If you notice unusual vaginal discharge, itching, burning or other unpleasant sensations in the intimate area, bacterial vaginosis may be the cause. It's a common treatable condition that occurs when too much harmful bacteria builds up in the vagina.

There are many possible causes, and in turn, this problem can increase your risk of contacting a sexually transmitted infection, so let's see what can be done. Here's everything you need to know about bacterial vaginosis, how it occurs and how to treat it.

What is bacterial vaginosis?

Bacterial vaginosis is a condition in the vagina that occurs when there is an imbalance and an overgrowth of certain bacteria. Usually, the cause is Gardnerella vaginalis, a bacterium that is part of the vaginal microbiome and which, when it is out of balance and outnumbers the other bacteria that make up the vaginal flora, causes this infection.

It is neither rare nor tragic, because many women between the ages of 15 and 44, especially those who are sexually active, face this problem at some point in their lives. It can be treated after a simple visit to the gynecologist.

But it's important to get treatment as quickly as possible, because bacterial vaginosis rarely occurs in sexually inactive people, and when it does, the risk of contracting a sexually transmitted disease increases.

How does this infection manifest itself?

There are situations, even up to 50% of cases - when a woman suffers from bacterial vaginosis without knowing it, because the symptoms are non-existent or go unnoticed. However, when they make their presence felt, the main signs of infection are:

• Vaginal burning or pain
• Itching in or outside the vagina
• Stinging sensation when urinating
• Bad smell that intensifies after intercourse
• White or gray discharge with a thin texture

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Let's talk about them one by one.

Vaginal itching

Bacterial vaginosis may cause pruritus, i.e. that itchy sensation in or outside the vagina.

However, there are many other causes that can cause itching in the intimate area, and considering that half of the cases of bacterial vaginosis are asymptomatic, it is very possible that this is not the source of the itching. I told in another blog article why you feel itching in the intimate area , because there can be a lot of other reasons.

So it is best to go to the doctor as soon as this sensation appears, to rule out all other possible causes and determine whether or not you are suffering from vaginosis.

Change in vaginal secretions

There are many types of vaginal discharge and secretions that are normal, but just as many that are not. We talked more about their types and causes in the article HERE .

But essentially, any unusual change in vaginal secretions can indicate an imbalance or problem in the vagina, and this is also the case with bacterial vaginosis. Specific changes in consistency and color may include discharge becoming:

• thin
• aqueous
• foam
• Whitish
• Gray
• Greenish

So track the consistency and color of your vaginal discharge to see how it normally fluctuates throughout your menstrual cycle (because it's normal for it to change depending on what phase of your cycle you're in), and to spot any unusual changes as soon as possible .

Unpleasant smell

And the unpleasant smell in the intimate area can be a result of the excessive accumulation of Gardnerella vaginalis, a smell that in the popular name is called "fish smell".

Usually, any activity that increases the vaginal pH will result in an intensification of this odor. This means that it becomes stronger after intercourse or after menstruation.

Burning sensation during urination

Sometimes, bacterial vaginosis can also cause discomfort when urinating, even more so if the imbalance of the vaginal flora is accompanied by an infection in the urinary tract.

This means that in addition to itching, you may also feel burning, stinging or even pain when urinating. Usually this irritating sensation goes away when you finish and stop urinating.

What are the causes of bacterial vaginosis?

The real causes behind bacterial vaginosis are not exactly known. What we do know, however, is that it occurs most often in people who have an active sexual life, and who, in one way or another, end up creating an imbalance in the vaginal flora. In other words, when the ratio between beneficial bacteria (lactobacilli) and harmful ones (anaerobes) is disturbed, the latter multiply excessively and we speak of bacterial vaginosis.

According to researchers, you don't develop such a problem just because you use a public toilet or swim in a pool. Instead, vaginal douching, sexual contact without a condom or frequent changes of sexual partners can be possible causes. Let's take them one at a time and talk about them in more detail.

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Sexual contact with multiple partners or with a new partner

Because it occurs when that imbalance occurs in the vaginal microbiome that we were talking about above, bacterial vaginosis does not fall into the category of infections or sexually transmitted diseases. We are not talking about a sexually transmitted virus or parasite, but about a disturbance in the normal balance of bacteria in the vagina.

However, the condition can also occur following sexual intercourse. Only not transmitted from the partner, but as a direct result of contact with the partner's body. This is why the risk of vaginosis actually increases when you have sex with a new partner, or if you frequently change the people you have sex with

When your partner's natural genital chemistry interferes with your intimate balance, certain bacteria can accumulate excessively and thus bacterial vaginosis can occur.

