This article is part of the series “Ask your Gyno” with Dr Amalia Savvidi, omgyno’s very own resident queer gynecology guru. If you have a question, write to us and we’ll make sure that you are heard and that your questions are answered.
I will be referring to people with vaginas who have sex with people with vaginas, as VSV (Vaginas who have sex with Vaginas, also known as lesbians). I will use this term for all my articles, because I think it is the most inclusive, but I am open to your opinion about it. So, VSV have the same chance of getting STIs as heterosexual women. This is a fact you maybe didn’t know, because most of the information online is targeted towards heterosexual women. At omgyno, we believe in informing people of all genders and sexual orientations with the right information for better health. We will begin with Bacterial Vaginosis which accounts for 60% of all vaginal infections.
The bacteria that live naturally in the vagina are called Lactobacilli and they stabilize the vagina’s acidic PH. Nevertheless, sometimes due to certain conditions the number of Lactobacilli is decreased and other atypical bacteria get the chance to multiply and cause Bacterial Vaginosis (also known as BV). The most common ones are Gardnerella vaginalis, Mycoplasma hominis, Ureaplasma spp. Mobiluncus spp, Bacteroides spp, Prevotella spp which normally live in the vagina in small numbers.
What factors can disrupt vaginal PH and help atypical bacteria multiply?
-Soap that is not suitable for vaginal washing
-Frequent change of partners
-Intrauterine contraceptive devices (IUD)
How common is it?
25.7% in VSV
14.4% in heterosexual Women
Why is it more common in VSV (and lesbian, bisexual, homosexual women) people?
The answer to this question is under investigation. Potential explanations for this increase of BV in VSV people may be because of genital hygiene behaviours or sexual practices. Certain vulval cleansing agents and vaginal douching may affect the vaginal ecology through alteration of pH, or creating bacterial effects on the normal lactobacilli and so increasing the likelihood of BV. It has been suggested that receptive oral sex could introduce abnormal flora or lactobacillus viruses into the vagina, or that a salivary mediator could cause alteration in the vaginal flora because saliva has less acidic PH that the vagina, so it alters it. A high concordance of vaginal flora between lesbian partners has led to the suggestion of a sexually transmissible factor, transmitted by exchange of vaginal secretions.
50% of Bacterial Vaginosis cases are asymptomatic. The most common symptom, though, is malodorous or unusual smell in vaginal discharge.
The diagnosis is made via vaginal cultures. In our Femshop you will find Home Tests for cultures that cover the most common atypical bacteria (Gardnerella Vaginalis, Mycoplasma spp, Ureoplasma sp).
Classic antibiotic treatment includes Metronidazole and Clindamycin which are prescribed by a gynecologist. If you want to choose a more holistic treatment you can combine classic antibiotics with probiotics and prebiotics that help stabilize vaginal acidic PH. You can find probiotics and prebiotics in tablets or naturally in foods such as yogurt, kefir, kombucha, pickles, miso, and kimchi.
Stay tuned for more info in our next article, until then…take care of your vagina!
Bacterial vaginosis: Standard treatments and alternative strategies MarianaTomás
Bacterial vaginosis:[Epidemiology and risk factors], A Georgijević
Prevalence of bacterial vaginosis in lesbians and heterosexual women in a community setting Amy L Evans
Prebiotics – A Review Paiboon Thammarutwasik