Preventing Bacterial Vaginosis
According to the Centers for Disease Control and Prevention, bacterial vaginosis (BV) affects around 21 million American women each year.1 While that figure alone may make it seem as if BV is unavoidable, there are things you can do to greatly reduce your personal risk of infection.
This includes avoiding douching to keep your vaginal flora balanced, using condoms consistently and correctly, and reducing your number of sex partners.
Bacterial vaginosis is caused by an imbalance of the vaginal flora in which “good” bacteria is depleted, allowing harmful bacteria to thrive.2 Why this happens to some women and not others is not entirely clear. What we do know is that certain practices can undermine the integrity of the vaginal flora and promote infection.
To ensure you maintain your optimal vaginal health, there are things you should do and others you should avoid. Among them:3
Do not douche. Simply put, vaginal douching can strip away many of the healthy bacteria in your vagina. Despite what people may tell you, there is really no need for it; the vagina has its own self-cleaning mechanisms. Don’t succumb to the old-fashioned belief that douching can reduce odor or treat an infection. More often than not, it does just the opposite.
Use mild (or no) soap. Soap of any kind can deplete the vaginal flora and help facilitate an infection. This is especially true with scented soap, bath oils, and bubble bath, all of which contain chemicals that can irritate the vagina. Instead of soap, try washing with plain water and your hands. If you do use soap, use a milder brand like Cetaphil.
Use unscented tampons and pads. The very idea of placing perfume in or on the vagina is a bad one. Always use unscented tampons and be sure to change them regularly. Leaving one in for longer than recommended increases the risk of inflammation and alters the vaginal pH, both of which can promote BV.
Wear cotton underwear. Bacteria thrive in warmer temperatures and moister climates. Wearing nylon panties creates the perfect environment for a bacterial infection by trapping in heat and moisture. Breathable cotton underwear, by contrast, allows the free flow of air to better prevent infection. You can do the same at night by not wearing any underwear. Wearing loose clothing allows air to circulate around inflamed tissues can provide far more relief from itchiness and discomfort than wearing a pair of tight pants. Choose softer fabrics or opt for a skirt to avoid pressure in the crotch.
Keep your workouts light to avoid irritation and inflammation. Wear loose workout clothes and change out of your sweaty gear as soon you are finished. Shower at the gym or as soon as you get home.
Wipe from front to back. After urinating, tilt your body forward and, reaching between your buttocks, starting wiping from the front of the vagina to the back. This will prevent the accumulation of harmful bacteria. When you are finished, take a separate piece of paper to clean the anus, starting at the perineum (the space between the vagina and anus) and wipe back between your buttocks. Doing so prevents introducing bacteria from the anus into the vagina.
Avoid feminine sprays. As with scented soaps, these perfumed sprays will only end up causing irritation. The better way to deal with odor is to wash regularly with plain water or a mild soap. You can also bring an extra pair of cotton underwear to work to change into halfway through your day.
Treat the itch with cold water. Splashing or spraying cold water on the vagina can help calm the itch better than scratching. Always shower the vaginal area in a downward position and never directly into the vagina itself. To help during the day, moisten a clean cloth with ice water and apply directly to the vagina.
While bacterial vaginosis is not a sexually transmitted disease (STD), it shares many of the same characteristics in that the risk will increase with the number of sex partners you have.4
For reasons not fully understood, sexual intercourse with different (or especially new) partners can alter the balance of the vaginal flora and promote the development of BV.4
This, in turn, increases your vulnerability to actual STDs such as gonorrhea, chlamydia, trichomoniasis, and HIV.
To this end, short of sexual abstinence, there are certain practices that can help reduce your risk of BV:
Limit your number of sex partners. Moreover, if you have a new partner, take the time to discuss your sexual histories and whether or not you have been tested for STDs. This not only includes male partners but female partners as well. The more information you have, the better choices you can make.
Use condoms consistently. A 2013 study from the journal PLoS One found that consistent condom use increases the colonization of Lactobacillus crispatus in the vagina and may protect against bacterial vaginosis (BV).5 As much as you need to use condoms consistently, you also need to know how to use them correctly.
Avoid flavored condoms or lubricants. These novelty products are not only unsuitable for safer sex, they contain sugars and other chemicals that can significantly alter your vaginal pH. When choosing a lubricant, always go for a plain, water-based one. Oil-based lubricants can quickly degrade the chemical bonds in latex and cause a condom to break.
Avoid IUDs. Intrauterine devices (IUDs) are an effective form of contraception but may need to be avoided in women with recurrent BV infections or who have irregular bleeding while using an IUD. A 2012 study from the St. Louis School of Medicine concluded that IUD users who had irregular bleeding and an imbalance of vaginal flora (usually without symptoms) were twice as likely to develop BV than women who used other forms of contraception.6
Bacterial vaginosis affects more than just your physical health; it can undermine your emotional health, as well.
According to research from Monash University and the University of Melbourne in Australia, women who experienced recurrent BV commonly reported that the symptoms made them feel ashamed, “dirty,” and self-conscious about the vaginal odor and discharge.7
Perhaps the biggest impact was on a woman’s self-esteem and sex life, with many avoiding sexual activity, especially oral sex, out of sheer embarrassment or self-consciousness.7
Despite these challenges and frustrations, there are things you can do to help better control your BV symptoms:
Get treated. Clearly, the only way to resolve BV symptoms is to eradicate the infection. A short course of oral or topical antibiotics can usually do the trick.8 If you do start treatment, never stop halfway through, even if symptoms disappear. If you do, you not only risk recurrence, you may develop antibiotic-resistant bacteria, making the infection all the more difficult to treat the next time around.
Take daily probiotics. Probiotics found in foods like yogurt or over-the-counter nutritional supplements contain live bacteria and yeasts that can help you maintain normal digestion. They can also help maintain the vaginal flora. While probiotics cannot resolve an active infection, a 2014 review of clinical studies concluded that the daily use of an oral probiotic may help prevent a BV infection or support antibiotic therapy.9
Talk with your partner. The best way to alleviate shame and embarrassment is to speak with your partner and be honest about not only what you are going through but what you are feeling. According to the Australian study, while many partners did not understand what BV was, most did not want women feeling uncomfortable or inhibited because of it. By letting your partner in, he or she can become a part of the solution.7
Bacterial Vaginosis Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.