Bacterial vaginosis during & after menopause

There is still great uncertainty surrounding bacterial vaginosis (BV) and perhaps especially among postmenopausal women, that is, women who have passed menopause. Bacterial vaginosis is most common in women of reproductive age, but women both during and after menopause can also be affected. Bacterial vaginosis is a common vaginal infection that occurs when there is an imbalance in the natural bacteria of the vagina. This imbalance means that the "good" bacteria (lactobacilli) decrease, while the "bad" bacteria (anaerobes) increase. This leads to an elevation of the vaginal pH value, where one of the characteristic symptoms is a strong fishy odor. However, for postmenopausal women, the symptoms may be somewhat different compared to younger women. 

THAT IS WHY POSTMENOPAUSAL WOMEN SUFFER FROM BACTERIAL VAGINOSIS 

After menopause, a woman's body undergoes significant hormonal changes. One of the most noticeable changes is the decrease in estrogen levels. Estrogen plays an important role in maintaining a healthy vaginal environment by stimulating the production of glycogen in vaginal epithelial cells. Glycogen is converted by lactobacilli into lactic acid, which helps keep vaginal pH low (acidic), normally between 3.8 and 4.5. 

When estrogen levels drop below and after menopause, glycogen production decreases, leading to fewer lactobacilli and a higher vaginal pH. This more alkaline pH makes it easier for harmful bacteria to grow, increasing the risk of bacterial vaginosis. Additionally, drier mucous membranes, which are common after menopause, can make the vagina more susceptible to infections such as bacterial vaginosis. 

VAGIVITAL AKTIVGEL FOR DRY MUCOSAL MEMBRANES 

VagiVital AktivGel is a non-sticky vaginal gel studied at Swedish university hospitals. The results show that VagiVital AktivGel reduces symptoms of dry mucous membranes, including itching, irritation, and pain during intimate contact and urination, as well as improves the management of urge incontinence. 

Buy VagiVital AktivGel 3-pack and get 10% off here!   

RESEARCH ON PH CHANGES AND BV IN POSTMENOPAUSAL WOMEN 

Research has shown clear links between menopause, changes in vaginal pH, and the occurrence of bacterial vaginosis. A study published in the journal Menopause found that postmenopausal women often have a vaginal pH above 4.5, which is significantly higher than the acidic pH common in premenopausal women. The study also showed that the decreased amount of lactobacilli in postmenopausal women contributes to this pH increase and thus to an increased risk of bacterial vaginosis. 

Another study published in Journal of Lower Genital Tract Disease investigated the prevalence of bacterial vaginosis in postmenopausal women and found that up to 30% of women in this group experienced symptoms of BV. The researchers noted that the most common symptoms in these women were vaginal dryness, irritation, and an unpleasant odor, rather than the classic fishy smell often associated with BV in younger women. 

Read more about how a healthy intimate area should smell here!

SYMPTOMS OF BACTERIAL VAGINOSIS IN POSTMENOPAUSAL WOMEN 

For postmenopausal women, the symptoms of bacterial vaginosis may be different compared to younger women. This is mainly due to hormonal changes that occur during and after menopause. Reduced estrogen levels affect the vaginal environment and can lead to some symptoms being less obvious. 

After menopause, estrogen production decreases significantly, leading to thinner and drier vaginal mucous membranes. This change can affect the production of glycogen, an important nutrient source for lactobacilli (the good bacteria). When lactobacilli decrease, vaginal pH increases, making it easier for harmful bacteria to grow and cause bacterial vaginosis. 

The typical fishy odor often associated with bacterial vaginosis is the result of volatile amines produced by anaerobic bacteria in an estrogen-stimulated environment. After menopause, these bacteria and their activity may decrease, making the characteristic fishy odor not always as noticeable. 

COMMON SYMPTOMS IN POSTMENOPAUSAL WOMEN 

🌸 Unpleasant odor: Although the typical fishy smell is not always present, there may still be an unpleasant odor reminiscent of other smells, such as a "fart." 

🌸 Thin, gray-white discharge: These are a common sign of bacterial vaginosis, even in postmenopausal women. 

🌸 Irritation or itching in the genital area: Dryness and thinner mucous membranes can make the genital area more sensitive to irritation and itching. 

