Bacterial Vaginosis (BV) explained: What it is and why it happens

10 minutes ago

3 min read

If you've ever dealt with an unexpected change in vaginal discharge or a smell that wasn't quite "you," you're far from alone. Bacterial vaginosis (BV) is one of the most common vaginal conditions among women and can be quite challenging to treat.

What is Bacterial Vaginosis?

Your vagina has its own microbiome, a community of bacteria that, when balanced, is dominated by protective species called lactobacilli. These bacteria help keep your vaginal environment slightly acidic, which in turn keeps less helpful bacteria in check.

BV happens when that balance shifts. Lactobacilli decrease, other bacteria increase, and your vaginal pH rises from its normal acidic range (around 4) to a less acidic 7 or higher. It's essentially a case of microbial imbalance (or dysbiosis), rather than an infection you "catch" from someone else.

Image: Moth orchid | Phalaenopsis orchid — Image: Moth orchid | *Phalaenopsis orchid*

The symptoms (when there are any)

Did you know more than half of those with BV have no symptoms at all. When symptoms do appear, they typically include:

A thin, white or grey discharge
A noticeable fishy odour, especially after sex or during your period
Itching, burning, or general irritation around the vagina
Burning when you urinate

If any of this sounds familiar, or if you've noticed changes without obvious symptoms, it's worth getting it properly assessed rather than guessing.

So what causes it?

BV isn't just a "vaginal" issue, it's connected to your whole-body health.

A few of the key contributors include:

Gut health. Your gut and vaginal microbiomes are linked, and gut dysbiosis can influence what's happening "down there."
Diet. Low-fibre diets and diets high in sugar or refined carbohydrates have been associated with a higher risk of BV.
Blood sugar swings. When blood glucose levels are constantly fluctuating, it places stress on your immune system, one of the key mechanisms contributing to BV.
Chronic stress. Ongoing stress raises cortisol, which affects blood sugar regulation and immunity, and can reduce the protective lactobacilli in your vagina.
Smoking
Vaginal douching
IUD use and certain hormonal contraceptives
Sexual activity factors. New or multiple partners, and reduced condom use, are associated with higher risk; consistent condom use appears to offer some protection
Recent antibiotic use
Low oestrogen levels

Notice how many of these are everyday, modifiable factors? That's important, because it means there's a lot you can do to support your body, not just treat a single "flare-up."

Can BV be passed between partners?

Firstly, BV isn't classified as a traditional sexually transmitted infection, as it's not caused by a single bug passed from person to person in the way, say, chlamydia is. You can also have BV without having sex. That said, sexual activity is very much connected to BV risk, as the bacteria associated with BV can be passed back and forth between partners. Males can carry the bacteria associated with BV without any symptoms.

Image: Butterfly pea | Clitoria ternatea — Image: Butterfly pea | *Clitoria ternatea*

Why it's worth taking seriously

It might seem like "just a little itch or smell" and "not that bad". But research has linked BV to a range of downstream effects, including:

Increased vaginal inflammation
Higher susceptibility to other infections, including certain STIs
Increased risk of HPV-related changes and pelvic inflammatory disease (PID)
Effects on fertility and IVF outcomes
In pregnancy, an increased risk of miscarriage and preterm birth

This isn't meant to alarm you, it's meant to highlight why addressing the root cause matters, rather than just managing symptoms when they show up.

BV isn't something you just have to live with. Book a 1:1 Naturopathic Consultation and let's work out what's really going on, and how to fix it from the ground up.