Bacterial vaginosis (BV) is a common bacteria infection experienced by over 21.2 million women in the United States alone . The vagina has a delicate balance of bacteria that offer disease control by regulating the pH levels within the area. When the normal balance of bacteria becomes compromised, women can become more susceptible to sexually transmitted infections (STIs), such as chlamydia and gonorrhea. Left untreated, BV can lead to pelvic inflammatory disease (PID) and fertility issues.
So, what is BV? What are the symptoms, and what should you do if you get a diagnosis of bacterial vaginosis? Here is everything you need to know about this common vaginal infection!
What is Bacterial Vaginosis?
Our bodies are teeming with trillions of cells only visible with a microscope. These microbes include thousands of species of probiotic bacteria, bad bacteria, viruses, fungi, yeast, and more. A healthy gut microbiome is dependent on microbial diversity. The same cannot be said of the vaginal microbiome.
Vaginas require a balance of specific bacteria for disease control. Namely, these good bacteria are of the Lactobacilli genus. This crew is ride-or-die, helping each other regulate pH levels and preventing unfavorable vaginal health issues, such as candidiasis, Human Papillomavirus (HPV), and STIs.
The average pH level of a healthy vagina is around 4. A vaginal microbiome with BV is less acidic. It has a pH level of at least 7.
According to research, some of the most common bacteria associated with bacterial vaginosis are Leptotrichia amnionii and Sneathia sanguinegens . When they’re around, the vaginal microbiome tends to have less abundance of the Lactobacilli genus. Unfortunately, women are at high risks of bacterial imbalances.
There are many factors that can potentially cause BV, which we’ll get to in a bit. However, the official diagnosis of bacterial vaginosis means one of your vaginal bacteria species have become predominant. In general, BV is a drop in protective bacteria and a rise in potentially bad bacteria. BV is easy to treat. So, it’s imperative you talk to your health care provider if you show symptoms of BV.
Bacterial Vaginosis Symptoms
What makes BV so nerve-wracking is that you might not know you have an imbalance. According to the Centers for Disease Control and Prevention (CDC), approximately 84% of women show no symptoms of bacterial vaginosis . With that said, here are the most telling BV symptoms.
Abnormal Vaginal Discharge
Vaginal discharge is normal for women. It’s part of the self-cleaning process of the vaginal microbiome. These fluids consist of dead cells and bacteria that are being removed by glands within the vagina and cervix. Typically, they are clear to milky. When the color changes, there is a reason for concern.
As Justine Burris, CNM, MSN explained to Unity Point Health,
“There are times when discharge amounts can change. Immediately after a period, there is almost no discharge. Two to three days after the period ends, there is a thick, white discharge. A few days later, the consistency changes to appear more like mucous. Before ovulation, the discharge becomes clear and sticky, and before the next period, discharge is thick and white in consistency .”– Justine Burris, CNM, MSN explained to Unity Point Health
During pregnancy, vaginal discharge can become thinner. You will notice the amounts of vaginal discharge increase during this time period. However, if the vaginal discharge changes colors, you should contact your health care provider.
Types of vaginal discharges include:
• Thick, White: Might Be Post-Menstrual Vaginal Discharge or Signs of a Yeast Infection
• Cottage Cheese White: Potential Yeast Infection
• Yellow: Signs of Bacterial Infection, Gonorrhea, Chlamydia, or HPV
• Brown: Irregular Period Cycles, Uterus Cancer, or Cervix Cancer
• Green: Signs of Parasitic STIs, such as Trichomoniasis
If you have brown, green, or long-term yellow vaginal discharge, please seek a health care provider. You should get a thorough pelvic exam and might need to use a course of antibiotics to treat the issues. Any of these colors can also be signs of bacterial vaginosis.
Vaginal discharges are also regulated by hormones. It’s ubiquitous for women going through menopause not to experience vaginal discharge. Therefore, some women might miss out on symptoms of BV.
While that sounds delightful to be symptom-free, you might be missing out on key clues about your vaginal health. That’s why it’s important to test your vagina bacteria regularly with a Thryve Vaginal Health Kit.
It is common for genitals to have a slight odor. They’re very moist and are void of much ventilation.
These odors might increase with the presence of vaginal discharge or during pregnancy. They also tend to be at their highest potency following sexual intercourse.
Even when vaginal discharge is at its peak, it should never have the pungent odor associated with odor. If you notice a fishy odor, talk to your health care provider about a potential whiff test.
