Free Book Excerpt from "The V Book: A Doctor's Guide to Complete Vulvovaginal Health"

Bacterial vaginosis (BV)

Of all the causes of odor, BV is the likeliest suspect. The leading cause of vaginal complaints in the United States, BV is not an infection but an imbalance in the bacteria normally found in the vagina. Instead of being the most predominant bacteria, the lactobacilli disappear. In their place large numbers of other bacteria overgrow. They can wax and wane during the menstrual cycle, and are often worse after intercourse. These huge numbers of bacteria cause a heavy discharge and change the acid-base balance of the vagina to alkaline. With the elevated pH come increased concentrations in the vaginal fluid of proteins that tell you how bad they smell: putrescine and cadaverine. In mild form the odor is like ammonia; a bad case smells like dead fish.