A lack of vaginal moisture may have a significant impact on a woman’s sex life. Sex does not have to hurt. Fortunately, there are many available options to provide the vagina with moisture and make sex pleasurable.

Here are eight tips to help solve the problem of vaginal dryness. 

1. Water-based sexual lubricants

Sexual lubricants reduce friction. Lubricants enhance the experience and eliminate painful chafing and burning. 

The application of sexual lubricant as a part of foreplay is a simple trick for many women to improve sexual pleasure. Lube may be applied directly to the vagina, clitoris, or penis before penetration.

Not all lubricants are the same. Most lubricants available at a local pharmacy are water-based. Water-based lubricants are the safest choice to prevent sexually transmitted infections. They do not break down latex in condoms or sex toys. Water-based lubricants are ideal for those with sensitive skin or those prone to vaginal irritation. 

Water-based lubricants do not leave stains on sheets and are easy to clean in the laundry. 

Popular brands include Astroglide and KY. 

On the downside, water-based lubricants dry out quickly. Rapid drying may require reapplication for longer sexual sessions. For those suffering from chronic vaginal dryness or inadequate natural lubrication during sex, they may be insufficient. Water-based lubricants are often suboptimal for postmenopausal women.  

2. Silicone-based sexual lubricants

Silicone-based lubricants stay slippery longer, avoiding the frustration of rapid drying and reapplication messiness. This type of lubricant does not evaporate when exposed to air and provides a wet sensation for longer sexual sessions. Since they are not water-based, silicone lubes may be used in the shower or bathtub.

One popular brand is Platinum Wet. This Paraben and Glycerin free product reduces the risk of chemical irritation. Penchant Premium is another hypoallergic option ideal for those with sensitive skin. 

Silicone-based lubricants may be more effective and pleasurable for monogamous couples at low risk for sexually transmitted infections. 

Non-water-based lubricants have downsides too. They are messy. Soap and water must be used to remove them, and they will also stain sheets. 

Silicone-based lubricants will break down latex condoms or latex in sex toys.

3. Foreplay 

We can not underestimate the value of foreplay for those with chronic vaginal dryness. Foreplay gets the juices flowing by increasing sexual arousal. Blood flow to genitals increases, causing the vagina, labia, and clitoris to swell. 
Better stimulation leads to more natural lubrication and an increase in vaginal elasticity. The vagina then secretes natural lubrication, which increases pleasure and reduces pain. 

For those with chronic vaginal dryness, communicating sexual needs and desires to your partner is critical. Sexual partners may be unaware of the physiological changes and not know what to do. Providing feedback allows the partner to learn how best to meet your needs.

4. Vaginal Moisturizers

Multiple products over-the-counter products are available to help increase vaginal moisture. The basic idea is to prevent dryness and improve the vaginal ph balance. These products do not treat the underlying cause of vaginal dryness. They are useful for day to day use to alleviate discomfort and improve vaginal moisture.

Those will sensitive skin may benefit from avoiding products containing parabens, glycerin, or propylene glycol. These additives may cause skin irritation. 

Popular products include Replens and Luvena. 

5. Vaginal Estrogen

Estrogen is one of the most important female hormones. A decrease in the production of estrogen by the ovaries triggers physiological changes in the vagina. The vaginal tissues thin out, and lubrication decreases. 

Breastfeeding, certain medications, and menopause all cause estrogen deficiency.

Prescription estrogen medication can be placed directly into the vagina to offset the deficiency. Low dose Estrogen applied directly to the vagina bulks up vaginal cells and increases blood flow. Restoring vaginal health allows cells to produce more moisture. Natural lubrication improves, and the more elastic vaginal walls reduce resistance to trauma during penetration.

Vaginal estrogen comes in a variety of forms from creams, rings, and vaginal tablets. All require a prescription and evaluation by a health provider before use. 

6. DHEA supplements 

The DHEA hormone is a highly effective alternative to estrogen therapy. Before menopause, DHEA levels are high. As the ovaries stop functioning, DHEA levels fall. DHEA supplements can be placed into the vagina to restore vaginal health, reduce intercourse pain, and improve vaginal dryness. 

Only one medication is commercially available. Prasterone, sold under the brand name Intrarosa, is a plant-derived form of DHEA. Prasterone is inserted into the vagina once a day through an easy to use applicator. DHEA converts into estrogen targeting the underlying cause of dryness. It is FDA indicated for painful intercourse.

