All That Itches Isn't Yeast

A patient came into my office last week with the common complaint of itching down below. K told me that she has had multiple yeast infections in the past, but her self-treatment with an over-the-counter remedy wasn’t working this time. I examined K and found not yeast but bacterial vaginosis, or as it’s more whimsically known, BV.

For those of you lucky enough to not ever (yet) had BV, it is a vaginal infection but not an STD. Our vaginas normally have a number of bacteria that merrily reside there and keep us healthy, just like on our skin and in our intestines. Sometimes, and we don’t know all the reasons why, one particular bacterium oversteps its bounds and grows out of balance with the rest. We do know that women who are sexually active are much more likely to get BV, but they don’t get infected directly from their partner—it’s a homegrown bug, as it were. I know it sounds confusing—an infection that you get from having sex, but not one that you catch from your partner.

BV has a classic set of symptoms:

• The vaginal discharge is thin, white to grayish, and a bit sticky.
• There may be an unpleasant odor, unfortunately fishy in nature.
• Some women experience vulvar pain or burning, or like K, itching.

Fortunately, BV is easily treated, but you do need to see a doc for treatment—there’s no over-the-counter remedy. Your doc will likely give you metronidazole, in either the oral (Flagyl 500mg twice daily for a week) or vaginal gel (MetroGel, 0.75% nightly before bed for five nights) form. You won’t hurt yourself using a treatment for yeast if you have BV…but you won’t feel any better either. So if you notice a funky discharge, with or without itching or an odor, head to the gyno.