Vaginal and Vulva Itching
While women are warriors who put up with discomfort on the reg, itching inside or outside the vagina should be a reason for worry. Itching is always a sign of irritation.
Irritation is essentially inflammation. Therefore, you’re having an immune response to something. In the case of BV, that immune response is being caused by a bacterial imbalance.
Don’t try to tough through painful urination. This common issue for women can be a sign of many health-related issues. Be proactive and seek medical help and get a thorough pelvic exam if you suffer from painful trips to the bathroom.
What Causes Bacterial Vaginosis?
There is no specific known cause of BV. Rather, there is a list of factors that might increase your risk of developing BV. Here are some of the most common.
For centuries, women have been conditioned to believe that their genitals should smell like a pristine flower. This expectation is unrealistic and dangerous. It’s caused women to turn to using a douche to achieve what they believe to be cleanliness.
Sure, douching rids the vaginal microbiome of bad bacteria. However, it also leaves the vagina void of the Lactobacilli strains it needs to maintain optimal pH levels. Once you change the protective pH, the bad bacteria can flourish.
Even worse, women are using douches that have artificial scents. Scented douches can cause potential allergic reactions. In turn, you may experience skin irritations or itchiness.
There is no evidence that a male can transmit bacterial vaginosis to a female directly. However, the CDC does note that the risk of developing BV increases when the number of sex partners increases .
Subsequently, men who have been diagnosed with nongonococcal urethritis tend to have higher levels of Leptotrichia amnionii and Sneathia sanguinegens in their gut microbiome . As we mentioned earlier, these bacteria strains tend to facilitate BV development.
Cases of BV are more likely to increase when someone becomes intimate with a new sex partner. It kind of makes sense if you think about it. You’re allowing new bacteria and other microbes within and around your body. They’re bound to create new reactions and disrupt the current state of your vaginal microbiome.
The findings that BV risk increases with the number of sex partners infers that bacterial vaginosis might be spread based on bodily fluids exchange. Many doctors recommend using condoms and dental dams as forms of BV prevention.
Furthermore, research suggests that women are more likely to contract BV after being with a female partner rather than a male sexual partner. One study looking at the prevalence of BV among the lesbian community found that lesbians are 2.5 more likely to develop bacterial vaginosis .
Low Levels of Lactobacilli
Lactobacilli are the true regulators of the vagina. Without them, you are pretty much prone to complications with BV. It’s important to find out if you have adequate levels of good bacteria in your vagina. Use our upcoming Thryve Vaginal Health Kit in 2021 to help keep potential dangers at bay!
Long-Term Complications of Bacterial Vaginosis
Ignoring bacterial vaginosis can set your body up for bigger challenges down the road. It is important you seek medical help to prevent any other conditions that might impact your wellness, comfort, or ability to reproduce.
Risk of Preterm Birth
The CDC notes that those with BV while pregnant are at increased risk of having a premature baby. They note that the average child born from a mother with bacterial vaginosis has a birth weight of 5.5 pounds .
Increased HIV Problems
Women who have BV are more susceptible to contracting Human immunodeficiency virus infection (HIV) if their sexual partner is infected with the virus. Additionally, women who have HIV and BV are more likely to transmit their infection to their sexual partners .
Susceptibility to STIs
A lack of good bacteria in the vagina is the perfect criteria for an STI to develop. Protective vaginal bacteria make the area more acidic so that harmful microbes that cause STIs don’t survive.
That’s why BV has been linked to increased risk of:
• Gonorrhea 
• Chlamydia 
• Herpes Simplex Virus 
• Human Papillomavirus (HPV) 
It is important to get a pelvic exam regularly and use a Thryve Vaginal Health Kit coming 2021 to ensure you have optimal levels of good bacteria.
Pelvic Inflammatory Disease (PID)
One of the most common long-term effects of bacterial vaginosis is the development of Pelvic Inflammatory Disease (PID). PID is an infection that spreads from the vagina to the womb. It causes inflammation around the ovaries and fallopian tubes .
Left untreated, PID can cause swelling and scar tissue within the fallopian tubes. Therefore, eggs won’t make it to the uterus. So, developing PID from BV can cause fertility and reproductive issues.
How To Know If You Have BV?
There are many ways to determine if you have bacterial vaginosis. Doctors use BV tests to determine certain factors about vaginal health. If three out of the four criteria are met, then a doctor determines a positive BV result.
