Our flagship product was developed to treat the symptoms of Bacterial Vaginosis, but we all know that proper treatment is only half the battle. The other half? Ensuring that you have the information you need to combat future occurrences and set your vaginal health on the right track. So we decided to create the ultimate guide to understanding BV. It’s always important to see a doctor, but our guide is a great start to understanding what might be going on.

What is Bacterial Vaginosis?

Bacterial Vaginosis has been best described by The Review of Obstetrics and Gynaecology as “loss of the normal bacterial population of the vagina and their replacement by other species.”

Simply put, Bacterial Vaginosis is an anaerobic infection that occurs when bad bacteria outnumbers good bacteria.

Simple enough, right? Now let’s dive in and learn about what causes BV, what the symptoms of Bacterial Vaginosis are, and what to do if you find yourself with this common infection.

What causes BV?

You’ve probably heard it before; your vagina is a delicate ecosystem and keeping the natural vaginal flora balanced is crucial for feminine health. Well, this is certainly true! Let’s start by breaking down the vaginal ecosystem so you can understand what causes BV.

When you hear “ecosystem”, think about what we were taught in elementary school: a biological community of organisms living together in their ideal climate and physical environment. And it’s not just earth that has this ecosystem containing a variety of animals, landscapes and climates, so does every organ in our body, including your vagina!

One of the most important drivers of life is climate. Animals tend to thrive in better climates that allow for vegetation to grow. In the vagina, this is certainly the same as it has a climate of its own. However, whereas we may say a place is dry or humid, we measure the environment of the vagina using a pH scale (short for the potential for Hydrogen). To explain pH, think of an orange (acidic) as having low pH and a potato (alkalized also known as basic) as having high pH. This is going to be very important, so make sure to fully understand before continuing to read.

Just like the earth has a population of humans, our bodies have a population of living organisms that thrive in a great environment that we call good bacteria or probiotics! They are crucial for great gut health, a properly working immune system and also maintaining the health of your vaginal flora. The most commonly found probiotic in the vagina, which is also the most essential, is known as Lactobacilli.

Lactobacilli are an incredible microorganism that are essential to our overall health. Probiotics such as lactobacilli consume prebiotics, natural fibers and glucose found in ingredients like BiAloe®, in order to produce hydrogen peroxide and lactic acid as a natural defense against foreign bacteria. When lactobacilli are prominent and the vaginal pH level is in an acidic state, your vaginal flora is in its ideal state.

When the pH in the vagina changes, which could have been caused by many factors (more on this later), the opportunity for harmful bacteria known as anaerobes to overtake the vaginal flora increases. These anaerobes cause the symptoms of Bacterial Vaginosis to occur, which may include; unusual or foul odor, vaginal discharge, and vaginal itching. In some cases, the harmful bacteria can be aerobic as well.

Generally, good bacteria — such as Lactobacilli — are responsible for the delicate balance of pH and maintaining the acidic environment of the vagina. Think of them as moderators making sure everything is running smoothly by stopping the growth of bad bacteria while preventing vaginal infections.

Vagina PH levels

There are two theories as to why Bacterial Vaginosis infections occur:

The first is that lactobacilli die due to lifestyle and/or diet reasons which means vaginal pH cannot be regulated. This leads to the vagina becoming basic or alkalized (higher pH) and allowing the growth of anaerobes to then cause Bacterial Vaginosis.

The second is reversed; due to the vagina moving to a less acidic state, lactobacillus cannot thrive in the vaginal flora, which causes anaerobes to begin colonizing in the vagina which then causes Bacterial Vaginosis.

There are many types of bad bacteria that are capable of causing infections, but Gardnerella Vaginalis is the most common type of anaerobic bacteria in your vagina, and it is the one that must be dealt with in order to tame the symptoms of BV.

While there are biological factors that may cause Bacterial Vaginosis, certain habits or lifestyle choices may also increase your chances of getting BV. We cover some of these potentially harmful habits later on in the guide.

Who can get Bacterial Vaginosis?

According to the Center for Disease Control and Prevention, nearly 21.2 million women will be affected by this recurring vaginal infection in the U.S. every year, making BV the most common anaerobic vaginal infection.

For the women who will experience this infection, only 50% will notice symptoms. That’s why it’s important to have your regular checkups with your gynecologist or primary physician.

Now if you’re worried about these numbers, don’t be! You should feel more comfortable that Bacterial Vaginosis is an infection that can go away naturally while minimizing future occurrences when addressed properly.

Is Bacterial Vaginosis an STD?

