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Pelvic Health

BV: Causes, Symptoms & How to Treat It

BV: Causes, Symptoms & How to Treat It

by Dr. Barb DePree, MD

Bacterial vaginosis (BV) is a vaginal infection caused by an imbalance of bacteria naturally found in the vagina. Although common in sexually active women in their reproductive years, and easily cured, BV can lead to further complications if left untreated.

Read on, to learn more about bacterial vaginosis, what causes it, common symptoms, and the best treatment options available. 

Bacterial Vaginosis Symptoms

Even though BV is most frequently diagnosed in sexually active women aged 14-45, it can occur in women of any age. For many women, BV is often symptomless until their gynecologist notices signs of a bacterial infection during routine smear tests. When symptoms do occur, they typically present as:

  • Burning sensation while urinating
  • Vaginal itching
  • An unpleasant (fish-like) vaginal odor
  • A gray-colored vaginal discharge
  • Pain or discomfort during sex
  • Fever (but not for everyone)

While symptoms seem similar to yeast infections, the gray vaginal discharge is usually what differentiates bacterial vaginosis. In the case of a yeast infection, vaginal discharge is white as opposed to gray, it can sometimes become lumpy like cottage cheese, and it does not smell unpleasant. 

What Causes Bacterial Vaginosis?

Vaginas are essentially self-cleaning machines, naturally capable of balancing good bacteria with harmful bacteria to maintain a healthy environment and balanced pH levels to ward off possible vaginal infections.

However, if this microflora becomes unbalanced for any reason, pH levels are altered, and the vagina environment becomes suitable for harmful bacteria like Gardnerella Vaginalis to thrive, resulting in bacterial vaginosis. 

While researchers cannot exactly pinpoint the exact cause of the environmental change that results in BV, certain factors are known to increase the risk of infection. These include:


As previously mentioned, vaginas are naturally capable of cleaning themselves, so using synthetic hygiene products like douches does more harm than good. Douching to clean the inside of the vagina will, without a doubt, upset the vaginal pH balance and natural environment of the vagina, which increases the risk of bacterial overgrowth. 

Instead of douching, wash your genitals daily, and after sex, with warm water and unscented soap to keep the vagina clean and healthy. 

Using Scented Menstrual Products

Scented menstrual products can also alter the pH balance of your vagina and increase your risk of BV. Although they might seem like a good idea, they are similar to douching products in that they do more harm than good. 

To avoid pH imbalances that lead to BV infections, use regular, non-fragranced menstrual products. 

Sex Without a Condom

In the same way that your vagina is designed to balance healthy and harmful bacteria, male genitalia function in the same way. That being said, the bacteria present in male and female genitalia, as well as how they are balanced, will differ.

So while any harmful bacteria on a penis might be balanced by a man’s healthy bacteria, it can cause vaginal infections in some women. In addition, the pH of a vagina is mildly acidic, whereas semen is alkaline, and when the two come together it can alter the pH of the vagina, making women more prone to vaginal infections.  

If you are sexually active and susceptible to BV infections, use a condom every time you have intercourse. 

New Intimate Partners

New sexual partners can increase some women’s risk of a BV infection due to the new partner’s genital chemistry i.e. the balance of healthy and harmful bacteria on the penis. Even though a male’s genital chemistry may be healthy for him, it can affect some females’ natural vaginal chemistry balance and result in a vaginal infection like bacterial vaginosis. 

The best option to prevent this is to wear condoms with new male partners until you have both been tested. 

Several Sexual Partners

Given the above-mentioned factors regarding male genital chemistry, medical experts caution that having sex with multiple male partners can significantly increase a woman’s risk of getting bacterial vaginosis. If you are having intercourse with several partners, ensure you use condoms with each one and always wash your genitals with warm water and unscented soap after sex. 

Female Partner With BV

Although BV is not categorized as a sexually transmitted infection, it was concluded in a recent study that BV can be spread between female sex partners. To practice safe sex between female partners, ensure all sex toys are cleaned after use and consider using a dental dam for oral sex. 


Researchers have found that the increased levels of carbon dioxide in the body caused by smoking can escalate the risk of women getting bacterial vaginosis. Higher levels of carbon dioxide from smoking tend to intensify the acidity of the bloodstream and alter the natural pH balance of the body, meaning infections like BV and other chronic conditions can be more prevalent in smokers.  

Some women who suffer from recurring BV infections have found that they stop completely when they give up smoking. 

Does Bacterial Vaginosis Lead to Something More Serious?

If left untreated, yes, bacterial vaginosis can lead to the onset of additional conditions and complications such as: 

  • An increased risk of contracting sexually transmitted infections (STIs) like chlamydia, gonorrhea, herpes, trichomoniasis, and HIV due to altered vaginal pH levels 
  • Pelvic inflammatory disease (PID) where untreated BV infects the uterus and/or fallopian tubes
  • Infertility
  • Ectopic pregnancies
  • Early labor & underweight newborns

How Do You Know If You have Bacterial Vaginosis?

