Bacterial Vaginosis: Prevention and Treatment

Our body naturally contains different kinds of bacteria. That may sound disgusting but it’s true and perfectly normal. Our body works to maintain the perfect balance between the different bacteria in our body. And by finding that right balance, our body prevents specific types of bacteria from growing out of control. The vagina, in particular, is one example of a part of the body that naturally contains different kinds of bacteria.


Unfortunately, there are times that this delicate balance of ‘good and harmful’ bacteria in the vagina is disrupted. This change in balance results in bacterial vaginosis in women. If and when you find out that you do have this condition, there’s no need to panic, as it is a pretty common condition in women. However, once with symptoms, you do need to seek medical advice as soon as possible. 


Read on to learn how to recognize the symptoms of bacterial vaginosis and what to do if you have it.

What is Bacterial Vaginosis?

As briefly explained above, bacterial vaginosis is an infection in a woman’s vagina caused by an overgrowth of certain bacteria that normally live in the vagina.


Bacterial vaginosis is the most common cause of vaginitis (vaginal inflammation) and the most common infection encountered in the outpatient gynecologic setting. It’s the most common type of vaginal infection in women ages 15 to 44 and is surprisingly prevalent among pregnant women. 

What are the symptoms of Bacterial Vaginosis?

Bacterial vaginosis can be asymptomatic in some patients. But when it does occur with with symptoms, they can include: 

  • burning sensation when urinating
  • increased vaginal discharge (mild to moderate)
  • gray or white watery or thin vaginal discharge
  • fishy-smelling vaginal discharge 
  • itching and pain in vulva (outer part of the vagina) 
  • pain during sexual intercourse (rarely)

What are the causes and risk factors of bacterial vaginosis?

Again, bacterial vaginosis results when certain types of bacteria are present in greater amounts than usual. This imbalance overpowers the ‘healthy’ bacteria that usually keep the ‘bad’ bacteria in check.


To be specific, Gardnerella vaginalis is the bacteria most often associated with bacterial vaginosis. Also, in bacterial vaginosis, there is an increase in local pH (the vagina is naturally acidic). Lactobacilli is one of the ‘good’ bacteria that helps maintain the acidic pH of healthy vaginas and in turn inhibit the overgrowth of the other ‘harmful’ bacteria. In a healthy vagina, lactobacilli are found in high numbers.


However, in bacterial vaginosis, the lactobacilli population is greatly reduced. Therefore, the overgrowth of Gardnerella or other harmful bacteria as well as the lack of the “good” bacteria such as lactobacilli, can result in the symptoms of bacterial vaginosis. 


It is not completely understood why some women develop bacterial vaginosis and others don’t. However, you may have an increased risk if you:

  • do not using a barrier method during sex such as condoms
  • have an intrauterine device (IUD)
  • have a history of using douches or other vaginal washes
  • have multiple sex partners or having sex with a new partner
  • are pregnant
  • have recent antibiotic use
  • are daily smokers or drink alcohol daily
  • are overweight or obese
  • are using a perfumed bubble bath
  • are using some scented soaps
  • are bathing in water that contains antiseptic liquids
  • are washing underwear with a strong detergent

Although bacterial vaginosis is not considered a sexually transmitted disease, sexual activity has been linked to development of this infection.


There has been recorded incidences and studies that have indicated that Gardnerella can be spread via direct contact of mucous membranes or even transmitted on fingers or sharing of sex toys. 


It is however, equally important to know that a person cannot acquire bacterial vaginosis from the following: 

  • toilet seats
  • bedding
  • swimming pools

What are the features of the vaginal discharge in bacterial vaginosis?

One of the hallmarks (and often initial) symptoms of bacterial vaginosis is a strong-smelling “fishy” vaginal discharge. This specific odor may even get stronger or may only be recognized after unprotected sexual intercourse especially if semen mixes with the vaginal discharge.


On closer inspection, the vaginal discharge features of bacterial vaginosis are most often greyish-white, thin, and watery. You may also observe small bubbles in the discharge fluid.

How to prevent bacterial vaginosis?

The exact mechanism on how bacterial vaginosis spreads is still unknown, but there are some measures that may lower your risk:


  • Practice healthy vaginal hygiene habits. Make sure to use only warm water to wash your vagina, avoid strong-scented soap, wipe only from front to back when using the toilet, and wear cotton or cotton-lined underpants. These are steps you can take to keep the bacterial populations in your vagina balanced.
  • Avoid vaginal deodorants and douching. These can affect your vaginal pH, making you more vulnerable to BV.
  • Limit your number of sex partners 
  • Use barrier methods, such as condoms or dental dams, during sexual activity. By limiting the interaction between semen and vaginal discharge you can decrease your risk of getting bacterial vaginosis.

