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Here's something I'm not a fan of: getting laid really well and then coming down with a ferocious infection that produces abnormal discharge, smells funky, and hurts when I pee, walk, sit, exercise, and/or have more sex. Clinically, it's called vaginitis, irritation and/or inflammation of the vagina - vulvovaginitis if the problem is also on the vulva, like mine often is.

What causes it? We don't always know. Two people can have the same experience, one gets it, one doesn't. We do know that irritants like cleaning products, your soaps and detergents, can result in vaginitis. Clothing and semen, low estrogen levels, diet, antibiotics, long periods of dampness like if you don't get out of your gym clothes or your swimsuit fast enough, poor hygiene, soaking in hot springs that can change pH and make you more susceptible. Hell, I think that even certain kinds of toilet paper, partners touching their phones right before rubbing one off on you.

Again, we don't always know, but most often vaginitis is caused by yeast, viruses, and bacteria that grow naturally in the person's own body but overgrow. Bacterial vaginosis, for example, is a form of vaginitis thought to be instigated by the bacteria gardnerella vaginalis, or maybe gardnerella creates a base for other microorganisms to attach to and for this army of replicating weed flora to grow out of control. Either way, the bacteria are usually a natural part of our bodies. They become problematic when they grow too much and upset the balance with the rest of the flora in there.

What causes this? Bacterial vaginosis, BV, like other forms of vaginitis, isn't entirely understood, but there are known risk factors for it - smoking; douching; longer, irregular periods, maybe because the blood changes the pH; new partners; multiple partners; not using condoms; vaginal penetration of any kind; or anal penetration and then vaginal penetration - the things that might throw off good bacteria and give the less beneficial ones room to flourish.

Symptoms? One in three people with vaginas have had or will have BV at some point in their lives, often multiple times. Of those, 84% report not having any symptoms at all; it's just their normal. For others, like me, gah, my vagina, my whole crotch hurts, sometimes my stomach. There can be an unfamiliar gray, green, or white fluid. I experience pain, burning, itching, especially when my vulva and vagina are touched or during urination.

And things smell fishy. Not like grilled salmon fishy, but new dead fish fishy. In fact, one method of diagnosing BV is actually a whiff test, where potassium hydroxide is added to a sample of the bacterial vaginosis suspect discharge to express the scent even more. Smells like fish? That's BV.

Other methods to detect it include running a DNA test on the bacteria - is it indeed BV? - or testing the vaginal pH to see if it's above healthy 3.8-4.5. If yes, it's likely BV. Most commonly, labs will do what's called a wet mount. This technique uses a microscope to look for unusual clue cells in a sample of the discharge that has been mixed with saline. There are clue cells? BV.

Is it treatable? Yes. There are pills you can take orally and/or gels and creams that gets squirted into the vagina directly. The crappy thing about these is that they can take a while to complete, and during that time, it's best to avoid genital contact so that you're not pissing everything off the whole time that the medication is trying to do its thing.

Three important notes on treatment. One, it will be prescribed to you in a very specific duration - a day, three days, a week, two weeks. It is very important to follow through with the timeline even if your symptoms go away, even if you want to stop shooting antibiotic goo into your body so that you can have sex. If you suspect the medication is doing harm in any way, let your medical provider know, and then it may be okay to stop taking the medication early, but if you're doing just because your vagina smells and feels better, then you may be increasing your risk of BV coming back again.

Two, most of the medications used to treat BV interact violently with alcohol. Make sure that, if you're on one of them, that you do not have alcohol during this time, including mouthwash.

Three, up until recently, it was believed that partners with penises did not need to get tested and treated to interrupt the passing back and forth of the infection. Your provider may still be operating under this belief. Tell them in August of this year, Frontiers in Cellular and Infection Microbiology published a study that determined penises can cause an imbalance of the vaginal microbiome, especially if sex is unprotected, and treating the penile microbiome can reduce the likelihood of getting BV for their partners.

What happens if BV isn't addressed, if no one gets treated and it just hangs out? Bacterial vaginosis has been linked to pelvic inflammatory disease, which can lead to infertility. It can cause inflammation of the endometrium called endometriitis. It increases the risk of acquiring sexually transmitted infections like HIV, and it's known to cause spontaneous abortions - miscarriages. This is why, if you're pregnant, it's really important to call your provider immediately if you have any of these symptoms.

How can we prevent it? As with any form of vaginitis, it's difficult to prevent, especially when we don't fully understand the causes. Some people will take probiotics to strengthen the helpful flora in the vagina. It's recommended that you definitely avoid any deodorizers, products meant to clean or freshen you up, because it's not supposed to smell like fish, but it's also supposed to smell and taste like vulva.

Be careful about the clothing that you're wearing, what fabrics, how breathable they are, what kinds of detergents you use to wash them, and again, avoid fragrances and unnecessary chemicals. Wipe front to back; you know this already. Have sex from front to back, too. By that I mean vaginal then anal, not the other way around, unless things are cleaned up in between.

Dry off completely after soaking or sweating so that your crotch isn't a moist, friendly environment for pathogens. And sexually, you can take showers before playing, keep your hands clean, use condoms, dams, and gloves, choose lubes that are body-safe, and make sure that everyone is aptly turned on so there is less microscopic tearing.

BV, all forms of vaginitis, are frustrating. For many of us, they're recurrent, they're painful, they make it difficult to feel sexy and hard to be intimate. Try to understand that none of this is your fault; your body is trying to work out internal and external microorganisms. You are not dirty. You are not sexually doomed.

Share this video with your partners if it helps. Take them with you to the clinic. Learn about treatment options and hygiene. Experiment and report back in the comments what things have worked for you. I'd also love it if you would go to med school, conduct research, and help me address the problems vaginas experience, because ah! 

Stay curious. You're okay right now. It's okay right now. A big thanks again to our sponsor for this episode, Care/Of. There's a link to their site in the description, TakeCareOf.com. SEX50 gets you 50% off your first order.

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