- BV is a common infection that can affect any woman, including those who are not sexually active.
- BV is caused by a disruption in the natural levels of bacteria in the vagina, leading to an overgrowth of bacteria, which changes the vaginal pH balance.
- Symptoms of BV include a change in vaginal discharge color, fishy vaginal odor, itchy and irritated skin, and burning during urination. However, most women with BV report no symptoms.
- Some of the risk factors for BV include douching, new or multiple sexual partners, having an IUD, and being a woman who has sex with other women.
- BV is not classified as an STI but can increase the risk of complications such as pelvic inflammatory disease, infertility, and pregnancy complications if left untreated. Using condoms, avoiding douching and perfumes, and maintaining good hygiene can lower the risk of BV.
Symptoms of bacterial vaginosis
According to the CDC, women report having no symptoms in around 84% of diagnosed BV cases. This underscores the importance of routine women’s health screenings.
Bacterial vaginosis symptoms include:
- A change in your normal vaginal discharge, which may become gray, white, or green in color.
- A change in your normal scent. Particularly a "fishy" vaginal odor.
- Itchy and irritated skin of the inner labia.
- Burning sensations during urination
What causes bacterial vaginosis?
Bacterial vaginosis is caused by an overgrowth of the bacteria that normally occurs in the vagina, which then leads to a change in the vaginal pH balance. There are various things that can lead to this, including sex, the use of douches, taking antibiotics, having an STI, or a weakened immune system.
Risk factors for bacterial vaginosis
The vaginal environment is self-regulating and it takes a balance of healthy bacteria to keep it that way. Anything that changes the natural bacteria levels in the vagina will raise your risk of a BV infection. Here are some of the most common risk factors, according to the CDC:
- New sexual partner
- Multiple sexual partners
- Being a woman who has sex with other women
- Having an Inter-Uterine Device (IUD) as birth control
Who can get bacterial vaginosis?
BV is the most common among women who are sexually active. The CDC reports most cases of bacterial vaginosis are diagnosed in women aged 14 to 49. However, any woman can develop a BV infection at any time—even if they are not or have never been sexually active.
Is bacterial vaginosis contagious?
Due to the overgrowth of harmful bacteria in the vagina during a BV infection, it is possible to spread BV between female sexual partners, says the CDC. However, because BV involves an imbalance of normal vaginal bacteria, it cannot spread to male sexual partners.
BV is not classified as a sexually transmitted infection because it is possible to develop a BV without having sex with an infected partner. It is important for sexual health and wellbeing to be aware of what STIs are and how to protect yourself.
How can I lower my risk of bacterial vaginosis?
Some research suggests that the more sexual partners a woman has in her lifetime, the more risk she has to develop bacterial vaginosis infections. Here are some other ways a woman can lower her risk, according to the CDC:
- Avoid using douches and soaps inside the vagina.
- Avoid using powders and perfumes which have irritating ingredients.
- Practice good hygiene, using warm water on the outer vagina only.
- Although BV is not an STI, using condoms is helpful in reducing your chance of a BV infection. Especially if you are with a new partner or multiple partners.
What are the complications of bacterial vaginosis?
Bacterial vaginosis is a common and treatable infection, however, if left untreated, it can lead to other health complications, like pelvic inflammatory disease (PID) and infertility, reports the CDC
BV infections also put you at a higher risk of catching STIs like chlamydia, genital herpes, and gonorrhea. Because of these risks, it’s important to seek professional medical care as soon as possible if you think you may have a BV infection.
Bacterial vaginosis during pregnancy
A BV infection has the potential of spreading past the vagina, and into deeper areas of the reproductive system, says the American Pregnancy Association. Because of this, a BV infection during pregnancy increases a woman’s risk of complications, such as:
- Preterm labor
- Low birth weight
- Post-partum uterine infection
The American Pregnancy Association also notes that BV is associated with a two-fold increased risk of early miscarriage (sometimes referred to as a chemical pregnancy).
Bacterial vaginosis and infertility
BV can decrease a woman's fertility if left untreated. According to the American Pregnancy Association, any untreated infection of the vagina, including BV, can lead to:
- Deeper inflammation or infection of the cervix, uterus, fallopian tubes, and ovaries
- Damaged cells
- Decreased vaginal mucus that is necessary for conception
- Scar tissue
The American Pregnancy Association notes that bacterial vaginosis is three times more common in infertile women than in fertile women.
Bacterial vaginosis Diagnosis & Tests
Bacterial vaginosis is diagnosed by using a combination of physical examination and laboratory testing. Your healthcare provider may also ask questions about your sexual health history.