Prasterone requires a prescription and monitoring by a health provider.

7. Selective Estrogen Receptor Modulators 

Another alternative to estrogen therapy is a class of drugs called SERMS (Selective Estrogen receptor modulators). These medications act directly on the hormone receptors. Direct targeting of the vaginal tissue increases the thickness of the superficial and parabasal vaginal cells.

Like estrogen and DHEA therapy, the restored health of the vaginal cells improves the natural ability to produce moisture and lubrication. 

Ospemifene is the only FDA approved oral drug for vaginal dryness and painful intercourse.

Ospemifene requires a prescription and monitoring by a health provider.

8. Topical Sildenafil 

Sildenafil is a popular medication used to treat erectile dysfunction in men by increasing blood flow to the penis. Some women benefit from the topical application of Sildenafil. 

A pea-size amount of compounded Sildenafil cream is applied directly to the clitoris before intercourse. Sildenafil cream increases blood flow to the clitoris. For some women, the increased blood flow triggers more natural lubrication, improves pleasure, and helps to achieve orgasm. 

Sildenafil requires a prescription and monitoring by a health provider for this off label use.

Vaginal dryness is a problem you don’t have to ignore

Vaginal dryness is a common symptom among women. Painful intercourse and vaginal discomfort are not problems to be tolerated. These options can help one restore vaginal health and enhance the sexual experience. 

The post 8 Tips to Solve Vaginal Dryness and Overcome Painful Intercourse appeared first on Medika Life.

Most women will get a vaginal yeast infection at some point in their life. This common and frustrating issue is a common complaint in an Obgyn office. Many women want to know why yeast happens and how to fix it fast.

Yeast infections are easy to treat. Over-the-counter treatments are safe to use, but it is essential to see a doctor to confirm the diagnosis if the infection is not going away. Many assume abnormal vaginal symptoms are due to yeast, but yeast infection symptoms are similar to other vaginal infections and sexually transmitted infections (STIs).

Self-diagnosing often leads to errors, but the situation “down there” will not improve if we are not treating the right thing.

What is a vaginal yeast infection?

A yeast infection is a fungal infection, typically by candida, causing itching and burning of the vulva, the area around the vagina.

The vagina always contains small amounts of yeast. We have yeast on our skin, our mouth, and our gastrointestinal tract all the time. Our bodies keep yeast in check with healthy bacteria.

The vagina is an ecosystem maintained by a variety of yeast and bacteria living in perfect harmony. Periodically, something disruptive happens to break the status quo allowing yeast to flourish. When yeast outgrows the counterbalancing bacteria, women will notice a yeast infection.

Antibiotic use is a perfect example. When we take antibiotics to kill a bacterial infection, the medication also destroys the protective vaginal bacteria- balancing yeast. As a result, almost 50% of women end up with a yeast infection.

What causes yeast infections?

An overgrowth of the microscopic fungus Candida causes yeast infections. Candida albicans is the most common culprit accounting for 75% of the cases. Candida glabrata and candida tropicales are two other types of yeast causing candida species.

Who gets vaginal yeast infections?

Any woman can develop a yeast infection. In fact, three out of four women will have a yeast infection at some point in their life, and almost half of women have two or more infections.

Some medical conditions increase the risk of yeast infections. The risk is higher if:

• You are pregnant
• You have diabetes. Yeast loves glucose and will flourish in this environment.
• You use a type of hormonal birth control that has higher doses of estrogen.
• You douche. Douching disrupts the vaginal ecosystem by altering the vaginal acidity allowing yeast to grow.
• You recently took antibiotics
• You have a weakened immune system, such as from HIV or taking steroid medication

What are the symptoms of vaginal yeast infections?

Vaginal and vulvar itching is the most common symptom followed by an abnormal, thick, white cottage-cheese vaginal discharge. Some women notice pain during sex or painful urination. Others notice vulvar burning, irritation, or swelling.

Everyone’s experience will vary. Symptoms may be severe for some and barely noticeable for others.

Can I get a yeast infection from having sex?

The relationship between sex and yeast is tricky. A yeast infection is not considered an STI, but sexual intercourse alters the vaginal chemistry by changing the pH balance. The vagina regulates its ecosystem by maintaining a normal pH level. A vaginal pH between 3.5–5.5 suppresses yeast and anaerobic bacteria.

