Written by Ada’s Medical Knowledge Team
What is bacterial vaginosis?
Bacterial vaginosis, also called bacterial vaginitis or BV, is an infection of the vagina caused by an imbalance of various types of natural vaginal bacteria. It is the most common cause of abnormal vaginal discharge and is estimated to affect as many as one in three women at some point in their lives. BV can be a significant source of embarrassment and distress for affected women, but is relatively simple to treat using antibiotics. Long-term problems are rare as a result of bacterial vaginosis, but it can increase the risk of developing various sexually transmitted infections (STIs), including HIV.
Bacterial vaginosis symptoms
Roughly 50 to 75 percent of women with bacterial vaginosis experience no symptoms. Among those who do, the most common symptom is milky, off-white or grey vaginal discharge, which is often described as having a fishy odour. The discharge tends to be heavier after sexual intercourse or a period.
Symptoms common to other vaginal disorders, such as pain during sex or when urinating, redness and swelling, are not typical of BV. Some women, however, may experience vaginal itching. The Ada app can help you to check your symptoms. Download the app now for a free symptom assessment or find out more here.
Bacterial vaginosis causes
Bacterial vaginosis occurs when the distribution of vaginal bacteria becomes unbalanced. Normally, the vagina contains a mixture of bacteria, including anaerobic bacteria and lactobacilli. As a result of BV, anaerobic bacteria multiply and the amount of lactobacilli is reduced. The precise reason as to why this happens is not known, though it is thought to involve a change in the acidity of the vagina.
Bacterial vaginosis risk factors
A common misconception about bacterial vaginosis is that it is made more likely by poor vaginal hygiene: this is not true. Conversely, use of certain soaps may in some cases play a role.
Other factors that may contribute to the development of bacterial vaginosis include:
- Sexual activity
- Frequently changing sexual partners
- A history of sexually transmitted infections (STIs)
- Use of an intrauterine contraceptive device (IUD)
- Being of Afro-Caribbean descent
- Having heavy periods
- Use of bubble baths
- Hormonal changes, including puberty, pregnancy and menopause
- Use of sex toys and lubricants
- Use of antibiotics
These factors make BV more likely; they do not guarantee that a person will develop the condition. Women who have never had sex, however, rarely develop BV.
Bacterial vaginosis diagnosis
Bacterial vaginosis is typically diagnosed following an examination of the symptoms and laboratory testing. The characteristic discharge of BV will usually indicate the presence of the condition, with testing necessary to confirm that it is not the result of another, similar condition, such as thrush or chlamydia.
Bacterial vaginosis treatment
In some cases, bacterial vaginosis will resolve without specific treatment. Seeking professional medical treatment, however, is recommended. This will typically involve a short-course of antibiotics, which may be taken orally or applied directly to the vagina as a gel or cream. When taking antibiotics, always be sure to take the whole course, even if the problem clears up before this time.
The male sexual partner(s) of women with BV do not need to receive treatment. An estimated 30 percent of women experience a relapse of symptoms within 3 months of receiving treatment, and roughly 50 percent of women will relapse within 12 months. A longer course of antibiotics will usually be required to treat a recurrent infection.
Bacterial vaginosis complications
- Infection of the womb following a surgical procedure, such as a vaginal hysterectomy
- Pelvic inflammatory disease (PID)
The condition also slightly increases a woman’s likelihood of developing HIV after having sexual intercourse with a person who is already infected. Women with BV and HIV are also more likely to transmit HIV to another person.
Bacterial vaginosis during pregnancy
Untreated bacterial vaginosis can slightly increase the risk of several complications during pregnancy. These include:
- Premature labor
- Premature birth
- Low birth weight
- Postpartum endometritis, an infection of the womb following childbirth
Women displaying symptoms of BV during pregnancy should seek treatment promptly.
Bacterial vaginosis prevention
There is no guaranteed way to prevent bacterial vaginosis. Certain actions and behaviors, however, are thought to help. These include:
- Avoiding the use of perfumed bubble baths, shampoos, soaps, oils, etc.
- Avoiding pushing water into the vagina (douching) when bathing
- Avoiding the use of strong or scented detergents to wash underwear
- Avoiding washing the vagina too often; once daily is usually enough
- Using a condom during sexual intercourse
- Using water-based lubricants during sexual intercourse, if lubricants are required
- Cleaning sex toys thoroughly before use
- Taking showers rather than baths
The birth control pill may also help to prevent the onset of BV.
Bacterial vaginosis FAQs
Q: Is bacterial vaginosis sexually transmitted?
A: Bacterial vaginosis has not traditionally been thought of as being sexually transmitted. This is because, although BV is most common among sexually active women, it can affect women who don’t have or never had sex. Moreover, it cannot be passed from a man to a woman, or vice versa. However, studies show that the condition can be passed from one woman to another through sexual intercourse. It is recommended, therefore, that female partners of women with BV be tested for the condition.
Q: Can men get bacterial vaginosis?
A: No, men cannot contract bacterial vaginosis. The condition is exclusive to the vagina.
Q: Should my partner receive treatment for bacterial vaginosis?
A: Male sexual partners of a person with BV do not need to receive treatment. Female sexual partners, however, are advised to seek testing and, if appropriate, treatment, for the condition.
Other names for bacterial vaginosis
- bacterial colpitis
- bacterial vulvovaginitis
- bacterial vaginitis
Sexually Transmitted Diseases. “Bacterial Vaginosis in Lesbians and Bisexual Women.” November, 2004. Accessed August 29, 2018. ↩