Vaginal Infection: Bacterial Vaginosis

Both good and bad bacteria are present in a healthy vagina. Bacterial vaginosis (BV) occurs when these bacteria get out of balance. The numbers of good bacteria decrease. This allows the numbers of bad bacteria to increase and cause BV. In most cases, BV is not a serious problem.

Causes of bacterial vaginosis

The cause of BV is not clear. Douching may lead to it. Having sex with a new partner or more than 1 partner makes it more likely.

Symptoms of bacterial vaginosis

Symptoms of BV vary for each woman. Some women have few symptoms or none at all. If symptoms are present, they can include:

  • Thin, milky white or gray or sometimes green discharge

  • Unpleasant “fishy” odor

  • Irritation, itching, and burning at opening of vagina which may indicate mixed vaginitis  

  • Burning or irritation with sex or urination which may indicate mixed vaginitis

Diagnosing bacterial vaginosis

Your healthcare provider will ask about your symptoms and health history. He or she will also do a pelvic exam. This is an exam of your vagina and cervix. A sample of vaginal fluid or discharge may be taken. This sample is checked for signs of BV.

Treating bacterial vaginosis

BV is often treated with antibiotics. They may be given in oral pill form or as a vaginal cream. To use these medicines:

  • Be sure to take all of your medicine, even if your symptoms go away.

  • If you’re taking antibiotic pills, do not drink alcohol until you’re finished with all of your medicine.

  • If you’re using vaginal cream, apply it as directed. Be aware that the cream may make condoms and diaphragms less effective.

  • Call your healthcare provider if symptoms do not go away within 4 days of starting treatment. Also call if you have a reaction to the medicine.

Why treatment matters

Even if you have no symptoms or your symptoms are mild, BV should be treated. Untreated BV can lead to health problems such as:

  • Increased risk of preterm delivery if you’re pregnant

  • Increased risk of complications after surgery on the reproductive organs

  • Possible increased risk of pelvic inflammatory disease (PID)