According to the CDC, the most commonly used tests for diagnosing BV are:
- A pelvic exam
- A vaginal swab
- Testing vaginal pH
During a pelvic exam, a medical provider will physically and visually examine the inside and outside of the vagina to determine if signs of infection are present. This is the most common first step in testing for BV.
A vaginal swab is also used to test for bacterial vaginosis. For this procedure, your medical provider will use a cotton-tipped swab to collect vaginal secretions and cells from inside the vagina. The swab is then sent to a laboratory for testing.
A medical provider may also test the pH of the vagina by placing a pH test strip inside the vagina. A high pH value will indicate a Bacterial infection.
According to the CDC, more than 80% of women report having no symptoms when they are diagnosed with bacterial vaginosis. For this reason, it is important to get routine women’s health exams.
Where can I get tested for BV?
Most healthcare facilities are equipped to test for bacterial vaginosis, including:
- Walk-In Clinic
- Urgent Care Clinic
- Gynecologist Clinic
- Primary Care Physician
There are currently no at-home testing options available for BV.
Bacterial vaginosis Treatment
Because BV is a Bacterial infection, it is treatable using antibiotics. According to the Mayo Clinic, it is usually not necessary to treat a woman's male partner. Because BV has the potential to spread between female partners, it is important for women who have sex with women to seek testing if their female partner is diagnosed with BV.
Antibiotic treatments for bacterial vaginosis
Antibiotic treatments for BV can be prescribed in either an oral antibiotic form or a cream that is inserted into the vagina, or a combination of the two. According to the Mayo Clinic, the most common antibiotics used to treat bacterial vaginosis are:
- Metronidazole (available as an oral pill or vaginal cream)
- Clindamycin (available as an oral pill or vaginal cream)
- Tinidazole (available as an oral pill)
- Secnidazole (available as one-dose, oral granules that are mixed into soft food)
It is important to note that there may be other antibiotic treatments available that are not listed here. Your healthcare provider will be able to discuss what the best treatment option is for you.
Treatment for recurring symptoms
Recurrent infections are common with bacterial vaginosis. The Mayo Clinic cites that the most common timeframe for reinfection is within 3 to 12 months. The treatment for recurrent infections will depend on the length of time between infections. A healthcare provider should determine if a different antibiotic is necessary, or if a longer antibiotic regimen is needed.
One reason for recurrent BV infections is that there are not enough healthy bacteria in the vagina. Your healthcare provider can discuss ways to recolonize the healthy bacteria within the vagina.
There is limited research that suggests eating foods that have lactobacilli (the “good” bacteria) such as yogurt or probiotics may help. It is important to note that these may be helpful but are not treatments for BV and cannot be trusted to cure an infection.
Can I treat BV at home?
BV is a serious bacterial infection that requires antibiotics. If left untreated, the Mayo Clinic notes that BV can lead to more serious health complications.
Bacterial vaginosis Prevention
There are things you can do at home to support a healthy balance of bacteria and pH in your vagina.
- Avoid douching
- Avoid using soaps, powders, perfumes, and body sprays around or inside the vagina
- Use warm water to clean the outside of your vagina
- Avoid thong underwear
- Always wipe front to back
- Practice safe sex techniques, especially with new or multiple sex partners
When to See a Doctor About BV
It is important to start treatment for bacterial vaginosis as soon as possible. The Mayo Clinic advises that you should see a doctor if you notice any of the following:
- A change in your normal vaginal discharge
- A foul or “fishy” odor coming from your vagina
- Itchy or irritated skin of the vagina or labia
- Burning sensation during urination
- Signs or symptoms of a yeast infection that do not resolve with over-the-counter yeast infection treatments
Because some women have no symptoms during a BV infection, it is important to have regular women's health check-ups and regular STI screenings if you are sexually active.
Other health conditions related to Bacterial vaginosis
Bacterial vaginosis puts you at a higher risk of developing other infections, says the CDC. It also puts you at a higher risk of catching a sexually transmitted infection.
Yeast Infection of the vagina is a common fungal infection that can be caused by a disruption of the normal bacteria in the vagina. Some antibiotics can cause a yeast infection, including the antibiotics used to treat bacterial vaginosis. Although you can have a yeast infection and BV infection at the same time, one does not cause the other.
