Dear Anne, I've had some funky vaginal discharge, and my friend told me to get checked for BV. What is BV and how to I make it go away!?--"Gina"
BV, or bacterial vaginosis, is the most common cause of abnormal vaginal discharge in the United States. This condition occurs when the balance of bacteria in the vagina is disrupted, resulting in a thin, grayish-white discharge said to have a musty or fishy smell. If you remember your high school Latin you'll note that "bacterial vaginosis" is actually a misnomer, since it literally means "bacteria with an excess of vaginas." "Vaginal Bacteriosis" would make a lot more sense, but then again a vaginal discharge by any name still doesn't smell very sweet.
Like most other areas of the body, the vagina is happiest when it has a very particular population of bacteria living on it. The presence of some normal bacteria is actually a good thing, as any woman who has wound up with a raging yeast infection after taking antibiotics can attest. Just as some bacteria live in the human gut, aiding in digestion and out-competing bad bugs, some yeasts and bacteria are ordinary, harmless tenants of the female anatomy. Too many of these microbial guests, however, can quickly overstay their welcome. Things can get particularly ugly (and odiferous) when bacteria known as anaerobes set up shop. These bugs don't require oxygen to survive and are responsible for the lovely, trout-like smell of BV discharge.
Some controversy remains in the scientific community about what exactly causes BV, although it is not considered an STI. Evidence that BV isn't transmitted sexually includes the finding that treating male partners doesn't reduce recurrence among women with BV, as well as the fact that women who have never had intercourse will occasionally develop this condition. BV is, however, seen more frequently among women with multiple sexual partners and often develops in those who have recently started having sex with a new partner, implying that sex often plays a role in its pathology. Other factors that contribute to the development of BV include the use of IUD contraceptive devices and douching. Theoretically, thongs can contribute to the problem by creating a little cotton highway for bacteria to travel from the anus to the vagina, although this hasn't been proven clinically.
Most of the time, the worst thing about BV is the unpleasant discharge. It can, however, occasionally be associated with much more serious problems. For one thing, BV lowers resistance to sexually-transmitted infections, so women with this condition are more likely to contract HIV, gonorrhea and chlamydia. BV also increases the risk of developing pelvic inflammatory disease, which results in scarring around the uterus and fallopian tubes, making future pregnancies more difficult.
If you think you might have BV, go see your gynecologist. She'll need to do a pelvic exam and collect a sample of discharge for examination under a microscope. The microscopic finding of increased bacteria in the vaginal cells combined with characteristic discharge, low pH and a positive "whiff test" (yes, she will actually smell your discharge) confirms the diagnosis of BV. The good news is that treatment is very easy and effective: BV responds to antibiotics either taken orally or applied in the vagina as a cream. Metronidazole and Clindamycin are the drugs of choice because they attack anaerobes, which are resistant to many other antibiotics. This treatment should address the excess bacteria in your vagina ... and who knows, it may even help the bacteria get rid of all their excess vaginas.
Anne Mills is a Cavalier Daily Health & Sexuality Columnist. She can be reached at mills@cavalierdaily.com or through the Sex & Balances submission page at cavalierdaily.com/sex.asp. This column should be used for educational purposes only and is not meant to substitute advice from your doctor.
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