No, Bacterial Vaginosis is not a sexually transmitted disease, according to the Center for Disease Control. In fact, Bacterial Vaginosis is an anaerobic infection that occurs when bad bacteria outnumber the good bacteria in your vaginal flora. Studies have shown, however, that because less naturally occurring lactic acid and hydrogen peroxide are present in the vagina, having sex while experiencing Bacterial Vaginosis may increase your chances of getting a sexually transmitted infection (STI) or sexually transmitted disease (STD). This includes herpes, chlamydia, and gonorrhea.

What are the signs and symptoms of Bacterial Vaginosis?

The symptoms of BV can differ from person to person, but here are some general signs to look out for. Some women may experience no symptoms at all meaning they are asymptomatic. Other women experience mild symptoms of BV, whereas others may have multiple symptoms at the same time. The most identifiable BV symptoms include:

  • An unusual or unfamiliar odor
  • Heavy amounts of discharge, especially when you’re sexually active
  • Vaginal discharge, which is thin and grayish in color
  • Burning and itching while urinating

The biggest issue regarding these symptoms? They can easily be misdiagnosed for a different infection that displays similar symptoms. It’s important that you are able to tell the difference between infections such as Bacterial Vaginosis, Vaginal Yeast Infection, Urinary Tract Infections, and Trichomoniasis.

In the end, you know your body best, so pay attention!

When to see a doctor

Make an appointment to see your doctor and/or Gynecologist if:
  • You notice a new vaginal discharge or vaginal discharge that’s associated with an odor, discharge, vaginal itching, or burning sensation.
  • You’ve had vaginal infections before but this occurrence comes with new symptoms, such as odor, discharge, vaginal itching or burning sensation.
  • You have new or multiple sex partners or past partners have had bacterial infections.
  • Over-the-counter or home remedies are not treating the symptoms.

Ask your doctor for medical advice and a what you can do.

What are the complications if BV is left untreated?

Bacterial Vaginosis is a treatable infection when diagnosed properly. However, until properly treated, or if not treated at all, Bacterial Vaginosis is potentially harmful. The anaerobes that are present during the infection are capable of producing a dense biofilm, or a collection of bacterial mass, known as epithelium that hides and nurtures the bad bacteria under it, making them less exposed to antibiotics, antimicrobials, and natural remedies. This makes BV hard to get rid of altogether.

While Bacterial Vaginosis doesn’t generally cause complications. Having Bacterial Vaginosis may lead to:
  • Pregnancy Complications. In a 2006 study on pregnant women, Bacterial Vaginosis was associated with small birth weight and small size, but not with spontaneous preterm birth.

  • Sexually transmitted infections. According to the Center for Disease Control, having BV can increase your chances of acquiring an STD such as HIV, herpes simplex virus, chlamydia, or gonorrhea while also increasing the odds that you’ll pass the virus on to your partner.

  • Infection risk after gynecologic surgery. According to an article published by Mayo Clinic, having Bacterial Vaginosis may increase the risk of developing a post-surgical infection after procedures such as hysterectomy or dilation and curettage (D&C).

  • Pelvic inflammatory disease (PID). PID is an infection of the female organs such as the uterus and the fallopian tubes. When this disease occurs it can lead to an increased risk of infertility. Bacterial Vaginosis and other vaginal infections can lead to PID.

How is Bacterial Vaginosis diagnosed?

If you notice any changes in vaginal discharge or odor, go see your doctor. They will determine whether or not you have BV on the basis of 4 clinical criteria:

  1. Vaginal discharge was homogeneous;
  2. the vaginal discharge had a pH greater than or equal to 4.7;
  3. the vaginal discharge had an amine-like odor when mixed with 10% potassium hydroxide;
  4. vaginal discharge contained clue cells representing greater than or equal to 20% of vaginal epithelial cells.
However, your visit to your primary physician or gynecologist may also include:
  • Physical examination
  • An assessment of your hygiene routine
  • Assessment of your medical history
  • Pelvic examination
  • Swab test sample so that they can rule out other sexually transmitted infections such as gonorrhea or trichomoniasis

If you’re diagnosed with BV, don’t fret! The good news is that you can work with your doctor to ensure the right steps are taken so that it can be properly treated and managed.

How does a doctor treat bacterial vaginosis?

Typically, when your OB/GYN diagnoses you with Bacterial Vaginosis they prescribe antibiotics as the treatment. Antibiotics are an antimicrobial that is used by medical professionals to fight off bacterial infections. This is accomplished by killing off and inhibiting the growth of bacteria.

Now we personally aren’t fans of antibiotics because of their affects on beneficial bacterial colonies, however its important that you know what doctors may prescribe you with.

Metronidazole (vaginal cream, vaginal gel, and pills) is one of the most commonly prescribed antibiotics for this condition. The second option is Clindamycin vaginal suppositories. Both of these conventional treatment strategies can be helpful, but they are not 100% fool-proof. This is because:

  • Conventional medicine is not capable of preventing recurrence of the infection. Nearly 60% of women who have been diagnosed with Bacterial Vaginosis will get experience it again, even after treatment.

