Bacterial Vaginosis Symptoms + How to Treat It

If you’ve dealt with Bacterial Vaginosis (BV), you know that the symptoms can feel super shameful or embarrassing. But you’re far from alone in this! According to the CDC, about 30% of women struggle with BV each year, making it the most common vaginal condition. Since it’s such a shared experience, there are dozens of home remedies online that claim to cure BV for good, including drinking orange juice, douching with hydrogen peroxide, and inserting raw garlic into your vagina. Spoiler alert: we recommend skipping those suggestions but we promise to offer you a handful of targeted herbal remedies that are clinically proven to both prevent and treat BV at home.

What is Bacterial Vaginosis?

Simply put, BV is a bacterial infection in your vagina caused by an overgrowth of pathogenic species of bacteria. A healthy vaginal microbiome (or flora) is made up of predominantly Lactobacilli, which are a beneficial genus of bacteria that create lactic acid to maintain an optimal pH, fight any invaders, and crowd out harmful bacterial species. Your vaginal flora is constantly adapting to your environment, stress, diet, and behaviors, working extremely hard to keep things in balance. However, there are the inevitable times where your body just can’t keep up. Think: you’re traveling, eating differently than you usually do and are wearing wet swimsuit bottoms OR you just took antibiotics and your immune system is run down. When the delicate balance of bacteria gets disrupted (known as dysbiosis), pathogenic bacteria are able to get a foothold and multiply, causing infection(s) and the associated, uncomfortable symptoms. 

Research shows that women with BV have 9-17 different bacterial species in their vaginas, while women with healthy microbiomes have 1-6 (1). The species typically responsible for BV is Gardnerella vaginalis, an anaerobic gram-negative bacteria that is present in 98% of women with BV (2). However, Atopobium vaginae, Megasphaera, Leptotrichia amnionii, Sneathia sanguinegens, Porphyromonas asaccharolytica, a bacterium related to Eggerthella hongkongensis, and bacteria related to Prevotella species may also be to blame (3).

Signs and symptoms of BV

It’s worth noting here that in milder cases of BV, you may not even know you have it. In fact, 84% of women don’t experience any symptoms at all (4). There is also a decent amount of overlap between the symptoms of a yeast infection and the symptoms of BV, but the tell tale signs of BV are: 

• A strong fishy odor (often worse after sex)
• Thin gray, white or even slightly green discharge
• Vaginal pain, irritation or itching
• More rare: pain or burning when you pee
• A vaginal pH of 4.5 or higher, which is easily diagnosable by a doctor

Causes of BV

Unfortunately for us, there isn’t a cause of BV, per say. Rather, anything that is able to throw off your vaginal microbiome can potentially cause BV, or any other vaginal infection for that matter. For instance:

• Soaps and body washes
• Diet
• Smoking
• Stress
• Race
• IUDs
• Improper hygiene (like wiping incorrectly)
• Hormonal fluctuations (menopause, pregnancy)
• Vaginal products
• Douching
• Having multiple sexual partners
• Being HIV positive
• Antibiotics
• Sexual behavior (unprotected sex, having a female partner)
• Certain lubes

As you can see from the laundry list of potential causes, one through line is sex. So much so that BV is often confused for an STD or STI, which it is not! However, sexual activity can introduce new bacteria into your vagina and alter your vaginal pH, both of which are biggies for the development of BV. Since semen is naturally alkaline and a healthy vagina is quite acidic, semen can easily increase the vaginal pH to an unhealthy level and make your vagina more vulnerable to pathogenic bacteria.

Additionally, lube is a sneaky BV offender. Most lubes on the market contain bacteriostatic or bactericidal ingredients (like chlorhexidine gluconate or nonoxynol-9) that kill or prevent bacterial growth of Lactobacillus species – the good guys. Recent research shows that many of these lubes also have glycerol, propylene glycol, polyquaternary compounds or other ingredients that make them up to 30 times the osmolality of healthy vaginal fluid (aka hyperosmolal). This chemical property of lube 1) reduces the function of the epithelial cell barrier that protects and defends your vagina and 2) damages the delicate vaginal mucosal tissue (5). Therefore, it’s essential that you use lubes that are pH friendly and aren’t hyperosmolal, like Maude. 

How to treat BV at home

Vaginal probiotics

Studies have shown that several Lactobacillus strains including L. acidophilus, L. rhamnosus GR-1 and L. fermentum RC-14 can replenish your populations of vaginal Lactobacilli and help to restore order and balance to your vaginal microbiome (6). Because of this, probiotics with vaginal-specific strains like Lactobacilli are effective in preventing chronic BV as well as treating it. Our complete vaginal health formula, Flora-V, contains four different Lactobacillus species in addition to a spore-based probiotic strain that repopulates your gut microbiome as well as your vaginal flora. Win win.

Garlic

In one study, patients with BV were given either two 500 mg garlic pills or the commonly prescribed antibiotic metronidazole for a period of seven days. The researchers found that garlic was equally as effective as the oral antibiotic yet had no side effects, suggesting that garlic may be a powerful and safe antimicrobial treatment for BV (7).

Boric acid suppositories

If you’ve had recurrent yeast infections at some point in your life, you may be familiar with boric acid suppositories. This old school vaginal infection treatment involves inserting a boric acid capsule up your vagina daily for 10 consecutive days (it’s way less gnarly than it sounds, we swear!). Boric acid suppositories have been used for over 100 years at this point and are shockingly effective at both treating and preventing BV and yeast infections by lowering your vaginal pH (8). So if you’re experiencing uncomfortable symptoms like itching or irritation but aren’t sure what the cause is, boric acid suppositories will cover all your bases! Better yet? It’s available over the counter now, too.

Apple cider vinegar

Hear us out here. While there isn’t currently any clinical research on the efficacy of apple cider vinegar (ACV) on BV, the internet is abuzz with anecdotal evidence that it can in fact lessen BV symptoms. The thinking here is that the high acidity of ACV, due to acetic acid, helps to shift your vaginal pH to a lower, more acidic environment ideal for our lovely Lactobacilli bacteria. Many women swear by filling their bathtub about ⅓ of the way up, adding in one cup of ACV and soaking your lower half in the warm water for 15-20 minutes.

Tea tree oil suppositories

Tea tree essential oil is known to be an incredible antimicrobial for anything from acne to athlete’s foot. Unsurprisingly, it also works wonders for BV as it is able to kill pathogenic bacteria while sparing the beneficial Lactobacilli bacteria, unlike antibiotics (9, 10). Just be sure to NEVER use tea tree oil straight from the bottle since it can burn your skin! You can whip up your own tea tree oil suppositories quite easily by mixing <5 drops of tea tree essential oil in coconut oil and then pouring this mixture into molds (which you can make with foil in a pinch) to let it harden. If DIY isn’t your jam, you can purchase tea tree suppositories online or in most health food stores. In either case, insert a suppository into your vagina before going to bed for six consecutive nights and you’ve got a cheap, gentle treatment for BV. Note: tea tree oil is not safe for pregnancy, so if you’re currently pregnant and are struggling with BV opt for one of the other home remedies we’ve detailed!

Antibiotics 

And if all else fails or your BV is lingering for an extended period of time, antibiotics are always an option. Your doctor may prescribe you any combination of oral pills, topical creams or ointments, and (in extremely rare cases) IVs. Just remember, when taking a round of oral antibiotics you always want to repopulate your gut microflora with beneficial bacteria by taking a probiotic. This also reduces your chances of getting antibiotic-associated diarrhea or other negative side effects.