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Understanding Bacterial Vaginosis: Symptoms, causes, and treatments

Dr. Ajay KohliJun 20, 2024

One in every ten women of childbearing age experiences Bacterial Vaginosis (BV) at some point in their life. The condition can increase the risk of sexually transmitted infections and pregnancy complications when left untreated. Symptoms typically include an off-white fishy smelling vaginal discharge. In most cases, BV can be effectively treated with antibiotics. Read ahead to know more about this condition so that you can take timely action.




What is Bacterial Vaginosis?

Bacterial vaginosis (BV) is a vaginal infection that ensues when there is a shift in the natural balance of vaginal microflora, where the count of good and bad bacteria is altered. The condition seems to afflict women of any age, though the risk is high for those aged between 15 and 44. Furthermore, if you have a BV that's not treated, you are more likely to get affected by sexually transmitted infections (STIs). This can amplify your risk of pelvic inflammatory diseases, preterm delivery, spontaneous abortion, and low birth weight during pregnancy.

Signs and Symptoms of Bacterial vaginosis?

According to the CDC, over half of the women with Bacterial Vaginosis (BV) are symptomless, often causing the condition to go undiagnosed. However, if you do develop this infection, you may notice the following symptoms: 

  • Intense fishy odour-like vaginal discharge that’s greyish-white and thin, especially after sex or during menstruation

  • Burning sensation when peeing

  • Irritation around the outside of the vagina (not so noticeable)

At times, Bacterial Vaginosis is also misdiagnosed as yeast infection, which makes it necessary to identify the actual cause. See your doctor if you have a vaginal condition related to Bacterial Vaginosis while avoiding self-medication until a definitive diagnosis is made.

What causes Bacterial Vaginosis?

It is still a mystery as to what exactly causes BV in women. However, it is theorised that when the "bad" bacteria, such as Gardnerella vaginalis, outnumber the "good" bacteria, it triggers an imbalance in vaginal acidity leading to issues.

Treatment of Bacterial Vaginosis

Your doctor can prescribe a few antibiotics, although metronidazole and clindamycin are the most common. Both these antibiotics have broad activity against a spectrum of bacteria, and you can take them either as pills or apply them as gel or cream in your vagina at the site of infection. When taken by mouth, they must be taken for at least 5-7 days, even if you start feeling better. Because not taking them as directed can result in an infection returning, which may require treatment for a longer duration. Also, avoid having sex until you finish your treatment, or your infection is completely cleared. 

Treatment of BV is similarly crucial when you undergo a diagnostic or treatment procedure in the uterus, have an abortion, or use contraception intrauterine device (IUD).

Since Bacterial Vaginosis is not a sexually transmitted infection, your male sex partner may not require treatment. However, your female partner might want to see their doctor to establish if they need treatment.

Diagnosis of Bacterial Vaginosis

When you are suspected of BV, your doctor will take your medical history and conduct a physical examination of your pelvis. They would then collect the sample of your vaginal discharge and send it for laboratory analysis to microscopically look for cells covered with bacteria.

How can I prevent Bacterial Vaginosis?

It is hard to avoid BV since we do not know how it spreads or what exactly causes it. But some measures that may help you to prevent the reinfected are as follows.

  • Avoid using scented vaginal deodorants and perfumed "feminine hygiene" products 

  • Follow safe sexual practices like using condoms  

  • Use water to wash your genitals 

  • Change your pads or tampons every 4 to 6 hours 

  • Clean your sex toys or menstrual cups after every use 

  • Wear cotton or cotton crotch undergarments to keep your genital area dry

  • Get yourself regularly checked for STI

Risk Factors for Bacterial Vaginosis

Even though BV has several risk factors, you are more likely to develop it if you:

  • Have unprotected sex with too many sex partners, especially females who have BV

  • Share sex equipment or have oral-genital contact

  • Douche

  • Smoke cigarettes

  • Place an intrauterine device (IUD) in your uterus

  • Do not complete the antibiotic course 

  • Have decreased oestrogen production

Frequently Asked Questions

Here’s a section highlighting some common queries and their resolution regarding Bacterial Vaginosis.

Is Bacterial Vaginosis contagious?


No. Bacterial Vaginosis (BV) doesn't spread from person to person. However, involvement in all sorts of sexual activity can increase a woman's risk of this infection.

What happens If I am pregnant and get BV?


Having BV during pregnancy is associated with an increased risk of preterm birth (before 37 weeks of pregnancy) or delivering a baby with a low birth weight (less than 2.4 kg). In some cases, it even causes miscarriage. Because of this, the CDC recommends that pregnant women must be tested and treated if they have symptoms of BV.

Can I get BV again once I am fully treated?


Yes, it is possible. Unfortunately, BV is one of the most difficult-to-treat women's health conditions that just won't disappear. According to a 2020 review published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, nearly 80% of women who undergo treatment contract another infection within three months.

What happens if you leave BV unattended for too long?


The uncomplicated cases of BV usually resolve after the standard antibiotic treatment. However, long-standing or untreated BV has more serious sequelae.

  • Higher chance of contracting and spreading STIs, like HIV, genital herpes, chlamydia, and gonorrhoea.

  • Pregnancy-related problems include delivering a baby too early or low birth weight.

  • Mixed infection with yeasts.

Is Bacterial Vaginosis (BV) an STD?


Bacterial Vaginosis seems to be associated with sexual activity, but it isn't a sexually transmitted infection. Studies suggest that sex can alter the vaginal bacterial environment, which increases the likelihood of bacterial overgrowth.








Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.


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