What Is Bacterial Vaginosis? Causes, Symptoms, & Treatment

By Chesney Fowler, MD
Medically reviewed checkmarkMedically reviewed
August 10, 2020

Bacterial vaginosis, otherwise known as BV, is the most common vaginal condition that affects women ages 15-44. Like many women’s health issues, you may feel uncomfortable discussing or acknowledging the symptoms of BV, but it is important to recognize them.

Read on to learn about the symptoms and causes of this common bacterial infection, how to prevent it, and when to see a doctor.

What Is Bacterial Vaginosis?

Bacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina. BV is not a STD, and cannot be transmitted during sex.

To create a natural pH balance in the vagina, the “good” bacteria (lactobacilli) outnumber the “bad” bacteria (anaerobes). When this balance shifts, which can happen for a number of reasons, an infection can occur. BV typically goes away within a few days with a course of antibiotics.

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Bacterial Vaginosis Symptoms

For many women, they experience few, if any, symptoms of bacterial vaginosis. When symptoms are present, they typically include:

  • Vaginal discharge that may be white, grey, or green and potentially foamy
  • Discharge with strong, foul odor
  • Vaginal odor with a strong fish-like smell, especially after vaginal sex
  • Pain or burning during urination
  • Itching around the outside of the vagina

These symptoms are similar to the symptoms of a vaginal yeast infection, which is why it is important to see a doctor in order to determine the exact cause.

Bacterial Vaginosis Causes & Risk Factors

Bacterial vaginosis occurs when too much bacteria grows in the vagina and causes a shift in the vagina’s natural pH balance. While researchers continue to study why women get BV, there are several known factors that can upset the pH balance of the vagina.

Risk factors

  • Sexual partners: Women who have multiple sexual partners or a new sexual partner can be more likely to experience BV, although researchers are still unsure why.
  • Douching: This practice of rinsing out your vagina with water or a cleanser can upset the natural balance. Because the vagina is self-cleaning, douching is not necessary.
  • Lack of lactobacilli bacteria: For some women, their natural vaginal environment doesn’t produce enough of the good lactobacilli bacteria which can lead to higher amounts of anaerobes.
  • Hormonal changes: Menstruation, pregnancy, and menopause can cause the vaginal pH to fluctuate.
  • Pregnancy: About one in four pregnant women get BV due to the hormonal changes that occur in the body.
  • Race: BV is twice as common in black women as it is in white women.

Diagnosing Bacterial Vaginosis

Because bacterial vaginosis symptoms are closely associated with other conditions like vaginal yeast infections, or there are no symptoms at all, you should speak to a doctor to receive a proper diagnosis.

A pelvic exam can help a doctor diagnose bacterial vaginosis, and, in instances where it may not be as clear, a doctor or nurse may take a sample of vaginal discharge for additional testing.

Bacterial vaginosis vs. yeast infections

Bacterial vaginosis and yeast infections are both types of vaginitis. While the conditions have similar symptoms, yeast infections are fungal while BV is bacterial, and, in turn, require different treatment.

All cases of BV require prescription medications, while many yeast infections can be treated with over-the-counter medications.

Bacterial Vaginosis Treatment

If you are diagnosed with bacterial vaginosis, you’ll most likely be prescribed vaginal or oral antibiotics by a doctor. The most commonly prescribed antibiotics are metronidazole and clindamycin.

It is important to note that BV cannot be treated with over-the-counter yeast infection medicine.

After being diagnosed and meeting with your doctor, it’s important to take the following steps to make sure you are properly treating BV:

  • Take all of your medicine, even if symptoms go away, otherwise the condition can return.
  • Avoid sexual contact and inserting anything into your vagina (such as tampons) until you finish your treatment.
  • See your doctor or nurse again if you have symptoms that do not go away within a few days after finishing the antibiotic.
  • Some women repeatedly get BV. If that happens to you, see your OBGYN for an exam to identify the cause of your reoccurring symptoms.

Bacterial vaginosis home treatments

The best known bacterial vaginosis treatment is a course of antibiotics prescribed by a doctor. However, certain foods and supplements can help with treatment and prevention, including:

  • Probiotics: To increase the presence of “good” bacteria, increase your intake of probiotics, found in foods like yogurt and pickles, or in oral supplements.
  • Garlic: Garlic has strong antibacterial properties and can be eaten or taken as a supplement.

If you are looking to treat BV with natural home treatments, you should consult your doctor first.

Bacterial vaginosis treatment during pregnancy

Due to hormonal changes in the body, bacterial vaginosis affects 16% of expectant mothers in the United States. Pregnant women with BV may also be at a higher risk of having premature births or babies with a low birth weight, which is why it is important to seek treatment as soon as possible. Thankfully, the antibiotics used to treat BV can be safely used during all stages of pregnancy.

How to Prevent Bacterial Vaginosis

The vagina’s natural pH balance can change for a number of reasons—certain things that may upset the balance for some women may not be a problem for others. No matter what, it is important to keep the vagina healthy in order to help lower your risk of bacterial vaginosis by doing the following:

  • Minimize vaginal irritation: Use mild soaps and unscented tampons or pads. Keep the area cool by wearing cotton or cotton-lined underwear.
  • Avoid douching: Douching washes away the good, healthy bacteria in your vagina and throws off its natural balance.
  • Limit your number of sex partners: Researchers believe that your risk of getting BV goes up with the number of partners you have.
  • Abstain from sex: You can get BV without having sex, but it is believed to be more common in women who are more frequently sexually active.

Bacterial Vaginosis Complications

Bacterial vaginosis doesn’t generally cause serious complications, but if left untreated, BV can lead to more serious health issues including:

  • Pelvic inflammatory disease (PID): BV can sometimes cause PID, an infection of the uterus, fallopian tubes, and occasionally the ovaries that can increase the risk of infertility and sepsis.
  • Pregnancy complications: Pregnant women with BV may be at a higher risk for premature deliveries and low-birth-weight babies.
  • Increased risk of infection after surgery: BV can increase your risk of infections after surgeries affecting the reproductive system, including a hysterectomy or an abortion.

When to See a Doctor

If you think you have bacterial vaginosis or are experiencing symptoms, you should see a doctor as soon as possible. A doctor can properly diagnose and easily treat BV with an antibiotic. Along with the symptoms mentioned in this article, see your doctor if you experience any of the following:

  • You are experiencing vaginal discharge that is more abundant and associated with an odor or fever.
  • You notice that the color and consistency of your vaginal discharge has changed.
  • You have multiple sex partners or a recent new partner. Sometimes, the signs and symptoms of a sexually transmitted infection are similar to those of bacterial vaginosis.
  • You try self-treatment for a yeast infection with an over-the-counter treatment and your symptoms persist.

When you visit your doctor, they will likely ask about your medical history, administer a pelvic exam, and perform a few simple tests like checking your vagina’s pH or acidity level and taking a sample of the discharge from your vagina to look for cells covered with bacteria.

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How K Health Can Help

Did you know you can access BV treatment online with K Health?

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes all through K Health.

K Health’s AI-powered app is based on 20 years of clinical data.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Chesney Fowler, MD

Dr. Fowler is an emergency medicine physician and received her MD from George Washington University. She completed her residency in emergency medicine at Christiana Care Health System. In addition to her work at K Health, Dr. Fowler is a practicing emergency medicine physician in Washington, DC.

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