Bacterial Vaginosis (BV) is an imbalance of bacteria that live in the vagina, and actually is not an infection. It is caused by the loss of protective acid-producing bacteria called lactobacilli. As the vagina becomes less acidic, other bacteria can overgrow, causing symptoms.
BV has a discharge with a burning sensation and a strong, offensive odor. Oftentimes this occurs after frequent sexual intercourse. It is the most common vaginal complaint for which women come to the office. However, many have never heard of it. Symptoms can be mistaken for yeast and will not clear up with antifungal medicine such as Monistat. The discharge can be white to grayish, watery or creamy, sometimes staining underwear. It can cause mild vaginal itching or burning. Fifty percent of women will have no symptoms at all; however, it is seen by her clinician on the routine exam.
It is important to treat BV as it has been linked to other health-related problems such as abnormal pap smears, or infection in the fallopian tubes and uterus which can subsequently affect fertility. Pregnant women have the risk of it causing premature rupture of membranes, preterm delivery, and it has been associated with postpartum endometritis (infection of the uterus after the baby is born).
Diagnosis is made by examination in the office and looking at the discharge on a slide under the microscope. Treatment can be an oral antibiotic or an antibiotic inserted into the vagina. Both are daily doses for about a week.
Recurrence is frequent as much as 30% within 3 months and 80% within a year. This has led many women to use boric acid in a vaginal suppository a couple of times a week to keep the acidity of the vagina at a high level. Other natural treatments may be worth trying in recurrent problems – but most have not been subjected to careful scientific testing.