I Keep Getting Bv

I Keep Getting Bv

Now Reading BV Is The Vaginal Infection That Just Won't Quit
Bacterial vaginosis is like an obnoxious party guest who can't take a hint that it's time to leave. Just when you think they're on the way out the door, they come back in to start yet another tedious conversation. And this party guest also happens to smell like fish , leave a trail of discharge, and cause your vagina to itch.
Anthropomorphizing aside, BV is irritating to say the least, and even tougher to get rid of. Studies suggest that 10-30% of women who have sex with men, and 20-50% of women who have sex with women will experience the glory of BV at some point. And, over 50% of people who get BV will be lucky enough to experience it again over the course of 12 months.
Getting BV even once can be incredibly annoying. The infection leads to a brutal combination of vaginal symptoms: discharge that smells fishy , burning when you pee, and itching in and out of the vagina. Although BV is one of the most common bacterial infections out there, experts still don't know what causes it . The best guess is that BV hits when more "unhealthy bacteria" grow inside the vagina than "healthy bacteria," according to MedlinePlus .
Despite everything we don't know about BV, there are a few factors that can certainly mess with your vaginal pH and influence your risk of getting the infection again (and again, and again). For example, habits like douching or using vaginal deodorants tend to do more harm than good. Additionally, people who have sex with multiple partners is associated with a higher prevalence of BV bacteria , and other microorganisms in the vagina, explains Adeeti Gupta , MD, FACOG, an Ob/Gyn and founder of Walk-In Gyn Care in Manhattan. Having unprotected sex can also trigger BV, although it's not a sexually transmitted infection. And finally, some people have vaginas that are just extra susceptible to BV, and there's not a ton that you can do about it.
As anyone who's had BV knows, treatment options are limited to prescription oral antibiotics or vaginal suppositories. But, when you're getting BV several times a year, it's wildly discouraging to have to take antibiotics frequently only to have your symptoms pop back up again. When patients come to Dr. Gupta with recurrent BV, she'll typically run tests to ensure it's not something more serious (such as trichomoniasis ), and then prescribe a "suppressive treatment." That may include a strict diet , genital hygiene, and high dose probiotics, she says.
In a 2016 study in the peer-reviewed journal PLOS One , researchers noted that women who got frequent BV felt frustrated by the available treatments, so they often felt compelled to try their own home remedies and lifestyle modifications to get rid of it. There aren't any proven home cures for BV, but that hasn't stopped people from trying. Many people eat probiotic foods such as yogurt , and take probiotic supplements in hopes that it will help balance out the good and bad bacteria inside the vagina. (That said, there hasn't been a proven link between diet and vaginal health .) Using a boric acid suppository or probiotic tampon is also supposed to be helpful.
Other good-for-your-vag lifestyle habits include wearing cotton underwear and avoiding hot baths or perfumed soaps. Using condoms or dental dams consistently is also often recommended, given the link between unprotected sex and BV. Then, there are some Goop-y holistic remedies that people swear help with BV, including using steaming the vagina with "detoxifying" herbs . Sitting in a bathtub full of apple cider vinegar is often touted as a cure — because, of course it is — but there's no proof that this actually works.
Even though these so-called cures have questionable efficacy, study authors in the same 2016 study said that home remedies made people "more likely to feel in control of their BV, because they felt they were able to treat it somewhat effectively themselves." Feeling like you're in control of your own health is always a good thing, but with something as persistent and finicky as BV, it's a good idea to let your doctor know what you're doing and trying at home.
Also, there's absolutely nothing to be embarrassed about if you get BV a lot. Dr. Gupta says that she sees this problem a lot at her clinic. Speaking up when you notice a pattern is key to stopping it from coming back. "We believe in addressing the root cause of the problem, not just a shorthand fix," she says.
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By
Tiffany Curtis Updated
April 13, 2022

Medically Reviewed by

Mayoni Ranasinghe, MBBS, MPH

You may be able to beat recurrent BV by getting more probiotics in your diet via food or a supplement.