Using the vaginal irrigator

No, a healthy vagina does not need a vaginal irrigator. It is enough to wash with water and a natural intimate gel on the outside of the vagina and at the level of the vulva.

The woman's vagina is designed so complexly that there is no need for vaginal douches to maintain our daily intimate hygiene. Except in cases when they are recommended by the doctor (for example when we suffer from an infection and use eggs), vaginal washes and any substances inserted into the vagina can do more harm than good. Even if you feel like you're cleaning yourself, you're only disturbing the natural balance of the vaginal flora.

Thanks to the self-cleaning function of the vagina, it removes everything that needs to be removed by itself, together with the vaginal secretions. So you don't even need water, let alone any other substance, to keep the inside of your vagina clean. Intravaginal douches, for a healthy vagina, can disturb the pH and lead to the growth of anaerobes, thus causing bacterial vaginosis.

Recent use of antibiotics

Antibiotics are one of the most well-known treatments for bacterial infections, because they kill the bacteria and, by implication, the cause of the infection. The problem is that they also have a side effect, because they can also kill the good bacteria in the body (including lactobacilli).

That is why if you take antibiotics without also using a protection of the intestinal and vaginal flora (ie without taking probiotics), it is possible that the medicine creates an imbalance in the bacteria in the vagina and thus leads to bacterial vaginosis.

Use of scented absorbents

Any substance that is not a natural ingredient that comes into contact with your intimate area and is not normally there has the potential to disturb your vaginal flora. And here we raise a big alarm about the absorbents and tampons you use, because they come into contact with your vagina and vulva month after month, several days in a row.

So you have to pay attention to what the absorbent you use contains, because it is not uncommon for it to be the cause of itching and stinging in the intimate area. Conventional menstrual products often contain fragrances and other toxic chemicals, which can upset your vaginal pH and thus lead to bacterial vaginosis.

So we recommend you to choose absorbents made from as natural materials as possible, without perfumes or other chemicals, preferably made only from organic cotton that lets your skin breathe, and nothing else. I also told more about this topic in a previous blog article, where I discussed why to use organic absorbents .

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Unprotected sexual contact

In addition to contracting a sexually transmitted disease, unprotected sex also increases the risk of a vaginal infection. Semen has a high pH, typically between 7.2 and 7.8, and this high level can upset your own vaginal pH if your partner ejaculates without using a condom.

So if the partner's pH is incompatible with the pH of your vagina, sexual contact without barrier protection can lead to an imbalance of the vaginal flora and, implicitly, to bacterial vaginosis.

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Complications of bacterial vaginosis

Bacterial vaginosis usually has no complications and may even go away on its own without treatment. That doesn't mean it should be ignored. If you notice any of the symptoms of the condition, be sure to see a doctor as soon as possible to determine whether or not it is bacterial vaginosis, if there is any other vaginal, urinary or sexual infection, and if you need treatment.

Even if the symptoms disappear on their own, the condition can recur after a few months. Or in some situations, untreated, vaginosis can lead to various health problems that we are talking about right now.

Sexually transmitted infections

We repeat what we told you at the beginning of the article, namely the fact that bacterial vaginosis increases the risk of infection with a virus, parasite or sexually transmitted disease , which early treatment can help you avoid. Among the most unpleasant and serious such infections are:

• HIV
• Chlamydia
• Gonorrhea
• Herpes Simplex virus etc.

Pelvic inflammatory disease

When chlamydia or gonorrhea infections are left untreated, the bacteria can cause pelvic inflammatory disease (PID), a problem also known as adnexitis , which attacks the female reproductive organs. It can affect the ovaries, cervix, uterus and fallopian tubes, which can increase the risk of infertility.

At the same time, an untreated bacterial vaginosis or other diseases of the reproductive system can also cause problems during pregnancy, including premature birth. But we talk about them immediately in a separate section.

Infections after gynecological surgery

Bacterial vaginosis can also increase the risk of a post-operative infection. If the flora is not normal and there is an imbalance in the vaginal microbiome after gynecological surgery (eg hysterectomy or dilation and curettage), the likelihood of developing a post-surgical infection also increases.

How can bacterial vaginosis affect pregnancy?

There are statistics that approximately 10-30% of expectant mothers experience bacterial vaginosis at some point during their pregnancy. This occurs mainly against the background of hormonal changes that occur constantly throughout pregnancy (eg: fluctuations in estrogen and progesterone, increase in HCG levels, etc.).

In the absence of treatment, complications can occur that endanger both the mother's health, the pregnancy and the fetus. See what they are below.

