The Uncomfortable Vaginal Condition You Need To Know About

Photographed by Nicholas Bloise.
Of all the things that could be up with your vag, bacterial vaginosis — or simply BV — may be the most confusing. It comes with the classic itchiness of a yeast infection and sometimes even the hallmark burning pee of a urinary tract infection (UTI), so it's understandable that so many of us mistake BV for those other more well-known issues.

That's not good, because bacterial vaginosis is a totally different thing — and requires its own kind of treatment plan. Here's what you need to know.

What is bacterial vaginosis?
It's a state of vaginal inflammation caused by an overgrowth of certain types of bacteria. You have these bacteria normally, but they're kept in check by the other members of your vaginal ecosystem (e.g. yeast and other bacteria). When things get out of whack, these bacteria seize the opportunity to up their numbers.

What causes it?
The exact mechanisms aren't totally understood, but we know that anything that messes with that fragile balance can cause bacterial vaginosis. That includes having a lot of sexual partners or having a lot of sex with someone new (in the same way that this makes you more likely to get a UTI). It also includes douching, which is totally unnecessary anyways. And some people just naturally produce fewer good bacteria, so they may be constantly fighting that imbalance.

What are the symptoms?
Many people who have bacterial vaginosis don't actually have any symptoms. But the condition can cause a burning sensation when you pee, itchiness around your vagina, and white or gray discharge that has a fishy smell.

If you have symptoms of BV, it's important to check in with your doctor. Although it might seem like a minor annoyance, the infection can cause other problems down the line. In particular, it can increase your risk for other types of infections, including STIs and pelvic inflammatory disease. Also, the symptoms of bacterial vaginosis are easy to confuse with other issues, such as yeast infections and UTI. So it's crucial to make sure that you know what's really going on to make sure you get the right treatment — please don't just rely on Dr. Google for this one.

How bacterial vaginosis treated?
Sometimes BV goes away on its own. But if you do have symptoms, you'll need to be checked out. There are a couple of antibiotic medications out there that your doctor may prescribe, in the form of either pills or gels and creams that you put inside the vagina.

While you're recovering, remember that your vagina and the surrounding area are going to be pretty sensitive and inflamed. So take care to use gentle unscented soap when washing and wear loose-fitting clothes and cotton underwear to keep things dry and comfortable.

What happens if it comes back?
Unfortunately, it's pretty common for bacterial vaginosis to return within a year of treatment. If it does, your doctor will give you a different medication than the one you previously took. And if it keeps coming back, you may have to go on long-term antibiotic treatment. The CDC recommends using metronidazole, an antibiotic gel, twice a week for up to six weeks. There's also some evidence that consistently using condoms and taking a course of probiotics may help prevent BV from returning.

But staying in touch with your doctor is the first step to making sure you get on the path to treatment.
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