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Bacterial Vaginosis

Woman with hands on crotch

What is bacterial vaginosis (BV)?

Bacterial vaginosis (BV) is a bacterial infection in the vagina. It is the most common cause of abnormal vaginal odor and discharge in young women and is caused by a change in the balance and type of bacteria which are normally present in the vagina.

Although BV is not considered a sexually transmitted disease, the risk of developing BV seems to increase the more sexual partners a woman has.

Normally, Lactobacillus bacteria are the most common type of bacteria within the vagina. These produce chemicals that keep the vagina mildly acidic. In BV, numbers of other types of bacteria within the vagina that are usually only present in small numbers increase and disrupt both the pH of the vagina and its lining. This can result in BV, and symptoms may include:

  • Mild itching in and around the vagina
  • Bad-smelling, fishy odor that is more noticeable during menstruation or after sex
  • Pain when urinating.

Some women with BV have no symptoms, which is a bit concerning because if BV isn’t treated it can increase the chance of women developing sexually transmitted infections (STIs), such as chlamydia, herpes, HIV or gonorrhea pelvic inflammatory disease; and possibly increase the risk of miscarriage. In women who are pregnant, BV can result in premature labor and delivery, premature rupture of membranes, and postpartum uterine infections.

Who is at risk of developing bacterial vaginosis (BV)?

Experts are not sure what causes the imbalance of bacteria that happens during BV to occur in the first place but have identified a few risk factors that make some women a lot more likely to develop BV. These include:

  • A history of multiple sex partners
  • A new sexual partner
  • Cigarette smoking
  • Presence of an intrauterine contraceptive device (IUD)
  • Vaginal douching.

Although most risk factors are associated with sexual activity, women who have never had vaginal intercourse can still develop BV.

How is bacterial vaginosis diagnosed?

If you have symptoms of BV or have a history of new or multiple or sexual partners, then make an appointment with your doctor.

Your doctor or nurse practitioner will ask you about any symptoms, take a medical history, and then perform an examination. A swab may be taken of your vaginal fluid which will be tested in a laboratory. Other possible causes will be ruled out before your doctor arrives at a diagnosis of BV.

How is bacterial vaginosis treated?

Antibiotics prescribed by your doctor are usually needed to treat BV. These may be in the form of tablets or vaginal creams. BV tends to recur, so you may need to take more than one course of antibiotics. Always finish the course of treatment prescribed, even if you feel better halfway through.

Male sexual partners don’t normally need to be treated for BV; however, female sexual partners will need treatment.