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Bacterial Vaginosis

Bacterial Vaginosis

Table of Contents

Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance of bacteria, often leading to symptoms like thin grayish discharge, a fishy odor, and discomfort. It’s usually treated with antibiotics to restore the natural balance of bacteria in the vagina. Seeking medical advice for proper diagnosis and treatment is crucial if you suspect BV, and avoiding practices like douching or using scented products can help prevent its recurrence.



About half of the time, women with BV have no symptoms. But they can include:

  • Itching
  • Burning sensation when urinating
  • The smell of fish gets stronger after sex
  • Thin white, gray, or green discharge


Bacterial vaginosis (BV) doesn’t have a single known cause, but it’s typically associated with an imbalance in the bacteria that naturally inhabit the vagina. Several factors can contribute to this imbalance, including:

  • Bacterial Overgrowth: Reducing the number of beneficial lactobacilli bacteria allows other harmful bacteria like Gardnerella vaginalis to overgrow, triggering BV.
  • Sexual Activity: While BV isn’t classified as a sexually transmitted infection (STI), it’s more common in sexually active individuals. Multiple sexual partners or a new sexual partner can increase the risk.
  • Douching: This practice can disrupt the natural balance of bacteria in the vagina, making it more susceptible to infections like BV.
  • Hygiene Products: Using scented soaps, vaginal sprays, or certain hygiene products can upset the pH balance of the vagina, promoting bacterial imbalance.
  • Hormonal Changes: Changes in hormone levels, such as those occurring during menstruation or pregnancy, can also influence the vaginal environment and contribute to BV.
  • Smoking: Some studies suggest a link between smoking and an increased risk of BV.

These factors can alter the vaginal environment, allowing harmful bacteria to thrive, leading to the symptoms associated with bacterial vaginosis.

sexual partners

Risk factors

Risk factors for bacterial vaginosis include:

  • Having different sexual partners or a new sexual partner: The relationship between sex and bacterial vaginosis is not clear. But BV happens more often when a person has different or new sexual partners. Also, BV is more common when both sexes are female.
  • Douching: The vagina is self-cleaning. Therefore, there is no need to wash the vagina with water or anything else. It may even cause problems. Douching disrupts the healthy balance of vaginal bacteria. It can lead to overgrowth of anaerobic bacteria and cause bacterial vaginosis.
  • Natural lack of lactobacillus bacteria: If your vagina does not produce enough lactobacillus, you are more likely to develop bacterial vaginosis.


Bacterial vaginosis often does not cause complications. But sometimes, having BV can lead to:

  • Sexually transmitted infections: If you have BV, your risk of getting an STI is higher. Sexually transmitted infections include HIV, herpes simplex virus, chlamydia, or gonorrhea. If you have HIV, bacterial vaginosis increases the risk of passing the virus to your partner.
  • Infection risk after gynecological surgery: Women with BV may have an increased risk of infection after surgery, such as a hysterectomy or dilation and curettage (D&C).
  • Pregnancy issues: Past studies have shown a possible link between BV and pregnancy problems. These include premature birth and low birth weight. New studies suggest that these risks may be due to other reasons. These reasons include having a history of premature birth. However, studies agree that if you notice symptoms of BV during pregnancy, you should get tested. If it is positive, the doctor can choose the best treatment.
  • Pelvic inflammatory disease: Bacterial vaginosis can sometimes cause PID. This infection of the uterus and fallopian tubes increases the risk of infertility.

safe sex


Prevention of bacterial vaginosis (BV) involves maintaining a healthy vaginal environment to support the growth of beneficial bacteria and prevent the overgrowth of harmful bacteria. Here are some strategies to reduce your risk of BV:

  • Practice Safe Sex: Consistent and correct use of condoms can help reduce the risk of BV. Limiting the number of sexual partners can also lower the chances of developing BV.
  • Avoid Douching: Douching disrupts the natural balance of bacteria in the vagina. The vagina is self-cleaning and doesn’t require douching for hygiene.
  • Limit Scented Products: Avoid using scented soaps, bubble baths, and other perfumed products in the genital area. They can disrupt the natural pH balance and bacterial harmony.
  • Be Careful with Antibiotics: Avoid using scented soaps, bubble baths, and other perfumed products in the genital area. They can disrupt the natural pH balance and bacterial harmony.
  • Practice Good Hygiene: Clean the genital area gently using mild, unscented soap and water. Wipe from front to back after using the bathroom to prevent the spread of bacteria from the rectum to the vagina.
  • Boost Immune System: A healthy immune system helps the body fight off infections, including BV. Eating a balanced diet, exercising regularly, and managing stress can support a robust immune system.
  • Limit Smoking and Alcohol: There’s evidence that smoking and excessive alcohol consumption can increase the risk of BV. Cutting down on these habits may help lower the risk.