Sex temporarily disrupts the balance. Vaginal secretions and semen change the chemistry, and in some cases, allow abnormal amounts of yeast or bacteria to flourish. The good news is vaginas, in most cases, effectively reestablish normal pH to keep itself healthy.

In rare cases, some women get yeast infections from a sexual partner or improperly-washed sex toys. The cases are not common. In my experience, most cases of sex-induced yeast are misdiagnosed and warrant a second opinion.

Because yeast infections are not STIs, sexual partners do not need to be treated.

Should I call my doctor if I have a yeast infection?

It is acceptable to self-medicate with an over-the-counter antifungal medication if you feel certain a yeast infection is present. If the infection is recurrent or not going away, then it is time to call a doctor.

Seeing your doctor or practitioner is the only way to find out for sure if you have a yeast infection and not a more serious problem.

The signs and symptoms of a yeast infection are a lot like symptoms of other more serious infections. Trichomoniasis is an STI that also causes itching, and bacterial vaginosis (BV) often causes vaginal discharge.

If left untreated, STIs and BV raise your risk of getting other STIs, including HIV. Untreated gonorrhea and chlamydia can lead to problems getting pregnant. BV can also lead to problems during pregnancy, such as preterm labor and premature delivery.

How is a yeast infection diagnosed?

A doctor will do a pelvic exam to look for swelling and characteristic discharge. The doctor may also use a cotton swab to take a sample of the discharge from the vagina, and then look at the sample under a microscope to evaluate for fungus.

Nucleic acid amplification microbial testing is a widely available rapid test technology to help distinguish between yeast, bacterial vaginosis, and trichomoniasis. Yeast cultures are sometimes performed to determine the candida species to help guide treatment in recurrent cases.

How is a yeast infection treated?

Yeast infections are treated with antifungal medicine.

Antifungal medications can be purchased at any pharmacy without a prescription. Antifungal medicines come in the form of creams, tablets, ointments, or suppositories to be inserted into the vagina. Treatments vary from single-dose therapy to daily use for up to seven days.

A doctor or practitioner can also prescribe a single dose of oral antifungal medicine such as fluconazole.

Patients suffering from recurrent vaginal yeast infections may qualify for more robust testing and treatment.

Are over-the-counter yeast medications safe?

In general, self-treatment for suspected yeast is safe. If the diagnosis is uncertain or not improving, it is best to talk with a provider to confirm we are treating the correct problem.

It may sound silly, but if we are not treating the right problem then it will not get better. Studies show that two out of three women who buy yeast infection medicine don’t really have a yeast infection.

If a yeast infection is not going away then some other infection may be causing the problem.

How do I treat a yeast infection if pregnant?

During pregnancy, it is safe to treat a yeast infection with vaginal creams or suppositories that contain Terconazole, Miconazole, or Clotrimazole.

Obgyns typically avoid the oral fluconazole tablet to treat a yeast infection during pregnancy. Some studies show high-dose first-trimester use may cause birth defects. This medication may be indicated in certain clinical situations.

How can I prevent a yeast infection?

These steps may lower the risk of getting yeast infections:

• Do not douche.
• Do not use scented feminine products
• Change tampons, pads, and panty liners often.
• Avoid tight underwear or restrictive clothing that increases body heat, sweat, and genital moisture.
• Change out of wet swimsuits and workout clothes when finished.
• Wipe from front to back when using the bathroom.
• Avoid hot tubs and very hot baths.
• Control your blood sugar if you have diabetes. ,

What should I do if I get repeat yeast infections?

If you get four or more yeast infections in a year, talk to your doctor or nurse.

About 5% of women get four or more vaginal yeast infections in one year. This is called recurrent vulvovaginal candidiasis (RVVC). RVVC is more common in women with diabetes or weak immune systems, such as with HIV, but it can also happen in otherwise healthy women.

Doctors most often treat RVVC with antifungal medicine for up to six months.

The post Vaginal Yeast Infections: Why Women Get Them and What to Do About It appeared first on Medika Life.

The external genitalia are the accessory structures of the female reproductive system that are external to the vagina. They are also referred to as the vulva or pudendum. The external genitalia include the labia majora, mons pubis, labia minora, clitoris, and glands within the vestibule.

The clitoris is an erectile organ, similar to the male penis, that responds to sexual stimulation. Posterior to the clitoris, the urethra, vagina, paraurethral glands and greater vestibular glands open into the vestibule.

