Bacterial Vaginosis: What is it, Symptoms, Causes & Treatment

Overview

What is bacterial vaginosis (BV)?

Bacterial vaginosis (BV) is a vaginal infection caused by bacteria. It is the most common cause of abnormal vaginal discharge that occurs in reproductive-age women (women who have not gone through menopause yet).

Bacterial vaginosis may cause a "fishy" odor and cause vaginal irritation in some women. Others may not have any symptoms.

Bacterial vaginosis is associated with poor obstetrics and gynecologic outcomes such as preterm delivery, infection after surgeries such as a hysterectomy, and may make a woman more susceptible to sexually transmitted infections, especially HIV.

How common is bacterial vaginosis (BV)?

Bacterial vaginosis (BV) is the most common vaginal problem for women ages 15 to 44. In fact, an estimated one in three American women will get BV. The rate is higher in black women.

Who can get bacterial vaginosis (BV)?

Anyone with a vagina can get bacterial vaginosis (BV), even if you haven't had sex. But that's rare. It usually occurs in people who are sexually active. You may have a higher risk of getting BV if you:

Are pregnant.
Don't use condoms or dental dams.
Have an intrauterine device (IUD).
Have multiple sex partners.
Have a new sex partner.
Have a female sex partner.
Use douches.

Symptoms and Causes

What causes bacterial vaginosis (BV)?

Your vagina is home to multiple types of bacteria (called a microbiome), just like your digestive system. Bacterial vaginosis (BV) happens when some of the vaginal bacteria grow more quickly than others. Too much of one type of bacteria leads to an imbalance.

Is bacterial vaginosis contagious (BV)?

Bacterial vaginosis (BV) doesn't spread from person to person, but sexual activity can increase your risk of getting the infection.

Is bacterial vaginosis (BV) an STD?

Bacterial vaginosis isn't sexually transmitted, but it is linked with sexual activity. Researchers think that sex may change the bacterial environment in your vagina. This makes bacterial overgrowth more likely.

What are the symptoms of bacterial vaginosis (BV)?

Up to 84% of people with bacterial vaginosis (BV) don't have symptoms. If you do, you may have:

Off-white, grey or greenish color vaginal discharge (fluid).
Discharge that smells "fishy."
"Fishy" smell that is strongest after sex or during the menstrual cycle.
Rarely, an itchy or sore vagina.

BV symptoms are similar to other infections. It's important to visit your healthcare provider to determine if what you have is BV or another vaginal infection.

What's the difference between bacterial vaginosis (BV) and a yeast infection?

Both bacterial vaginosis (BV) and yeast infections are vaginal infections that increase discharge. Here's how you can tell the difference:

Discharge: The hallmark sign of BV is discharge with a "fishy" smell. Discharge from yeast infections doesn't usually have a strong smell but may look like cottage cheese.
Vaginal irritation: Typically, BV doesn't cause vaginal irritation or itchiness. Yeast infections do.
Over-the-counter treatment: You can treat yeast infections with over-the-counter medications. You'll need to see your healthcare provider to get antibiotics for BV.

Diagnosis and Tests

How is bacterial vaginosis diagnosed?

During an exam, your healthcare provider takes a sample of fluid from your vagina. Healthcare providers view the fluid under a microscope, test it in the office or send it to the lab for analysis.

Management and Treatment

Can bacterial vaginosis (BV) clear up on its own?

In one-third of cases, bacterial vaginosis (BV) resolves on its own without any medications. However, if you have symptoms, you should seek medical care. Having BV makes you prone to sexually transmitted infections and can affect pregnancy.

What is the treatment for bacterial vaginosis (BV)?

Your doctor will prescribe antibiotics, typically metronidazole or clindamycin. These medications come in a gel or cream you insert into your vagina. They also come in pills you can take orally.

Is there a home treatment for bacterial vaginosis (BV)?

There are no over-the-counter products to treat bacterial vaginosis (BV). Avoid using douches or products meant for yeast infections, which could make BV worse. See your healthcare provider for treatment.

Prevention

How can I lower my risk of bacterial vaginosis (BV)?

Because bacterial vaginosis (BV) isn't fully understood, there are no foolproof ways of avoiding it. These steps may reduce your risk:

Avoid douching. It changes the natural balance of bacteria in your vagina. Instead, practice healthy vaginal and vulvar care.
Avoid vaginal contact with anything that has touched your anus. Things like toilet paper and sex toys could transfer bacteria found in your poop to your vagina. Make sure sexual toys are properly cleaned after every use.
Limit your number of sex partners. Research shows you're more likely to get BV if you have multiple sex partners.
Use latex condoms or dental dams. Although it's unclear why, research indicates that sexual activity is associated with BV.
Wear cotton or cotton-lined underwear. Bacteria thrive in moist environments. Cotton helps wick away moisture.

Outlook / Prognosis

How long does bacterial vaginosis (BV) last?

Most of the time, one round of antibiotics — taken for up to seven days — eliminates the infection. About 10% to 15% of people need another round of treatment.

Can you get bacterial vaginosis (BV) multiple times?

Yes. Up to 80% of women may get bacterial vaginosis again.

Living With

Should I be treated for bacterial vaginosis (BV) if I'm pregnant?

If you have bacterial vaginosis (BV), your provider can prescribe medication that's safe to use during pregnancy. You should get treated for the infection whether or not you have symptoms. BV can cause pregnancy complications, such as early delivery or having a baby that weighs less than average.

When should I tell my partner?

Male partners don't need to be treated for bacterial vaginosis (BV). If you have a female partner, she may have BV too. It's important to let her know so she can get treatment.

When should I call my healthcare provider?

Call your provider if you have:

Discharge that changes color or consistency.
Discharge that smells different than usual.
Vaginal itching, burning, swelling or soreness.

A note from Cleveland Clinic

Although bacterial vaginosis is a mild infection, it can make you vulnerable to more serious conditions. Don't put off seeing your healthcare provider if you notice anything unusual. A simple course of antibiotics could set things straight.

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