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.

Signs and symptoms of bacterial vaginosis can include:

  • Vaginal discharge that may appear watery and whitish-gray 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

It's also possible to have the infection without any symptoms.

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:

  • New or multiple sexual partners
  • Douching
  • Natural lack of lactobacilli

Testing for BV usually includes a pelvic exam and a sample from vaginal secretions. Bacterial vaginosis can only be diagnosed by a health care provider and is typically treated with antibiotics (either in pill or topical form). If left untreated, the infection can increase the chance of low birth weight and premature delivery in those who are pregnant (as a side note: if someone is pregnant or taking other medications, it's critical that they let their provider know to inform appropriate and safe medical care). Those with BV are also at an increased risk of contracting sexually transmitted infections (STIs) and it’s possible for the bacteria to cause pelvic inflammatory disease (PID). Once treatment has started, symptoms may get better before the condition is completely cured. However, taking all of the prescribed medication for the indicated length of time is advised. That being said, it’s common for BV to recur within three to twelve months even after treatment is complete for the first infection.

Although there are no 100 percent effective ways to prevent bacterial vaginosis, there are a few ways to reduce the risk of infection:

  • Avoid douching and using other chemical products (e.g., vaginal deodorant sprays, powders, perfumed soaps, or scented tampons or pads) in the vaginal area.
  • Regular cleansing of the vagina while bathing or showering, but not douching.
  • Consider 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 to make an appointment with your health care provider in order to get an accurate diagnosis and treatment.


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