Can BV Cause Pelvic Pain? Exploring the Causes

What is Bacterial Vaginosis (BV)?

Understanding BV and Its Prevalence

Bacterial Vaginosis (BV) is a vaginal infection caused by an imbalance of bacteria in the vagina. Normally, the vagina contains a healthy balance of good bacteria (lactobacilli) and some bad bacteria. However, when the bad bacteria outnumber the good, BV occurs. This imbalance can lead to various uncomfortable symptoms and complications if not addressed promptly.

According to the WHO, BV prevalence varies globally, with a recent systematic review and meta-analysis showing that 23–29% of women of reproductive age are affected. 

While it is not a sexually transmitted infection, certain sexual behaviors can increase the risk of developing BV. Additionally, BV can occur in women who have never been sexually active.

Risk Factors Include

• Having Multiple Sexual Partners: Engaging in sexual activities with multiple partners can increase the risk of developing BV. This is because the introduction of different bacteria from multiple partners can disrupt the natural balance of bacteria in the vagina.
• Engaging in Vaginal Douching: Douching, or the practice of rinsing the vagina with water or other fluids, can disrupt the natural bacterial balance. This practice can remove the beneficial bacteria that help maintain vaginal health, making it easier for harmful bacteria to grow.
• Using Certain Types of Birth Control: Some birth control methods, such as intrauterine devices (IUDs), have been associated with an increased risk of BV. The presence of a foreign object in the uterus can sometimes alter the vaginal flora.

Causes

Several lifestyle and health factors can contribute to the imbalance of vaginal bacteria, leading to BV:

• Poor Hygiene Practices: Not maintaining proper hygiene can lead to the growth of harmful bacteria. It is important to clean the genital area regularly with mild, unscented soap and water.
• Use of Scented Products: Using scented soaps, feminine sprays, and other scented products can disrupt the natural balance of bacteria in the vagina. It is best to avoid these products and stick to unscented ones.
• Diet and Nutrition: A diet lacking in essential nutrients can affect overall health, including vaginal health. Eating a balanced diet rich in vitamins, minerals, and probiotics can help maintain a healthy bacterial balance.
• Smoking: Smoking has been linked to an increased risk of BV. The chemicals in cigarettes can affect the immune system and the natural bacterial environment of the vagina.
• Stress and Immune System: High levels of stress and a weakened immune system can also contribute to the development of BV. Managing stress through relaxation techniques and ensuring a strong immune system through a healthy lifestyle can help.

Symptoms of Bacterial Vaginosis

BV often presents with distinct symptoms that can help in its identification. Common symptoms include:

• A thin, white, or gray vaginal discharge
• A noticeable fishy odor, especially after intercourse
• Vaginal itching or irritation
• A burning sensation during urination

Some women may not experience any symptoms, making it important to be aware of the potential signs and seek medical advice if any unusual changes occur.

To better understand your BV symptoms and potential causes, try Symptom Checker. While it’s not a replacement for professional medical advice, it can provide valuable insights.

Methods to Identify BV

Diagnosing BV typically involves a visit to a healthcare provider, who will conduct a pelvic examination and possibly take a sample of vaginal discharge for testing. The diagnosis can be confirmed through:

• Vaginal Gram Stain: A laboratory method that examines the types of bacteria present in the vaginal discharge.
• Amsel’s Criteria: A clinical diagnostic tool described by StatPearls where at least three of the following criteria must be met:
  • Vaginal pH greater than 4.5
  • Presence of clue cells in the vaginal fluid
  • Homogeneous, milky discharge
  • Release of a fishy odor when a potassium hydroxide solution is added to the vaginal fluid

• Speculum-Assisted Pelvic Examination: Inserting a speculum to separate vaginal walls, collecting a discharge sample, and visually inspecting the vaginal and cervical area.

These diagnostic methods help healthcare providers accurately identify BV and differentiate it from other vaginal infections that may present similar symptoms.

The Link Between BV and Pelvic Pain

Bacterial Vaginosis (BV) can have significant repercussions on pelvic health, often leading to pelvic pain. Understanding this connection is essential for effective management and treatment.

How BV Can Cause Pelvic Pain

BV can lead to pelvic floor dysfunction, a condition where the muscles of the pelvic floor become too tight or too weak, causing various symptoms. The infection and resulting inflammation can irritate the pelvic floor muscles, leading to hypertonicity (increased muscle tension).

Recent Studies on BV and Pelvic Pain

Recent studies from Clinical Infectious Diseases have highlighted the link between BV and pelvic pain, showing that the inflammation caused by BV can extend to the pelvic region. The imbalance of bacteria in the vagina can lead to an increase in inflammatory markers, which can cause pain and discomfort in the pelvic area.

Moreover, a study by Microorganisms indicates that women with BV had a significantly higher rate of STIs (28%) compared to those without BV (20.4%) which can lead to pelvic pain.

Symptoms of Pelvic Pain Related to BV

• Pain During Intercourse: The inflammation and increased muscle tension can make intercourse painful and uncomfortable.
• Difficulty with Bowel Movements: The irritation of the pelvic floor muscles can lead to constipation or painful bowel movements.
• Urinary Issues: BV can cause a burning sensation during urination and may lead to changes in urinary habits.
• General Discomfort and Pain: Many women with BV-related pelvic pain report a general sense of discomfort or aching in the pelvic region.

Managing Pelvic Pain Caused by BV

• Physical Therapy:: Physical therapy focusing on the pelvic floor can relieve pain and improve muscle function.
• Myofascial Release: A technique that involves applying gentle pressure and stretching to the connective tissue surrounding pelvic floor muscles.
• Biofeedback: Uses specialized equipment to help patients understand and visualize their pelvic floor muscle activity.
• Stretching and Strengthening Exercises: Exercises designed to stretch tight muscles and strengthen weak ones in the pelvic floor.
• Education and Behavioral Strategies: Guidance on bladder habits, posture, and breathing techniques to improve pelvic health.
• Relaxation Techniques: Techniques such as deep breathing and visualization to reduce stress and anxiety.