Why do I have BV?

TL;DR

Bacterial Vaginosis (BV) can develop on its own or be sexually transmitted, often triggered by unprotected sex. It’s caused by an imbalance in vaginal bacterial flora, leading to symptoms like fishy odour. Understanding the role of biofilms and maintaining a balance of good bacteria like lactobacilli are key to effective treatment and prevention.

If you have been diagnosed with bacterial vaginosis (BV), you might be wondering where you got it from. The answer is not necessarily straightforward, and in many cases, you will never know if you developed it on your own, or if a partner passed it to you.

BV can either develop on its own in your vagina, or it can be sexually transmitted. One of the main triggers of BV is unprotected sex with a new partner (male or female), which was previously thought to be due to the more alkaline pH of semen (or that BV was a lesbian’s problem), but evidence has demonstrated that men can carry infective bacteria on their penises, and women can pass BV bacteria to each other easily. The biofilm-based bacteria is then transferred to each woman they have unprotected sex with, making it more likely that BV will appear in each new partner.

Just like in our intestines, we have both good and bad bacteria present in our vaginas, but the problem starts when the normally harmless bacteria known as Gardnerella vaginalis overpopulates the vagina and overthrows our friendly microbes, called lactobacilli. This results in the classic symptoms of BV, like fishy odour and different discharge.

BV is caused by an imbalance in the bacterial flora in a woman’s vagina, which is why it’s called ‘vaginosis’, not ‘vaginitis’ – vaginosis means abnormal, while vaginitis means inflammation. BV by itself does not cause inflammation due to the type of bacteria that BV refers to, so any itching, soreness, rawness or other signs of inflammation are coming from other bacteria in your vagina, which may indicate aerobic vaginitis (AV). You can have BV and AV at the same time, which is why proper testing and appropriate treatments are key to ridding yourself of these bacteria.

If you don’t treat the biofilms that BV or AV bacteria create, you will not treat your BV effectively, which is why about half of all antibiotic treatments fail. Many women are on long doses of either vaginal or oral antibiotics, with no cure, however this is because antibiotics on their own are an ineffective treatment for recurrent BV. Recurrent BV is BV that appears to ‘come back’ regularly, but really it just never goes away – the biofilms are still lurking, keeping the bacteria comfortable. Period blood and semen are both alkaline, and can cause a flare-up of symptoms.

When the lactobacilli and other beneficial bacteria are present in high numbers, they keep G. vaginalis in check and so we have a happy, healthy vagina. Good bacteria also form a protective shield to your vaginal cells, while defending their colony.

In order for you to eliminate BV for good, you have to treat the cause by removing the G. vaginalis biofilm and at the same time repopulate your vagina with lactobacilli. Read Killing BV, and if you have a male partner, he should read Killing BV: Guide for Men, to thoroughly understand the problem, and treat your biofilms effectively.  



Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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