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Latinas Are More Prone To Bacterial Vaginosis — Here's How To Avoid And Treat It
Self-love, for many, means making time to slow down, meditate, and journal every day. But it can also look like taking care of your body — including your vaginal and sexual health. The vagina is quite magical, but in order to keep it healthy, it needs to be in balance. While our bodies contain what we need to stay healthy, external factors can impact what's happening inside. Our vagina is basically a canal that extends from the vulva to the neck of the uterus or cervix. Think of it as a highway where miracles occur, like the shedding of the uterus during menstruation and childbirth. It's also where penetration can occur during sex. All of this activity can muddle the path of this highway, leaving it vulnerable to bacteria and infections.
Bacterial Vaginosis, or BV, is a common vaginal infection caused by the overgrowth of disruptive bacteria in the vaginal microbiome. It is the most common cause of vaginal symptoms among women globally, impacting an estimated 21.2 million women between the ages of 14 and 49 in the United States. BV is directly related to an imbalance in vaginal pH levels, and research shows that Latinas and African American women have disproportionately high diagnosis rates.
"The incidence of BV globally is about 20 to 30 percent among all women. Latin America is in the same range," says Monica Simons, MD, a Latina gynecologist currently working at BronxCare in New York. "There is a slightly higher incidence among Latinas in the US, however."
Daniella Levy is the co-founder and CEO of Happy V, a Latina-owned and operated wellness company focused on delivering high-quality information about vaginal health, along with a line of clinically proven products.
"Latinas may be more prone to BV due to our genetic predisposition affecting the composition of our vaginal microbiome," Levy explains, adding that microbial profiles can vary, with some having a higher proportion of pathogenic bacteria, while others may have a balance of beneficial bacteria or probiotics.
"It's kind of like a family thing — this trait gets passed down through generations in Latinx communities, so it's literally in our DNA," she says. "When you start looking into the science and our cultural background, you realize it's a whole intricate web of factors that makes us more prone to BV."
Rebecca Alvarez, a Latina sexologist and founder of Bloomi, an intimate wellness brand, says she believes Latinas are more susceptible to BV due to two primary reasons: "Genetics and bad ingredients in intimate products we use."
She explains, "Within the vagina, there are hundreds of good bacteria strains that keep the ecosystem balanced. This is where the term 'self-cleaning oven' comes from."
Vaginal acidity keeps our pH levels balanced, but when those levels become basic or when the bacteria is higher in our vaginal flora, BV may be the cause. Good bacteria include lactobacillus, which Alvarez explains is a strain with protective qualities that keeps our pH low and acidic.
"However, when there is an overgrowth of candida in our vagina, it can lead to yeast infections, and an overgrowth of bacteria can lead to BV," Alvarez says. "Research shows that Latinas are genetically predisposed to BV because our vaginal pH is naturally higher. On average, Latina women have a pH of 5, whereas white women have a pH of 4."
Additionally, Latinas tend to use intimate care products like douches and deodorizers more often than women of other ethnic backgrounds, Alvarez adds. She says these products are pushing the idea that strong fragrances are associated with cleanliness and that Latinas may opt for products containing synthetic fragrances, glycerin, and propylene glycol, like Summer's Eve and Lemisol, the popular Dominican vaginal wash that reportedly leaves your vagina smelling and tasting like mint.
"Unfortunately, these ingredients have been linked to disrupting the vaginal microbiome and increasing the risk of BV," Alvarez says.
Dr. Simons explains that BV presents itself with symptoms including abundant white discharge (generally associated with yeast infections) or gray-colored discharge (often associated with BV); in some cases, women can also experience a fishy odor.
According to Levy, other symptoms may include experiencing itching or irritation around the vaginal area, as well as discomfort during urination.
The risk factors that can expose a woman to contracting BV include lack of condom use because unprotected intercourse may cause a change in the flora and pH, Dr. Simons explains.
Other risk factors include harsh and perfumed soaps, IUD use, and other vaginal infections and STDs, adds Dr. Simons. When a woman has BV, she becomes vulnerable to other infections as well.
