STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Posted on November 2, 2015 by Anna C.

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? Continue reading →

Is Douching Safe?

Posted on June 29, 2015 by Anna C.

This vintage douche ad claims that its product is “safe to delicate tissues” and “non-poisonous.”

Douching is the practice of squirting a liquid, called a douche, into the vagina. Many people believe it helps keep the vagina clean and odor-free, and some are under the impression that it helps prevent pregnancy and sexually transmitted diseases. An estimated 25 percent of American women 15 to 44 years old douche regularly. But just because douching is widespread doesn’t mean it’s safe; indeed, there are two possible mechanisms by which douching might be harmful.

First, douching might alter the pH of the vagina, changing its ecosystem. You might not think of a vagina as an “ecosystem,” but the bacteria and other microscopic organisms that live there sure do — and altering their habitat can harm the beneficial microbes that live there, opening the door for disease-causing microbes to take over the territory. Frequent douching can result in the vagina’s normal microbial population having difficulty reestablishing its population.

Douching increases risk for infections and fertility problems, and has no proven medical benefits.

Second, a douche’s upward flow might give pathogens a “free ride” into the depths of the reproductive tract, granting them access to areas that might have been difficult for them to reach otherwise. In this manner, an infection might spread from the lower reproductive tract to the upper reproductive tract. Douching might be an even bigger risk for female adolescents, whose reproductive anatomy is not fully formed, leaving them more vulnerable to pathogens.

While douching is not guaranteed to harm you, there is no evidence that it is beneficial in any way. Establishing causation between douching and the problems that are associated with it is trickier — does douching cause these problems, or do people who douche also tend to engage in other behaviors that increase risk? So far, the best evidence indicates that douching is correlated with a number of diseases and other problems, including sexually transmitted diseases (STDs), bacterial vaginosis, pelvic inflammatory disease, fertility and pregnancy complications, and more. Continue reading →

STD Awareness: Bacterial Vaginosis and Chancroid

Posted on August 22, 2011 by Anna C.

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 / FreeDigitalPhotos.net

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. Continue reading →