Common Symptoms and Signs of BV

BV can be silent: some women have no symptoms at all. When they do show up, they include:

• Unusual discharge: thin, gray or white.
• Fishy odour: often stronger after sex.
• Burning when you pee.
• Itching around the outside of the vagina.

Causes and Risk Factors

BV happens when the balance between good and bad bacteria in the vagina tips out of whack. Things that raise your risk:

• Multiple sexual partners: switching partners often disrupts the bacterial balance.
• Douching: it disturbs the natural bacterial mix.
• Low lactobacilli: lactobacilli are the good bacteria that keep the vagina healthy. Lower levels open the door to BV.
• Smoking: smoking changes your vaginal flora.

Why Diagnose Bacterial Vaginosis?

Catching BV early matters. Here's why.

What Happens if BV is Left Untreated

Ignoring BV leads to real problems:

• Pelvic inflammatory disease (PID): the infection can spread to the uterus or fallopian tubes, causing chronic pain and infertility.
• Other infections: BV raises the risk of urinary tract infections.

BV in Pregnancy

Pregnant women have extra risks from untreated BV:

• Preterm birth: BV can lead to premature labour and delivery.
• Low birth weight: babies born to mothers with untreated BV may weigh less, with health knock-on effects.
• Postpartum endometritis: an infection of the uterine lining after childbirth.

Higher STI Risk

BV makes you more vulnerable to STIs:

• HIV: women with BV have a higher risk of contracting HIV if exposed.
• Other STIs: BV raises the risk of chlamydia and gonorrhea infection.

Why Treat Promptly

Treating BV doesn't take long:

• Antibiotics: they restore the bacterial balance, ease symptoms, and prevent complications.
• Prevention: knowing what causes BV helps you avoid triggers like douching and reduce your chance of recurrence.

Testing for BV

In Canada, you can be diagnosed with BV through:

• Vaginal swabs
• Urine tests
• At-home test kits

Each has trade-offs.

Vaginal Swabs

A sterile swab collects a sample from the vaginal walls. The lab runs several tests:

• Microscopic exam: the sample goes on a slide under the microscope. "Clue cells" (vaginal cells coated in bacteria) point to BV.
• Whiff test: potassium hydroxide is added. A fishy smell suggests BV.
• pH test: vaginal fluid pH above 4.5 suggests BV.

Doctors often use Amsel's criteria. You need at least three of the four:

• Vaginal pH above 4.5, measured with pH paper or a stick.
• Clue cells under the microscope.
• Homogeneous, milky discharge on visual inspection.
• Positive whiff test after potassium hydroxide is added.

Urine Test

Urine sampling for BV has limits:

• Less accurate: urine tests miss BV more often than swabs do.
• False negatives: you can have BV but get a negative result.
• Less detail: urine tests don't tell you which specific bacteria are involved.

Urine tests are non-invasive but not as reliable. For the most accurate diagnosis, vaginal swabs combined with clinical criteria are the way to go.

Prep Before the Test

For accurate results, in the 24 hours before your test:

• Don't douche.
• Don't use tampons, vaginal creams, or vaginal medications.
• Don't have sex.
• Tell your provider about any medications or supplements you take.

At-Home Vaginal pH Test Kits

Home kits let you test for BV in private. They usually include:

• pH paper strips: measure acidity or alkalinity.
• Swabs: for collecting a sample from the vaginal walls.
• Colour chart: for interpreting the strip.

You can pick them up at most pharmacies or online.

Limits of Home Testing

• Accuracy: home tests aren't as accurate as lab tests.
• Limited info: they only measure pH. They don't identify specific bacteria.
• Follow-up: if your pH is high, see a healthcare provider for a definitive diagnosis and treatment.

Home kits are a decent first step but they don't replace professional testing.

Cost

In Canada, testing (swab or urine) is usually covered for those with OHIP. Without insurance, most labs charge $15 to $20 for a swab. At TeleTest, you only pay for messaging with the doctor to discuss symptoms and get treatment if needed. Home test kits run $50 to $200.

Will Bacterial Vaginosis Go Away on Its Own?

Self-Limiting BV in Asymptomatic Cases

BV sometimes clears on its own, especially when you have no symptoms. The body can rebalance the bacteria. That's not always how it plays out, though.

When Treatment Might Not Be Needed

In some cases, BV doesn't need treatment:

• No symptoms: your doctor might just monitor instead of prescribing medication.
• Mild symptoms: sometimes mild BV resolves without antibiotics.

When to See a Doctor Anyway

Even with mild symptoms, see a provider if:

• Symptoms last more than a week.
• You're pregnant or planning to be: BV needs to be checked regardless of severity.
• You have recurring BV: frequent episodes need medical evaluation to prevent complications.
• You have other health concerns: weakened immune system or other conditions mean you shouldn't ignore even mild symptoms.

How to Interpret BV Test Results

Positive vs. Negative

BV results come back positive or negative.

• Positive: your sample shows the bacterial imbalance of BV.
• Negative: the sample shows a normal balance of bacteria.

Next Steps if Your Test is Positive

If you test positive for BV:

1. Talk to your healthcare provider about treatment.
2. Follow the plan: doctors usually prescribe oral or topical antibiotics. Finish the full course.
3. While treating: avoid douching, scented products, and unprotected sex. They can make things worse or slow healing.

Follow-Up and Prevention

After treatment, take steps to prevent recurrence:

• Follow-up visits: make sure the infection has actually cleared.
• Probiotics: they may help maintain a healthy bacterial balance.
• Good hygiene: keep clean, but don't over-clean. Over-washing disrupts the natural balance.
• Safer sex: condoms and limiting partners reduce BV risk and other infections.

Reading your results and following through on treatment is the best way to handle BV.

Disclaimer: This blog post is intended for educational purposes only and should not be taken as medical advice. Always consult your healthcare provider for personal health concerns.