Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University
Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.
There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?
All good questions. Let’s examine them one by one.
Is BV an STD?
The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”
On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.
The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).
What about heterosexual transmission? Bacteria from a penis can be introduced into a vagina, possibly disrupting its ecosystem. The Lactobacillus population can usually keep these invaders in check, but sometimes the vaginal flora can go haywire. Men have been found to host G. vaginalis in their penises, and because BV can be caused by numerous other bacteria — not all of which are known to scientists at this point — it is certainly possible that men could transmit BV-associated microbes to their partners during sex. Oddly, antibiotics for male partners are not recommended, as they are not found to be effective in reducing BV recurrence in female partners. However, better-designed studies might change these recommendations in the future.
The upshot? BV can be transmitted sexually, but because it can strike people who have had zero sex whatsoever, it’s not officially an STD. Many of the machinations of BV are shrouded in mystery for now, but here’s what we seem to know for sure: Virgins can get BV, but risk is increased when someone has a new sexual partner or multiple sexual partners. In fact, the more sexual partners someone has over their lifetime, the greater their risk for BV — a pattern that is consistent with STDs.
BV isn’t the only not-technically-an-STD that can descend upon a female reproductive or urinary tract in the wake of sexual activity. You might have heard of “honeymoon cystitis” — a bladder infection preceded by frequent sex. You don’t have to have sex to get a bladder infection, but some doctors believe that the friction from vaginal intercourse can push preexisting bacteria into the urethra, where it can start its journey to the bladder. Yeast infections are another non-STD that can be transmitted from one partner to another by sexual activity.
Bacterial vaginosis does increase risk for acquiring other STDs, such as HIV, herpes, chlamydia, and gonorrhea. So, while you can get it even without being sexually active, a BV infection can make you more vulnerable to STDs if you do become sexually active.
What Are the Symptoms of BV?
More than 80 percent of people with BV have no symptoms at all. But, for those of us unlucky enough to get symptoms, here are some afflictions we might experience:
- thin white or gray vaginal discharge, which can be watery or foamy
- vaginal odor, which might smell “fishy”
- burning in the vagina
- itching around the vaginal opening
- burning sensation while urinating
These symptoms can be easily confused for trichomoniasis (trich) or a yeast infection. To get a proper diagnosis, you’ll need to see a health care provider, who can take a vaginal sample and look at it under a microscope or perform a lab test.
Can BV Cause Sores?
A lot of people might find sores in their vaginal region and hope they are symptoms of something like BV — rather than evidence of an STD. None of the sources consulted for this article listed sores as symptoms of bacterial vaginosis, but they can be symptoms of other infections, including:
- genital herpes: symptoms can include blisters and open sores
- molluscum contagiosum: symptoms can include round growths that may itch or feel tender
- scabies: symptoms can include small bumps or rashes arranged in small curling lines
- syphilis: symptoms can include a painless sore or open, wet ulcer
A health care provider will be able to give you proper diagnosis and treatment. Some infections can be dangerous when untreated — or improperly treated.
How Can I Prevent BV?
The CDC and Office on Women’s Health have some recommendations for reducing BV risk:
- abstain from sex
- limit sexual partners
- refrain from douching
- use condoms and dental dams during sexual contact
- use condoms on shared sex toys
Alternative remedies, including probiotic supplements, are not adequately studied at this point.
You can seek diagnosis and treatment for bacterial vaginosis at a Planned Parenthood health center. Remember, if something is amiss below the belt, an accurate diagnosis from a qualified health care provider is your best chance for successful treatment!
Click here to check out other installments of our monthly STD Awareness series!
This is very informative, however my partner and I still remain unsure of how I got the infection; he is my only sex partner for two years now, and I’ve always been against douching (never douched). Are there other ways I might had gotten the infection even with one continuous sex partner, and does anal sex increase the chances?
Yeah him cheating on you. I had been getting this constantly and then found out my other half was sleeping with someone else. I’m sure that’s where I was getting it from cause they had been seeing each other for awhile and I only slept with one person while we were off n on n we used a condom. Other then that my other half has been the only man I’ve been with in about 5 years. Now since I’ve gotten pregnant I haven’t had this problem at all. First I chalked it up to using wipes but now I’ve put two n two together n I know I was getting it from him n her.
I got BV from a pH imbalance. I’d just had a really serve sinus infection and went through two different cycles of antibiotics. When I started getting symptoms, my doctor took samples and did test to find I had BV. Ask your doctor about it, mine prescribed me a 7-day medication plan and then my symptoms went away.
What medication did he give you ?
BV is definitely sexually transmitted I don’t care what you read about I have had it many times and it’s only when men not treated do you get it and probably they are with someone else passing.it back to you…it’s how doctor’s make money by not treating men and you keep having go back and get Flagyl every month …make him where condom or get him meds too …then if you get it back it’s him cheating with someone else who has it too…all partners need to be treated best to just use condoms and I never get it anymore…but I swear it sexually transmitted don’t believe it’s not and save your self hundreds in doctor visits or get a big supply of Flagyl and take it when that horrible odor starts if you don’t believe me it’s the only other choice because you will get it back if he is not treated too and of course not cheating with someone else with it too..
