Bacterial Vaginosis

General Info

  • A vagina contains many types of bacteria, particularly large numbers of "good" bacteria called Lactobacillus, which help keep a healthy vagina in an acidic (low pH) condition.
  • If there is a loss of Lactobacillus, the pH balance of the vagina changes, which can cause an increase in the numbers and types of "harmful" bacteria which can result inBacterial Vaginosis (BV).
  • The "harmful" bacteria involved in BV include Gardnerella vaginalis, Mobiluncus species, Bacteroides species, Mycoplasma species, and others.

For more information about Bacterial Vaginosis, visit: Centers for Disease Control and Prevention: Bacterial Vaginosis (BV)

What is it?

  • Bacterial Vaginosis (BV) is a condition in which normal, healthy vaginal bacteria are disturbed, and an overgrowth of harmful bacteria occurs.
  • BV is often confused with other vaginal complaints caused by a yeast infection (Candidiasis) or infection with Trichomonas vaginalis (Trichomoniasis).
  • BV is the most common vaginal infection in women of childbearing age.
  • BV is common in pregnant women in the United States.
  • Many women with BV have no signs or symptoms.
  • Symptoms can include discharge, odor, pain, itching, and/or burning.
  • BV can make a woman more likely to catch other STIs, including HIV.
  • BV is not completely understood by scientists, and the best way to prevent it is unknown.
  • It is not clear what role sexual activity has in the development of BV - women who have never had sex can be affected by BV.

How do I get it?

  • There is no clear explanation for what causes Bacterial Vaginosis (BV).
  • Several studies have linked BV with vaginal douching, which can cause changes to the normal balance of bacteria in the vagina.
  • Having a new sex partner or multiple sex partners may put some women at increased risk.
  • There is no evidence that spermicides increase BV risk.
  • Pregnant women and women with other sexually transmitted infections are at risk for getting this condition.
  • It is not clear what role sexual activity has in the development of BV - women who have never had sex can be affected by BV.
  • Women do NOT get BV from toilet seats, bedding, swimming pools, or from touching objects around them.

How common is it?

  • Scientific studies suggest that Bacterial Vaginosis (BV) is common in women of childbearing age.
  • In the U.S., BV is common in pregnant women - as many as 16% of pregnant women have BV.
  • BV varies by race and ethnicity:  6% in Asians, 9% in whites, 16% in Hispanics, and 23% in African Americans.

What happens if I get it?

In most cases, Bacterial Vaginosis (BV) causes no complications. But there are some serious risks from BV including:

  • Having BV can increase a woman's chances of acquiring or transmitting HIV - the virus that causes AIDS.
  • Having BV may increase the risk of developing an infection following surgical procedures such as a hysterectomy or an abortion.
  • BV can increase a woman's risk of getting other STis, such as herpes, chlamydia, and gonorrhea.
  • Bacteria that contribute to BV can infect the uterus and fallopian tubes and cause Pelvic Inflammatory Disease (PID).
  • PID can cause infertility, and increases the risk of having an ectopic ("tubal") pregnancy.
  • Having BV while pregnant may put a woman at increased risk for:
    • Pre-term (premature, early) delivery of babies.
    • Low birth weight babies (less than 5.5 pounds).

Signs and Symptoms

  • Women with Bacterial Vaginosis (BV) may have an abnormal vaginal discharge with an unpleasant odor.
  • Some women report a strong fish-like odor, especially after sex.
  • Vaginal discharge is usually white or gray; it can be thin.
  • Women with BV may have burning during urination.
  • Women with BV may have itching arount the outside of the vagina.
  • Many women with BV report no signs or symptoms at all.
  • It is not known how long it takes for BV to develop, and studies are currently being done to understand the condition.
  • The overgrowth of bacteria probably takes days or weeks to develop, depending on the cause of the change in vaginal bacteria.

Diagnosis and Treatment

How is Bacterial Vaginosis (BV) diagnosed?

  • A healthcare provider must perform a vaginal examination to look for signs of BV.
  • Laboratory tests are available to look for the bacteria associated with BV.
  • A healthcare provider can obtain a vaginal sample and send the sample to a laboratory for the test.
  • A quick laboratory test for BV can be done in some clinics or doctors' offices - this test is called a "wet mount". Some of the vaginal discharge is placed on a glass slide with a drop of saline (a salt solution) and is looked at under a microscope for cells from the vagina covered with bacteria. These cells are called "clue cells".
  • An alternative procedure for viewing the sample is called a Gram stain. A Gram stain of a vaginal sample allows the doctor or a laboratory to see the changes to the normal bacteria under a microscope.
  • IWTK does NOT perform testing for Bacterial Vaginosis.

Is Bacterial Vaginosis treatable?

  • Sometimes BV will clear up without any treatment, but all women with symptoms of BV should be treated to avoid complications.
  • Bacterial vaginosis may be spread between women who have sex with women.
  • Male sex partners usually do not need to be treated.
  • Treatment is espcially important for pregnant women - all pregnant women who have symprtoms of BV should be checked and treated by their healthcare provider.
  • BV is treated with the prescription antibiotics (medicines) metronidazole or clindamycin.
  • Use all of the medicine prescribed for treatment of BV, even if the signs and symptoms go away.
  • Even if you are treated for BV, you can get it again.


Can Bacterial Vaginosis (BV) be prevented?

  • Because there is evidence that BV is associated with douching and sexual activity, the following behaviors may help prevent BV:
  • Do not douche. Douching removes some of the normal bacteria in the vagina that protects you from infection.
  • Douching may increase your chances of getting BV.
  • It may also increase the chances of BV coming back after treatment.
  • Don't have vaginal, anal, or oral sex. The best way to prevent any sexually related condition is to practice abstinence.
  • Limit the number of sexual partners. The more sex partners you have, the greater your risk of encountering someone who has a sexually related condition or STI.
    • Only have sex with one partner who only has sex with you.
  • Use a condom properly, every time you have sex (vaginal, anal, or oral), with every partner.
  • Use all of the medicine prescribed for treatment of BV, even if the signs and symptoms go away.

Once I have had Bacterial Vaginosis, am I immune?

  • No. You can get BV again.