Bacterial vaginosis is an incredibly common vaginal disorder with a number of uncomfortable symptoms. The hormonal changes that occur during pregnancy can increase your risk of developing bacterial vaginosis.
But how do you know if you have it, and how can you treat it during pregnancy in a way that’s safe for both you and your baby?
What is Bacterial Vaginosis?
Bacterial vaginosis (BV) is the most common cause of vaginitis--a group of related vaginal conditions involving inflammation or irritation of the vagina. In fact, one study of data from over 3,700 U.S. women between 2001-2004 found that 29% tested positive for BV.
This number was three times higher in African-American women than white women (Allsworth & Peipert, 2007).
BV is not a sexually transmitted infection (although it is more common in sexually active women), but many other STIs also fall under the category of vaginitis, including trichomoniasis (“trich”), gonorrhea, genital herpes, and chlamydia.
Yeast infections are also a form of vaginitis (Cleveland Clinic, 2018). A urinary tract infection is not a vaginitis condition.
What Are the Symptoms of BV?
The different types of vaginitis are worth mentioning because it is easy to confuse their symptoms (Livengood, 2009):
- Abnormal discharge:The most commonly noticed symptom of BV is a “fishy” smell to the discharge. Discharge may appear thin and milky. If it is thick and clumpy, you may have a yeast infection instead; if it is greenish-yellow with a foul odor, you may have trichomoniasis.
- Vaginal Itching: Vaginal itching (whether inside or outside the vagina) is a common symptom of BV, but it shares this with yeast infections and most UTIs. In addition, vaginal itching can have reasons like stress and psoriasis that have nothing to do with vaginitis.
- Burning: A burning sensation, whether persistent or only during urination, can be a symptom of BV--but burning during urination is a very common UTI symptom, and can also be a symptom of yeast infections or trichomoniasis.
This confusion is only compounded by the fact that over 50% of cases of BV are asymptomatic. If you are experiencing any of these symptoms or other vaginal discomfort, it’s important that you ask your doctor to run a test so that they can assign the proper treatment for your condition.
Are BV Treatments Safe During Pregnancy?
BV during pregnancy can have several adverse effects on both the baby and their carrying parent, from irritation of the uterine lining to--in extreme cases--spontaneous abortion (Nelson & Macones, 2002). It is important to treat your BV as soon as possible.
Most of the time, BV is treated with antibiotics--and most antibiotics are safe to take during pregnancy. You should onlybe receiving antibiotics from your doctor, especially during pregnancy.
They may recommend that you avoid streptomycin, kanamycin, tetracycline, or other medications that do not have a long record of being safe for both the baby and their parent (Norwitz & Greenberg, 2009).
Emerging research also shows a promising effect when combining antibiotics and probiotics in the treatment of BV (Senok et al, 2009). Probiotics are generally safe to use during pregnancy and carry no adverse effects for the baby (Elias, Bozzo, & Einarson, 2011).
However, you should always ask your doctor and/or OBGYN about their recommendations for the type of probiotic you should take--if your doctor thinks you should take one at all.
Your risk for bacterial vaginosis does increase during pregnancy, but this does not have to be a scary prospect so long as you keep in contact with your doctor during the entire process.
Let them know your specific vaginal symptoms, ask them to run a test, and make sure you discuss any concerns about how your medications may impact your pregnancy.
- Allsworth, J. E., & Peipert, J. F. (2007). Prevalence of bacterial vaginosis: 2001–2004 national health and nutrition examination survey data. Obstetrics & Gynecology, 109(1), 114-120. https://pubmed.ncbi.nlm.nih.gov/17197596/
- Cleveland Clinic (2018). Vaginitis: Causes, symptoms, treatments & prevention. https://my.clevelandclinic.org/health/diseases/9131-vaginitis
- Livengood C. H. (2009). Bacterial vaginosis: an overview for 2009. Reviews in obstetrics & gynecology, 2(1), 28–37. https://pubmed.ncbi.nlm.nih.gov/19399292/
- Nelson, D. B., & Macones, G. (2002). Bacterial vaginosis in pregnancy: current findings and future directions. Epidemiologic reviews, 24(2), 102-108. https://doi.org/10.1093/epirev/mxf008
- Norwitz, E. R., & Greenberg, J. A. (2009). Antibiotics in pregnancy: are they safe?. Reviews in obstetrics & gynecology, 2(3), 135–136.
- Senok, A. C., Verstraelen, H., Temmerman, M., & Botta, G. A. (2009). Probiotics for the treatment of bacterial vaginosis. Cochrane Database of Systematic Reviews, (4). https://doi.org/10.1002/14651858.CD006289.pub
- Elias, J., Bozzo, P., & Einarson, A. (2011). Are probiotics safe for use during pregnancy and lactation?. Canadian family physician Medecin de famille canadien, 57(3), 299–301. https://pubmed.ncbi.nlm.nih.gov/21402964/