What is bacterial vaginosis?

Bacterial vaginosis is a vaginal infection due to an imbalance of good and bad bacteria in the vagina. Factors that may cause an imbalance for BV include sexual activity, douching, and scented soaps.
Bacterial vaginosis is a vaginal infection due to an imbalance of good and bad bacteria in the vagina. Factors that may cause an imbalance for BV include sexual activity, douching, and scented soaps.

The body’s natural balance is important in keeping people with vaginas comfortable and healthy. Usually, the vagina has a balance of “good” and “bad” bacteria. When the balance is thrown off, you can get bacterial vaginosis, a vaginal infection also known as BV. 

Bacterial vaginosis is the most common vaginal infection. Nearly 30% of women in the U.S. will experience bacterial vaginosis at some point in their lifetime. Some women, however, are more likely than others to get bacterial vaginosis. These include:

  • Women who are sexually active or who have multiple partners
  • Women who douche
  • Women of African ethnicity.

Bacterial vaginosis is usually mild, but it can have lasting impacts if the infection goes untreated for too long.

Recognizing the signs and symptoms of bacterial vaginosis is important for treating the infection and for ensuring you are diagnosing your infection correctly.

Signs and symptoms of bacterial vaginosis

Signs and symptoms of bacterial vaginosis vary. In fact, many women with bacterial vaginosis don’t even experience symptoms.

Bacterial vaginosis symptoms may include:

Discharge

When you have bacterial vaginosis, you might notice a thin discharge (fluid) from your vagina. This discharge may be white, green, or gray, and it may be very watery.

Odor

Discharge from bacterial vaginosis may have a strong “fishy” smell. This smell may be strongest after sex, or during your period.

Vaginal itching

Itching is another less common symptom of bacterial vaginosis. A sore vagina is also possible.

Causes of bacterial vaginosis

Doctors believe that bacterial vaginosis is most often caused by an overgrowth of the bacteria G. vaginalis. When this bacteria outnumbers lactobacilli, “good” bacteria in the vagina, the acidity level of your vagina changes and infection can occur.

More research is needed as doctors are not completely sure how bacterial vaginosis is caused. However, there are several factors that can cause an imbalance of bacteria that may lead to bacterial vaginosis.

Sexual activity

Sexual activity may increase your risk of getting bacterial vaginosis. While the infection is not sexually transmitted, people who have sex frequently or who have sex with multiple partners contract BV more frequently. 

Some studies have shown that using a condom every time you have sex may help protect against BV.

Douching

Douching is cleaning the vagina with water or soap by spraying upward into the vagina. Douching can upset the natural balance of bacteria in the vagina, which can cause bacterial vaginosis.

Scented soaps

Similar to douching, the use of a scented soap on your genitals may upset the natural pH of your vagina, leading to possible infection

QUESTION

The vagina includes the labia, clitoris, and uterus. See Answer

When to see the doctor for bacterial vaginosis

Severe cases of bacterial vaginosis can create complications if left untreated. Bacterial vaginosis may increase your chance of contracting HIV or other sexually transmitted diseases (STDs). These STDs can cause pelvic inflammatory disease (PID), which can make it difficult to have children in the future.

If you’re pregnant and contract bacterial vaginosis, a premature birth becomes more likely.

It’s easy to confuse bacterial vaginosis with other infections, because many vaginal infections have similar symptoms. BV presents most similarly to yeast infections and trichomoniasis (an STD). If you are unsure whether you have bacterial vaginosis or another infection, go see your doctor.

Diagnosing bacterial vaginosis

Your doctor can diagnose bacterial vaginosis using four methods.

  1. When you have bacterial vaginosis, the pH (acidity level) of your vagina increases. Your doctor can measure the pH of your vagina.
  2. Your doctor can look to see if you have discharge typical of bacterial vaginosis.
  3. Your doctor can examine a discharge sample under a microscope to look for bacteria attached to your skin cells.
  4. Your doctor can perform a “whiff test” in which your doctor adds a chemical to the discharge and smells it to see if it has the characteristic “fishy” odor.

Treatments for bacterial vaginosis

Mild cases of bacterial vaginosis may go away on their own. In more severe cases of bacterial vaginosis, your doctor may recommend taking antibiotics.

Taking probiotics, live bacteria found in some foods and supplements, might help prevent future infections. Studies show that eating yogurt or probiotic supplements may treat bacterial vaginosis by balancing vaginal bacteria.

Health Solutions From Our Sponsors

Medically Reviewed on 12/17/2020
References
American Journal of Obstetrics and Gynecology: "Paternal race and bacterial vaginosis during the first trimester of pregnancy."

Archives of Pediatric and Adolescent Medicine: "Douching: a problem for adolescent girls and young women."

Centers for Disease Control and Prevention: "Bacterial Vaginosis (BV)."

Cleveland Clinic: "Bacterial Vaginosis."

Cleveland Clinic: "Itching Down There Isn't Always a Yeast Infection."

International Journal of Environmental Research and Public Health: "Probiotics for the Treatment of Bacterial Vaginosis: A Meta-Analysis."

Journal of Applied Microbiology: "The Etiology of Bacterial Vaginosis."

Mayo Clinic: "Bacterial Vaginosis."