A healthy vagina has a balanced harmony of bacteria. But when that balance is disrupted, you can get bacterial vaginosis (BV). While it’s possible to be asymptomatic, symptoms of this condition typically include an unusual vaginal odor, vaginal discharge, and itching. If you’re wondering, “What is bacterial vaginosis and how do I treat it?” we’ve got answers.

What is bacterial vaginosis?

Having BV isn’t anything to be ashamed of. According to the Centers for Disease Control (CDC), 21.2 million vagina-owners on average experience this infection where harmful bacteria, known as anaerobes, start to outnumber the healthy vaginal bacteria. Dr. Jessica Shepherd, a gynecologist on the medical board of Happy V, tells O.school, “Whether it’s due to sex, diet, or lifestyle choices, when lactobacillus [the bacteria present to fight off anaerobes] decrease in the vaginal flora, new harmful bacteria enter the body or pH increases on its own.” 

There’s a tug-of-war between the two types of bacteria. “Then, anaerobes have an advantage in consuming precious prebiotics and creating by-products such as toxins, which leads to a higher vaginal pH,” says Dr. Shepherd. A higher pH means your vagina is more basic than acidic, the bad bacteria thrives, and you have those classic BV symptoms of a fish-like vaginal odor and greyish discharge. 

Symptoms of BV

Along with fishy-smelling or off-white discharge, some other common symptoms of bacterial vaginosis include burning while urinating, and itching or pain on the vulva. Something to note is that 84 percent of people with vaginas don’t experience any major symptoms, according to the CDC. So either way, it’s best if you get checked, and have a doctor or nurse let you know for certain whether you have BV.

How do you get BV?

You can get BV from having sex, but doing the nasty isn’t always the culprit. According to the CDC, 18.8 percent of those surveyed had not engaged in vaginal, oral, or anal sex. BV can be caused by a variety of things, and knowing these causes can help you prevent getting BV. 

• Improper post-sex hygiene. Peeing after sex and using water to clean your genitals can be a good way to stay hygienic after sexual 
• Sharing sex toys. It’s always best to clean sex toys between uses, especially if you are sharing them with a partner or switching from vaginal to anal use. 
• Irritation from products like condoms, lube, soaps, or detergent. Chemicals in condoms, spermicides, and lubricants can cause irritation in the vagina and disrupt vaginal pH. “Similarly, products such as soap, laundry detergents, and scented toilet paper can also cause vaginal infections.
• Staying in wet bottoms too long. If you’ve stayed in wet bottoms too long after a swim or exercise session, you’re creating the optimal conditions (warm, moist, and humid)  for infection. 
• Diet. If your diet is high in sugar, you may be more prone to bacteria as bad bacteria thrives when there is glucose present. 
• Not changing menstrual products enough. “The pH of blood is higher than that of the vaginal flora [or ecosystem]. Having too much blood in the same area for a prolonged period can increase pH levels,” says Dr. Shepherd. 

How to treat BV

BV can be treated and cured with antibiotics. You can also address the condition by taking pills like metronidazole, or with a topical cream like clindamycin. If you want to prevent BV from occurring in the first place, try these little life hacks. 

• Choose your underwear wisely. Dr. Shepherd says, “Don’t wear tight underwear — especially those that are made of synthetic fibers. Your vagina needs to breathe!” 
• Choose the right condoms. Take note of whether you have an adverse reaction to certain condoms and look into alternatives.
• Change menstrual products regularly. Dr. Shepherd adds, “During your menstrual cycle, make sure to change your tampons, pads, or menstrual cups every three to five hours.” 
• Make sure your vagina isn’t “too” wet. A “wet ass pussy” isn’t always a good thing — be sure to not sit around in wet clothes and keep your vaginal area as dry as possible. 
• Be mindful of anal germs getting near or into your vagina. “Use different toilet paper between your vagina and anus. The same paper should not be used interchangeably,” Dr. Shepherd says. Similarly, clean sex toys between anal and vaginal use. 
• Avoid douching. Even though this practice washes away harmful bacteria, Dr. Shepherd says, “It also removes the good bacteria and replaces it with scented chemicals that could change your vagina’s pH. Your vagina is perfectly capable of cleaning itself, and introducing chemicals to feel ‘fresh’ does the opposite — literally!” Instead, she recommends washing your vulva with mild, unscented soap, or just plain water.
• Eat proper nutrients. “There are opportunities for you to replenish your body with the nutrients that your vagina needs to prevent these infections from occurring,” Dr. Shepherd says. “That includes probiotics in the form of yogurt from live cultures or probiotics in the form of dietary supplements that contain lactobacillus acidophilus LA-14 and lactobacillus rhamnoses HN-001 at their effective clinical dosages.”
  

She recommends Happy V’s prebiotic-probiotic supplement to her patients, as it’s been tested in a double-blind controlled study to help with probiotic colonization in the vagina. That is to say, as Dr. Shepherd explains, “This leads to an increase in beneficial bacteria in the vagina. Therefore, displacing harmful bacteria and creating an acidic environment for probiotics to thrive in.” Additionally, she suggests incorporating prebiotic-rich, fibrous foods such as onions, leeks, garlic, and asparagus, and antioxidant-rich foods such as healthy fruits. “Your diet is essential to a well-maintained microbiome,” she says. 

At the end of the day, don’t freak out

Even before you hop on Pinterest to look up “easy leek recipes,” stock up on probiotic supplements, and throw out all your ultra-close-fitting underwear, you can make simple, efficient changes to your daily routine that’ll help keep BV at bay.