Maintaining optimal vaginal health requires an understanding of different conditions and their symptoms. Two common yet often misunderstood conditions are aerobic vaginitis (AV) and bacterial vaginosis (BV).
Both AV and BV occur due to an imbalance in the vaginal microbiome, specifically a decline in beneficial Lactobacillus bacteria. This imbalance, known as vaginal dysbiosis, can lead to uncomfortable symptoms, making it essential to distinguish between the two for proper treatment.
Although both conditions can cause abnormal vaginal discharge and unpleasant odor, the underlying causes and treatment approaches differ. Let’s explore the key differences, symptoms, diagnosis, and treatments for AV and BV.
What is Aerobic Vaginitis (AV)?
Aerobic vaginitis is a relatively lesser-known vaginal infection caused by an overgrowth of aerobic bacteria. Studies suggest that 7-12% of women may experience AV, though the condition is often misdiagnosed, making it more common than believed.
Unlike bacterial vaginosis, which is linked to an overgrowth of anaerobic bacteria, AV is caused by aerobic bacteria such as Staphylococcus aureus, Escherichia coli, and Enterococcus. These bacteria trigger inflammation, leading to symptoms that may resemble other vaginal infections.
Symptoms of AV include:
- Thick, yellow or greenish vaginal discharge
- A strong, foul, or rotten vaginal odor
- Itching, irritation, and burning sensation during urination
- Painful intercourse
Severe cases of AV, known as desquamative inflammatory vaginitis (DIV), involve significant vaginal inflammation and discomfort.
What is Bacterial Vaginosis (BV)?
Bacterial vaginosis is a common vaginal condition caused by an overgrowth of harmful anaerobic bacteria, such as Gardnerella vaginalis and Prevotella, which reduce the presence of protective Lactobacillus bacteria. This shift disrupts the vaginal pH, leading to discomfort and infection.
Symptoms of BV include:
- Thin, gray, or white discharge
- A noticeable fishy odor, often stronger after sex
- Mild irritation or burning
BV is not considered a sexually transmitted infection (STI), but sexual activity and other factors can contribute to its development.
AV vs. BV: Understanding the Differences
While both conditions stem from an imbalance in the vaginal microbiome, their causes, symptoms, and treatment approaches vary:
Feature
Aerobic Vaginitis (AV)
Bacterial Vaginosis (BV)
Cause
Overgrowth of aerobic bacteria
Overgrowth of anaerobic bacteria
Discharge
Thick, yellow-green
Thin, gray or white
Odor
Strong, foul, rotten smell
Fishy odor
Irritation
Often includes itching and burning
Usually mild or absent
Treatment
Antibiotics like clindamycin, kanamycin
Metronidazole, clindamycin, tinidazole
Diagnosis and Treatment
To diagnose AV or BV, a healthcare provider will conduct a pelvic examination and collect a vaginal discharge sample. This sample is analyzed microscopically to determine the presence of specific bacteria.
For aerobic vaginitis, treatment depends on severity and the specific bacteria involved. Mild cases may require antibiotics like clindamycin, kanamycin, or fluoroquinolones, along with vaginal probiotics to restore healthy bacteria.
For bacterial vaginosis, standard treatment involves antibiotics like metronidazole, clindamycin, tinidazole, or secnidazole. However, metronidazole is ineffective against AV, so persistent symptoms may indicate a misdiagnosis.
Since different antibiotics target different bacteria, knowing the exact bacterial composition in your vaginal microbiome can help in selecting the most effective treatment, particularly for recurrent infections.
Preventing AV and BV
While treatments are available, adopting everyday practices can help reduce the risk of developing aerobic vaginitis or bacterial vaginosis:
Avoid douching and scented feminine hygiene products, which disrupt natural vaginal flora.
Wipe from front to back after using the restroom to prevent bacterial spread.
Change period products regularly to maintain hygiene.
Practice safe sex using condoms or dental dams.
Clean sex toys with unscented soap and water after each use.
Quit smoking, as it can negatively impact vaginal health.
The Role of Vaginal Probiotics
Incorporating vaginal probiotics into your routine may help maintain a balanced vaginal microbiome. Probiotic supplements containing Lactobacillus strains can aid in preventing both AV and BV by promoting healthy bacterial growth.
Impact of Diet on Vaginal Health
A well-balanced diet rich in probiotics, fiber, and essential vitamins can support vaginal health. Foods like yogurt, kefir, and fermented vegetables contain beneficial bacteria that help maintain optimal pH levels.
How Evvy’s Vaginal Health Test Can Help
Since symptoms alone may not be enough to differentiate between AV and BV, Evvy’s Vaginal Health Test provides a detailed analysis of your vaginal microbiome. This at-home test identifies bacteria linked to BV, AV, and other vaginal conditions, allowing for a more accurate diagnosis.
Based on your results, Evvy offers personalized treatment recommendations, including custom prescription treatments developed by Evvy-affiliated healthcare providers.
FAQ
What is the main difference between BV and AV?
BV is caused by an overgrowth of anaerobic bacteria, while AV is linked to aerobic bacteria. The discharge in BV is thin and gray with a fishy odor, whereas AV discharge is thicker, yellow-green, and has a foul smell.
How can I tell if I have AV?
Symptoms of AV include thick, yellow or green discharge, an unpleasant smell, and irritation. Since these symptoms overlap with other infections, a healthcare provider can confirm AV through a vaginal swab test.
Can BV and AV occur together?
Yes, it is possible to have both BV and AV simultaneously. Both conditions result from a microbiome imbalance but involve different bacterial types.
Will metronidazole cure AV?
No, metronidazole is effective for BV but not for AV. AV requires antibiotics targeting aerobic bacteria, such as clindamycin or kanamycin.
Can I manage AV or BV naturally?
While medical treatment is often necessary, maintaining vaginal health through proper hygiene, probiotics, and a balanced diet can help prevent recurrences.
By understanding the differences between AV and BV, you can seek the right treatment and take steps to maintain long-term vaginal health. If you’re experiencing persistent symptoms, consider using Evvy’s Vaginal Health Test for an accurate diagnosis and personalized care recommendations.