"The risk of other STDs, infections, and even premature labor increases since the usual vaginal acidity or protection is decreased," she says. "Men do not carry the organisms which produce BV, but since semen generally has a higher pH than the vagina, it may cause the bacteria to overgrow."
The vagina is self-cleaning and self-regulating, so there's no need for washes. In fact, washes containing perfumes may cause irritation and allergic vaginitis. Dr. Simons adds that the use of boric acid helps to maintain the acidity of the vagina and may reduce the risk of BV, especially in those who may develop it more frequently.
According to Dr. Simons, semen can also up your chances of developing BV. Alvarez breaks it down further to explain that semen is alkaline, with a high pH ranging from 7.5 to 8.0, so if a cis woman has sex with a cis man without a condom, it could lead to BV for the woman.
"Other intimate activities like sharing toys, oral sex, or fingering can also lead to BV," Alvarez adds.
BV can cause discomfort and is something that can recur even after taking antibiotics to restore balance in the vaginal flora. Levy adds that if left untreated, BV can lead to severe health issues.
"One of the big risks is an increased susceptibility to sexually transmitted infections like HIV, herpes, and gonorrhea, especially with a lowered immune system," she says. "It can also interfere with your reproductive health, increasing the risk of complications like pelvic inflammatory disease (PID), which can lead to infertility or pregnancy complications. It's definitely something you want to address sooner rather than later."
The good news is that we can prioritize our vaginal wellness to keep infections like BV at bay. Levy says this includes the practice of good hygiene habits, including urinating and cleansing before and after sex and using condoms with non-irritating lubricants to maintain a healthy pH balance in the vaginal environment.
"Incorporating probiotics containing strains known to support vaginal health can be beneficial," she adds.
Levy knows and understands this firsthand, as the foundation of her company Happy V came from her own vaginal health journey. She struggled with BV for five years before launching her company. This led to extensive efforts in sourcing the highest quality and safest ingredients, prioritizing formulations that support her health and wellness goals.
"Witnessing the positive impact these products had on my own well-being, I felt compelled to share this formula with others who may struggle with chronic or occasional BV," Levy says. "It became apparent that there was a genuine need for safe and effective solutions in the market, and I was driven by the desire to provide individuals with a reliable option for managing their health concerns."
Let's face it, there's an underlying shame many women carry when they are susceptible to recurring vaginal infections like BV, yeast infections, UTIs, and more. Levy's goal is for customers to feel supported, informed about their options, and empowered to take control of their health journey.
"Oftentimes, these conditions create a feeling of isolation, which can lead to other health concerns, such as emotional and mental health issues," Levy says. "By fostering a community where individuals feel empowered to discuss and prioritize their health and well-being, we aim to make a positive impact beyond just the products we offer."
Alvarez similarly wants to empower women through Bloomi to provide inclusive sexual education and intimate health essentials for all bodies. Bloomi's products include plant-based ingredients and aphrodisiacs, as well as recyclable or compostable packaging. Alvarez considers wellness from the inside out (including doing good by the environment), with a particular focus on Latina consumers.
"As a sexologist and researcher, I was genuinely taken aback when I learned about the disparities in Latina women's intimate health," she says. "It hit close to home as I realized how deeply ingrained our cultura is in promoting the idea of 'smelling fresh,' often leading us to rely on products that harm rather than help our vaginal microbiome."
To maintain vaginal hygiene, Levy suggests sticking to gentle cleansing methods like using a soft washcloth or your hands. "Opt for a mild cleanser without any harmful ingredients aimed at enhancing scent or making you smell 'fresher' — these can disrupt the microbiome," she says.
Wash only the vulva, or the outside visible part of the vagina, which includes the labia or lips, while avoiding the vaginal opening and opening of the urethra. Try your best to avoid getting any soap inside the vagina.
"This is especially harmful if the wash contains fragrances," Levy says. "Recognize that vaginas possess the remarkable ability to self-cleanse, requiring minimal external intervention for natural maintenance."
Like Latinas, Black women also face similar challenges when it comes to BV and being susceptible to contracting it, Alvarez says. Additionally, Black women also tend to use intimate products with fragrance more often compared to caucasian women. In the end, Alvarez says, "Understanding these differences is crucial for tailored healthcare and promoting vaginal wellness among diverse communities."
