Bacterial Vaginosis

BV is the overgrowth of a specific bacteria, Gardnerella vaginalis, in your vagina. This overgrowth causes your vagina to become unfriendly to your healthy bacteria, lactobacilli, by creating a sticky antibiotic-resistant biofilm.
The biofilm is what keeps BV returning time and again, because it’s never really gone. Antibiotics, probiotics and home remedies do not get rid of the biofilm by themselves, which is why BV can seem impossible to get rid of.
Read our book on removing the biofilm.

G. vaginalis isn’t only free-floating (planktonic) bacteria: these bacteria have made a home inside your vagina, displacing your natural, friendly bacteria. BV can go on for a long time, with multiple unsuccessful treatments, typically Metronidazole, a common antibiotic that only works about half the time.

You may have tried apple cider vinegar, hydrogen peroxide, lactic acid, vitamin C, vitamin D, vitamin B, folic acid, probiotics and yoghurt. We explain why your treatments have continually failed, and provide you with a dedicated treatment plan to get rid of your BV once and for all.

     How do you know if you have BV?

BV symptoms are pretty specific – the fishy vaginal odour is your first clue (but this can be caused by some sexually transmitted infections too), plus this watery discharge.

But, you may have watery discharge, no discharge, no smell, and no itch (asymptomatic). You could have been diagnosed with BV via a swab taken at your doctor’s office. The test will come back high for G. vaginalis and you will have a higher than normal pH.

     BV symptoms

  • Watery, grey thin discharge (meaning it is not thick, clumpy, or very white)
  • Fishy vaginal odour
  • Sometimes vaginal or vulvar itch
  • Any mixture of the above or no symptoms at all

     Symptoms that are usually NOT caused by BV

  • Pain
  • Rawness
  • Itching
  • White, thick, green or yellow discharge

     The precise cause of your symptoms – fishy odour, discharge

  • The odour is caused by a chemical reaction of molecules in your vagina that results in the production of trimethylamine (TMA), which is the exact same molecule that causes fish to smell like fish. You can read more about the exact reaction here.
  • The watery discharge is caused by enzymes that the bacteria excrete breaking down your naturally-produced vaginal mucous. This causes it to become watery. It is also why BV can trigger preterm birth – the mucous plug that holds the fluid in the womb gets broken down by the enzymes.
  • Any itch is due to irritation and damage to your vaginal cells caused by the bacteria and biofilm.

     Who gets BV?

BV is one of the most common vaginal infections in the world, and affects all populations almost equally, though women of African descent naturally have fewer protective lactobacilli in their vaginas and are more prone to BV than other groups of women. (Read more about black women and BV here.)

Children do not get BV, but past puberty, any woman can get BV whether they are sexually active or not – while BV can be sexually transmitted, it isn’t always. The bacteria may naturally reside in the vagina, but when the balance of good bacteria is off for whatever reason, the bad bacteria can overgrow from something as slight as a pH change (think semen, menstrual blood), causing an imbalance. It is not an infection per se, but an imbalance of bacteria (dysbiosis) that results in symptoms like fishy odour, itch and watery discharge.

     The biofilm causes recurrent BV

Recurrent BV is caused by the sticky bacterial biofilm of Gardnerella vaginalis, which blocks your friendly microbes from controlling the lion’s share of your vaginal surface area. The planktonic bacteria may be killed off by antibiotics, but the biofilm remains, meaning that your BV actually never goes away; it just temporarily abates.

Women often think that their BV is ‘coming back’ all the time, especially after sex where semen enters the vagina or a menstrual period. This happens because both semen and menstrual blood have an alkaline pH. Learn more about BV and pH here. 

The symptoms you are experiencing are caused by your vaginal environment becoming an unfriendly home to your good microbes.

We’ve written an excellent book on how to break down the bacterial biofilm that causes recurrent BV, with email support and access to the BV support section. Check out Killing BV here.


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Aerobic vaginitis

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Mycoplasma infections

Mycoplasma refers to a few species of bacteria that can reside in and infect the female genital tract, with several species resistant to antibiotics.

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