Is it Bacterial Vaginosis or Pelvic Floor Dysfunction?

By Dr. Christine Martirez PT, DPT on 4/11/2024

A pelvic floor physical therapy patient with bacterial vaginosis.

Bacterial vaginosis (BV) and pelvic floor dysfunction (PFD) are two distinct conditions that can affect pelvic health and cause discomfort for individuals. While they may share some symptoms related to the pelvic region, they are fundamentally different in terms of causes, diagnosis, and treatment approaches. In this blog post, we'll delve into the specifics of bacterial vaginosis and pelvic floor dysfunction, highlighting their unique characteristics and key differences.

Understanding Bacterial Vaginosis (BV)

  1. What is Bacterial Vaginosis?

    Bacterial vaginosis is a common vaginal infection caused by an imbalance of bacteria in the vagina. Normally, the vagina contains a balance of beneficial bacteria and harmful bacteria, but in BV, the harmful bacteria outnumber the beneficial ones.

  2. Diagnosis of Bacterial Vaginosis:

    BV is diagnosed through a combination of symptoms assessment (such as unusual vaginal discharge, fishy odor), physical examination, and laboratory tests (e.g., pH testing, microscopic examination of vaginal fluid).

  3. Treatment of Bacterial Vaginosis:

    BV is typically treated with antibiotics prescribed by a healthcare provider. Common medications include oral antibiotics or vaginal creams/gels. It's important to complete the full course of treatment to prevent recurrence.

  4. Symptoms of Bacterial Vaginosis:

    Symptoms of BV may include:

    • Thin, grayish-white vaginal discharge

    • Fishy odor, especially after sex

    • Itching or irritation in the vaginal area

    • Burning sensation during urination

Understanding Pelvic Floor Dysfunction (PFD)

  1. What is Pelvic Floor Dysfunction?

    Pelvic floor dysfunction refers to a wide range of conditions that affect the muscles, ligaments, and connective tissues of the pelvic floor. This can include pelvic pain, urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction.

  2. Diagnosis of Pelvic Floor Dysfunction:

    PFD is diagnosed through a comprehensive evaluation by a pelvic floor specialist and healthcare team, which may include a physical examination, pelvic floor muscle assessment, and diagnostic tests (e.g., urodynamic testing, imaging studies).

  3. Treatment of Pelvic Floor Dysfunction:

    Treatment of PFD depends on the specific symptoms and underlying causes. It may include pelvic floor physical therapy (including exercises, manual therapy, and biofeedback), lifestyle modifications, medications, or in some cases, surgical interventions.

  4. Symptoms of Pelvic Floor Dysfunction:

    Symptoms of PFD vary depending on the specific condition but may include:

    • Pelvic pain or pressure

    • Urinary urgency, frequency, or leakage

    • Fecal incontinence or difficulty with bowel movements

    • Painful intercourse

    • Pelvic organ prolapse (sensation of pelvic organs bulging into the vagina)

Differences Between Bacterial Vaginosis and Pelvic Floor Dysfunction

  1. Cause:

    BV is caused by an imbalance of vaginal bacteria, while PFD can be caused by various factors such as childbirth, trauma, chronic constipation, or neurological conditions.

  2. Diagnosis:

    BV is diagnosed based on vaginal symptoms and laboratory tests, whereas PFD requires a comprehensive pelvic floor evaluation by a specialist.

  3. Treatment:

    BV is treated with antibiotics, while PFD may be managed with pelvic floor physical therapy, lifestyle modifications, or other interventions tailored to the specific symptoms.

  4. Symptoms:

    BV primarily presents with vaginal discharge and odor, whereas PFD encompasses a broader range of symptoms related to pelvic dysfunction and musculoskeletal issues.

Seeking Proper Evaluation and Treatment

Bacterial vaginosis and pelvic floor dysfunction are distinct conditions that require different approaches to diagnosis and treatment. If you suspect you have symptoms related to either condition, it's essential to seek evaluation and guidance from a healthcare provider or pelvic floor specialist. With proper diagnosis and targeted interventions, individuals can effectively manage their symptoms and improve their pelvic health for overall well-being and quality of life. Don't hesitate to reach out for professional help to address your pelvic health concerns.

If you're suffering from pelvic floor symptoms, please reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at

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