What’s the difference between bacterial vaginosis and a yeast infection?

Bacterial vaginosis (BV) and yeast infections differ in their causes and treatment. BV results from an imbalance in vaginal bacteria, leading to a fishy odor and thin discharge. At the same time, yeast infections are caused by an overgrowth of the Candida fungus, resulting in thick, white discharge and itching. BV is treated with antibiotics, while yeast infections are treated with antifungal medications. Seeking medical advice for an accurate diagnosis is crucial as symptoms overlap, and proper treatment depends on the specific infection.

How is it diagnosed?

If you suspect you have bacterial vaginosis (BV), it’s essential to consult a healthcare provider for an accurate diagnosis. During the appointment, the healthcare provider will likely:

  • Review Symptoms: They’ll ask about your symptoms, such as any unusual discharge, odor, itching, or discomfort.
  • Physical Examination: They might perform a pelvic exam to check for any signs of BV, such as an unusual vaginal discharge or redness.
  • Vaginal Swab: A sample of vaginal fluid may be taken using a swab. This sample is then examined under a microscope or sent to a lab for further analysis to identify the type of bacteria present.

Based on the findings, the healthcare provider will confirm whether you have BV and discuss appropriate treatment options, such as antibiotics like metronidazole or clindamycin, to restore the balance of bacteria in the vagina. They may also advise preventing recurrence and answer any questions about managing BV.


Treatment bacterial vaginosis

The treatment for bacterial vaginosis (BV) usually involves antibiotics to restore the balance of bacteria in the vagina. The most commonly prescribed antibiotics for BV include:

  • Metronidazole: This antibiotic is available in oral form or as a vaginal gel or cream. It’s usually taken for a week by mouth or applied intravaginally as directed by a healthcare provider.
  • Clindamycin: Similar to metronidazole, clindamycin can be prescribed in oral form or as a vaginal cream. The healthcare provider will determine the treatment duration and dosage.

It’s essential to complete the full course of antibiotics before finishing the medication, even if symptoms improve. Treating BV helps alleviate symptoms and reduces the risk of complications, especially in pregnant individuals, where BV can lead to complications like preterm birth or low birth weight.

While undergoing treatment for BV, it’s advisable to avoid alcohol consumption as it can cause adverse reactions with some antibiotics, specifically metronidazole and tinidazole. Also, it’s generally recommended to refrain from sexual activity during the treatment period to prevent the spreading of the infection or disrupting the healing process.

If you’re pregnant or have recurring BV, your healthcare provider might tailor the treatment approach to suit your specific situation and suggest further steps to prevent recurrence. Always follow your healthcare provider’s instructions regarding treatment and follow-up care for the most effective management of BV.

The bottom line

BV is a common condition that results from an imbalance between beneficial and harmful bacteria in the vagina. Experts do not fully understand what causes this imbalance. However, certain factors seem to increase the risk, such as using feminine hygiene products and having sex with a new partner or multiple partners.

Untreated BV can increase the risk of sexually transmitted diseases and cause complications, some of which are related to pregnancy and fertility. The symptoms of BV can also mimic those of other health problems that require different treatments.

For these reasons, anyone with symptoms of BV should contact a healthcare professional before trying any treatment or solution. Remember that you can have frequent episodes of BV, but there are steps you can take to reduce your risk.

Additional questions

  1. Is bacterial vaginosis contagious?

Bacterial vaginosis is not spread from person to person, but sexual activity can increase the risk of infection.

  1. Can bacterial vaginosis cause bleeding?

Bacterial vaginosis (BV) typically doesn’t cause bleeding on its own. The primary symptoms of BV are usually abnormal vaginal discharge, often with a fishy odor, and sometimes discomfort, itching, or a burning sensation during urination.

  1. How long does bacterial vaginosis last?

Usually, one round of antibiotics for up to seven days clears the infection. About 10 to 15 percent of people need another round of treatment.

  1. Are pregnant women more likely to get BV?

About 25 percent of people who are pregnant develop BV. This is because of all the hormonal changes that occur during pregnancy.

  1. Can men get bacterial vaginosis?

Bacterial vaginosis (BV) is specifically a condition affecting individuals with vaginas due to the imbalance of bacteria in the vaginal environment. However, while men don’t get BV, they can be carriers of the bacteria associated with BV.

Men can carry and transmit the bacteria (Gardnerella vaginalis) that are commonly associated with BV through sexual activity. Even though BV is not considered a sexually transmitted infection (STI), the bacteria can be transferred between sexual partners, contributing to the development or recurrence of BV in their female partners. While men don’t experience the symptoms of BV themselves, they can play a role in its transmission.