The four BV criteria under Amsel’s criteria include:
• Wet Mount (Tested for Clue Cells)
• Vaginal Discharge (Test Vaginal Discharge for DNA and Bacteria)
• Vaginal pH (A Vaginal pH of 4.5 or More)
• Whiff Test (Fishy Odor in the presence of 10% Potassium Hydroxide)
Here are some of the most common ways to test vaginal bacteria. Make sure you talk to your doctor about your options.
A wet mount test uses vaginal discharge samples to check for bacteria, white blood cells, and other cells in the body, known as clue cells.
Clue cells are vaginal epithelial cells that comprise the vaginal wall . If at least 20% of the sample contains clue cells, then you might have bacterial vaginosis.
Vaginal Discharge Test
During this test, a physician might look for clue cells. They will determine if it’s necessary by analyzing the color of your vaginal discharge first.
Vaginal pH Test
Under 4 is considered the ideal pH level of the vaginal microbiome. Anything over 4.5 leaves the body susceptible to infection. Low acidity in the vagina usually means a good amount of protective bacteria in the area.
Vaginal discharge is integrated with 10% potassium hydroxide. The bacteria in the discharge has a chemical reaction with this solution. As a result, it lets off a fishy order that doctors correlate with BV.
Thryve Vaginal Health Test
The Thryve Vaginal Health Test will be the ultimate resource for your doctor as they run their laboratory tests. This kit has everything you need to swab your vaginal microbiome at home. Within weeks, your doctor will know the bacterial levels throughout your vaginal microbiome.
Based on this information, your doctor can help you create a diet plan conducive to vaginal health. Plus, you might be able to receive a custom probiotic recommendation that can help bring balance to your overall wellness.
A Thryve Vaginal Health Test Kit doesn’t just help once you have BV. It’s also the perfect resource for infection prevention. This kit is extremely helpful for people planning to conceive or someone who has a new sexual partner.
Bacterial Vaginosis Prevention
Bacterial vaginosis is the most common vaginal infection for women. Luckily, there are a few things you can do to prevent the development of this infection.
Douching is ruining your vaginal microbiome. It’s unnecessary. Your vagina is pretty self-cleaning! Instead, stick to a healthy lifestyle. Maintain regular exercise and eat a balanced diet. These lifestyle changes will ensure you have the proper hormones necessary to keep your vagina healthy and clean.
Stay Clear of Harsh Soaps and Bubble Baths
We all love to lounge in a nice bubble bath. However, these luxuries are sometimes laden with abrasive chemicals and artificial scents. These items can end up drying up some of a woman’s natural lubricants. In turn, your body is more susceptible to bacteria overgrowth.
Scented soaps come with many of the same issues that douches do. Let your body clean itself naturally. Limit your bubble baths and use as many organic ingredients in your beauty routine as possible.
Practice Safe Sex
Limiting your sexual partners might prevent the development of BV. When you do encounter a new sexual partner, be sure to use condoms. They will prevent unwanted pregnancy or STIs.
Plus, condoms will lower the risk of transmitting any infections you have to a partner. Remember, those who are HIV+ and have BV put their sexual partners at greater risk, too.
If you are with an HIV+ sexual partner and have BV, consider getting on PrEP. Research on Oral PrEP found that this medication had a 77% success rate in preventing women with BV from contracting HIV from a sexual partner .
Regular Pelvic Exams
As much as a woman knows her own body, sometimes things can slip through the cracks. There is so much of a woman’s body they can’t see. So, rely on an expert. Be proactive and get a thorough pelvic exam regularly.
Thryve Vaginal Health Kit
The hardest part about dealing with BV is that the recurrence of this condition is extremely common. That’s why you should get your vagina tested regularly. You can skip the expensive copays of laboratory tests by getting an at-home vaginal health test kit from Thryve next year.
This breakthrough program in women’s health gives in-depth insights into your unique vaginal microbiome. You get actionable results such as dietary recommendations and personalized probiotics. We work with you every step of the way in trying to prevent the recurrence of BV.
How to Treat Bacterial Vaginosis
Bacterial vaginosis is curable. You might need medication to make it go away. However, all cases can be cured with a course of antibiotics. While antibiotics are excellent for destroying bad bacteria, they can also harm good bacteria. So, a meaningful way to stop bacterial vaginosis is through prevention.
That’s why it’s essential to do your own due diligence by using a Thryve Vaginal Health Kit in 2021 to determine bacterial ratios in your vaginal microbiome. Take these results to your doctor and get a full pelvic exam regularly. Once you speak to your doctor, here are some treatments they might suggest.