DIAGNOSE BV WITH VAGIVITAL VS SELF-TEST 

VagiVital VS Self-test for bacterial vaginosis diagnoses bacterial vaginosis with 92% accuracy. The high accuracy is due to the VS Self-test not only measuring pH but also the buffering capacity in the discharges, which means the discharges' ability to resist changes in pH. Good buffering capacity means that the discharges can effectively counteract sudden pH changes, which is important to maintain a healthy vaginal environment.  

A stable vaginal pH level is crucial to prevent infections such as bacterial vaginosis. Normally, the vagina has an acidic pH, which is unfavorable for many harmful bacteria and fungi. If the pH level increases (becomes less acidic) due to reduced buffering capacity, this can create an environment where harmful bacteria thrive, leading to infections and unpleasant symptoms. Thanks to the VS Self-test also measuring the buffering capacity in the discharges, the test can also include women with bacterial vaginosis who still have a normal pH. A common pH test for bacterial vaginosis has only 78% accuracy, which makes VagiVital VS Self-test superior. For postmenopausal women, however, the vaginal pH can be elevated, which can give a false positive result with both the VS Self-test and a traditional pH test. 

Read more about VS Self-test for bacterial vaginosis here!   

DIAGNOSE BV WITH A GYNECOLOGIST 

To diagnose bacterial vaginosis by a gynecologist, three out of four criteria must be met: 

1. A sniff test: A sample of vaginal secretion is taken and a drop of potassium hydroxide is added, which raises the pH and in bacterial vaginosis the typical fishy smell then appears.
2. Examination of the discharge under a microscope
3. A pH test on the discharge: If the pH is above 4.5, it may indicate bacterial vaginosis, but for postmenopausal women, it can give a false positive result
4. Examination of the discharge's color and consistency

TREATMENT OF BACTERIAL VAGINOSIS WITH ANTIBIOTICS 

Traditionally, bacterial vaginosis has been treated with antibiotics, but this can disrupt the entire vaginal flora and lead to other problems. Antibiotics are effective against bacterial infections but also affect the body's beneficial bacterial flora, including lactobacilli in the vagina. The good lactobacilli are especially important because they maintain an acidic pH in the vagina and protect against harmful organisms. When antibiotics reduce the number of lactobacilli, the pH value can increase, which then creates a favorable environment for infections to grow uncontrollably. 

Read more about why you can get a yeast infection from antibiotics here!   

ANTIBIOTIC-FREE TREATMENT OF BACTERIAL VAGINOSIS 

Vernivia vaginal mousse from VagiVital offers an antibiotic-free treatment of bacterial vaginosis that works by mimicking the vagina's own immune defense. The mousse restores the pH balance and supports the good lactobacilli, whose production of lactic acid is an important part of the vagina's defense against bacterial and fungal infections. With Vernivia, you can easily treat bacterial vaginosis in 7 days and foul-smelling discharge already after 12 hours. The effect is clinically proven and equivalent to prescription antibiotics 🙌 

Buy Vernivia vaginal mousse from VagiVital here!

DRY MUCUS MEMBRANES CAUSE PROBLEMS  

Vaginal dryness is a common problem, especially in postmenopausal women, and can lead to a range of uncomfortable and sometimes painful symptoms such as: 

🌸 Small wounds and cracks: Dry mucous membranes can develop small wounds or cracks, creating entry points for bacteria to penetrate and cause infections. 

🌸 Urinary tract infections: Dryness can also lead to an increased risk of urinary tract infections because bacteria can more easily spread to the urinary tract. 

🌸 Pain during intercourse: Dry and sensitive mucous membranes can make intercourse painful, negatively affecting quality of life and sexual health. 

🌸 Burning sensation when urinating: Due to the dry and irritated mucous membranes, urination can become painful and uncomfortable. 

🌸 Urge to urinate: Dryness in the vaginal mucous membranes can also affect the urinary tract and cause frequent urges to urinate. This can be very uncomfortable and affect daily activities. 

When the mucous membranes become dry, they also become thinner and more vulnerable, which can make it easier for harmful bacteria to take over. By using VagiVital ActiveGel can moisturize and strengthen the mucous membranes, which helps to prevent and relieve these discomforts. 

Take care of yourself & Stay Pussytive❤️ 

/Fanny Falkman Grinndal 
Business Manager Nordics 
Peptonic Medical AB 
fanny.falkman-grinndal@peptonicmedical.se