to pin down all of its causes. Basically, though, BV results when the normal balance of healthy and potentially harmful bacteria in the vagina is upset, so that the number of healthy bacteria diminishes while the harmful bacteria flourish. Any number of things can trigger this imbalance, from changes in vaginal care to shifts in a woman's emotional or psychological state, and there is no set of rules a woman can follow to guarantee she won't get bacterial vaginosis. However, experts have identified a few specific factors that seem to consistently increase a woman's risk of developing BV, and avoiding those is at least a place to start.
Bacterial Vaginosis Prevention
First and most importantly, please do not douche. Vaginal douching is both unnecessary and unhealthy because the vagina is structured to keep itself clean. Not only does vaginal discharge flush contaminants out of the vaginal canal, but the vagina is also constantly engaged in self-regulating its pH level and maintaining an ideal balance of the various types of microorganisms that normally live in the vagina. When douche is introduced into the vagina, it disrupts this balance, often leading directly to bacterial vaginosis. Turns out those TV commercials in the '80s were right: douching will make you feel as fresh as a summer's eve. A hot, sticky, mosquito-infested summer's eve.
Although bacterial vaginosis is not transmitted directly between heterosexual partners during sex, researchers have noted that women are more likely to get bacterial vaginosis when they have a new sexual partner or if they have more than one partner. Why this should be true is one of the many things about BV that is not well-understood, but it could be that each new penis that enters the vagina brings with it new and exotic microorganisms that challenge the vagina's ability to keep itself chemically and biologically balanced. Whatever the reason, though, it's clear that women who practice sexual abstinence or monogamy and use a condom when they do have sex with a new partner are at a lower risk of developing bacterial vaginosis.
Women who smoke are more than twice as likely as nonsmokers to get BV. Multiple studies have demonstrated this link between cigarette smoking and bacterial vaginosis, and some researchers believe that smoking has a direct effect on the types of microorganisms that can live in the vagina. If this is the case, it makes sense that smoking could make it more difficult for the vagina to maintain the balance of bacteria and flora it needs to prevent infections like bacterial vaginosis. So, if you needed a more immediate reason to quit smoking than cancer or heart disease, there it is.
If you want to avoid bacterial vaginosis, practice good genital hygiene. That means letting the inside of the vagina do its thing without any help from you while you take care of the outside—the vulva. And even that doesn't require a lot of fuss. The vulva should simply be washed every day or two with gentle soap and water. Then, between showers or baths, you can keep the vulva dry by wearing underwear and pants made of natural fibers that don't restrict air flow. The types of bacteria associated with BV are anaerobic, meaning they can live without oxygen, so if there's air circulating around that region, anaerobic bacteria may find it harder to stage a hostile takeover. Finally, try to remember to wipe from front to back when you use the bathroom to avoid transferring bacteria from the anus to the vaginal opening.
Once a woman has had BV, there's a decent chance she'll get it again. One way to avoid recurrent bacterial vaginosis is to make sure you take every single dose of antibiotics prescribed by your doctor, even after your symptoms have disappeared. When you're on antibiotics, you'll often start feeling better once the medicine has killed some, but not all, of the guilty bacteria. However, if you stop taking the antibiotics at that point, before they've had a chance to completely wipe out the problem, the remaining bacteria get a second chance to multiply and put you right back where you started.
Bacterial Vaginosis Treatment
If you're experiencing bacterial vaginosis symptoms, you should visit a doctor who can make a positive diagnosis. Once you've been officially diagnosed with BV, you will almost certainly be sent home with a prescription for antibiotics. Three types of antibiotics—metronidazole, clindamycin, and tinidazole—are commonly prescribed to treat bacterial vaginosis. All of these except tinidazole, which is only available in pill form, can be taken either orally or vaginally. While vaginal creams or gels usually cause fewer side effects than oral antibiotics, they may also be less effective and can weaken condoms or diaphragms. Your doctor should take your individual circumstances into consideration when choosing which medicine to prescribe.
