Bacterial vaginosis is an infection of the vulva and vagina. It is associated with an imbalance of bacteria in the vagina.
A mix of good and bad bacteria are normally found in the vagina. Bacterial vaginosis occurs when there is an increase in the amount of bad bacteria. The increased bad bacteria causes a decrease in good bacteria. This imbalance can lead to symptoms.
It is not clear exactly what causes the increase in bad bacteria.
Factors that may increase your chance of bacterial vaginosis include:
- Antibiotic use
- Having a new sexual partner or multiple partners
- Having sex without a condom
- Using an intrauterine device (IUD) for birth control
Any woman can get bacterial vaginosis, including those who have never had sex.
Some women with bacterial vaginosis do not have any symptoms.
Symptoms that can develop include:
- Itching around the vagina
- Vaginal irritation
- Burning feeling while urinating
Abnormal vaginal discharge
- Color: white or gray
- Consistency: thin, foamy, or watery
- Odor: fish-like, especially after sex
There are several different conditions that can causes these symptoms. Your doctor will help you determine the cause of your symptoms.
You will be asked about your symptoms and medical history. A physical exam will be done.
Fluid from your vagina may be tested to look for specific bacteria or other infectious agents.
Bacterial vaginosis can lead to complications such as an increased risk of:
- Sexually transmitted diseases such as HIV, gonorrhea, or chlamydia
- Pelvic inflammatory disease
- Premature birth
Treatment is important even if you do not have any symptoms. The main course of treatment is prescription antibiotic pills or vaginal creams. Finish all medication as prescribed by your doctor even if the symptoms have gone away. This can prevent the infection from recurring.
Avoid sexual intercourse during treatment. If you do have sexual intercourse, use condoms. Usually, male sexual partners do not need to be treated. Talk with your doctor about the best treatment plan for you.
To help reduce your chances of getting bacterial vaginosis, take the following steps:
- Abstain from sex or remain monogamous.
- Use condoms when having sex.
- Do not use douches.
- After bowel movements, wipe from front to back, away from the vagina.
The American Congress of Obstetricians and Gynecologists
Women's Health—US Department of Health and Human Services
Sexuality and U—The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Bacterial vaginosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2014. Accessed October 30, 2014.
Bacterial vaginosis. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm. Updated March 11, 2014. Accessed October 30, 2014.
Bacterial vaginosis fact sheet. Women's Health—US Department of Health and Human Services website. Available at: http://womenshealth.gov/publications/our-publications/fact-sheet/bacterial-vaginosis.cfm. Updated July 16, 2012. Accessed October 30, 2014.
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.
Martin HL, Nyange PM, Richardson BA, et al. Hormonal contraception, sexually transmitted diseases, and risk of heterosexual transmission of human immunodeficiency virus type 1. J Infect Dis. 1998;178:1053-1059.
Martin HL, Richardson BA, Nyange PM, et al. Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. J Infect Dis. 1999;180:1863-1868.
Myer L, Kuhn L, Stein ZA, et al. Intravaginal practices, bacterial vaginosis, and women's susceptibility to HIV infection: epidemiological evidence and biological mechanisms. Lancet Infect Dis. 2005;5:786-794.
Taha TE, Hoover DR, Dallabetta GA, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS. 1998;12:1699-1706.
Van de Wijgert JH, Morrison CS. Cornelisse PG, et al. Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women. JAIDS. 2008;48:203-210.
7/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Qaseem A, Humphrey LL, et al. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014 Jul 1;161(1):67-72.
Last reviewed December 2014 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.