Can Bacterial Vaginosis Cause UTIs? | Risk Factors

Both bacterial vaginosis (BV) and urinary tract infections (UTIs) are caused by imbalances in the microbial flora but in different parts of the body.

Bacterial vaginosis results from an overgrowth of harmful bacteria in the vagina, disrupting the natural balance of vaginal flora. [1] Urinary tract infections, on the other hand, occur when bad bacteria enter the urinary tract and multiply, leading to infection. [2]

Both vaginal health conditions share some symptoms, such as discomfort and abnormal vaginal discharge. But, can bacterial vaginosis cause UTI symptoms? Let’s explore.

Understanding BV and UTIs

If left untreated, bacterial vaginosis infections typically remain localized to the vagina and other reproductive organs. However, in some cases, untreated BV can lead to complications or secondary infections. For example [1]:

• Pelvic inflammatory disease (PID) – PID is a serious infection of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. Untreated BV can increase the risk of developing PID, as the bacterial imbalance in the vagina can facilitate the ascent of bacteria into the upper reproductive tract, leading to inflammation and vaginal infection. Discover more in our guide: Can bacterial vaginosis cause pelvic pain?

• Sexually transmitted infections (STIs) – The disruption of the vaginal microbiome can create an environment that is more conducive to the growth and transmission of pathogens that cause such STIs as chlamydia, gonorrhea, or human immunodeficiency virus (HIV).

• Pregnancy complications – Untreated BV infections, which can affect the fetus during pregnancy, have been associated with an increased risk of various complications, including preterm birth, low birth weight, and premature rupture of membranes.

The most common bacteria found in bacterial vaginosis infections include Gardnerella spp., Prevotella spp., Mobilincus spp., Megaspahera spp., and Sneathia spp. [3]

Alternatively, the bacteria Escherichia coli (E. coli), which is found in the bowel, most commonly causes urinary tract infections. [4] These infections are localized to the urinary tract, which includes the urethra, bladder, ureters, and kidneys. [4]

The Connection Between BV and UTIs

All that said, there may be some correlation between bacterial vaginosis and urinary tract infections.

According to one study published in the Nepal Medical College Journal, it was found that 75% of women with bacterial vaginosis also had a UTI. [5]

Another study published in The Journal of Global Infectious Diseases, which conducted research on 174 women, found that 119 of them had bacterial vaginosis. Of the BV-positive population, 58 also had a urinary tract infection. Researchers hypothesize that the association of BV with UTIs may be attributed to an increase in the pH of the vagina when BV-causing anaerobic flora overpopulates the vagina. Those who have frequent sexual intercourse may also be at a higher risk of developing both types of infections. [6]

Further evidence suggests that bacterial vaginosis may trigger recurrent UTIs, though more research is still needed to confirm this relationship. [7]

The study, published in the journal of Current Infectious Disease Reports, concluded that bacteria found in the vagina, as opposed to in the bowel, may also trigger urinary tract infections. BV disrupts the optimal vaginal microbiota, potentially increasing one’s risk for UTI.. [7]

This study suggested that these bacteria trigger E. coli already present in the bladder to multiply, and it may also be responsible for more severe infections if the bacteria make their way up the urinary tract. [7]

How to Lower the Risk of BV and UTIs

There are several ways to lower your risk of contracting bacterial vaginosis, according to the Cleveland Clinic. These include [1]:

• Avoiding douching – Douching disrupts the natural balance of bacteria in the vagina and can increase the risk of BV. Further, the vagina is largely self-cleaning and does not require douching for hygiene purposes.
• Properly cleaning yourself – Maintaining good genital hygiene is important for preventing BV and urinary infections. This includes washing only the external genital area with mild soap and water and avoiding harsh or scented hygiene products that can disrupt the vaginal microbiome.
• Limiting your sexual partners – Having multiple or new sexual partners increases the risk of BV, as it can introduce new bacteria into the vagina. As such, limiting the number of partners can help reduce your chances of developing BV.
• Using protection – Consistent and correct use of barrier methods such as condoms during sexual activity can help prevent BV by reducing the transmission of bacteria between partners. However, it's important to note that condoms may not provide complete protection against BV, as the bacterial infection can also occur without sexual activity.
• Wearing cotton underwear – Cotton underwear allows for better air circulation and helps keep the genital area dry, which can discourage the growth of harmful bacteria associated with BV.

Similarly, limiting your number of sexual partners and practicing good hygiene can also help to reduce the risk of urinary tract infections. Other prevention methods include [4]:

• Drinking water to flush out harmful bacteria from the urinary tract
• Urinating frequently and after sex
• Using a water-based lubricant during sex
• Changing your birth control from a diaphragm
• Avoiding tight-fitting clothing

Seek BV Treatment With Everlywell

If you believe you have bacterial vaginosis or a UTI and would like to reduce the risk of complications, it’s important to seek medical care right away.

At Everlywell, we provide quick and easy online bacterial vaginosis treatment. Simply fill out your health profile, detail your symptoms, and submit your information. A licensed healthcare provider will review your condition and prescribe antibiotics, if needed.

1. Bacterial Vaginosis (BV). Cleveland Clinic. Last reviewed February 26, 2023. Accessed May 15, 2024. Medical Citation URL.
2. Bono MJ, Leslie SW, Reygaert WC. Uncomplicated urinary tract infections. StatPearls - NCBI Bookshelf. Published November 13, 2023. Accessed May 26, 2024. Medical Citation URL.
3. Mondal AS, Sharma R, Trivedi N. Bacterial vaginosis: A state of microbial dysbiosis. Medicine in Microecology. 2023;16:100082. doi:10.1016/j.medmic.2023.100082. Accessed May 26, 2024. Medical Citation URL.
4. Urinary Tract Infection. Cleveland Clinic. Last reviewed April 6, 2023. Accessed May 15, 2024. Medical Citation URL.
5. Amatya R, et al. Urinary tract infection in vaginitis: a condition often overlooked. Nepal Med Coll J . Published 2013. Accessed May 15, 2024. Medical Citation URL.
6. Sumati A H, Saritha N K. Association of Urinary Tract Infection in Women with Bacterial Vaginosis. J Glob Infect Dis. Published 2009. Accessed May 15, 2024. Medical Citation URL.
7. Handa VL, Brotman RM, Ravel J, Tuddenham S. Does bacterial vaginosis contribute to urinary tract infection? Current Infectious Disease Reports. 2023;25(2):17-27. doi:10.1007/s11908-022-00795-0. Accessed May 26, 2024. Medical Citation URL.