Zayda Rivera is a former POPSUGAR contributor. She has been a professional writer for more than 20 years. Z is a certified Reiki Master Teacher, yoga and Zumba instructor, mindfulness and meditation guide, tarot reader, and spiritual mentor.
Pain And Itch 'Down There' Can Signal A Vaginal Ulcer — See The Remedies Ob/Gyns Recommend
Swapping tried-and-true health tips with friends is great when you're dealing with a headache or hot flash. If you have a vaginal ulcer, though, you may not want to hop on a group chat discuss it. But there's no need to feel embarrassed. The painful sores are actually more common than you may think. Here's everything you need to know about a vaginal ulcer, including what causes it and the best home remedies to speed relief.
What is a vaginal ulcer?Time for a quick anatomy reminder: The vagina is a small part of your vulva. The vulva is the skin outside of your genitals and includes the labia, clitoris, vaginal opening and urethra opening. A vaginal ulcer is an open sore that's not so much on your vagina, but rather on the vulva skin, says Jill Purdie, MD, a board-certified OB/GYN at Northside Women's Specialists in Atlanta, GA.
That isn't to say an ulcer can't pop up near the vagina, though. "Vaginal ulcers are commonly skin-related, but it is possible to have one right at the opening of the vagina where the outside skin meets the inside mucous membrane," says Dr. Purdie. Another area where vaginal ulcers may appear is the perineum, the area between the anus and vulva, adds Kelly Culwell, MD, a board-certified OB/GYN in San Diego, CA.
Related: Is That Bump on Your Vaginal Lips Harmless? A Gynecologist Reveals How To Spot a Boil — And What To Do If You Find One
Symptoms of a vaginal ulcerTypically, you'll feel a vaginal ulcer before you see it. "Vaginal ulcers feel painful and itchy," says Rikki Baldwin, DO, a board-certified OB/GYN at Memorial Hermann Medical Group in Cypress, TX. "Here's how I explain a vaginal ulcer to my patients: Think about the sensation when you scrape your hand a welt and irritation forms after. It's a similar feeling when you have a vaginal ulcer."
Dr. Purdie says other symptoms of vaginal ulcers include:
A raised, eraser-sized bump or blister that may ooze and be painful
Burning after urinating, wiping or sexual intercourse
Swollen lymph nodes in the groin area
A rash or raised bumps that may be painless
Fever or other flu-like symptoms
"If you have a vaginal ulcer, it's rarely a single ulcer," adds Dr. Purdie. "It's similar to chicken pox — the pox come up, blister, crust over and then go away. You'll notice a similar pattern happening in the vulva area if you're dealing with vaginal ulcers."
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Common causes of a vaginal ulcerMany folks assume that a vaginal ulcer is caused strictly by a sexually transmitted infection (STI). And while it's true that they're a common culprit, they're far from the only cause. Here's what can trigger an outbreak:
1. Herpes"Herpes is very common sexually transmitted infection," says Dr. Culwell. "Even with condoms, you pass herpes through skin-to-skin contact. If someone has a lesion on an area that's not covered by a condom, the skin-to-skin contact on the outside can spread it."
Even if you aren't currently sexually active, you may have been exposed in the past to herpes simplex virus 2 (HSV-2) without knowing it. "Herpes can stay latent for many years," Dr. Culwell says. "Someone might not know they had herpes exposure because they never had an outbreak. They only discover it after they go through a period of immunosuppression for some reason. This can be from a new medication they're taking, stress or a medical condition that causes a herpes lesion to appear, even though they weren't recently exposed."
Dr. Culwell adds that if you have certain chronic conditions that cause immunosuppression, such as diabetes, it may increase your risk of an outbreak when exposed to HSV-2. (Herpes simplex virus 1, on the other hand, is responsible for cold sores. Find out how to get rid of cold sores fast.)
2. SyphilisWhen it comes to infectious triggers, syphilis is another sexually transmitted infection (STI) that can cause a vaginal ulcer. Different from herpes simplex virus 2 vaginal ulcers, Dr. Purdie says this can be a single, nickel-sized ulcer and it often starts off painless.
