HEALTH & WELLNESS: Here's the truth about bacterial vaginosis.

 Author: S. Gordon-Jeffery

Bacterial Vaginosis is a bacterial infection that mainly affects women. Men don't really get BV because it isn't a venereal disease, but we'll get to that shortly.

According to statistics found on the Centers for Disease Control and Prevention (CDC) website, about 21.1 million (29.2%) women in America are affected by the infection, but surprisingly, of that number, 84% of them don't know they have it! [1] This is a worrying trend because this infection can lead to fertility issues in women. The CDC also notes that women of color are more likely to be affected by this infection than Caucasian women. 

What is Bacterial Vaginosis?

While searching for information online I found an interesting article on WebMD, a popular medical advice website on the internet. According their article Bacterial Vaginosis (BV): Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications, BV is "an infection of the vagina. It results from a change in the normal balance of vaginal bacteria." [2] So, BV is caused by an overgrowth of bad bacteria. Several symptoms of BV are:

• Odor - a fishy smelling odor from the vagina
• Itching
• Burning sensation when peeing
• White, gray or greenish looking discharge [2]

Balance 

Diagram courtesy of TopperLearning

A healthy vagina's pH level* (measurement of how acidic or alkaline something is) is usually between 3.8 to 4.5, which is moderately acidic (during your period it's slightly higher). [3] At those pH levels good bacteria such as lactobacillus can thrive and promote the conditions for protecting against infections. [2] If however, there is a depletion of this good bacteria and others, the possibility is ripe for bad bacteria to attack and infect the vagina. 

Factors that lead to BV:
There are several factors that can lead to an overgrowth of bacteria that cause BV:

1. Unprotected Sex with New or Multiple Sex Partners
2. Soap and Douching (soap lather and or water is forced inside the vaginal cavity to cleanse it)
3. Antibiotics (Some antibiotics kill the good bacteria and weaken the immune system)
4. Hygiene practices (wiping from front to back instead of the reverse after going to the bathroom is recommended; changing soiled underwear regularly)

We will however be focusing on sex and how it may cause bacterial vaginosis.

1. Unprotected Sex with New or Multiple Sex Partners

During sexual intercourse there is a mingling of semen and vaginal excretions. Now I know some of y'all didn't know this, but in comparison to a woman's vagina pH level which is a bit acidic, a man's semen is more alkaline! Semen's pH level is between 7.1 and 8.0, any lower and it would be considered acidic. [4] A man's sperm can therefore alter the vagina's pH level, making it easier for bacteria to grow. Multiple sex partners therefore throws off the natural balance and can lead to an infection. How? The introduction of several semen types with different pH levels, proteins and hormonal compositions may exacerbates any bacteria (remember semen is alkaline) present, making a woman's vagina more susceptible to infections such as STIs, and not just BV. It is much safer for women to share bodily fluids with only one devoted partner. [2]

Also during sex, the pH level inside the vagina temporarily rises, creating the perfect conditions for a man's sperm to survive, so they will be able to make it to the woman's egg to fertilise it. [3]

The good news is, over time a woman's body adjusts to the chemicals in a man's semen, so that it will be easier for her to get pregnant by him [5]. Conversely though, a woman can have an allergic reaction to her sex partner's semen and make sperm antibodies, especially if she's having sex with him for the first time, and his semen is incompatible with her immune system. [6] In God's plan all of this would be avoided if men and women engage in lasting committed relationships. We were made for just one partner, even on a biological level, our bodies reveal this truth.

In conclusion, BV or bacterial vaginosis is an infection which can be caused by a depletion of good bacteria or over production of bad bacteria. Women of color are more likely to develop this condition. BV can be caused by several factors including unprotected sex with multiple partners.

References
* Low pH level is acidic, usually higher levels being alkaline. 0-6 being acidic, 7 is neutral, and above alkaline.

1. Centers for Disease Control and Prevention (CDC). Bacterial Vaginosis (BVl): Statistics. https://www.cdc.gov/std/bv/stats.htm#:~:text=The%20prevalence%20in%20the%20United,84%25)%20reported%20no%20symptoms.
2. WebMD. Bacterial Vaginosis (BV): Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications, BV. August 2020. https://www.webmd.com/women/guide/what-is-bacterial-vaginosis#:~:text=Douching%20upsets%20the%20natural%20balance,partners%20are%20most%20at%20risk.
3. Healthline. Everything You Need to Know About Maintaining Your Vaginal pH Balance. July 2019. https://www.healthline.com/health/womens-health/vaginal-ph-balance
4. WebMD. Infertility and Reproduction: What is Semen Analysis? August 2020. https://www.webmd.com/infertility-and-reproduction/guide/what-is-semen-analysis#:~:text=Your%20pH%20level%20measures%20the,means%20you%20have%20acidic%20semen.
5. Michigan Medicine. Antisperm Antibody Test. University of Michigan. May 2019. https://www.uofmhealth.org/health-library/ux1248
6.   John E. Schjenken et al. Female Response to Seminal Fluid. American Physiological Society. Abstract published 27 April 2020. https://journals.physiology.org/doi/abs/10.1152/physrev.00013.2018