Image Credit:
Moyo Studio/E+/GettyImages

Thin, gray, white or green vaginal discharge
Foul-smelling or fishy vaginal odor
Vaginal itching
Burning during urination

1. Your Vaginal Hygiene Routine Is Too Complicated

Avoid products with perfumes and dyes
Use a pH-balanced cleanser or water to wash your vulva
Avoid douching, because the vagina is self-cleaning

4. You're Wearing Underwear That Isn't Breathable

Pelvic inflammatory disease
HIV
Pregnancy complications
Infection after surgery

Oral medication (typically an antibiotic)
Prescription-strength vaginal gel or cream
Vaginal suppositories

Bacterial vaginosis (BV) is just one of the many unpleasant conditions that people with vaginas can experience, but it's especially annoying when it's recurring. BV that keeps coming back could be connected to your sex life, hygiene routine or something else.
The vagina contains many bacterial organisms that help keep it healthy, says Jodie Horton, MD , urogynecologist and chief advisor for Love Wellness. But if that bacterial balance goes out of whack, BV can happen.
"The most dominant bacteria are lactobacilli, which help maintain a healthy vaginal pH between 3.8 to 4.5 and keep the organisms in balance," Dr. Horton says. "BV occurs when lactobacilli decreases and there's an overgrowth of bacteria called Gardnerella vaginalis or Prevotella."
And BV is a common condition for people with vaginas who are of reproductive age — in fact, it may affect as many as 50 percent of people assigned female at birth (AFAB), according to the National Institutes of Health .
Fortunately, you can take steps to prevent and treat it. Here's everything you need to know about the condition, including how you get BV, why it can recur and how to prevent it.
Managing your stress levels, practicing safe sex, wearing breathable underwear and simplifying your vaginal hygiene routine can all help reduce recurring BV.
Some people with vaginas may not experience any discomfort from BV, while other people may deal with a variety of symptoms, per the Mayo Clinic .
Here are some of the most common signs of the condition:
BV is a condition unique to people with vaginas. But some research suggests that people with penises can spread BV or other bacterial infections to partners who have vaginas.
For instance, a December 2013 study in Sexually Transmitted Diseases found that people assigned male at birth with a history of an inflammatory urethra condition (called nongonococcal urethritis) were more likely to carry BV-causing bacteria on their penises.
So, how do you get bacterial vaginosis? Here are common causes of the condition (and the potential reasons why you keep getting BV infections):
A vaginal hygiene routine with too many or the wrong products can affect your pH balance and lead to an infection. Really, all you need is water to clean this area of your body.
"Feminine hygiene products like soaps, douching and sprays can change the pH of the vagina and [lead to] an overgrowth of bacteria, causing vaginal infections like bacterial vaginosis," Dr. Horton says.
Fix it: Dr. Horton recommends stripping down your vaginal hygiene routine. Here are her tips:
BV isn't a sexually transmitted infection, but it typically occurs in people with vaginas who are sexually active, according to the Centers for Disease Control and Prevention . And having multiple sexual partners or a new sexual partner can increase your chances of getting BV.
Research has also shown that you can have recurring BV with the same partner. Indeed, a small March 2016 study of 35 people AFAB in PLOS One noted that those who had sex with the same partner before and after treatment for BV were two to three times more likely to experience BV again.
However, larger studies are needed to better establish this link.
Oral sex has also been linked to an increased risk of BV. According to an August 2020 study in PLOS Biology , BV-causing bacteria can be transferred via saliva into the vagina.
Fix it: This doesn't mean you have to deprive yourself of sex — rather, remember to prioritize safety.
For instance, using condoms every time you have sex and limiting the amount of sexual partners you have can help lower your chances of recurring BV infections, per the New York State Department of Health .
You can also use dental dams and condoms on sex toys if you are having sex with a partner who also has a vagina.
It's also important to be mindful of the link between semen and BV. Semen can alter the pH level in your vagina and contribute to a higher rate of bacteria growth, according to the Mayo Clinic .
Yes, you read that right — stress can cause BV.
High levels of the stress hormone cortisol can negatively affect your overall wellbeing , which includes vaginal health. This physical stress can throw your vaginal pH levels out of balance, which can lead to BV, per Stony Brook Medicine .
Fix it: Managing your stress may help you avoid health issues like BV. To help, try techniques such as:
Your underwear may be another one of the reasons why your BV keeps coming back.
Non-breathable fabrics like nylon, for example, can block air movement in the vaginal area, which can lead to increased bacterial growth, per the Mayo Clinic.
Fix it: Opt for breathable, natural undies made of fabrics like cotton or bamboo, Dr. Horton says. "And at night, don't wear underwear to give the vagina a chance to breathe," she says.
Dr. Horton also suggests changing your underwear often and wearing panty liners (you should also change these often) if you have increased discharge.
"Also consider using hypoallergenic laundry detergent, which decreases the risk of vaginal irritation," she says.
BV is just one type of vaginitis, which is a group of inflammatory vaginal conditions. That's why some symptoms of BV and yeast infections (another kind of vaginitis) are similar, like having vaginal discharge, per the Mayo Clinic .
Here's how you tell the difference: BV is usually accompanied by discharge that is thin, gray or yellow with a foul, fishy odor. Yeast infections instead cause thick, white discharge with minimal or no odor.
Fix it: The best way to determine if your symptoms are BV (and get the treatment you need) is to visit your doctor, who can perform a pelvic exam and take fluid samples to give you a diagnosis, per the Mayo Clinic.
Even though BV and yeast infections share similarities, they can be treated differently, according to the Mayo Clinic. As a result, it's important to visit your doctor to get the right diagnosis so you can properly heal your symptoms.
Now you know the major bacterial vaginosis causes. But how do you take care of it if an infection arises?
First, there are several risks associated with recurring BV, according to Baylor College of Medicine , so it's important to see your doctor if you're experiencing symptoms. This includes an increased risk for developing conditions such as:
Fortunately, you can lower your risk for these issues and banish BV with treatment. Dr. Horton says treatment options include:
Still, it's common for BV to recur within three months to a year, even after treatment, per the Mayo Clinic. If that's the case for you, talk to your doctor about long-term treatment options like extended-use antibiotics.
Dr. Horton also recommends using boric acid vaginal suppositories to help treat recurrent BV and maintain normal pH levels, as well as taking a probiotic to help keep vaginal bacteria levels in check.
In addition to minimizing your risk of BV by avoiding over-cleaning your vagina, using protection during sex, managing stress and wearing the right undies, there are a few more general precautions you can take.
For instance, Dr. Horton suggests taking a probiotic to keep your vaginal pH levels in balance. Besides supplementing BV treatment, this could also help prevent another infection after you've healed.
Your diet may also help you ward off recurrent BV. Eating probiotic-rich foods that contain lactobacilli may help increase the amount of good bacteria in your vagina, according to the Mayo Clinic. These foods include:

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BV that just won’t go away is one of the most difficult-to-treat women’s health conditions.
Ask a woman for the most frustrating and uncomfortable health condition she’s ever dealt with down there, and bacterial vaginosis (BV) likely tops the list. And, if you keep getting BV, it’s understandable to wonder how to stop recurring BV infections permanently.
It’s important to point out that what’s happening down there isn’t your fault. Rather, it’s a reflection of the complex and ever-changing balance of bacteria inside the vagina.
“During evolution, the vagina developed a careful equilibrium of different bacteria that can help keep harmful microbes away from the vaginal microbiome,” says Anke Hemmerling, M.D., Ph.D., M.P.H. , a women’s health researcher and project director of the UCSF Bixby Center for Global Reproductive Health. “These ‘healthy’ bacteria such as lactobacilli produce acids and acidify the vaginal pH to below 4.5, which creates an environment unfavorable for genital infections to thrive in.”
Whether you keep getting bacterial vaginosis, think you might have the condition, or are just curious, it’s understandable to have questions. Doctors break it down.
Bacterial vaginosis is what happens when the amount of ‘good’ bacteria like lactobacilli and ‘bad’ bacteria known as anaerobes is disturbed. With lower lactobacilli counts, the vaginal pH goes up, allowing ‘bad’ bacteria to take hold and cause an overgrowth of pathogens or disease-causing microorganisms like viruses.
Research suggests up to a third of women who have sex with people who have penises and around up to half of women who have sex with people who have vaginas develop BV at some point in their lives, making it the most common vaginal infection in existence. Variations in vaginal pH—and in turn a greater susceptibility to developing BV—seem to be linked to many different factors such as your diet, geography, genetics, race, or ethnicity.
“Furthermore, the vaginal microbiome fluctuates throughout the menstrual cycle, when using contraception such as birth control pills or intrauterine devices , during pregnancy, with exposure to semen, shared sex toys, and douching,” says Dr. Hemmerling. All of the above can increase your risk of developing BV, but what exactly causes it remains a mystery.
If you’re in the midst of a battle with BV, you know the process: Hit the self-checkout line with over-the-counter suppositories, take a break from sex, sleep without underwear, and avoid hot baths. When that doesn’t work, a trip to your doc for antibiotics such as metronidazole or clindamycin in the form of oral pills or a vaginal gel can sometimes do the trick, despite common side effects like nausea and spin-off yeast infections . However, 80% of women who go in for treatment end up with another infection within three months, according to a 2020 review published in the European Journal of Obstetrics & Gynecology and Reproductive Biology.
“Many women experience an endless cycle
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