3. Contact dermatitisIt's also possible to develop a rash and ulcers after being exposed to something that irritates the skin. "A woman may have an allergy to latex, and has a reaction after intercourse with a latex condom," says Dr. Baldwin. "Or if you switch soaps or even the detergent that you wash your underwear in, it can cause irritation that results in a vaginal ulcer."
Dr. Purdie adds another common culprit for contact dermatitis is the type of wax used during a bikini wax. This can cause the skin to rash or blister, or may irritate you to the point where you scratch the vulva area enough that it causes the skin to blister. (Contact dermatitis may also be behind your itchy scalp and hair loss — but these tricks can help.)
4. MenopauseThere's no direct link to an increased risk of vaginal ulcers with age or menopause. But a small group of women who are in peri-menopause and post-menopause may deal with chronic itching and irritation, says Dr. Baldwin. In these cases, that can lead to vaginal ulcers.
When to see a doctor for a vaginal ulcer"A vulvar ulcer is never normal," says Dr. Culwell. "It should always be evaluated to treat the root cause. This is the fastest way to get relief."
If your vaginal ulcers come from a viral infection, your dotor will likely prescribe an antiviral medication like valacyclovir (Valtrex), says Dr. Purdie. For vaginal ulcers that come from dermatitis, you can find relief by removing the irritant (whether it be latex, soap or something else) and following comfort measures to ease the pain.
How to relieve vaginal ulcer symptomsNo matter the cause of your vaginal ulcers, there are simple things you can do at home to relieve uncomfortable symptoms. Our experts' best advice:
1. Wash with mild soapDr. Baldwin suggests using a fragrance-free, mild soap to clean yourself in the shower. (A product like Dove Sensitive Skin Beauty Bar should do the trick.) This is less likely to cause irritation, eliminating itching and scratching that can lead to vaginal ulcers.
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2. Take Benadryl"If your vaginal ulcer is a result of an allergic reaction, take a Benadryl tablet to ease symptoms like itching," says Dr. Baldwin. Just be sure to read the label and following dosing instructions: Benadryl may cause drowsiness. It's best to skip topical Benadryl to avoid further vulva irritation. But if you find you want topical relief, Dr. Baldwin says an over-the-counter cream like Vagisil is a safer bet.
3. Draw a sitz bath"Sitting in a warm sitz bath with lukewarm water — by either using a small sitz bath tub or your own bathtub — can be very soothing if you have vaginal ulcers," says Dr. Culwell. Adding Epsom salt can also help with swelling, itching and pain. Soak for about 10 to 20 minutes at a time for natural relief. (Tip: A sitz bath can help with itchy hemorrhoids, too.)
4. Swap your undiesIf you have vaginal ulcers, Dr. Culwell says keeping the area clean and dry will help manage symptoms. Wear breathable underwear (they don't need to be fancy, Fruit of the Loom or Hanes is fine) to avoid irritation. For some, this may still cause discomfort. If so, consider ditching the undies altogether until your vaginal ulcers subside.
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How long does it take for a vaginal ulcer to heal?Vaginal ulcers caused by a non-viral issue like dermatitis will go away in about four to seven days, says Dr. Purdie. The most important thing to do before you treat them on your own is to make sure your vaginal ulcers are an allergic reaction versus a virus or other health issue.
For viral-related vaginal ulcers caused by HSV-2, you're never rid of the virus once you contract it. This means you may have occasional outbreaks, which you need a prescription to treat (the home remedies above can help ease symptoms while the meds get to work). For those who have several outbreaks over the course of a year, Dr. Purdie says your doctor may recommend daily medication to suppress symptoms.
For more ways to relieve common vaginal bothers:
Is That Bump on Your Vaginal Lips Harmless? A Gynecologist Reveals How To Spot a Boil — And What To Do If You Find One
Bacterial Vaginosis Home Remedies: Docs Reveal What to Try + What You Absolutely Should Skip
Ob/Gyns on How to Tell If That Lump Is a Vaginal Skin Tag Or Something More Serious
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
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Sexually Transmitted Infections—A Closer Look At NIAID Research
Science NewsResearchers are studying alternative treatments for syphilis, a vaccine for genital herpes and more.