BV vs. yeast infection
Some of the symptoms of a bacterial vaginosis infection and yeast infection are similar, says the CDC. Here is how you can tell the difference:
Foul or “fishy” odor
Usually no odor
Itching and skin irritation sometimes
Itching and skin irritation common
Vaginal discharge can be white, gray, green, or yellow
Vaginal discharge is white and can resemble cottage cheese
BV and Chlamydia
A bacterial vaginosis infection raises the risk of contracting STIs like Chlamydia. Researchers believe that is because any infection has the potential of weakening your immune response to other infections. Another factor may be connected to lifestyle choices.
Can BV turn into Chlamydia?
BV is caused by an imbalance of bacteria in the vagina, that leads to the overgrowth of harmful bacteria. Chlamydia is caused by a certain bacteria called Chlamydia Trachomatis. Although it is possible to have both infections at the same time, one cannot cause the other, notes the CDC.
Some of the symptoms of Chlamydia are similar to BV, so it is important to get regular women's health exams and sexual health screenings.
BV and Trichomoniasis
Bacterial vaginosis is a common bacterial infection of the vagina. Trichomoniasis is a common STI that is caused by a parasite. The CDC notes that both of these conditions have similar symptoms, but are not the same thing and require different treatments. BV raises the risk of acquiring STIs like Trichomoniasis, however, a BV infection cannot cause a Trichomoniasis infection.
BV and STIs
Bacterial vaginosis infections raise the risk of contracting STIs like Gonorrhea and HIV, says the CDC. Researchers believe this connection is due to infections like BV having the potential of weakening the immune response to other infections. Lifestyle choices are also a contributing factor.
BV is caused by an imbalance of bacteria in the vagina, that leads to the overgrowth of harmful bacteria. This imbalance can also make a woman more susceptible to STIs.
Since some symptoms of STIs are similar to BV, it is important to get regular women's health exams and sexual health screenings.
Frequently asked questions
Is bacterial vaginosis an STI?
No, bacterial vaginosis is not a sexually transmitted infection. In most cases, BV cannot be passed among sexual partners. However, the CDC reports that it is possible for BV to spread among women who have sex with women. It is also possible to develop a BV infection without being sexually active.
How long does bacterial vaginosis last?
Most cases of BV will resolve with one course of antibiotics. However, a second or longer course of antibiotics may be needed in some cases.
Will BV go away on its own?
In some rare cases, BV may resolve itself. However, because of the potential for secondary infections or damage to the reproductive system, you should always follow-up with a healthcare provider.
What happens if I don’t treat BV?
According to the CDC, untreated cases of bacterial vaginosis can lead to more serious health conditions like pelvic inflammatory disease, or infertility. If you are pregnant, untreated BV can lead to premature birth, low birth weight, and postpartum infections.
Can you get bacterial vaginosis multiple times?
Yes, you can BV more than once. According to The Cleveland Clinic, up to 80% of women experience repeat BV infections. You can prevent future infections by doing the following:
- Get regular women’s health exams
- Practice safe sex by using condoms
- Avoid douching
- Avoid irritating products like soap, vaginal cleansers, powders, perfumes, and body sprays in or around the vagina
Should I be treated for bacterial vaginosis (BV) if I’m pregnant?
Yes, if you have BV and are pregnant or planning to become pregnant, it is important to get treatment as soon as possible, notes the CDC. Schedule an appointment with a gynecologist or visit a clinic or urgent care.
Can I have sex if I have BV?
Bacterial vaginosis is not a sexually transmitted infection, so you can still have sex if you are feeling up to it, notes the CDC. Some pain or discomfort may interfere with your desire to have sex.
When should I tell my partner?
Open and honest communication is always best—especially when sexual health and wellness are concerned, says the CDC. Although male partners cannot contract BV, it is possible that BV can spread between female partners. If you have a female partner, it is best to let them know so they can get tested and treated if needed.
Does BV turn into chlamydia?
No, Bacterial vaginosis cannot turn into Chlamydia. Chlamydia is caused by a particular bacteria, whereas BV is caused by an imbalance of the normal bacteria in the vagina, notes the CDC. You can read our Guide to Chlamydia to learn more about what chlamydia is.
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- STD Facts—Bacterial Vaginosis, (January 30 2023) https://www.cdc.gov/std/bv/stdfact-Bacterial-Vaginosis.htm
- Bacterial Vaginosis, (January 30, 2023)
- Bacterial Vaginosis—The Facts, (January 31 2023)
- Management of Bacterial Vaginosis During Pregnancy, (January 31 2023) https://www.aafp.org/pubs/afp/issues/1998/0315/p1215.html
- Bacterial Vaginosis, (January 31 2023) https://my.clevelandclinic.org/health/diseases/3963-bacterial-vaginosis