The vagina is a pretty amazing organ. It’s also a particular organ, requiring just the right balance of good and bad bacteria in order to be healthy. When there’s an imbalance, the result is bacterial vaginosis; one in three women in the U.S. have had BV. While women of any age can get BV, menopausal women are at higher risk because estrogen and progesterone, which play an important role in maintaining that balance, drop off, paving the way for bad bacteria to multiply.
Symptoms of BV can vary, but the primary symptoms are a fishy odor and a thin white or yellow vaginal discharge. The only way to know for certain if you have it is to see a doctor, who will do an exam and also take samples of the discharge. It’s treated with antibiotics (one study showed that adding probiotics to the course of treatment reduced recurrence). Left untreated, BV can increase your chances of getting pelvic inflammatory disease and sexually transmitted infections, like gonorrhea, chlamydia, herpes, or HIV.
Preventing BV is a bit of a challenge, since anything that disrupts the balance of bacteria in your vagina can increase your risk. Antibiotics, sexual intercourse, douching, and smoking fall into that category. Some women just have the bad luck of having a naturally lower levels of good bacteria.
Don’t stop having sex (unless your doctor says to), and don’t stop taking prescribed antibiotics. Practice good vaginal hygiene. Use hypoallergenic, fragrance-free soap. Don’t use douche; the vagina is self-cleaning, and a douche disrupts the environment for good bacteria. Wear cotton underwear, which breathes. You can also try oral probiotics with Lactobacillus rhamnosus GR, which may reduce the chances that BV will recur.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten. Read more about and from her here.