Bacterial Vaginosis (BV)

Fish like the smell of bacterial vaginosis (BV)

A patient came into my office on Friday with the common complaint of itching down below. She told me that she has had multiple yeast infections in the past, but Monistat wasn’t working this time.  I examined her and found not yeast but bacterial vaginosis (BV).

For those of you lucky enough to not ever (yet) had BV, it is a vaginal infection but not an STI.  Vaginas normally have a number of bacteria that merrily reside there and keep us healthy. It’s just like the bacteria on our skin and in our intestines.  Sometimes, and we don’t know all the reasons why, one particular bacterium oversteps its bounds and grows out of balance with the rest.  We do know that women who are sexually active are much more likely to get BV, but they don’t get infected directly from their partner. (It’s a homegrown bug, as it were.)  I know it sounds confusing—an infection that you get from having sex, but not one that you catch from your partner. And you’ve got this increased risk of BV no matter what the gender identity of your partner.

BV has a classic set of symptoms:

  • The vaginal discharge is thin, white to grayish, and a bit sticky.
  • There may be an unpleasant odor, unfortunately fishy in nature.
  • Some women experience vulvar pain or burning, or like this patient, itching.
treatment for bv

Fortunately, bacterial vaginosis (BV) is easily treated, but you do need to see a doc or NP for treatment—there’s no over-the-counter remedy.  Your clinician will likely give you metronidazole, which comes in two forms. The brand name pills are Flagyl 500mg  taken twice daily for a week. The brand name vaginal gel MetroGel 0.75% is used nightly before bed for five nights. You won’t hurt yourself using a treatment for yeast if you have BV…but you won’t feel any better either.  So if you notice a funky discharge, with or without itching or an odor, head to the gyno.