A lot of women are worried about the impact of bacterial vaginosis (BV) on their fertility. Should they be? Let's start by understanding the condition a litte more. BV is a super common vaginal infection that affects around 16% of women in the US. It’s the most common vaginal infection diagnosed. And though it’s not technically a sexually transmitted disease, women who recently changed sex partners and those who have more than one partner tend to get BV more easily than other women.
The vagina is full of a wide variety of normal, healthy bacteria–lots of them. I repeat–they’re normal. When the vagina is healthy, all the different colonies of bacteria get along just fine–like friends in the neighborhood. They balance each other out so that no one colony (group of bacteria) takes over. When the vagina is unhealthy or when the normal pH balance that usually works to keep the peace is disrupted, one or more colonies can grow in unusual numbers while others can’t grow at all. Infection occurs when a group of bacteria grows at abnormal rates.
About half of women with BV have no symptoms at all. The other half might notice itching, odor, burning or pain. Doctors say that if there aren’t any symptoms, a woman doesn’t need treatment. In those non-symptomatic cases, most of the time, the woman’s own immune system takes care of the problem and she eventually gets back to a normal balance of bacteria. If she has symptoms, however, or if she’s had a few other BV-related complications (specifically, preterm labor) her healthcare provider will order antibiotics to kill the over-populating bacteria and cure the infection. About 90% of the time, treatment with antibiotics is effective as long as every single pill is taken as directed. Sometimes women have to take more than one course of antibiotics before they get cured.
WHO GETS BV?
Some women get BV more easily and/or more than once. Pregnant women tend to get BV more easily than other women too. So many factors are undergoing massive change down there that it’s not surprising if the keeping-the-peace conditions that normally stave off BV, are a bit off balance. If you change sex partners, use feminine hygiene products like douches and sprays, you’re a smoker, have an unhealthy diet or have immune system disorders, your chances for developing BV or having a chronic case are higher than other women. To get rid of it for good, you might need to make some lifestyle changes (for God’s sake, quit smoking already, will you?) and work on your body’s ability to heal itself – AKA your immune system. That means eating well and exercising, getting plenty of rest and keeping stress bombs from dropping on your life. Some women swear by probiotics (healthy bacteria taken in supplement form) for keeping all their lady bits in tip-top shape.
WHAT ARE THE CONCERNS REGARDING PREGNANCY?
The biggest concern we have about BV is that in some cases, the infection can travel up from the vagina to the cervix, uterus and fallopian tubes and cause a painful, potentially scarring condition called Pelvic Inflammatory Disease. If it scars and blocks the tubes, that can cause infertility or ectopic pregnancy. Here’s the good news – that doesn’t happen very often and it’s very, very unusual for a woman to have that level of infection without symptoms. More often, she’ll have an itch or pain that makes her go to the doctor for treatment long before the infection spreads.
BV can cause problems during pregnancy like premature labor, late miscarriage and premature rupture of membranes. It’s rare though and not something most women have to worry about. If you’re getting prenatal care, your doctor or midwife will be looking for signs and symptoms of infection. They’ll treat you with antibiotics and you’ll be just fine.
For those of you who are worried about BV causing infertility, here are my recommendations:
• Do everything you can to tune up your immune system. In addition to seeing a midwife or doctor, consult with a nutritionist, naturopath, or natural health specialist.
• Work on your diet and lifestyle to eliminate anything that could be reducing your body’s ability to heal itself and get pregnant.
After tuning up your immune system, if pregnancy doesn’t happen spontaneously after six months (if you’re over 35) to a year of real effort (having sex at the right time of the month and often enough), talk to your healthcare provider about next steps.
Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to firstname.lastname@example.org.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.