Complications of bacterial vaginosis during pregnancy

If you suffer from bacterial vaginosis during pregnancy and it is not kept under observation or treated, look at the dangers and risks you expose yourself and the fetus to:

• Preterm birth: ie before 37 weeks
• Low birth weight of the baby: which can cause health problems for the little one later
• Possibility of perforation of the amniotic sac
• Chorioamniotitis: infection of the amniotic fluid and inflammation of the membranes surrounding the fetus
• Postpartum endometritis: An infection that irritates or inflames the lining of the uterus and occurs shortly after birth, when the body is still sensitive, in the recovery stage, and needs careful postpartum care .

Diagnosis of bacterial vaginosis

Because the symptoms may be non-existent or identical to those of other conditions of the intimate area, the diagnosis of bacterial vaginosis is made only by the specialist doctor, after examining the vagina and testing the vaginal secretions in the laboratory.

Broadly speaking, the way they'll examine you to determine whether or not you have this condition is similar to a regular routine gynecological exam, so here's what to expect:

• The doctor will examine the vagina for visible signs of vaginosis (eg an increased amount of white or gray vaginal discharge)
• He will then collect a sample of secretion for lab testing using a sterile cotton-tipped swab.

In order for the results to be as accurate as possible, it is important to prepare for the consultation as for any vaginal secretion examination, namely to avoid vaginal douches, sprays or sexual contact 24 hours before the consultation.

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How is VB treated?

I mentioned earlier that in the absence of symptoms, it is possible for the vaginal flora to regulate and return to normal on its own, and for bacterial vaginosis to disappear on its own. In this case, no treatment is necessary

But there is also the possibility that the symptoms may persist, or that the condition may recur after a few months (a situation that apparently cannot be prevented by treating the partner - but this claim is still being studied). In this case, the gynecologist will prescribe the appropriate treatment.

Treatment is also necessary if you are pregnant, about to give birth or have surgery that could allow bacteria to reach the uterus, or if your symptoms are affecting your normal and sexual life.

So to treat and prevent any complications, it is usually recommended:

• Antibiotic treatments (metronidazole)
• Vaginal creams (clindamycin)
• Vaginal probiotics with healthy amounts of micronutrients (manganese, zinc, fie) needed for lactobacillary flora and a healthy vaginal microbiome
• Avoiding sexual contact until treatment is completed

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How do we prevent bacterial vaginosis?

A healthy and balanced vaginal flora is the best and most effective method of prevention. So basically anything that promotes the balance between beneficial and harmful bacteria in the vagina, and anything that prevents the disturbance of this balance, is a preventive measure. Specifically, here are some essential ways to prevent bacterial vaginosis:

• Administration of probiotics: together with a healthy lifestyle, with a proper diet rich in vitamins and beneficial nutrients, probiotics contribute to populating the vaginal flora with lactobacilli, the beneficial bacteria that the vagina needs for proper functioning
• Maintaining intimate hygiene as naturally as possible: only with water, soaps, intimate gels, tampons and absorbents with natural ingredients, without perfumes or harmful chemicals
• Wearing cotton underwear: which allows the skin to breathe and does not retain moisture in the intimate area, thus avoiding the creation of an environment conducive to the accumulation of harmful bacteria
• Avoiding vaginal irrigator and excessive douching
• Testing: own and partners', periodic, for sexually transmitted infections
• Using a barrier protection method: such as a condom

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Vaginal candidiasis VS bacterial vaginosis

Candidiasis, which we talked about in more detail HERE , is a common fungal infection caused by a type of fungus (fungus) called Candida. Most often women become infected with Candida albicans, a fungus that normally lives in the mouth, throat, intestines and vagina without causing problems, but which multiplies excessively and causes an infection when the environment in which it lives changes.

Bacterial vaginosis, on the other hand, occurs when harmful bacteria multiply excessively in the vagina and numerically dominate the lactobacilli population. This happens when there is an imbalance in the vagina.

So when we compare candidiasis with bacterial vaginosis, we are actually comparing an infection with an imbalance, that is, a problem based on a fungus with one based on bacteria.

Although both can be manifested by unusual vaginal discharge, itching and discomfort in the intimate area, we are talking about two different conditions by the nature of the infection itself. Also, with vaginosis there is an unpleasant smell, while the discharge in the case of candidiasis is odorless.

So as a summary, candidiasis is caused by a fungal infection, while bacterial vaginosis is based on an imbalance of the vaginal flora. Despite the similarities between the symptoms, the treatment is very different and that is why it is important that the doctor is the one who makes the diagnosis and recommends the right treatment after the gynecological consultation and the analysis of the secretions.