Discharge | Pain While Urinating | Vaginal Itching

Bacterial vaginosis (BV) is one of the most common vaginal conditions. One study in 2007 examined 3,739 women and girls between 14 and 49; at the time of testing, 29.2% had BV, while 84% reported no symptoms! (Koumans et al, 2007)

But does a diagnosis of BV mean you should worry about your partner cheating on you?

The short answer: no, bacterial vaginosis is not a sexually transmitted infection (though it does have a relationship with sex); therefore, you do not need to worry about your partner being unfaithful if you have BV.

Let’s take a little closer look at this uncomfortable condition and some other myths surrounding it.

Truth: Bacterial vaginosis is a form of vaginitis

It’s easy to see why BV is commonly associated with sexually transmitted infections (STIs). BV is part of a group of conditions known as vaginitis--conditions associated with irritation or inflammation of the vagina--which includes several STIs like gonorrhea, chlamydia, genital herpes, and trichomoniasis or “trich”.

But vaginitis also includes yeast infections, which are not transmitted via sexual intercourse. So which one is BV?

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Myth: Bacterial vaginosis has nothing to do with sex

BV is not a sexually transmitted infection, which is why it does not indicate that your partner is cheating on you (Cleveland Clinic, 2018).

However, frequent intercourse--particularly with multiple partners or between two partners with vaginas--does increase your risk of contracting BV. Using a condom or oral contraceptive can also decrease your risk of contracting BV.

In addition to vagina-on-vagina sex and frequent intercourse with multiple partners, other risk factors for contracting BV include (Livengood, 2009):

  • Ethnicity (African-Americans contract BV at 3x the rate as white Americans)
  • Smoking
  • Frequent douching
  • Pregnancy (Nelson & Macones, 2002)

Truth: Bacterial vaginosis can overlap with other vaginal conditions

It’s difficult to differentiate clearly between different kinds of vaginitis because their symptoms often overlap, and because it’s possible to have two different kinds of vaginitis at once (like BV and a yeast infection). While these symptoms can guide you toward understanding vaginal conditions, they should not replace testing by your physician.

Discharge. The discharge that comes with bacterial vaginosis is often the first symptom you’ll notice (if you have any symptoms at all). Most people describe it as having a “fishy” smell (Livengood, 2009), and it may also appear thin and milky (Cleveland Clinic, 2018). If that doesn’t describe your discharge…

  • Is it thick and lumpy, sort of like cottage cheese? That could indicate a yeast infection.
  • Is it green or yellow and smells foul? You may have trichomoniasis. (Spence & Melville, 2007)

Pain while urinating. The most common diagnosis for pain or a “burning” sensation during urination is a Urinary Tract Infection (UTI). But BV, yeast infections, and trichomoniasis also come with pain while urinating.

Furthermore, it’s possible to have a UTI on top of a vaginal condition, which could be causing multiple symptoms.

(By the way, a UTI is not part of the group of conditions known as vaginitis, as the urinary tract is separate from the vagina.)

Vaginal itching. Your vagina may feel itchy if you have bacterial vaginosis. However, vaginal itching also occurs with yeast infections and most STIs. It can also be caused by various other irritants like stress or scented products.

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Myth: Redness or bumps are a symptom of bacterial vaginosis.

BV does not usually come with any visual changes to the vagina like redness or bumps. Yeast infections do commonly cause redness of the vagina, and bumps could be an infection like genital herpes, or could simply be the result of ingrown hairs and acne.

However, it’s worth repeating that you can have BV and another vaginal condition at the same time--so even if BV is not causing your redness or bumps, you can still have redness and bumps together with BV.

Conclusion

Bacterial vaginosis is a bit of a tricky disorder, which is why there are so many myths surrounding it. It’s not a sexually transmitted infection, but frequent sex with multiple partners--especially without condom use--does increase your risk of getting it.

It can have strong symptoms like “fishy” smelling discharge, it can have overlapping symptoms with other vaginal conditions, or it can have no symptoms at all.

If you sense anything wrong with your vagina--for instance, it feels uncomfortable, painful, or simply different--see your doctor and ask them to test you. It’s vital that you get the proper treatment for your vaginal infection right away; left untreated, many vaginal conditions can spread to other organs and cause long-term damage to your body.

However, the good news is that it does not mean your partner is cheating on you (you can actually get BV from the same partner)--so don’t break up with them over this (unless you wanted to anyway!).

References

  1. Koumans, E. H., Sternberg, M., Bruce, C., McQuillan, G., Kendrick, J., Sutton, M., & Markowitz, L. E. (2007). The prevalence of bacterial vaginosis in the United States, 2001–2004; associations with symptoms, sexual behaviors, and reproductive health. Sexually transmitted diseases, 34(11), 864-869. https://doi.org/10.1097/OLQ.0b013e318074e565
  2. Cleveland Clinic (2018). Vaginitis: Causes, symptoms, treatments & prevention. https://my.clevelandclinic.org/health/diseases/9131-vaginitis
  3. Livengood C. H. (2009). Bacterial vaginosis: an overview for 2009. Reviews in obstetrics & gynecology, 2(1), 28–37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672999/
  4. Nelson, D. B., & Macones, G. (2002). Bacterial vaginosis in pregnancy: current findings and future directions. Epidemiologic reviews, 24(2), 102-108. https://doi.org/10.1093/epirev/mxf008
  5. Spence, D., & Melville, C. (2007). Vaginal discharge. BMJ (Clinical research ed.), 335(7630), 1147–1151. https://doi.org/10.1136/bmj.39378.633287.80

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