The vulva (pudendum) refers to the external female genitalia. Its functions are threefold:

• Acts as sensory tissue during sexual intercourse
• Assists in micturition by directing the flow of urine
• Protects the internal female reproductive tract from infection.

Structures of the Vulva

The vulva is a collective term for several anatomical structures:

• Mons pubis – a subcutaneous fat pad located anterior to the pubic symphysis. It formed by the fusion of the labia majora.
• Labia majora – two hair-bearing external skin folds.
  • They extend from the mons pubis posteriorly to the posterior commissure (a depression overlying the perineal body).
  • Embryologically derived from labioscrotal swellings
• Labia minora – two hairless folds of skin, which lie within the labia majora.
  • They fuse anteriorly to form the hood of the clitoris and extend posteriorly either side of the vaginal opening.
  • They merge posteriorly, creating a fold of skin known as the fourchette.
  • Embryologically derived from urethral folds
• Vestibule – the area enclosed by the labia minora. It contains the openings of the vagina (external vaginal orifice, vaginal introitus) and urethra.
• Bartholin’s glands – secrete lubricating mucus from small ducts during sexual arousal. They are located either side of the vaginal orifice.
• Clitoris – located under the clitoral hood. It is formed of erectile corpora cavernosa tissue, which becomes engorged with blood during sexual stimulation.
  • Embryologically derived from the genital tubercle

Vascular Supply and Lymphatics

The arterial supply to the vulva is from the paired internal and external pudendal arteries (branches of the internal iliac).

Venous drainage is achieved via the pudendal veins, with smaller labial veins contributing as tributaries.

Lymph drains to the nearby superficial inguinal lymph nodes.

Male External Genitalia

The penis is an external organ of the male reproductive system. It has two main functions:

• Sexual intercourse – During erotic stimulation, the penis undergoes erection, becoming engorged with blood. Following emission, (mixing of the components of semen in the prostatic urethra) ejaculation can occur, whereby semen moves out of the urethra through the external urethral orifice. Finally, the penis undergoes remission, returning to a flaccid state.
• Micturition –The penis also has an important urinary role. It contains the urethra, which carries urine from the bladder to the external urethral orifice, where it is expelled from the body.

Structure of the Penis

The penis can be anatomically divided into three parts:

• Root – the most proximal, fixed part of the penis. It is located in the superficial perineal pouch of the pelvic floor, and is not visible externally. The root contains three erectile tissues (two crura and bulb of the penis), and two muscles (ischiocavernosus and bulbospongiosus).
• Body – the free part of the penis, located between the root and glans. It is suspended from the pubic symphysis. It is composed of three cylinders of erectile tissue – two corpora cavernosa, and the corpus spongiosum.
• Glans –the most distal part of the of penis. It is conical in shape, and is formed by the distal expansion of the corpus spongiosum. This contains the opening of the urethra, termed the external urethral orifice.

Erectile Tissues

The erectile tissues fill with blood during sexual arousal, producing an erection. The root and body of the penis are spanned by three masses of erectile tissue.

In the root, these tissues are known as the left and right crura, and the bulb of the penis. The bulb is situated in the midline of the penile root, and is traversed by the urethra. The left and right crura are located laterally; attached to the ipsilateral ischial ramus, and covered by the paired ischiocavernosal muscles.

The erectile tissues continue into the body of the penis. The left and right crura continue anteriorly into the dorsal part of the penis – they form the two corpora cavernosa. They are separated by the septum of the penis, although often incompletely. The bulb forms the corpus spongiosum, which lies ventrally. The male urethra runs through the corpus spongiosum – to prevent it becoming occluded during erection the corpus spongiosum fills to a reduced pressure.

Distally, the corpus spongiosum expands to form the glans penis.

Muscles

There are four muscles located in the root of the penis:

• Bulbospongiosus (x2) – associated with the bulb of the penis. It contracts to empty the spongy urethra of any residual semen and urine. The anterior fibres also aid in maintaining erection by increasing the pressure in the bulb of the penis.
• Ischiocavernosus (x2) – surrounds the left and right crura of the penis. It contracts to force blood from the cavernous spaces in the crura into the corpus cavernosa – this helps maintain erection.

