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Bacterial Vaginosis

What is Bacterial Vaginosis?

Bacterial vaginosis is an infection caused by the overgrowth of certain bacteria that produce bacterial imbalance in the vagina. Women in their reproductive years between the ages of 15-44 are more likely to get bacterial vaginosis.


The cause of bacterial vaginosis is still unknown, but it is known to be caused by sexual activity with multiple partners especially unprotected or sex between women, douching that alters the balance also increases the risk. Pregnant women with vaginosis may have premature labor and low birth weight babies.

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It can be prevented by minimizing vaginal irritation by using soaps, tampons or odorless sanitary napkins, avoiding douching, using latex condoms and limiting the number of sexual partners.

Signs and Symptoms

Symptoms include

  • Thin gray, white or green vaginal discharge
  • Strong vaginal odor (fishy) after vaginal sex
  • Vaginal itching
  • Burning during urination


Bacterial vaginosis is treated with oral or topical gel antibiotics.

To treat vaginosis, Metronidazole 500mg orally twice a day or 2 g as a single dose, in the form of a 0.75% topical gel to be applied directly to the vagina once a day for 7 days is recommended; this application helps to reduce the side effects of oral antibiotics.

Other medications that also work to cure vaginosis are Clindamycin 2% in topical gel form, Tinidazole orally, and Secnidazole 2g orally as a single dose.

It is not necessary to treat the male sexual partner. It is important to complete the treatment even if the symptoms disappear, and to avoid sexual intercourse during the time of medication.

Common questions about Bacterial Vaginosis


Maintaining a healthy vaginal flora can help manage and prevent bacterial vaginosis. This includes practicing good hygiene, avoiding douching, wearing breathable cotton underwear, and minimizing the use of irritating products in and around the vaginal area.

Bacterial vaginosis and yeast infections may present similar symptoms but have different causes and characteristics. Bacterial vaginosis typically produces a thin, gray discharge and a fishy odor, while yeast infections usually result in a thick, white discharge and intense itching. Accurate diagnosis often requires a lab test or examination by a healthcare provider.

Although bacterial vaginosis is primarily a local infection of the vagina, if left untreated, it can increase the risk of acquiring other STIs, including HIV. It can also lead to complications like pelvic inflammatory disease, which can affect fertility.

During treatment for bacterial vaginosis, avoid actions that could disrupt the balance of bacteria in the vagina. This includes avoiding douching, not using scented soaps or vaginal deodorants, and avoiding overly tight clothing. It's also advisable to abstain from alcohol and smoking, as these can hinder the effectiveness of the treatment.

While stress does not directly cause bacterial vaginosis, it can affect your immune system and potentially contribute to an imbalance in vaginal flora. Managing stress through lifestyle choices, mindfulness, and adequate sleep can help maintain overall health and may indirectly help prevent recurrences of bacterial vaginosis.

If you have bacterial vaginosis or are prone to it, choose unscented, gentle products for personal hygiene. Avoid products that contain alcohol, fragrances, or other irritating chemicals. Opt for mild, non-antibacterial soaps and consider using hypoallergenic products designed for sensitive skin to minimize irritation.

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