What is bacterial vaginosis?

Dear Alice,

What is bacterial vaginosis? What are the signs and symptoms? And how can it be cured?

Dear Reader,                                                         

Vaginas play host to a variety of bacteria that help maintain a healthy environment. Some types of bacteria, which typically live in the vagina in small numbers, are called anaerobes (meaning they don't require oxygen to live). Bacterial vaginosis (also called BV or nonspecific vaginitis) occurs when these anaerobes become too numerous and the other types of bacteria, called lactobacilli, are reduced in number. Bacterial vaginosis is a common vaginal infection and while it can be uncomfortable, it tends to be pretty mild and easily treated.

In terms of signs and symptoms of bacterial vaginosis, it's possible for individuals to either exhibit very mild symptoms or not show symptoms, which can cause people to not know that they have BV. When a person does exhibit symptoms, they can include having:

  • Vaginal discharge that may appear watery and whitish-gray, greenish, or milky.
  • A change in the usual scent of the vagina, often described as a strong "fishy" odor — most notably after sex.
  • Itching or burning around the opening of the vagina.
  • Burning while urinating.

Experts aren’t sure exactly why certain folks develop bacterial vaginosis. Some have theorized that anything that changes the balance of bacteria in the vagina could make some people more likely to develop the infection. Potential risk factors include having new or multiple sexual partners, douching, or natural lack of lactobacilli.

With regards to testing for bacterial vaginosis, this process usually includes a pelvic exam and a sample from vaginal secretions. Given that BV can exhibit similar symptoms as other vaginal infections, it's key to note that bacterial vaginosis can only be diagnosed by a healthcare provider. Moreover, when talking about treatment, BV is typically treated with antibiotics that come in the form of either a pill or topical cream/gel. Additionally, if the individual is pregnant or taking other medications, telling their provider can inform appropriate and safe medical care. If left untreated, the infection can increase the chance of low birth weight and premature delivery in those who are pregnant. Moreover, those with bacterial vaginosis are also at an increased risk of contracting sexually transmitted infections (STIs) and having pelvic inflammatory disease (PID), as BV can sometimes cause this infection to occur. Once treatment has started, symptoms may get better before the condition is completely cured. However, it's advised that you continue to take all of the prescribed medication for the indicated length of time. That being said, it’s common for BV to recur within three to twelve months after treatment has concluded for the first infection, in which case it's recommended that you contact your medical provider to receive more treatment.

While there is no "sure-fire" way to prevent bacterial vaginosis 100 percent of the time, there are a few ways to reduce the risk of infection, which includes:

  • Avoiding douching and using other chemical products in the vaginal area (e.g., vaginal deodorant sprays, powders, perfumed soaps, or scented tampons or pads).
  • Regular cleansing of the vagina while bathing or showering, but not douching.
  • Using condoms during sex or limiting the number of sexual partners to reduce risk of STI transmission.

Again, if you think you might have bacterial vaginosis, it's best you make an appointment with your health care provider to ensure you are getting an accurate diagnosis and treatment.

Last updated Mar 11, 2022
Originally published Mar 08, 2002

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