Sexually transmitted infections (STIs) are caused by bacteria, viruses, or parasites. STIs have a devastating impact on adults and infants and annually affect millions of people in the United States.
Certain STIs can increase a person's risk of developing cancer and increase the likelihood of acquiring or transmitting HIV. In addition, STIs can cause long-term health complications, especially in the reproductive and central nervous systems. In rare cases, they can lead to serious illness or death.
NIAID supports research across the spectrum from basic to clinical science to develop effective diagnostic, preventive and therapeutic approaches to STIs in alignment with the National STI Strategic Plan. In recognition of National STI Awareness Week, NIAID shares a snapshot of new projects and recent scientific advances in STI research.
Improving treatment for syphilis and trichomoniasis
New reports of syphilis and congenital syphilis are increasing at an alarming rate in the United States. Syphilis is caused by the bacterium Treponema pallidum.
Benzathine penicillin G (BPG) is one of only a few antibiotics known to effectively treat syphilis. There is currently a shortage of BPG, and some people are allergic to penicillin antibiotics.
In February 2024, NIAID convened a workshop with a wide range of experts on alternative therapies to BPG for the treatment of adult syphilis, neurosyphilis, and syphilis in pregnant persons and infants. The workshop addressed preclinical evaluation of candidate drugs, the potential need for studies on how candidate drugs are processed in the body during pregnancy, and how to approach clinical trials of treatment for congenital syphilis. This work is part of NIAID's comprehensive portfolio of syphilis diagnosis, prevention, and treatment research.
Trichomoniasis is the most common parasitic STI, caused by Trichomonas vaginalis. Trichomoniasis can increase the risk of getting or spreading other STIs, including HIV. The parasite can also cause inflammation of the cervix and the urethra. T. Vaginalis is treated with an antibiotic drug class called nitroimidazoles.
The currently recommended nitroimidazole, called metronidazole, cures 84-98% of T. Vaginalis cases but does have high rates of breakthrough infection. A new project led by Tulane University will examine a single dose of secnidazole, a medicine in the same drug class, as a more effective and cost-effective treatment option for women and men.
Developing a vaccine for herpes simplex virus 2
Herpes simplex virus 2 (HSV-2) is a common subtype of herpes simplex virus that is transmitted through sexual contact. The Centers for Disease Control and Prevention estimates that 18.6 million people aged 15 years and older United States live with HSV-2. In severe cases, HSV-2 may lead to life-threatening or long-term complications. There is no licensed preventive HSV-2 vaccine, and there is no cure.
A new project led by the University of Pennsylvania seeks to define correlates of protection for HSV-2, meaning they intend to identify immune processes involved in preventing HSV-2 disease. They will do this by analyzing laboratory samples from animal studies of a promising preventive vaccine candidate that they developed with prior funding. That vaccine candidate is also now in an industry-sponsored early-stage clinical trial. The same project will expand on the HSV-2 targets in the preventive vaccine to develop a therapeutic vaccine concept to reduce recurrent outbreaks. This research responds to the scientific priorities in the NIH Strategic Plan for Herpes Simplex Virus Research.
Increasing fundamental knowledge of bacterial vaginosis
Bacterial vaginosis (BV) results from an imbalance in the vaginal microbiome. BV can be caused by sexual activity, douches and menstrual products. BV can increase women's biological susceptibility to HIV and other STIs and can cause premature birth or low birthweight if untreated in pregnant people.
In a recent publication, NIAID-supported researchers, led by researchers at the University of Washington and University of California San Diego, shared findings on how damage to the vaginal skin barrier occurs during bacterial vaginosis. Those skin barrier cells, called epithelial cells, are covered in carbohydrate molecules called glycans. The research team found that people with BV had damaged glycans on their vaginal epithelial cells. They suggested that future work should examine the relationship between treatment and restoration of normal glycans. If an association is detected, it could help healthcare providers monitor for successful treatment outcomes to reduce the likelihood that BV will return after a course of treatment. The findings were published in Science Translational Medicine.
These activities are among the research investments in NIAID's STI portfolio. For more information on STIs, please visit:
This NIAID News blog post was published by the National Institute of Allergy and Infectious Diseases on April 16, 2024.
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