Understanding and treating bacterial vaginosis

Bacterial vaginosis (BV) is the overgrowth of unfriendly bacteria in the vagina, resulting in bad smells, unusual discharge and/or a shift in pH to over 4.5. BV may be asymptomatic, only found during vaginal testing for other reasons.

BV can be resolved with appropriate treatment, but if the treatment isn’t sufficient to clean up the issue, BV can become chronic or recurrent. That is, it never seems to go away no matter what you do.

Recurrence rates after standard medical treatment with antibiotics (usually metronidazole or clindamycin) are unacceptably high, so if you’ve found yourself in a no-win situation, this may be why.

Chronic BV is a blight, slowly destroying self-esteem, intimate relationships and sometimes, sadly, clothes. But luckily western medicine isn’t the only one plugging away at solving BV! We’re on it.

My Vagina’s Killing BV system – we will help you!

Here at My Vagina, we specialise in treating BV and take our treatment failures seriously and personally. We know how horrible BV is – we’ve had it too.

Being educated is the first step to solving BV once and for all. Download Killing BV and join the exclusive membership area for loads more information and tips and tricks. Start your drug-free journey to a healthy, happy, BV-free vagina guided by one of the world’s very best vulvovaginal naturopaths, Jessica Lloyd.

Understanding BV

A BV vagina is a bus full of noisy, smelly, rude kids

BV is not an infection, but an imbalance. You’re on a bus when 15 rowdy, rude eight-year-olds get on board. The ratio of annoying, rude kid to preoccupied grown-up is off, but there is nothing technically ‘wrong’ with this – it’s just a change in who’s around.

BV is a change in who’s around in your vagina. The rude kids got on the bus, and they’re going to be hard to get off.

There is an umbrella term for when the rude kids get on the bus and take over: vaginal dysbiosis. Dysbiosis means a microbial imbalance where the rude kids are the bad bacteria that cares not for your feelings or hot date.

Vaginal dysbiosis appears in many forms, resulting in yeast infections and another BV-like problem known as aerobic vaginitis (AV).

Here at My Vagina we largely treat BV, AV and yeast the same: as vaginal dysbiosis. That is, a disruption to your healthy vaginal flora. There are many incarnations, but these three are the main ones.

Why does the balance shift?

Your vagina is not an isolated piece of your machinery; it is supported by your entire body. There are lots of reasons why the balance of your vaginal flora may change for the worse, including:

Hormonal changes (low oestrogen – oestrogen stimulates glycogen production in the vagina, which is the food for your healthy bacteria, so losing one or both ovaries, perimenopause, menopause, surgery, radiation, oestrogen-blocking breast cancer drugs, chemo)
Food intolerances (certain food colours, for example, are known to inhibit your immune system, leaving your vagina – and the rest of you – open to infection)
Stress (stress hormones like cortisol block glycogen production in the vagina, starving your healthy bacteria)
Digestive problems (people with irritable bowel, Crohn’s and other digestive problems/diseases tend to have more vaginal infections and imbalances – trouble upstairs can mean trouble downstairs)
Crappy lifestyle choices (people who drink a lot, we’ve found, get more BV, but drugs, cigs and late nights all reduce your immunity)
Low-quality food (if you live on burgers and chips and frozen food and carbs, you’re setting yourself up for a thousand problems including vagina problems)
Poor immunity (if you’re already under-performing immunity-wise, you’re a sitting duck for vaginal microflora imbalances)
Bareback sex (you can catch BV from a sexual partner)
Naturally low levels of lactobacilli (certain ethnic groups inherit naturally low levels of lactobacilli from their mothers, which can result in a greater susceptibility to BV)

How your vaginal microbes join forces to cause BV

Bacterial vaginosis produces bad smells, funny discharge and a pH out of the healthy range.

Each of you experiences BV a bit differently because everyone has different sets of bacteria present.

Think of your different species of vaginal microbes as one of the kids on the bus, with its own personality.

Each annoying eight-year-old on the bus (in your vagina) creates a different symptom. You’ve got the mean kid, the quiet kid, the chameleon kid, the comedian kid, the sporty kid, the nerdy kid.

The specific group of kids together create a unique set of symptoms, just like the vibe of all the different personalities at a party.

Who are all these eight-year-olds at my party?

Bacterial vaginosis is often caused by a bacteria called Gardnerella vaginalis, but there are many other culprits. Who is the bully on your bus?

