Is BV an STD?

Bacterial Vaginosis, more commonly referred to as BV, is the most common vaginal infection in women, and despite the fact that you can get it after having sex with a new partner, it is NOT a sexually transmitted disease; your new partner doesn't infect you.  I can't tell you how many times women have gone screeching into their GYN's office freaking out that they got an STD because something smells funky down there (which is a good practice to have, btw) but BV isn't an STD and you don't need to trash your new partner all over town about it!  Here is an explanation of what it is, symptoms, diagnosis, and treatment options.  I want you all to be aware of what could be going on down there...

What is BV?
Basically it is an overgrowth of one of the natural occurring bacteria in your vagina, and when the delicate balance that is your vagina gets an overgrowth of one bacteria, there can be foul smelling discharge, itchiness, odor, pain, and/or burning.  Most commonly it smells like a dead fish down there....not good, ladies.  And, if it takes someone saying something to you about it, even worse.  Pay attention to what's going on in your vagina, and notice if something smells off or looks funky.

So, How do I get BV?
Well, unfortunately, it is not completely known why some people are more prone to these infections than others.  But, new sexual partners and having multiple sexual partners can cause a BV infection; it may be due to the use of numerous condoms and your body is reacting, or due to the change in your natural flora from having everything disrupted frequently down there.  Some women know that after they have sex with a new person, they will get BV, so they preemptively have a plan with their HCP about it (which is some smart thinking!)  If you have unprotected sex, it can just be that mixing their bacteria with yours causes an upset, and your body reacts the way it knows how and can.  Also, women who douche tend to have a higher frequency of BV; although this is a little bit of the chicken/egg debate.  Women who douche tend to think that their vagina smells, and they may already have an overgrowth of bacteria just because they do, so they douche, and flush that bacteria all over the place, and cause an even bigger disruption in their flora, causing a more widespread BV, so they link the douche to BV, whereas they probably had the infection anyway.  OH, and women who are NOT sexually active can get BV infections; some peoples vaginal floras are just more sensitive than others.  It is a bit of a medical quandary though....

What are the signs/symptoms?
Strong fishy odor, that increases after sex
White/gray thin discharge
Itchiness around the outside of the vagina
Stinging/burning with peeing
OR no symptoms at all!

How can BV affect me?
Having a BV infection can increase your risk of contracting HIV if you are exposed to the virus
It also increases the risk that you will pass along HIV to a partner (if you are infected)
Having BV (past infections) increases your post operative risk for infection (post hysterectomy, abortion, or other gynecological surgeries)
Having BV increases your risk of also contracting HSV (Herpes simplex virus), Chlamydia, and Gonorrhea (your vaginas natural defense mechanisms are down due to the BV infection)
A BV infection while pregnant can increase your rate of complications such as pre-term labor, lead to low birthweight babies (under 5.5lbs), and premature babies.
Also, undiagnosed BV can lead to PID (Pelvic Inflammatory Disease)

Are there any tests to determine BV?
The only "test" of determining BV is based upon your complaints (i.e. grey discharge, smelly odor, etc) and with a pelvic exam and taking a small sample of discharge from your cervix and examining a smear by your HCP.  There are no blood tests or anything fancy to diagnose the infection, but seeing as it is so common, if an HCP even suspects it, without you complaining of symptoms, they may treat you anyway.

Is there a treatment available?
Honestly, many times it will clear up without treatment on its own, as long as you abstain from sex and using douche; the vaginas natural flora will fight to get back to normal BUT due to possible complications that can occur with long term infections, most likely you should get treatment if it is suspected.  Also, of note, male sexual partners do not need to be treated, but women partners do to prevent to possible spread!  There are two different antibiotics used to treat BV (you only need one): metronidazole or clindamycin orally (and the same treatment is for HIV+/-).  All pregnant women with any signs should be treated, and most HCP's require that all women post gynecological surgeries be preemptively treated.

How do I prevent BV infections?
The best way is to limit your sexual partners and don't douche!  Honestly, I am not sure why douche is still on the market, there is nothing good that comes from douching....so please don't!  Also, use all of the medication given to you to treat your BV, for the ENTIRE prescription, so that you actually kill off the bacteria and allow for your flora to re-grow.

It is important to note that BV infections can come back, and some people think that using probiotics can help encourage the regrowth of the natural bacteria and get it to normalize, there is no literature to support that, but if you are a chronic BV'er, it might be worth a try.  And, if you do get BV infections after sex, talk to your HCP about different things to might try, like different kinds of condoms (you may have a small allergy), if you are in a monogamous relationship an don't use protection maybe you need to clean your partners penis with antibacterial soap and you shower before intercourse.  This doesn't have to be a horrible life affliction, but to those who don't know about it, you need to be aware and get proper treatment because it can have longterm health effects!

Yours in Good Health