You may have developed bacterial vaginosis (BV) when you were of childbearing age, since it’s a common vaginal infection at that time in your life, but did you know menopausal women and those with new sexual partners also are at greater risk? I learned this crucial fact when I chatted recently with one of my favorite menopause experts, Dr. Alyssa Dweck.
GERI: WHAT IS BV?
DR. D: “The vagina has a very intricately balanced ecosystem of different bacteria and yeast. This perfect balance protects the vagina from infection. The ideal vaginal pH is acidic ( 3.5 to 4.5) . BV occurs when there’s a disruption of the normal balance of bacteria, or when there’s a disturbance of the vaginal pH.
“BV is not an infection you catch from someone, but rather it is an imbalance in the natural environment of bacteria and yeast and it can cause havoc.”
WHAT ARE THE SYMPTOMS OF BV?
“The most common symptoms are a fishy or foul vaginal odor, often accompanied by a thin, gray watery vaginal discharge; irritation; itching; discomfort with urination, and occasionally pelvic bloating.”
WHAT CAUSES BV?
“Caustic ingredients in hygiene products , such as highly fragrant body washes or soaps, perfumed bubble bath, wipes or douches can irritate the sensitive lining of the vagina and alter the pH. The hormonal changes during menopause, and its well known effects on the vulva and vagina, also can predispose a woman to BV. ”
ARE SOME WOMEN MORE AT RISK OF DEVELOPING BV THAN OTHERS?
“Some women get BV infrequently and others seem to get it all the time. You’re more at risk if you smoke, don’t use condoms, and have a new sexual partner or multiple sexual partners (not because the new partner is giving BV to you, but because the exposure to semen can precipitate the pH imbalance). BV and other STDs also tend to run hand in hand. In other words, BV in and of itself can be a risk factor for STDs, and vice versa. To be clear, BV is not a sexually transmitted infection; women who aren’t engaging in sexual intercourse also can contract it.”
HOW IS BV TREATED?
“It’s easily treated with an antibiotic gel or something else to keep the PH in check. Estrogen in general, whether used in the vagina or systemic, also is considered to be a possible protective factor.”
HOW IS BV DIFFERENT THAN A URINARY TRACT INFECTION (UTI)?
“UTIs are typically characterized by burning with urination, frequency, and the urge to go constantly despite urinating only a little bit. Blood in the urine and back pain might present if the infection advances.”
ARE YEAST INFECTIONS DIFFERENT THAN BV?
“A vaginal yeast infection is not uncommon, but is different than BV because it is caused by a fungus, not a bacterial imbalance. Yeast naturally lives in the vaginal environment, but when it overgrows, you get this thick white non-foul discharge, incredible itching, redness and swelling.
“Yeast infections can result from antibiotic use, changes in the vaginal environment where the pH is upset (similar to BV); and a compromised immune system. Some women are particularly prone. It is important not to automatically assume that every vaginal infection is a yeast infection. Now that over-the-counter treatments are available, many women treat themselves, when in reality, they don’t have a yeast infection at all. This can be frustrating for both patients and gynecologists since diagnosis and treatment then becomes more complex.”