I used to have sex with condoms only and I would still get bv all the time this information is really incorrect
Douching causes it too. Have you douched?
It is also passed backwards n forwards despite use of condoms, as it lives in the crouch as well. The man must be treated as he carries it, n reinfects whom ever hes in contact with.
Do you know what men are prescribed?
rx
Dose
# of days
I agree with you 100%!!! I was pregnant at 18 & kept getting BV & after the 4th time my doctor finally said it was probably sexually transmitted. We both got treated & it did not reappear. Then 4months after by baby was born the low down piece of crap gave me Trich. He was the only person I had ever been with. He had been cheating the entire time. More research is definitely needed & men need to be held accountable. Whoever publishes info about BV & other infections like Trich must really hate women by putting the blame of transmission solely on women.
I slept with 1 person,for 2 years and now I keep getting bv,I think men have a lot to do with it,men should be treated and more studying should be done
My partner sleeps around, I got it again and it is a sure measure that your flora is interrupted with foreign flora that man Carrie’s back to the woman. I’m done at this point. It can be passed along sexually. Point blank period. I k ow my body, I dont sleep around and it’s almost certain when I get it, he has been elsewhere.
Hey,
I’ve been a nurse for over 20 years. If the man isn’t treated-he can give it right back to you, obviously if you have it and (he’ll say he doesn’t and surely he didn’t give it to you, RIGHT-) he just slept with you and you now have it, then get treated, don’t sleep with him during treatment and use condoms if he won’t get treated. You can go to the health department together for free or pretty cheap. Now, I ‘ll say this. You can get BV on your own from just getting an imbalance in your vag. from soaps, leaving sperm inside etc.(I get up, go pee and everything ) before going to sleep. May not be romantic but oh well.
Think about it- does it make sense in this survey to say both can be carriers, women need antibiotics to clear it up but men-it doesn’t work for them? Yeah-I’m not doing that!!
Do I have to tell the guys I slept with that I have BV?
No you don’t
Getting BV while being with your significant other doesn’t mean he’s cheating. I’ve noticed over the past 5 years with 2 partners that once I get bv then my partner smells like he has bv too(even tho he technically can’t get it) but they definitely have some type of bacteria. And when we go to the doctor to get medicine it comes back because the partners bacteria isn’t tested. It’s a scam for the doctors and clinics to consistently make money off us women. It’s sad but true. I’m looking into a natural way to cure my partner of the bacteria so he doesn’t pass it to me AGAIN.
I’ve never been sexually active, kissed or anything with a male or female. I’ve had BV for about 35 weeks with only the past 3 weeks clear. Now it’s back again. Treated with 150mg Diflucan and 500mg Flagyl. My gynecologist gives me a hard time refusing to give me the Flagyl pills and wants me to use MetroGel which is not right for me. I’m sick of suffering, doctors not wanting to help, not believing me and i feel so hopeless.
Unfortunately, BV can be caused by many culprits –including, but not limited to, a disruption of the vaginal pH [the vagina should be acidic for the good, Lactobacilllus-type bacteria to flourish so, when it becomes too basic –which can happen by your period blood passing through the vagina, sex (contact with a partner can alter your pH), or from the foods/beverages you consume, the bad bacteria –namely just the one, Gardnerella vaginalis, which is mainly responsible for BV– that share your vaginal environment can grow out of control]. Another culprit can be wearing clothes that don’t breathe, especially polyester, or any non-cotton underwear, but also non-cotton pants and leggings. Lactobacilli are aerobic bacteria that need to breathe in order to flourish, whereas Gardnerella, and other BV-causing bacteria, are anaerobic bacteria that flourish when there is no air (which also means that, simultaneously, the Lactobacilli are being killed due to lack of air).
In my research, I have found that if an antibiotic regimen is not successful in treating recurrent BV, a boric acid vaginal-suppository regimen is the next step. It does not require a prescription, and it can be purchased online or at a pharmacy, but it should be administered under the consultation of a doctor, preferably a gynecologist.
I really hope this helps!!
I a virgin or sexually inexperienced woman myself. Yes BV can happen. Probably so many different forms bacteria in the vagina that causes the problem that our medical scientists or OB/GYN or other experts have not yet discovered. Probably thousands of Non-STD related bacteria that even effect virgins. I have had my share of suffering Non-STD vaginitis even without a infection. Sometimes yeast or BV. Maybe even billions of unknown bacterial strains exist too!
Get a new doctor or go to Planned Parenthood. I will get rid of that doctor asap for being unwilling to provide the common treatment for BV which is Flagyl.
Even non-sexually active or virgin women can get BV. However there is probably unknown bacterial strains undiscovered by medical scientists, or OB/GYNs haven’t identified and discovered. In fact there is thousands to beyond billions or bacteria, germs, or other things that have not been discovered yet. Non-STD bacteria, and other kinds do exist.