This medication can be taken orally as a pill or as a topical gel that goes into the vagina. You will want to reduce alcohol intake when on Metronidazole. It can cause nausea or abdominal pain.
This oral treatment can also cause nausea, similar to Metronidazole. Try to steer clear of alcohol up to three days after treatment.
Clindamycin is a topical cream that gets inserted into the vagina. Sexually active people should be careful using contraceptives while on Clindamycin. This topical can weaken latex condoms up to three days after applying.
Live a Healthy Life Without Bacterial Vaginosis
Bacterial vaginosis can make life a bit uncomfortable. Why grin and bear it? Reclaim your wellness and peace of mind by being proactive with your health.
If you show symptoms of BV, be sure to contact your health care provider immediately. Stay up-to-date with regular exams. Also, keep track of your vaginal health by enrolling in the Thryve Vaginal Health Program in the New Year!
Click Here To View Resources
 “CDC – Bacterial Vaginosis Statistics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Feb. 2020, www.cdc.gov/std/bv/stats.htm.
 Thilesen, Carina M., et al. “Leptotrichia Amnionii, an Emerging Pathogen of the Female Urogenital Tract.” Journal of Clinical Microbiology, American Society for Microbiology Journals, 1 July 2007, jcm.asm.org/content/45/7/2344.
 Burris, CNM, MSN, Justine. “5 Types of Vaginal Discharge & What They Mean (Infographic).” 5 Types of Vaginal Discharge and What They Mean – UnityPoint Health, 6 Dec. 2020, www.unitypoint.org/livewell/article.aspx?id=06f8f035-9f6e-4a79-bb58-9045b9d7d0d8.
 Manhart, L. E., Khosropour, C. M., Liu, C., Gillespie, C. W., Depner, K., Fiedler, T., Marrazzo, J. M., & Fredricks, D. N. (2013). Bacterial vaginosis-associated bacteria in men: association of Leptotrichia/Sneathia spp. with nongonococcal urethritis. Sexually transmitted diseases, 40(12), 944–949. https://doi.org/10.1097/OLQ.0000000000000054.
 Evans, A. L., Scally, A. J., Wellard, S. J., & Wilson, J. D. (2007). Prevalence of bacterial vaginosis in lesbians and heterosexual women in a community setting. Sexually transmitted infections, 83(6), 470–475. https://doi.org/10.1136/sti.2006.022277.
 “STD Facts – Bacterial Vaginosis.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Feb. 2020, www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm.
 Mirmonsef, P., Krass, L., Landay, A., & Spear, G. T. (2012). The role of bacterial vaginosis and trichomonas in HIV transmission across the female genital tract. Current HIV research, 10(3), 202–210. https://doi.org/10.2174/15701621280061816.
 Wiesenfield, Harold C., et al. “Bacterial Vaginosis Is a Strong Predictor of Neisseria Gonorrhoeae and Chlamydia Trachomatis Infection.” Oxford Academic, Clinical Infectious Diseases, Volume 36, Issue 5, 1 March 2003, Pages 663–668, 1 Mar. 2003, academic.oup.com/cid/article/36/5/663/456379.
 Allahna, Esber, et al. “Risk of Bacterial Vaginosis Among Women With Herpes Simplex Virus Type 2 Infection: A Systematic Review and Meta-Analysis .” Oxford Academic, The Journal of Infectious Diseases, Volume 212, Issue 1, 1 July 2015, Pages 8–17, 14 Jan. 2015, academic.oup.com/jid/article/212/1/8/1844919.
 Guo, Y-L, et al. “Bacterial Vaginosis Is Conducive to the Persistence of HPV Infection.” ResearchGate, International Journal of HIV & AIDS 23(8):581-4, Aug. 2012, www.researchgate.net/publication/230756337_Bacterial_vaginosis_is_ conducive_to_the_persistence_of_HPV_infection.
 “Pelvic Inflammatory Disease – CDC Fact Sheet.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 19 Nov. 2020, www.cdc.gov/std/pid/stdfact-pid.htm.
 Money D. (2005). The laboratory diagnosis of bacterial vaginosis. The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale, 16(2), 77–79. https://doi.org/10.1155/2005/230319.
 Publish date: February 26, 2017, and M. Alexander Otto. “Oral PrEP Works despite Bacterial Vaginosis.” MDedge, 18 Jan. 2019, www.mdedge.com/obgyn/article/132186/hiv/oral-prep-works-despite-bacterial-vaginosis.