Bacterial vaginosis (BV) is one of the most common vaginal conditions among women of reproductive age. It develops when the balance of bacteria in your vagina shifts, leading to a decrease in protective bacteria and an overgrowth of others. Bacterial vaginosis BV is a common reason women visit their healthcare providers for concerns about discharge and odor.
While often mild, BV can increase the risk of sexually transmitted infections (STIs), pregnancy complications, and recurring infections. Recognizing the signs and symptoms matters for both comfort and long-term health. This guide explains what BV is, the symptoms, causes, how it is diagnosed, treatment for bacterial vaginosis, and how to prevent bacterial vaginosis from coming back.
What Is Bacterial Vaginosis?
Bacterial vaginosis happens when the vaginal microbiome shifts out of balance. Normally, lactobacilli dominate and help keep the environment healthy. In BV, these bacteria are reduced, and others, such as Gardnerella vaginalis, multiply.
BV is not the same as a yeast infection or an STI. Yeast infections result from fungal overgrowth and typically cause itching and thick discharge. STIs like chlamydia or gonorrhea spread through sexual contact and may involve pain or systemic symptoms. BV is not classified as an STI, though being sexually active can influence risk.
Many women assume BV is caused by poor hygiene, but that is a misconception. Over-washing, scented products, or douching can actually disrupt the balance of bacteria in your vagina and increase your risk.
Causes and Risk Factors
BV develops when certain bacteria, particularly Gardnerella vaginalis, grow more than usual. Risk factors include:¹
- Multiple sex partners: The more partners you have, the more likely the vaginal microbiome may shift. Experts often advise to limit your number of sex partners when possible.
- Female sex partners: BV can occur in women with female partners, showing it is linked to bacterial changes rather than one specific route of transmission.
- Unprotected sex: Condoms or dental dams can help lower risk by reducing bacterial exchange.
- Smoking: Smoking has been linked to BV due to its effects on the immune system and vaginal environment.
- IUD use: Research suggests a possible association between IUDs (especially non-hormonal types) and BV.
- Douching: This disrupts the natural balance of bacteria in the vagina.
- Hormonal or immune changes: Shifts during menstruation, pregnancy, or immune suppression may contribute.
BV is not always sexually transmitted, and women who are not sexually active can still develop it.
Symptoms of BV
While some women may have no noticeable symptoms, the main signs and symptoms of BV include:¹
- Thin, gray or white vaginal discharge
- Fishy-smelling odor, especially after sex
- Mild irritation or itching
Because these overlap with yeast infections and trichomoniasis, it can be difficult to tell them apart without testing. Yeast infections usually bring intense itching and thicker discharge, while trichomoniasis often causes yellow-green discharge and pain with urination or sex. BV, by contrast, is more likely to present with a strong, fishy odor and thinner discharge.
Diagnosis
Doctors can check for bacterial vaginosis by testing a sample of vaginal discharge in several ways. One option is a microscope exam, sometimes called a wet mount or vaginal smear, where the sample is placed on a glass slide to look for bacteria, white blood cells, and other changes linked to infection.
A “whiff test” may also be used, which involves mixing the sample with a chemical to see if it produces a strong fishy odor. Vaginal pH testing is another tool, since BV often raises acidity levels, though this test alone cannot confirm the diagnosis. In some cases, a PCR test is performed to detect genetic material from bacteria, but this method is less common because of its higher cost.²
Complications and Health Risks
If untreated, BV may:¹
- Increase risk of sexually transmitted infections like HIV, gonorrhea, and chlamydia
- Contribute to pelvic inflammatory disease (PID)
- Lead to pregnancy complications such as preterm birth or low birth weight
- Impact fertility over time
Treatment Options
Treatment for bacterial vaginosis is usually with antibiotics prescribed by a healthcare provider. Options include:¹
- Metronidazole: Oral tablets or vaginal gel
- Clindamycin: Oral capsules or vaginal cream
Both oral and vaginal preparations can be effective. It is important to finish the full antibiotic course, avoid alcohol if using metronidazole, and follow medical advice closely. Because recurrence is common, some women may need extended or repeat treatment.
Preventing BV & Reducing Recurrence
There are steps you can take to prevent bacterial vaginosis and lower recurrence rates:¹,³
- Avoid douching and scented products
- Use condoms or dental dams during sex
- Limit your number of sex partners where possible
- Wear cotton underwear and breathable clothing
- Consider probiotics, though research is still developing
When to See a Doctor
You should see a doctor if symptoms of bacterial vaginosis do not improve, keep coming back, or if you are pregnant and notice possible signs of BV.
It is also important to seek medical care if you develop new or unusual vaginal discharge, especially when it is accompanied by pain, fever, or sores. Professional evaluation ensures that BV is diagnosed correctly and treated appropriately, helping to prevent complications and reduce the chance of recurrence.
Take Control of BV—Get Treated From Home
Bacterial vaginosis is common, but that doesn’t mean you should put off care. Untreated BV can increase the risk of sexually transmitted infections, pregnancy complications, and frustrating recurrences. The good news is that BV is highly treatable, and you can now get BV treatment online without waiting for an in-person appointment.
At 24hrdoc, our licensed providers can evaluate your symptoms, prescribe safe and effective medication, and guide you through recovery—all from the comfort and privacy of home. If you’re experiencing signs of BV or dealing with frequent infections, start your visit today and take back control of your health.
Sources:
- Healthline. Bacterial Vaginosis Is Extremely Common — Here’s What You Need to Know.
- MedlinePlus. Bacterial Vaginosis Test.
- Centers for Disease Control. About Bacterial Vaginosis (BV).
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