What Is Bacterial Vaginosis?

Both “good” and “bad” bacteria live in your vagina. If this delicate balance is upset, you can get an infection called bacterial vaginosis, or BV, for short. Even if you don’t have symptoms, you may need to be treated. If you’re pregnant or trying to get pregnant, BV could cause other health problems.

What Causes It?

Your vagina contains a type of bacteria called lactobacilli. It keeps your vagina slightly acidic so bad types of bacteria don’t flourish. If your lactobacilli levels drop, bad bacteria move in, causing BV.

Any woman can get BV, but some things put you at higher risk, like:

  • Smoking
  • Sexual activity. Having a new sex partner, or more than one, makes it more likely that you’ll get BV. The reason why isn’t clear, but women who have female partners are most at risk. You can also get BV from oral and anal sex.
  • Douching. When you wash out your vagina, you upset its natural balance of bacteria. Scented soaps, bubble baths, and vaginal deodorants also have this effect.
  • Using an intrauterine device (IUD). This birth control device, which fits inside your uterus, has been linked to BV -- especially if you have irregular bleeding.

You might have heard that you can get vaginal infections like BV from swimming pools or public toilet seats, but this isn’t true.

What Are the Symptoms?

Around half of all women with BV show no symptoms. But if you do, you could notice:

  • A thin white, gray, or green vaginal discharge
  • A burning feeling when you pee
  • A fishy odor that becomes stronger after sex

How’s It Diagnosed?

You’ll need to check with your primary care doctor or gynecologist. She’ll ask about your symptoms and do a vaginal exam. She may use a cotton swab to take a sample of your discharge. She’ll check it under a microscope for BV. The sample can also help rule out other sexually transmitted infections (STIs) like gonorrhea or trichomoniasis, which share some of the same symptoms as BV.

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How Is BV Treated?

If you’re not having any symptoms and aren’t pregnant, you may not need treatment. Your BV may go away on its own.

If you do have symptoms, your doctor can prescribe antibiotics to get rid of your infection. This could be a tablet you take by mouth or a cream or gel you apply to your vagina. You’ll need to take most treatments for 5 to 7 days.

It’s important that you finish all your medicine, even if your symptoms go away. If you stop them early, your infection could come back.

Since BV can be spread through sex, avoid all sexual contact until you’re better. If your partner is female, she may want to see her doctor so she can be treated, too.

If you have BV that keeps coming back (recurrent BV) and use an IUD, your doctor may suggest that you have it removed and use a different type of birth control instead.

Are There Any Complications?

Most of the time, BV doesn’t cause any other problems. But in some cases, it can lead to other issues, like:

  • Sexually transmitted infection (STI). Having BV makes it easier for you to get an STI like herpes, chlamydia, or gonorrhea. If you already have HIV, BV increases your chances of passing it on to your partner.
  • Surgical infection. If you have BV at the same time as a hysterectomy or other surgery on your female organs, you’re more likely to come down with a bacterial infection afterwards.
  • Pelvic Inflammatory Disease (PID). BV can lead to this infection of your uterus, fallopian tubes, and ovaries. Having PID can make it harder for you to get pregnant.
  • Problems with in vitro fertilization (IVF). If you have BV while you’re going through fertility treatments, you may have less success.
  • Problems during your pregnancy. Miscarriage during the first 23 weeks is more likely if you have BV. Your baby could also be born premature (before your 37th week) or have a low birth weight. That means she could weigh less than 5.5 lbs.

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Even after BV is treated and goes away, it’s common for it to return. If yours does, you’ll likely need to take antibiotics again for a longer period of time.

WebMD Medical Reference Reviewed by Nivin Todd, MD on January 27, 2017

Sources

SOURCES:

CDC: “Bacterial Vaginosis -- CDC Fact Sheet.”

Mayo Clinic: “Bacterial Vaginosis.”

NHS Choices: “Bacterial Vaginosis.”

Womenshealth.gov/Office on Women’s Health, US Department of Health and Human Services: “Bacterial Vaginosis.”

Cleveland Clinic: “Bacterial Vaginosis.”

International Journal of STD & AIDS: “Bacterial vaginosis and smoking.”

Sexually Transmitted Disease: “Risk of Bacterial Vaginosis in Users of the Intrauterine Device: A Longitudinal Study.”

FamilyDoctor.org/American Academy of Family Physicians: “Bacterial Vaginosis (BV).”

US Department of Veteran Affairs: “Bacterial Vaginosis -- Women’s Health Guide.”

Merck Manual: “Bacterial Vaginosis (BV).”

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