BV is the most common cause of vaginal discharge in women of childbearing age, accounting for 40-50% of cases. BV is caused by a change in the normal bacteria in the vagina characterized as a reduction in the normal lactobacilli in the vagina and the overgrowth of other organisms.  These organisms cause a rise in the pH of the vagina, massive overgrowth of the bad organisms and breakdown of vaginal proteins that results in malodorous and copious discharge. The most common organisms that are found in cultures or swab tests are Gardnerella vaginalis, Prevotella, Porphyromonas and Bacteroides species.  Fifty to seventy-five percent of women are asymptomatic, however, those women who have symptoms will typically have a thin white-grayish discharge with a “fishy smell” usually noticed after intercourse or during menses.  

Your provider will do an exam, take a sample of the discharge, and do lab tests to look for an infection. Bacterial vaginosis can be treated with antibiotics such as metronidazole and clindamycin.  Both of the medicines and be taken as a pill or a gel inserted inside the vagina. And are equally effective. It can also be treated with boric acid vaginal suppositories in women with relapsing or recurrent BV.  To prevent recurrent infections, probiotics containing Lactobacillus rhamnosis, reuteri and acidophilus can be used to help restore the vagina’s natural bacteria levels. Thirty percent of patients with initial response to therapy have a recurrence of symptoms within 3 months so maintaining good vaginal health is important..

Risk factors for BV are associated with new sexual partners, douching, smoking, sex toys, oral-genital contact, vaginal contact with fingers, menopause, menses, semen, lubricants, spermicides and latex condoms.

The vagina is able to maintain a healthy balance of bacteria so douching, using soaps or feminine wash with dyes and perfumes, bubble baths to cleanse the vagina are harmful and increase your risk of infection. If you suffer from frequent infections, consider making these changes to  decrease your risk for future infections and potentially prevent recurrence. Hope these tips help!

  1. Don’t use soap with dye or perfumes.
  2. Sleep without underwear at night or sleep naked.  Let your vagina breath!
  3. Don’t use panty liners if you have discharge, just change your underwear more frequently.
  4. Always wear cotton underwear.  Anything else allows moisture to sit next to the vagina causing irritation.
  5. Consider using sensitive skin laundry detergent for your underwear, it may be causing irritation or change the pH of your vagina.
  6. Use non-latex condoms.

With love,

Dr. Jodie Horton