How is Bacterial Vaginosis Treated?

Research suggests that bacterial vaginosis is self-limiting in approximately one-third of non-pregnant persons and one-half of pregnant persons. Therefore, it is generally suggested that only symptomatic patients with confirmed bacterial vaginosis are given treatment. Another reason for not routinely giving treatment to asymptomatic patients is because any antibacterial therapy can be followed by symptomatic vaginal yeast infection. Aside from symptomatic individuals, treatment is also given to patients with confirmed bacterial vaginosis who are undergoing gynecologic procedures that involve the vagina, regardless of symptoms, to reduce the risk of postoperative complications. 


However, some experts still recommend treatment for asymptomatic individuals. This is because untreated bacterial vaginosis can lead to serious health risks or complications. Untreated bacterial vaginosis can increase your risk of getting sexually transmitted infections, such as HIV, herpes, gonorrhea, and chlamydia. It can also increase your risk of developing pelvic inflammatory disease (PID), which is an inflammation of the uterus, fallopian tubes, and even the ovaries, that can eventually cause infertility. In pregnancy, if a bacterial vaginosis goes undiagnosed or untreated, the likelihood of a premature birth increases. That’s also the reason why pregnant women need to be screened for bacterial vaginosis and treated immediately if diagnosed. 


Treatment for bacterial vaginosis requires a full course of antibiotics, such as clindamycin metronidazole and tinidazole. These are available in the form of pills, vaginal suppositories, cream, or gels. Be sure to complete the full course of antibiotics as directed by your healthcare provider, even if your symptoms clear up quickly. Most of the time, bacterial vaginosis is easily treatable and goes away with a course of antibiotics. But sometimes, for reasons that aren’t entirely understood, it may persist or recur, often within three months. Hence, if after 48-72 hours of finishing your antibiotic course and you still have symptoms, talk to your healthcare provider as soon as possible, you may need a longer course of antibiotics.


It is also important to avoid alcohol consumption during treatment and for 24 hours after completion of treatment, especially while taking metronidazole or tinidazole. In addition, it is advised that women should refrain from sexual activity or use condoms while on treatment. 


Probiotics have been used alone and as adjunctive therapy to antibiotics for the treatment of bacterial vaginosis and the prevention of relapse. However, it should be noted that in most clinical trials, evidence is inconclusive on whether or not probiotics should be part of the treatment regimen for bacterial vaginosis. Although some trials have reported very promising results,


With regards to treatment of sex partners, data from clinical trials show that a woman’s response to treatment and the risk of relapse or recurrence are not affected by treatment of her asymptomatic sex partner. Thus, routine treatment of sex partners is not recommended. However, bacterial vaginosis can be transmitted between people with vaginas or female sex partners, therefore, both partners may need treatment. 


Although seeing your health care provider at once when exhibiting symptoms of bacterial vaginosis is still first in line, there are also a few things you can do on your own at home to help clear up the condition. These include:

  • wearing loose-fitting, breathable cotton underwear
  • practicing healthy vaginal hygiene habits
  • using unscented soaps and unscented tampons whenever possible

How can EVA TELECONSULT help in the management of Bacterial Vaginosis?

Here at EVA Teleconsult, we have expert doctors like our Primary care physicians and Ob-gynecologists who can diagnose and give the appropriate treatment for bacterial vaginosis. Furthermore, our doctors are always ready to address any questions or concerns you may have about bacterial vaginosis or almost any other related condition. Here is how EVA works, EVA our patients are guaranteed to experience the following: 

  • Timely appointments – No more time wasted while waiting outside a doctor’s office. With us, appointments begin right when they’re supposed to, even if they’re made on the same day.
  • Guaranteed 30-minute consultation times – No rushing or quickly dashing off prescriptions with no explanations. Our doctors take the time needed to give you information about your concerns and are open to answering all your questions.
  • 5-star ratings for our doctors – Because our doctors know how to explain things in a way patients can understand, we frequently get positive feedback from them.

If you feel that you may have symptoms of bacterial vaginosis but are unsure, it is always best to seek medical advice from a healthcare professional. Get the treatment you or your loved ones need and book an online consultation today.

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