A patient came into my office on Friday with the common complaint of itching down below. K. told me that she has had multiple yeast infections in the past, but her self-treatment with an over-the-counter remedy wasn't working this time. I examined K. and found not yeast but bacterial vaginosis, or as it's more whimsically known, BV. It's an incredibly common mistake. A researcher at St. Louis University looked at the records of 150 patients at the campus clinic who thought they had yeast, but only 26 percent did.
For those of you lucky enough to have never had BV (yet), it is a vaginal infection but not an STD.  Our vaginas normally have a number of bacteria that merrily reside there and keep us healthy, just like on our skin and in our intestines. Sometimes, and we don't know all the reasons why, one particular bacterium oversteps its bounds and grows out of balance with the rest. We do know that women who are sexually active are much more likely to get BV, but they don't get infected directly from their partner--it's a homegrown bug, as it were. I know it sounds confusing; an infection that you get from having sex, but not one that you catch from your partner.

The most important thing to know is BV has a classic set of symptoms:

•  The vaginal discharge is thin, white to grayish, and a bit sticky.

• There may be an unpleasant odor, unfortunately fishy in nature. (Yeast may be itchy, but it won't be fishy.)

• Some women experience vulvar pain or burning, or like K., itching.

Fortunately, BV is easily treated, but you do need to see a doctor--there's no over-the-counter remedy. Your gyno will likely give you metronidazole, in either the oral (Flagyl 500 mg twice daily for a week) or vaginal gel (MetroGel, 0.75% nightly before bed for five nights) form. You won't hurt yourself using a treatment for yeast if you have BV--but you won't feel any better either. So if you notice a funky discharge, with or without itching or an odor, head to the gyno. Have any of you heard of BV before, or think you have these symptoms?