Fascial Coverings

Each mass of erectile tissue has two fascial coverings. The most superficial layer, immediately under the skin, is the external fascia of Colles (which is in continuity with the fascia of Scarpa which covers the abdominal wall).

A deeper stratum is the deep fascia of the penis (also known as Buck’s fascia). This is a continuation of the deep perineal fascia, and forms a strong membranous covering which holds all three erectile tissues together.

Underneath the deep fascia is the strong fascia called tunica albuginea, forming an individual capsule around each cavernous body and fused in the midline. The incomplete septum between the two corpora is comprised of tunica albuginea.

Ligaments

The root of the penis is supported by two ligaments, which attach it to the surrounding structures:

• Suspensory ligament – a condensation of deep fascia. It connects the erectile bodies of the penis to the pubic symphysis.
• Fundiform ligament – a condensation of abdominal subcutaneous tissue. It runs down from the linea alba, surrounding the penis like a sling, and attaching to the pubic symphysis.

Skin

The skin of the penis is more heavily pigmented than that of the rest of the body. It is connected to the underlying fascias by loose connective tissue.

The prepuce (foreskin) is a double layer of skin and fascia, located at the neck of the glans. It covers the glans to a variable extent. The prepuce is connected to the surface of the glans by the frenulum, a median fold of skin on the ventral surface of the penis. The potential space between the glans and prepuce is termed the preputial sac.

Neurovascular Supply

The penis receives arterial supply from three sources:

• Dorsal arteries of the penis
• Deep arteries of the penis
• Bulbourethral artery

These arteries are all branches of the internal pudendal artery. This vessel arises from the anterior division of the internal iliac artery.

Venous blood is drained from the penis by paired veins. The cavernous spaces are drained by the deep dorsal vein of the penis – this empties into the prostatic venous plexus. The superficial dorsal veins drain the superficial structures of the penis, such as the skin and cutaneous tissues.

The post The External Genitilia appeared first on Medika Life.

What is douching?

The word “douche” means to wash or soak. Douching is washing or cleaning out the inside of the vagina with water or other mixtures of fluids. Most douches are sold in stores as prepackaged mixes of water and vinegar, baking soda, or iodine. The mixtures usually come in a bottle or bag. You squirt the douche upward through a tube or nozzle into your vagina. The water mixture then comes back out through your vagina.

Douching is different from washing the outside of your vagina during a bath or shower. Rinsing the outside of your vagina with warm water will not harm your vagina. But, douching can lead to many different health problems.

Most doctors recommend that women do not douche.

How common is douching?

In the United States, almost one in five women 15 to 44 years old douche.

More African-American and Hispanic women douche than white women. Douching is also common in teens of all races and ethnicities.

Studies have not found any health benefit to douching. But, studies have found that douching is linked to many health problems.

Why should women not douche?

Most doctors recommend that women do not douche. Douching can change the necessary balance of vaginal flora (bacteria that live in the vagina) and natural acidity in a healthy vagina.

A healthy vagina has good and harmful bacteria. The balance of bacteria helps maintain an acidic environment. The acidic environment protects the vagina from infections or irritation.

Douching can cause an overgrowth of harmful bacteria. This can lead to a yeast infection or bacterial vaginosis. If you already have a vaginal infection, douching can push the bacteria causing the infection up into the uterus, fallopian tubes, and ovaries. This can lead to pelvic inflammatory disease, a serious health problem.

Douching is also linked to other health problems.

What health problems are linked to douching?

Health problems linked to douching include:⁵

• Bacterial vaginosis (BV), which is an infection in the vagina. Women who douche often (once a week) are five times more likely to develop BV than women who do not douche.
• Pelvic inflammatory disease, an infection in the reproductive organs that is often caused by an STI
• Problems during pregnancy, including preterm birth and ectopic pregnancy
• STIs, including HIV
• Vaginal irritation or dryness

Researchers are studying whether douching causes these problems or whether women at higher risk for these health problems are more likely to douche.

Should I douche to get rid of vaginal odor or other problems?

No. You should not douche to try to get rid of vaginal odor or other vaginal problems like discharge, pain, itching, or burning.

Douching will only cover up odor for a short time and will make other problems worse. Call your doctor or nurse if you have:

• Vaginal discharge that smells bad
• Vaginal itching and thick, white, or yellowish-green discharge with or without an odor
• Burning, redness, and swelling in or around the vagina
• Pain when urinating
• Pain or discomfort during sex

These may be signs of a vaginal infection, or an STI. Do not douche before seeing your doctor or nurse. This can make it hard for the doctor or nurse to find out what may be wrong.

