STD Awareness: Bacterial Vaginosis and Chancroid

Editor’s Note: Please see our post of November 2, 2015 to learn if bacterial vaginosis (BV) can cause sores, and to get the scoop on whether or not it’s actually an STD.

Sexually transmitted diseases can be caused by viruses, bacteria, protozoans, and even animals. Bacterial vaginosis and chancroid are both infections caused by bacteria, which means that they can be treated with antibiotics. While bacterial vaginosis only affects people with vaginas, chancroid disproportionately affects people with penises. You can seek diagnosis and treatment for bacterial vaginosis and chancroid at a Planned Parenthood health center, as well as health clinics, private health-care providers, and health departments.

Bacterial vaginosis is caused by an imbalance of bacteria species in the vagina. Image: renjith krishnan /

Bacterial vaginosis is caused by an imbalance of bacteria species in the vagina. Image: renjith krishnan /

Bacterial Vaginosis
Bacterial vaginosis seems to be most commonly caused by the bacteria species Gardnerella vaginalis. Scientists aren’t quite sure how this infection is caused, but risk seems to correlate with a change in sexual partners, having multiple sexual partners, douching, or using an intrauterine device; it can also occur in females who have never been sexually active. It is more common in pregnant women. There is no counterpart to this infection in males, although G. vaginalis can be found in their urethras; this raises the possibility that bacterial vaginosis can be sexually transmitted, in which case it could be directly transmitted between two females or indirectly transmitted from one female to another via a male.

Bacterial vaginosis seems to result from an imbalance in the vaginal flora (“flora” is a somewhat fanciful term for the bacteria that live in your body; under normal circumstances they are harmless and even beneficial). Vaginas usually are habitat to a population of bacteria called Lactobacillus, which produce hydrogen peroxide as a byproduct. When the number of Lactobacillus declines, G. vaginalis is able to move in on Lactobacillus’ old territory. The decrease in Lactobacillus and increase in G. vaginalis leads to a rise in the vagina’s pH. The new vaginal environment is less acidic and more alkaline; a vaginal pH of more than 4.5 is one criterion for the diagnosis of bacterial vaginosis. Another symptom includes a vaginal discharge that may smell somewhat fishy. There might also be genital itching or pain during urination. It is also possible not to have symptoms.

It is important to seek treatment for suspected bacterial vaginosis if you are pregnant, as the infection can lead to complications in your pregnancy. Bacterial vaginosis also makes you more vulnerable to infection by HIV and other STDs. Rarely, it can spread to the uterus or fallopian tubes where it can cause pelvic inflammatory disease.

Fortunately, bacterial vaginosis is treatable with drugs such as metronidazole or clindamycin, which kill some bacteria but not others, allowing Lactobacillus to reestablish its population in the vagina. Any medication you are given should be taken as directed and not discontinued earlier than prescribed – if you stop taking it early, the “bad” bacteria might not be under full control and could reestablish themselves, causing your infection to recur. Douching, even with a hydrogen-peroxide-based douche, is not an effective treatment. The consumption of dairy or non-dairy yogurt (whose live cultures include Lactobacillus species) is not clinically proven as an effective remedy for bacterial vaginosis when it is taken in lieu of antibiotics, although it might enhance the effects of antibiotics when both are taken together.

More information about bacterial vaginosis can be found at the Centers for Disease Control and Prevention’s website.

Microscopic image of Haemophilus ducreyi, the bacteria species responsible for chancroid infections. Image by Dr. N. J. Fiumara, courtesy of the CDC's Public Health Image Library.

Microscopic image of Haemophilus ducreyi, the bacteria species responsible for chancroid infections. Image: Dr. N. J. Fiumara, CDC’s Public Health Image Library.

Chancroid is caused by a bacteria species called Haemophilus ducreyi; its habitat includes our mucous membranes. Infections by these bacteria are very rare in the United States and rarer still in Arizona, where our dry weather stands in stark contrast to the tropical climates where chancroid is more common. Furthermore, it affects males at a greater rate than it affects females; according to the World Health Organization, this is possibly due to chancroid disproportionately affecting some sex-worker populations, whose clients are almost entirely male. Also, as cited in a 2006 systematic review, uncircumcised males are at increased risk for chancroid, which scientists hypothesize is due to the warm and moist environment the foreskin provides for bacteria. Many U.S. physicians are unfamiliar with this STD, which might cause difficulties in diagnosis and underreporting of its prevalence.

