What Black Women Need to Know About Bacterial Vaginosis
Every woman has a natural vaginal odor, but, at times, the "honeypot" can get a little musty. The truth is the vagina contains billions of different bacteria whose makeup changes daily. But if you find that your odor is a little off or more potent than normal, bacterial vaginosis (BV) may be to blame. Bacterial vaginosis is a common vaginal condition experienced more frequently by black women. But, before reaching for that over-the-counter odor relief product, here is what you really need to know about BV and some strategies to help reduce the risk of infection.
What is Bacterial Vaginosis?
Let's start with the basics. BV is the most common cause of abnormal vaginal discharge among women. In fact, 29.2 percent of women reported having BV according to the 2001 to 2004 National Health and Nutrition Examination Survey (NHANES) results. BV occurs when too much of a particular bacterium is in the vagina, upsetting the normal balance.
For black women, the likelihood of getting BV is 2.9 times greater than white women. And some experts believe that this is a result of their unique vaginal bacteria makeup.
Is Chronic BV a Thing?
It is also possible to have recurrent or chronic BV. Recurrent bacterial vaginosis (RBV) is defined as having three or more episodes in a 12-month period. Having frequent sexual intercourse without a condom, douching, and failure to reestablish the "good" bacteria in your vaginal flora are reasons for the chronic condition.
Recurrent BV will require multiple and sometimes long-term oral or vaginal treatments. Don't attempt to treat or prevent vaginal symptoms by using self-help remedies like douching, probiotics, or vitamin supplements. These treatments have little effect, and studies consistently show that douching is associated with a higher incidence of BV.
Why are BV Rates Higher Among Back Women?
The vagina contains many different types of lactobacilli species. These bacteria help maintain a healthy pH by producing lactic acid hydrogen peroxide, reducing yeast growth and other unwanted organisms.
Unfortunately, the most common bacteria found in the vaginas of black women do not provide enough protection against BV. A 2014 study in the Journal Microbiology identified six species of Lactobacilli that commonly colonize the vagina: L. crispatus, L. gasseri, L. jensenii, Lactobacillus johnsonii, Lactobacillus vaginalis, and L. iners. Researchers found that women with more L. iners bacteria had a greater risk of developing BV. And because L. iners is often the most dominant vaginal bacteria strain for black women, this increases the likelihood of infection. (PLOS one article)
Researchers also found that having similar strains of lactobacilli was protective against BV. Black women, however, have more diverse strains of bacteria, which may make them more prone to this condition.
Should Black Women Worry about Bacterial Vaginosis?
The truth is, having bacterial vaginosis also raises the risk for other sexually transmitted infections like genital herpes, chlamydia, gonorrhea, and HIV. And women with BV are 60 percent more likely to get HIV, according to a 2008 study in the Journal AIDS.
A 2021 study in Journal Microbiome showed that the L. iners bacteria was the most prevalent vaginal bacteria among African, Caribbean, and other black women. And unfortunately, this strain has been shown to provide less protection against HIV.
Is There a Relationship between BV and Uterine Fibroids?
Black women experience uterine fibroids (non-cancerous tumors in the uterus) at an earlier age, and more than 80 percent of black women will be diagnosed with fibroids by age 50.
Findings from the 2017 study in the Annals of Epidemiology reported that black women with bacterial vaginosis were 35 percent more likely to have fibroids. Similarly, black women with BV infections were more likely to have multiple fibroids and greater fibroid volume, according to a study in the 2015 Journal of Women's Health.
While most women don't have any issue with their fibroids, there are those with symptoms that may experience abnormal uterine bleeding, pelvic pain or pressure, and urinary dysfunction, which may decrease their quality of life.
Is Bacterial Vaginosis Linked to Preterm Birth?
Bacterial vaginosis has a strong association with preterm birth. Pregnant women with BV are more likely to give birth to a premature baby or have a low birth weight baby (less than 5.5 pounds at birth).
And even though most black women give birth to full-term babies, the current preterm birth rate among black women was about 50 percent higher than white or Hispanic women. Babies born too early-especially before 32 weeks, sadly have higher rates of death and disability.
What Signs and Symptoms of BV Should I Look Out For?
Bacterial vaginosis has a distinctive "fishy" odor, so this infection is hard to miss. But there are other symptoms to be aware of like:
Thin white or gray vaginal discharge
Burning, pain, or itching in the vagina
Burning while urinating
External vaginal itching
How is BV Treated?
The good news is that this condition is easily treated with antibiotics prescribed by a healthcare provider. Male sex partners don't need to be treated, but a female partner may also have BV, so she must follow up with a care provider.
And, don't use over-the-counter products to remedy your infection. BV is best treated with medicines prescribed by a doctor.
What are the Dangers of Leaving BV Untreated?
Many times, having BV does not cause other health problems; however, if left untreated, it may increase the risk for:
Sexually Transmitted Infection (STI)
Pelvic inflammatory disease is an infection where BV bacteria infect the uterus or fallopian tubes. Pelvic inflammatory disease can cause infertility and increase your risk for an ectopic pregnancy
An infection after procedures on the female organs like cesarean section, abortions, and surgery on the cervix or uterus
Early labor or birth during pregnancy
What Can I Do To Prevent BV?
Even if you are doing everything right, you can still get bacterial vaginosis. Experts aren't exactly sure how BV spreads, but here are some tips to fend off the infection:
Ditch the Fancy Cleansers and Wipes. Use your hands and a mild cleanser to wash the vulva. Your cleanser should be as close to your vulvar pH of 5.3-5.6 as possible. And don't insert cleansing products into the vagina.
Wipe in One Direction Only. Remember to wipe from front to back- from the vagina to the anus, not the other way around.
Don't Douche: The truth is, douching upsets the balance of good and harmful bacteria in the vagina and may increase the chance of infection.
Limit your number of sex partners. Researchers think that having new or multiple sex partners increases the risk of infection. If you can't limit your partners, consider using a latex or polyurethane condom every time you have sex.
Black Women and BV infections
As a black woman, it is vital to recognize the symptoms of bacterial vaginosis and know the steps to mitigate infection. By being knowledgeable and communicating with your trusted provider, you can create a plan to maintain optimal health.
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