Bacterial Vaginosis (BV) : Symptoms Causes & Treatment

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Updated On:January 26, 2025

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What is Bacterial Vaginosis (BV)

Bacterial overgrowth leads to vaginal illness known as bacterial vaginosis (BV). Bacteria are present in every healthy vagina. Normally, these bacteria maintain a delicate equilibrium. Sometimes the "bad" bacteria overgrow to the point that they overwhelm the "good" bacteria. Bacterial vaginosis results from this upsetting the equilibrium of germs in your vagina.

You can notice that your vaginal discharge smells "fishy" if you have bacterial vaginosis. Some people may get vaginal discomfort as a result of it. Others could be BV-symptom-free.

Causes of Bacterial Vaginosis (BV)

A variety of bacterial species, referred to as a microbiome, are present in your vagina. BV is brought on by an imbalance in these microorganisms. Bacterial vaginosis specifically takes place when "bad" bacteria (anaerobes) multiply faster than "good" bacteria (lactobacilli). An imbalance occurs when one species of bacteria is present in excess.

The bacteria in your vagina can be impacted by anything that alters the natural chemistry of your vagina, according to researchers. Because of this, some behaviors, such as douching or unprotected intercourse, might result in BV. Hot tubs, swimming pools, and toilet seats cannot transmit BV. A person with BV cannot transmit the disease to you by contacting a surface that they have touched.

Symptoms of Bacterial Vaginosis (BV)

Most persons who have bacterial vaginosis don't exhibit any symptoms. If so, you might have:

  • Vaginal discharge that is off-white, gray, or greenish
  • Vaginal discharge with a fishy odor, especially after intercourse
  • Itching or irritation in the vagina
  • A burning sensation after urinating

When to see a doctor for Bacterial Vaginosis (BV)?

Consult with your doctor for bacterial vaginosis if you have changes in color and consistency of your vaginal discharge, if you have an unusual smell, and if you experience any itching, burning, or swelling in the vagina. 

Bacterial Vaginosis (BV) Risk Factors

Bacterial vaginosis can affect everyone who has a vagina. Some people may inadvertently create an excessive number of BV-causing bacteria. You could be more susceptible to developing BV if you are expecting a baby, do not use condoms when sexually active, have an intrauterine device, have a number of sexual partners or new sexual partners, take antibiotics, and use douches and other vaginal cleansing products.

Bacterial Vaginosis (BV) Complications

Serious consequences from bacterial vaginosis are uncommon. But if unattended, it could result in:

  • Premature birth may result if you have BV while pregnant. Pregnancy complications.
  • BV makes you more likely to get STIs like chlamydia and gonorrhea. An increased risk of HIV transmission to your partner exists if you have HIV and develop BV.
  • PID, an infection of your reproductive organs, is brought on by BV. PID can make it difficult to become pregnant if left untreated.

Bacterial Vaginosis (BV) Diagnosis

The diagnosis of bacterial vaginosis is only possible by a medical professional. You will be questioned by your doctor about your medical history, including any STIs or vaginal infections, at your visit. Your doctor might also conduct a pelvic exam and/or run tests on a sample of your discharge.

Samples of your vaginal fluid are used in tests for bacterial vaginosis. There are many tests that may be run on the sample to check for bacterial vaginosis. The majority are:

  • Wet mount: This method entails examining your vaginal discharge under a microscope on a glass slide.
  • Whiff test: Your doctor smells your vaginal discharge for the presence of any fishy odors.
  • pH Test: Using this test, you can determine how acidic your discharge is. A higher pH might mean BV.

Bacterial Vaginosis (BV) Treatment

Your doctor will provide you an antibiotic prescription, usually for metronidazole or clindamycin. You inject the gel or cream form of these drugs into your vagina. Some antibiotics come in tablet form that you can consume.

It's crucial to take the antibiotic as directed by your doctor and to finish it. If you stop too soon because your symptoms go away, you have a higher chance of developing BV once more.

Bacterial Vaginosis (BV) Prevention

Bacterial vaginosis cannot be stopped. Nevertheless, avoiding these risks by exercising caution:

  • Avoid douching. Your vagina's normal bacterial balance is altered by it. Practice good vulvar and vaginal care instead.
  • Avoid touching anything that has touched your anus in the vagina. Toilet paper, for example, may spread germs from your feces to your vagina.
  • Limit your sex partners to a minimum. Having several sex partners increases your risk of developing BV.
  • Use cotton or cotton-lined underclothes. In damp settings, bacteria flourish. Cotton aids in the evaporation of moisture.

References

Coleman, J. S., & Gaydos, C. A. (2018). Molecular diagnosis of bacterial vaginosis: an update. Journal of clinical microbiology56(9), 10-1128.

Coudray, M. S., & Madhivanan, P. (2020). Bacterial vaginosis—A brief synopsis of the literature. European Journal of Obstetrics & Gynecology and Reproductive Biology245, 143-148.

Kenyon, C., Colebunders, R., & Crucitti, T. (2013). The global epidemiology of bacterial vaginosis: a systematic review. American journal of obstetrics and gynecology209(6), 505-523.

Nasioudis, D., Linhares, I. M., Ledger, W. J., & Witkin, S. S. (2017). Bacterial vaginosis: a critical analysis of current knowledge. BJOG: An International Journal of Obstetrics & Gynaecology124(1), 61-69.

Spiegel, C. A. (1991). Bacterial vaginosis. Clinical microbiology reviews4(4), 485-502.

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