  • Antibiotics may destroy the good bacteria as well, leaving you susceptible to other infections such as a yeast infection.

Natural Treatments for Bacterial Vaginosis

So here is where we get to the good stuff, how to address your current battle with bacterial vaginosis while minimizing future occurrences. So if you’re like us and you’d prefer not to take antibiotics or other prescribed medicine altogether, there are natural remedies you can experiment with.

  • Probiotics

    Vaginal probiotics are vital! They provide healthy strains of bacteria to your vaginal flora so that you can continue to produce the natural defenses the vaginal flora needs to be balanced. A great habit you can start right away is taking a probiotic supplement in order to introduce new lactobacilli to the body. If you want to do more than just take a supplement, you can also pair it by adding probiotic-rich foods into your diet. These food include yogurt, kefir, and fermented foods such as kimchi.

  • Prebiotics

    Prebiotics have been a hot topic as of late. With eveyone know understanding the importance of consuming probiotics they are wondering how to take their microbe game up a notch. That’s where prebiotics come in! Prebiotics are the dietary fibers and glucose that probiotics consume in order to make lactic acid and hydrogen peroxide. By adding prebiotics to your vaginal wellness routine, you ensure that probitoics are constantly feasting in order to function properly!

  • Cranberry

    Cranberries are filled with amazing antioxidants known as proanthocyanadins, or PACs. These compounds keep your vaginal wellness optimal by not allowing bacteria to stick the urinary tract and create biofilm. What this means is that when you consume cranberry extract, like Pacran found in Happy V Immune Boost, you begin the process of flushing bacteria out of your body. So, next time when you’re ordering a fresh juice try opting for a cranberry juice or you can also have them as supplements – like in our happy V daily Pack!

  • Medicated boric acid

    At Happy V, our product philosophy is to attack the root cause rather than just covering up the symptoms. That is why we use pharmaceutical grade Boric Acid. Boric Acid allows us to restore the vagina’s naturally acidic pH safely without harming the good bacteria. It’s like getting the benefits of the antibiotics without risking the life of the probiotics in your vaginal flora.

    bacterial vaginosis applicator

Prevention is always better than correction

If you’re perfectly healthy and your vagina is living its best life, then keep doing you!

Now, if you want to take your vaginal wellness to the next level and prevent future occurrences, we hope the list below will help you do so.

how to prevent bacterial vaginosis

Lifestyle and product choices

  1. We believe in safe sex! However, certain chemicals in condoms, vaginal lubricants, and spermicides may cause irritation in some people. The chemicals in these products can disrupt your vaginal pH and encourage bad bacteria to grow. If you have a bad reaction to a certain condom, try a new brand!

  2. Don’t wear tight underwear — especially those that are made of synthetic fibers. Your vagina needs to breathe!

  3. Avoid douching, please! Douching washes away the bad bacteria, but it also washes away the good bacteria and replaces it with scented chemicals that could change pH. All that this is going to do is once again throw your vaginal ecosystem off balance. Your vagina is perfectly capable of cleaning itself and introducing chemicals to feel “fresh” does the opposite — literally! Instead, washing your vulva with mild, unscented soap or just plain water is the healthiest way to clean up down there.

  4. Avoid foods that have high amounts of sugars. Bad bacteria love glucose, the broken down substance within sugary foods and drinks. So either reduce the amount of added sugars in your diet or remove it altogether. That means alcoholic beverages with sugary mixes as well.

  5. During your menstrual cycle, make sure to change your tampons, pads, or menstrual cups. The pH of blood is higher than that of the vaginal flora. Having too much blood in the same area for a prolonged period of time can increase pH levels.

  6. Staying in wet clothes after a swim or exercise session creates the optimal conditions for vaginal infections. Bacteria love warm, moist, and humid environments. So don’t just sit around in wet clothes, change and keep your vaginal area as dry as possible.

  7. Just as scented tampons or pads can irritate your skin, products such as soap, laundry detergents, and scented or colored toilet paper can also make you more susceptible to vaginal infections.

  8. We need to discuss the other place where germs naturally occur – your anus. The proximity between your vagina and anus matters. If those germs manage to get near or into your vagina, the likelihood of infection increases.

  9. Always remember to wipe carefully after using the bathroom. Use different toilet paper between your vagina and anus – the same paper should not be used interchangeably!

  10. And remember – try a great supplement routine that gives you the right dose of clinically proven ingredients that were made for vaginal wellness, Like Happy V’s Over the Counter BV Treatment. We made it for one reason only – Optimizing Total Vaginal Wellness.

Sex-based risk factors

Just like any infection, transmission during sexual intercourse or physical contact from one individual to another is possible. Knowing how to keep sex-based risk low is essential.

