Bacterial Vaginosis
Bacterial vaginosis (BV) happens when the normal balance of bacteria in the vagina changes. A clinician can confirm the diagnosis and distinguish it from other infections.
About bacterial vaginosis
Bacterial vaginosis (BV) happens when the normal balance of bacteria in the vagina changes. A clinician can confirm the diagnosis and distinguish it from other infections.
What can cause it?
BV develops when the normal balance of vaginal bacteria changes; it is not simply a hygiene problem.
Sexual activity, a new partner, douching, and changes in vaginal chemistry can influence risk, but BV can occur without sexual activity.
What a patient may notice
Symptoms vary from person to person. Possible signs may include:
- Thin white or gray vaginal discharge
- Fish-like vaginal odor
- Vaginal burning, itching, or irritation
How clinicians find the cause
A clinician reviews symptoms and examines vaginal discharge. Vaginal pH, microscopy, or a laboratory swab may confirm BV and help distinguish it from yeast infection, trichomoniasis, cervicitis, or another STI.
Treatment and next steps
- 1
BV is treated with a clinician-selected antibiotic taken by mouth or used vaginally.
- 2
Finish the full course even if symptoms improve and follow instructions about alcohol or sexual activity for the specific medicine prescribed.
- 3
Recurrent BV is common and may require a different or longer plan.
Supporting recovery
- Avoid douching and fragranced vaginal products.
- Take medicine exactly as directed and do not use leftover treatment from a prior episode.
- Ask whether STI testing is appropriate, since symptoms can overlap.
What to expect
Bacterial vaginosis usually improves with the prescribed antibiotic, but it commonly returns after successful treatment. A new episode should be evaluated because yeast infection, trichomoniasis, cervicitis, and some sexually transmitted infections can cause similar symptoms.
Possible complications
- A higher chance of acquiring certain sexually transmitted infections
- Pregnancy complications such as preterm labor or preterm birth
- Persistent or recurrent symptoms that require repeat testing and a different treatment plan
When to Contact a Medical Professional
Arrange an evaluation when symptoms are new, worsening, interfering with normal activities, or not improving as expected.
Pregnancy with symptoms, fever, severe pelvic pain, vomiting, or fainting needs prompt medical evaluation.Get emergency help for severe trouble breathing, new chest pressure, fainting, seizure, sudden weakness on one side, uncontrolled bleeding, blue or gray lips, or a person who is difficult to wake.
Ways to lower risk
- Using condoms and avoiding douching may reduce risk.
- There is no proven over-the-counter product that reliably prevents recurrence for everyone.
Trusted health information
This CHS patient-education page uses original wording and links to MedlinePlus for additional information.