Bacterial Vaginosis or BV  is characterized by a unique and offensive vaginal odor commonly described as “fishy” or “sour”. The smell is often worse at the end of your menses and right after sex with a man, if no condom is used. The smell can be embarrassingly strong, and the condition can be annoyingly recurrent for some women.

BV is not an infection, rather it is an imbalance of normal vaginal flora –I love that we refer to the vaginal ecology as flora.

When you have BV the vaginal fluid is usually white and often thinner–more watery, than normal. Under the microscope  there are specific cellular changes that are diagnostic. The vaginal PH is elevated—this is the basis of some over the counter diagnostic tests. However, if there is that unique odor, you probably have BV. Unlike yeast infections, there is no itching with BV, odor is the issue.

Causes

This is unknown.  BV reflects an imbalance in the normal bacteria with low levels of lactobacilli and high levels of other bacteria. Having seminal fluid (sperm) in the vagina makes it worse.  Seminal fluid is alkaline (higher PH) which brings out the smell and encourages the imbalance. Blood is also alkaline which is why your period can make BV worse.

Treatment

Left untreated BV goes away on it’s own 30% of the time. However, if you are pregnant and believe you have BV, please discuss this with your Midwife or Doctor.

There are prescription products which are antibiotic based (oral pills or vaginal  creams) which address bacterial imbalance.You need to visit a healthcare provider to get these.

Alternatively, you can use buffered or Ester vitamin C 500-1000mg available over the counter (regular Vit. C will BURN). Insert one into your vagina at night for 1-7 nights. Experiment, sometimes if it is mild one night will treat, if it comes back within a week, try a full 7 night treatment. You will get a watery discharge each day following treatment, so you might want to wear a pad.

I am a believer in antibacterial soap used EXTERNALLY (NEVER put soap in the vagina). Using soap where you have pubic hair and especially around the anal area I believe helps prevent recurrence. But now we know that some anti-bacterial soaps are hormone disruptors—so use with caution….

I do not recommend douching as it further alters the natural flora of the vagina.

Drying your external genital area with a blow dryer after showering also will help rid yourself of any unwanted bacteria on your skin which might find it’s way inside and create problems.

The problem with BV is that while you can treat the over abundance of one bacteria, it does not recreate the normal flora of the vagina.

If you are having recurrence problems, using one Vit. C after sex can be helpful. Equally using it for one night after your menses can quash a recurrence. However, none of these treatments restores your healthy vaginal bacteria balance, hence recurrence.

The restoration of normal vaginal flora has been a serious challenge. There are various products that aspire to do this, one with promise is Fem-Dophilis by Jarrow Formulas. It is a probiotic. Use of one vaginally 2 times a day for 5 days or orally once a day for a month has been shown to be effective in treating BV and helping restore the normal vaginal flora making recurrence less likely.

If you try and treat on your own, and are not getting good results, it is always helpful to consult with GYN/Woman’s Health practitioner to make sure you are on the right track.