  • Unprotected Sex

    We know that unprotected sex can impose a serious threat to overall health, but did you know that it can also lead to BV even if both partners are free of disease and infection? This is because semen tends to have a higher pH than that of the vagina, potentially leading to Bacterial Vaginosis.

  • New or Multiple Sex Partners

    Because semen can change the pH of the Vagina, it is easy to understand that having a new or multiple partners will make you susceptible to BV due to the difference in the bodies chemistry from person to person.

  • Sex toys

    Always 👏 Clean 👏 Your 👏 Toys! 👏 Make sure to clean your toys properly after each use — as not cleaning was shown to have an association with BV. Infections can occur if sex toys are not properly cleaned.

Medical factors

Excessive usage of certain medications and devices can cause an imbalance in your vaginal flora, too.

  1. Antibiotics are used to treat infections caused by bad bacteria but can also kill off the good bacteria. This makes you susceptible to other types of infections.
  2. Studies show that having an IUD (contraceptive device) can increase your chances of getting Bacterial Vaginosis. If you have had an IUD make sure to inform your doctor when seeking treatment.


We know navigating vaginal health can seem overwhelming, but we’re here to help! We hope that this guide has been informative and has given you a sense of what BV is, how it can be treated, and the best means for prevention.
If you believe you have BV, ask your doctor about Bacterial Vaginosis for more information.
You can let us know if you have any questions by asking here.


Anaerobes — a microorganism that grows in low oxygen states.

Anaerobic Infection — common infections that are caused by anaerobes.

pH Scale — A scale that measures how acidic or basic a substance is that ranges from 0 to 14.

Alkalized — having the properties of being non-acid; having a pH above 7.

Acidic — having the properties of an acid; having a pH below 7.

Probiotics — living bacteria and yeasts that are beneficial for you, especially your digestive system and flora.

Lactobacillus — a rod-shaped bacterium which produces lactic acid and hydrogen peroxide from the fermentation of carbohydrates in order to multiply and stave off anaerobes.

Trichomoniasis — The most common and curable STD which affects the urinary tract, vagina, or digestive system.

Epithelium — A thin tissue that forms on the outer layer of a body’s surface and lining the alimentary canal and other hollow structures.

Works Cited

“Bacterial Vaginosis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 July 2017, www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/symptoms-causes/syc-20352279.

“Bacterial Vaginosis and Contraceptive Methods.” NeuroImage, Academic Press, 25 Aug. 2000, www.sciencedirect.com/science/article/pii/S0020729200002174.

“CDC – Bacterial Vaginosis Statistics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/std/bv/stats.htm.

“CEArticle.” An Updated Review to Discourage Bacterial Vaginosis | Article | NursingCenter, www.nursingcenter.com/cearticle?an=00005721-201003000-00008&Journal_ID=54021&Issue_ID=984108#P76.

Eschenbach, D A, et al. “Diagnosis and Clinical Manifestations of Bacterial Vaginosis.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Apr. 1988, www.ncbi.nlm.nih.gov/pubmed/3259075.

Hill, G B. “The Microbiology of Bacterial Vaginosis.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Aug. 1993, www.ncbi.nlm.nih.gov/pubmed/8357043.

Marrazzo, J M, et al. “Characterization of Vaginal Flora and Bacterial Vaginosis in Women Who Have Sex with Women.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 1 May 2002, www.ncbi.nlm.nih.gov/pubmed/12001048.

Mijac, V D, et al. “Hydrogen Peroxide Producing Lactobacilli in Women with Vaginal Infections.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Nov. 2006, www.ncbi.nlm.nih.gov/pubmed/16814920.

Patterson, Jennifer, et al. “Analysis of Adherence, Biofilm Formation and Cytotoxicity Suggests a Greater Virulence Potential of Gardnerella Vaginalis Relative to Other Bacterial-Vaginosis-Associated Anaerobes. – Semantic Scholar.” Undefined, 1 Jan. 1970, www.semanticscholar.org/paper/Analysis-of-adherence,-biofilm-formation-and-a-of-Patterson-Stull-Lane/1d7a202f4442b090076d96216f094171a934dff0.

Thorsen, P, et al. “Bacterial Vaginosis in Early Pregnancy Is Associated with Low Birth Weight and Small for Gestational Age, but Not with Spontaneous Preterm Birth: a Population-Based Study on Danish Women.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Jan. 2006, www.ncbi.nlm.nih.gov/pubmed/16492583.

Wiesenfeld, et al. “Bacterial Vaginosis Is a Strong Predictor of Neisseria Gonorrhoeae and Chlamydia Trachomatis Infection.” OUP Academic, Oxford University Press, 1 Mar. 2003, academic.oup.com/cid/article/36/5/663/456379.