Symptoms of chancroid usually appear within 10 days of initial infection, and can include the formation of a swollen, open sore on the genitals. The lymph nodes in the genital region also become infected, and might swell to the point of breaking through to the skin’s surface, where they can release pus. Because chancroid can also be transmitted via oral sex, the infection can manifest itself in the oral cavity, such as the lips or tongue, where lesions can form. When lesions are present, the risk for transmitting other STDs, such as HIV, is increased. Chancroid symptoms can often be confused with those of other STDs, such as herpes or syphilis, so it’s important to get a diagnosis from a professional.

Chancroid is spread by the skin-to-skin contact inherent to most sexual activities, or by contact with pus from a chancroid sore. Risk for chancroid is correlated with multiple sex partners (15 to 20 partners per year, according to WHO). Sexually active people can reduce their risk of contracting chancroid by using latex barriers, such as condoms and dental dams. If you suspect that you or your partner has a chancroid sore, avoid contact with it as the pus from such sores can spread the bacteria.

Chancroid is diagnosed by examining pus collected from lesions and checking it for the presence of H. ducreyi. It is treated with certain antibiotics, such as erythromycin. In rare cases, it is possible for the lesions to lead to permanent scarring. More information can be found at Planned Parenthood’s website.

Click here to check out other installments of our monthly STD Awareness series!

13 thoughts on “STD Awareness: Bacterial Vaginosis and Chancroid

  1. Pingback: STD Awareness: 10 Sexually Transmitted Infections You Probably Don’t Know About | Planned Parenthood Advocates of Arizona | Blog

  2. Pingback: STD Awareness: HPV in Males | Planned Parenthood Advocates of Arizona | Blog

  3. I went to the doctor, the doctor told me I had Bv. I did the treatment, pills and cream. 5 days into my treatment it start to swelling and sore down there. What should I do. The sore is healing. It itch on left side next to my lip down there.

    • I would encourage you to get back to the doctor to talk about possible side effects. I don’t know about swelling, but it is rather common for people to develop yeast infections when taking antibiotics, and yeast infections cause itchiness. But you can’t be diagnosed over the Internet — see if you can make an appointment with a doctor to discuss the problems. It’s important to finish the course of antibiotics you are prescribed so drug-resistance doesn’t develop, but it also sounds like you are experiencing unpleasant symptoms, and a doctor might be able to help you with that. Good luck!

  4. Iv been dealing with, burning,irritations,itching and yellow discharge for over a year..Iv been checked for yeast and bacteria. Both negative. I don’t know what to do anymore. They put me on an anti- inflammatory cream. . Isn’t doing anything. I feel so depressed and uncomfortable

    • I’m so sorry to hear that! Have you been able to get a second opinion from a different provider? Have you been checked for allergies, or experimented with different soaps/toilet paper/underwear? Have they looked at a full range of bacteria, from sexually transmitted bacteria (chlamydia, gonorrhea) to bacteria that aren’t sexually transmitted (UTIs, BV)? Have they looked at non-bacterial infections, like trichomoniasis? Good luck with everything; I hope a doctor can figure out how to find the cause of your symptoms.

  5. I get bv alot. I got diagnosed with hsv2 but I think it’s chancroid. Does a doc usually check for hsv2 and chancroid when symptoms apear?

    • I don’t know where you live, but in the United States, chancroid is not included in a normal STD screening. You would have to ask to be tested for it. Good luck!

  6. I’ve had bv several times and I can tell you from experience that it has happened due to me and my husband not washing in the heat of the moment before having sexual intercourse, I have unintentionally passed bv to my spouse and he carried the bacteria in his urethra. We both got treated with flagyl and have been clear ever since, please take vaginal probiotics as well it will help!

    Remember folks wash before and after sex & if you contuine to get treated and reinfected go get your partner treated!

    Like yeast.. bacteria can be spread. So yes I would assume it’s sexually transferable.

  7. I have some itching and irration on the side of my lips (the crease of my legs and lips). It’s looks like there is sores in that area. I have not yet got a doctors opinion. Could it be BV?

    • The very best thing you can do is to see a licensed medical professional who can evaluate your symptoms and take your history. You can read more about BV here.

  8. So I got my test results back saying it’s bv… My symptoms however are different one day I ended up getting lesions really bad, it stinged to pee, I have what look like razor bumps… My only question is can my test be mistaken. She tested for everything except herpes and I’m freaking out.

    • If the sores have a red border and a yellow crust over during the later stages of the outbreak….more than likely sounds like herpes. I would get a doctors opinion though. You can put Vaseline on it or urinate in a bath tub of water. It’s less painful

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