September 01, 2021

Vaginas 101: What is BV and Why Does It Keep Coming Back?

Welcome to this weeks 2 part series. Where we look at Yeast and BV- Whats the difference? And why is pH SO important

VAGINAS 101: BV and why does it keep coming back??

Bacterial Vaginosis or BV, is a bacterial imbalance in the Vagina. 
The vagina is normally home to lots of bacteria good and bad, https://www.youtube.com/watch?v=FvBnijdN0KEthat for the most part play nicely with each other. Problems happen when the lactic- acid producing bacteria the “good guys” called Lactobaccilus are reduced and this leads to an overgrowth of the “bad guys”. Normally the vagina is a nice acidic pH of around 3.8-4.5….. This acidic environment keeps everything running smoothly. When the pH of the vagina rises higher than this or becomes more alkaline thats when BV can happen. 
The symptoms can vary from person to person but they can include an increase in discharge, a change in odour which can also smell distinctly fishy, and this can cause irritation. 

Why does it smell fishy? BV is associated with an increase in bacteria that are produced by the breakdown of amino acids(compounds called Putrescine and cadaverine, trimethylamine ) and this is what causes the musky, fishy smell. 

Often women will say they notice the smell after sex or after their partner ejaculates inside of them and this is because when those compounds I mentioned earlier mix with the higher alkaline pH of semen, they become stronger. 

Many women don't know they have BV and this isn't good because BV increases your chance of getting an STI (like chlamydia, or gonnorhea, even HIV) 
Women with BV are also more likely to get Pelvic inflammatory disease (which is an infection of the uterus). 

Almost half of all women's medical visits are because of vaginitis which is is really discouraging because often women are misdiagnosed, told they have yeast, when really have BV or vice versa, or they have something completely different and it often takes a long time to be diagnosed. Both infections are incredibly frustrating and thats why its so important for women and people who have vaginas to be informed about how they function, so they know what questions to ask and know about what medications are out there to help them. 

For instance, you could have BV, be given metronidazole or an antibiotic to clear that up, which wipes out all the good bacteria, leaving the yeast to flourish and then you have to go on an anti fungal like Diflucan or fluconazole and many women experience this back and forth or get rebound infections and its horrible. 

Why do some women get Yeast and why do some get BV. So a couple of things here: 

Some women are just genetically predisposed to one or the other. A woman may just not make enough lactic acid bacteria and this lets the bad stuff get out of control. 
The usual culprits, smoking, emotional stress, environmental stress, antibiotics, the birth control pill, IUD’s especially, lack of sleep, anything that can disrupt your bacterial balance. 
Hormones and periods, menstrual blood alters the pH of your vagina and can contribute, this is especially the case in women who notice their symptoms are worse right after their periods. 

The other thing we should talk about when we talk about BV is BIOFILM. Biofilm is getting a lot more attention these days and Im glad. Biofilm is like a protective coating on bacteria that prevent antibiotics from working. When biofilms develop often reinfection happens. There are studies that show almost 90% of women with BV may have biofilms present and thats why it comes back so often. 

Good news is, There are some ways you can destroy biofilms which I will get into in one of my next videos. 

So what can you do? 

So this is shitty but There is a link between Sex and BV, and as ive mentioned before not everyones bacteria is going to play nicely with ours. Thats why we might be fine with one partner and then not great with another. Obviously not having sex is not ideal, but there are a few things you can do if you're dealing with BV. 
Condoms do help, whether it's protection from the pH of semen, or biofilm, or other bacteria on the penis, we aren't sure what, but they do help. 

There is also a link to bv and women who have sex with other women. This is a puzzling one but it could be because vaginal secretions are shared, sex toys are shared, and vaginal microbiomes can be colonized by each others bacteria. 

So let's get into how BV is often treated. 
Antibiotics reduce bad bacteria yes but they don't increase good lactic acid producing bacteria. Also antibiotics do nothing to destroy biofilm. So you need to encourage the good bacteria to GROW BABY GROW. 
Physicians often recommend oral or vaginal metronidazole which is an antibiotic, and you should also take an anti-fungal at the same time if you are prone to yeast after BV. 
For women who have BV that keeps coming back, physicians recommend using something called boric acid.

For women who suffer recurring BV, doctors actually recommend using boric acid for 3 weeks because Boric acid destroys biofilm. 

No douching, no body washes, no spermicide (be careful of this one as some condoms have spermicide on them), nothing scented or flavoured EVER so please look at what lubricant you're using. And Lastly, Look into your IUD and Birth control methods- it may be a simple fix or you may have to do some more investigation but i promise you this can be managed. 

Thanks for checking out this video. Be sure to hit subscribe and check out the video up next for Part Two on Yeast Infections. 
See you there!