G. vaginalis is a big ‘un because this germ is a great ringleader, but your vaginal microbes may be being led down the garden path by the likes of E. coli or other rude kids.

G. vaginalis or E. coli, or whoever the bully on your bus is, recruits kids that help make the bully dominant. We all need a ringleader to lead us astray, but the characteristics of the ringleader will determine what sort of state the bus is in once the dust settles.

This group effort can cause or contribute to the many and varied symptoms you may be experiencing and makes getting rid of BV harder.

What is a bacterial biofilm?

Your bus’s bully and some of its cronies builds what’s known as a biofilm. Think of it like a perspex case that covers the bus, protecting the horrid little children from rubber bullets (antibiotics) and other attempts to get them off the bus (vinegar, hydrogen peroxide, boric acid, probiotics and so on).

Symptoms may go away temporarily as the rubber bullets put a few kids onto the ground, but they aren’t really hurt and they just get right back up and start taunting all over again.

Flare-ups may occur around reinfection opportunities (sex with an infected partner), or when an unfriendly pH substance enters the vagina, such as semen or period blood.

Symptoms of bacterial vaginosis, aerobic vaginosis or other vaginal dysbiosis

Itching
Redness
Soreness
Swelling
Pelvic or vaginal pain
Pain during or after sex
Cramping
White, grey, yellow, green, clumpy, thick or bloody discharge
Odour is fishy, foul, rotten meat, faeces, off-smelling, or like ammonia or vinegar
Rawness
Symptoms alleviated during period
A test may come back with no results (testing for the wrong thing)

Diagnosing BV, AV or vaginal dysbiosis

Regular swab and culture

Every country does diagnosis a little bit differently, but the main method, now getting outdated, is a culture: growing bacteria on a petri dish to determine the dominant growth of bacteria or yeast.

Comprehensive DNA-based vaginal microbiome testing

A culture cannot detect some BV-related bacteria, because some microbes are hard to grow in these conditions.

A comprehensive next generation sequencing (NGS) vaginal microbiome test looks for microbial DNA/RNA, and can detect even a dead microbe.

Polymerase chain reaction (PCR) tests can only find what the test asks for. If you don’t ask, it won’t tell. This is why the more comprehensive NGS tests are preferable.

Testing your pH (acidity levels)

To have bacterial vaginosis, your pH may be high. You can, and should, regularly test your vaginal fluid pH at home using pH strips.

Healthy vaginal fluids of a person who is getting periods typically sit between a pH of 3.5-4.5, however, prepubertal girls and those in menopause tend to have a healthy pH of about 5.0 or higher. This higher pH is due to the absence or low levelws of lactic-acid-producing lactobacilli.

The absence of lactobacilli does not mean the presence of pathogens, but it can mean increased susceptibility to imbalances.

My Vagina’s unique, effective Killing BV system

Here at My Vagina, we specialise in vaginal microbial imbalances and have developed our own effective, non-antibiotic treatments with ongoing support available. You’re not on your own!

We fully back our Killing BV treatments with free email support – you are all unique snowflakes! We know you have questions and we know each of your situations is different. Our vulvovaginal specialist naturopaths are here to support you in your journey to a happy, healthy vagina.

There is nobody else like My Vagina.

BV Research Section — Check out our BV research section.

References^1–4

1.
Cartwright CP, Pherson AJ, Harris AB, Clancey MS, Nye MB. Multicenter study establishing the clinical validity of a nucleic-acid amplification–based assay for the diagnosis of bacterial vaginosis. Diagnostic Microbiology and Infectious Disease. Published online November 2018:173-178. doi:10.1016/j.diagmicrobio.2018.05.022
2.
Das A, Panda S, Singh A, Pala S. Vaginal pH: A marker for menopause. J Mid-life Health. Published online 2014:34. doi:10.4103/0976-7800.127789
3.
Sianou A, Galyfos G, Moragianni D, Baka S. Prevalence of vaginitis in different age groups among females in Greece. Journal of Obstetrics and Gynaecology. Published online May 4, 2017:790-794. doi:10.1080/01443615.2017.1308322
4.
Morris M, Nicoll A, Simms I, Wilson J, Catchpole M. Bacterial vaginosis: a public health review. BJOG: An Internal Journal of Obs Gyn. Published online May 2001:439-450. doi:10.1111/j.1471-0528.2001.00124.x