Should I douche to clean inside my vagina?

No. Doctors recommend that women do not douche. You do not need to douche to clean your vagina. Your body naturally flushes out and cleans your vagina. Any strong odor or irritation usually means something is wrong.

Douching also can raise your chances of a vaginal infection or an STI. If you have questions or concerns, talk to your doctor.

What is the best way to clean my vagina?

It is best to let your vagina clean itself. The vagina cleans itself naturally by making mucous. The mucous washes away blood, semen, and vaginal discharge.

If you are worried about vaginal odor, talk to your doctor or nurse. But you should know that even healthy, clean vaginas have a mild odor that changes throughout the day. Physical activity also can give your vagina a stronger, muskier scent, but this is still normal.

Keep your vagina clean and healthy by:

• Washing the outside of your vagina with warm water when you bathe. Some women also use mild soaps. But, if you have sensitive skin or any current vaginal infections, even mild soaps can cause dryness and irritation.
• Avoiding scented tampons, pads, powders, and sprays. These products may increase your chances of getting a vaginal infection.

Can douching before or after sex prevent STIs?

No. Douching before or after sex does not prevent STIs. In fact, douching removes some of the normal bacteria in the vagina that protect you from infection. This can actually increase your risk of getting STIs, including HIV, the virus that causes AIDS. 

Should I douche if I had sex without using protection or if the condom broke?

No. Douching removes some of the normal bacteria in the vagina that protect you from infection. This can increase your risk of getting STIs, including HIV. Douching also does not protect against pregnancy.

If you had sex without using protection or if the condom broke during sex, see a doctor right away. You can get medicine to help prevent HIV and unwanted pregnancy.

Should I douche if I was sexually assaulted?

No, you should not douche, bathe, or shower. As hard as it may be to not wash up, you may wash away important evidence if you do. Douching may also increase your risk of getting STIs, including HIV. Go to the nearest hospital emergency room as soon as possible. The National Sexual Assault Hotline at 800-656-HOPE (4673) can help you find a hospital able to collect evidence of sexual assault. Your doctor or nurse can help you get medicine to help prevent HIV and unwanted pregnancy.

Can douching after sex prevent pregnancy?

No. Douching does not prevent pregnancy. It should never be used for birth control. If you had sex without using birth control or if your birth control method did not work correctly (failed), you can use emergency contraception to keep from getting pregnant.

If you need birth control, talk to your doctor or nurse about which type of birth control method is best for you.

How does douching affect pregnancy?

Douching can make it harder to get pregnant and can cause problems during pregnancy:

• Trouble getting pregnant. Women who douched at least once a month had a harder time getting pregnant than those women who did not douche.
• Higher risk of ectopic pregnancy. Douching may increase a woman’s chance of damaged fallopian tubes and ectopic pregnancy. Ectopic pregnancy is when the fertilized egg attaches to the inside of the fallopian tube instead of the uterus. If left untreated, ectopic pregnancy can be life-threatening. It can also make it hard for a woman to get pregnant in the future.
• Higher risk of early childbirth. Douching raises your risk for premature birth. One study found that women who douched during pregnancy were more likely to deliver their babies early. This raises the risk for health problems for you and your baby.

The post The Truth about Douching appeared first on Medika Life.

What is bacterial vaginosis (BV)?

Bacterial vaginosis (BV) is a condition caused by changes in the amount of certain types of bacteria in your vagina. BV can develop when your vagina has more harmful bacteria than good bacteria.

Who gets BV?

BV is the most common vaginal condition in women ages 15 to 44.¹ But women of any age can get it, even if they have never had sex.

You may be more at risk for BV if you:

• Have a new sex partner
• Have multiple sex partners
• Douche
• Do not use condoms or dental dams
• Are pregnant. BV is common during pregnancy. About 1 in 4 pregnant women get BV. The risk for BV is higher for pregnant women because of the hormonal changes that happen during pregnancy.
• Are African-American. BV is twice as common in African-American women as in white women.
• Have an intrauterine device (IUD), especially if you also have irregular bleeding

How do you get BV?

Researchers are still studying how women get BV. You can get BV without having sex, but BV is more common in women who are sexually active. Having a new sex partner or multiple sex partners, as well as douching, can upset the balance of good and harmful bacteria in your vagina. This raises your risk of getting BV.¹

What are the symptoms of BV?