BV symptoms are quite similar to yeast infections as well as some STIs, so the only sure way to diagnose BV is to schedule an appointment with your doctor. Especially if you notice the following:

  • Your vaginal discharge has changed and is accompanied by an unpleasant odor
  • You’ve tried an over-the-counter treatment for a yeast infection but nothing has improved
  • You have a new sex partner or multiple partners with whom you have intercourse without condoms
  • You are a smoker
  • You have recently douched
  • You have a female sexual partner

If BV is suspected, your doctor will typically carry out a pelvic exam and a vaginal pH test, as well as swab your vaginal secretions, to check for an overgrowth of harmful bacteria. 

Treating Bacterial Vaginosis

If your doctor confirms the overgrowth of harmful bacteria in the vagina after a pelvic exam and pH test, bacterial vaginosis is diagnosed and antibiotics will be prescribed. It is important to complete the full course of antibiotics to treat BV. And because BV can increase women’s risk of contracting STIs, it is best not to engage in any sexual activity until the antibiotics are finished and the infection has cleared. 

Female health experts also highly recommend taking boric acid supplements in conjunction with antibiotics for BV to speed up the healing process.  

It’s important to report any unexpected vaginal bleeding, fever, or increased pain to your doctor after you begin taking the prescribed antibiotics. Similarly, if symptoms don’t improve after a week, or if they return after the course of antibiotics is completed, it is vital to contact your doctor for further advice. 

Unfortunately, over 50% of women who experience BV will often experience a recurring infection within 12 months. 

Treating Recurring Bacterial Vaginosis Infections

For women experiencing recurring BV infections, research has clearly shown that taking boric acid suppositories in conjunction with prescribed antibiotics not only speeds up the healing process of the initial infection but significantly reduces repeating BV infections too.  

Furthermore, women who suffer from regularly recurring BV infections substantially benefit from a sustained and regular intake of boric acid. In this case, it’s always advisable to speak with your doctor to understand the guidelines for taking boric acid in the longterm as well as the correct dosage.   

How Does Boric Acid Treat BV?

As a natural antiseptic and antimicrobial, boric acid has been used as a holistic remedy for over a century to treat women’s reproductive health. By helping to restore the natural balance of bacteria in the vagina, boric acid relieves symptoms like itching, burning while peeing, and unpleasant vaginal discharge.  

That said, boric acid on its own will not clear a BV infection. It is always vital to complete the course of antibiotics prescribed by your doctor in conjunction with taking this natural remedy, whether to clear an initial BV infection or any recurring infection. 

How Soon Do Boric Acid Suppositories Work?

Boric Acid Balance Suppositories like the ones from Intimate Rose dissolve in the vagina within a few minutes and typically improve vaginal irritation within 24-48 hours. For best results, and to avoid a recurring BV infection, always finish the complete course of boric acid. 

Are There Side Effects to Taking Boric Acid Suppositories?

No serious side effects have been associated with boric acid suppositories when taken correctly, however, treatments affect different people in different ways, so it’s always best to check with your doctor before taking them with any other medications you are taking.  

Mild side effects for some women include a watery discharge after inserting the suppositories, but inserting the suppositories at night appears to solve this. A tingling sensation or some redness around the vaginal opening has also been known to occur, but this is extremely rare. 

What’s imperative to know about boric acid suppositories is that they should not be used during pregnancy and are poisonous if ingested orally.  All in all, however, boric acid suppositories are considered perfectly safe for treating vaginal infections like bacterial vaginosis.

How to Prevent Bacterial Vaginosis

  • If you suffer from recurring BV infections, take a regular boric acid suppository
  • Stop douching
  • Avoid using scented menstrual products
  • Only use unscented soap and warm water to wash your genitals
  • Clean sex toys after every use
  • Wear breathable cotton underwear rather than synthetic material – breathable cotton reduces the build-up of moisture around the vagina that can contribute to the overgrowth of harmful bacteria
  • Remove wet swimsuits or damp workout wear as soon as possible for the above-mentioned reason
  • Always wipe from front to back after using the toilet – this prevents bacteria from the anus from spreading to the vagina
  • Take a daily probiotic to help maintain a balanced pH in the vagina


Bacterial vaginosis (BV) is a common and treatable vaginal infection that can be cured with the help of antibiotics and boric acid suppositories. If left untreated, BV can lead to more serious complications, so if you can relate to the symptoms, make an appointment with your doctor and have yourself tested as soon as possible.

It’s also helpful to speak with your healthcare provider before taking boric acid suppositories to clearly understand the guidelines and daily dosage. 


Centers For Disease Control & Prevention – Bacterial Vaginosis -

Mayo Clinic – Diagnosing & Treating Bacterial Vaginosis -

National Library of Medicine - The influence of sexual activity on the vaginal microbiota and Gardnerella vaginalis clade diversity in young women -

National Library of Medicine - Bacterial vaginosis in lesbians: a sexually transmitted disease -

National Library of Medicine - Association between cigarette smoking and the vaginal microbiota: a pilot study -

Cleveland Clinic – Boric Acid Suppository -

National Center for Biotechnology Information – Clinicians' use of Intravaginal Boric Acid Maintenance Therapy for Recurrent Vulvovaginal Candidiasis and Bacterial Vaginosis -

National Library of Medicine - The Role of Probiotics in Vaginal Health -