Many women have no symptoms. If you do have symptoms, they may include:

• Unusual vaginal discharge. The discharge can be white (milky) or gray. It may also be foamy or watery. Some women report a strong fish-like odor, especially after sex.
• Burning when urinating
• Itching around the outside of the vagina
• Vaginal irritation

These symptoms may be similar to vaginal yeast infections and other health problems. Only your doctor or nurse can tell you for sure whether you have BV.

What is the difference between BV and a vaginal yeast infection?

BV and vaginal yeast infections are both common causes of vaginal discharge. They have similar symptoms, so it can be hard to know if you have BV or a yeast infection. Only your doctor or nurse can tell you for sure if you have BV.

With BV, your discharge may be white or gray but may also have a fishy smell. Discharge from a yeast infection may also be white or gray but may look like cottage cheese.

How is BV diagnosed?

There are tests to find out if you have BV. Your doctor or nurse takes a sample of vaginal discharge. Your doctor or nurse may then look at the sample under a microscope, use an in-office test, or send it to a lab to check for harmful bacteria. Your doctor or nurse may also see signs of BV during an exam.

Before you see a doctor or nurse for a test:

• Don’t douche or use vaginal deodorant sprays. They might cover odors that can help your doctor diagnose BV. They can also irritate your vagina.
• Make an appointment for a day when you do not have your period.

How is BV treated?

BV is treated with antibiotics prescribed by your doctor.

If you get BV, your male sex partner won’t need to be treated. But, if you are female and have a female sex partner, she might also have BV. If your current partner is female, she needs to see her doctor. She may also need treatment.

It is also possible to get BV again. Learn how to lower your risk for BV.

BV and vaginal yeast infections are treated differently. BV is treated with antibiotics prescribed by your doctor. Yeast infections can be treated with over-the-counter medicines. But you cannot treat BV with over-the-counter yeast infection medicine.

What can happen if BV is not treated?

If BV is untreated, possible problems may include:

• Higher risk of getting STIs, including HIV. Having BV can raise your risk of getting HIV, genital herpes, chlamydia, pelvic inflammatory disease, and gonorrhea. Women with HIV who get BV are also more likely to pass HIV to a male sexual partner.
• Pregnancy problems. BV can lead to premature birth or a low-birth-weight baby (smaller than 5 1/2 pounds at birth). All pregnant women with symptoms of BV should be tested and treated if they have it.

What should I do if I have BV?

BV is easy to treat. If you think you have BV:

• See a doctor or nurse. Antibiotics will treat BV.
• Take all of your medicine. Even if symptoms go away, you need to finish all of the antibiotic.
• Tell your sex partner(s) if she is female so she can be treated.
• Avoid sexual contact until you finish your treatment.
• See your doctor or nurse again if you have symptoms that don’t go away within a few days after finishing the antibiotic.

Is it safe to treat pregnant women who have BV?

Yes. The medicine used to treat BV is safe for pregnant women. All pregnant women with symptoms of BV should be tested and treated if they have it.

If you do have BV, you can be treated safely at any stage of your pregnancy. You will get the same antibiotic given to women who are not pregnant.

How can I lower my risk of BV?

Researchers do not know exactly how BV spreads. Steps that might lower your risk of BV include:

• Keeping your vaginal bacteria balanced. Use warm water only to clean the outside of your vagina. You do not need to use soap. Even mild soap can cause irritate your vagina. Always wipe front to back from your vagina to your anus. Keep the area cool by wearing cotton or cotton-lined underpants.
• Not douching. Douching upsets the balance of good and harmful bacteria in your vagina. This may raise your risk of BV. It may also make it easier to get BV again after treatment. Doctors do not recommend douching.
• Not having sex. Researchers are still studying how women get BV. You can get BV without having sex, but BV is more common in women who have sex.
• Limiting your number of sex partners. Researchers think that your risk of getting BV goes up with the number of partners you have.

How can I protect myself if I am a female and my female partner has BV?

If your partner has BV, you might be able to lower your risk by using protection during sex.

• Use a dental dam every time you have sex. A dental dam is a thin piece of latex that is placed over the vagina before oral sex.
• Cover sex toys with condoms before use. Remove the condom and replace it with a new one before sharing the toy with your partner.

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