Vaginal Infection: Bacterial Vaginosis

Both good and bad bacteria are present in a healthy vagina. Bacterial vaginosis (BV) occurs when these bacteria get out of balance. The numbers of good bacteria decrease. This allows the numbers of bad bacteria to increase and cause BV. BV is not a serious problem in most cases.

Causes of bacterial vaginosis

The cause of BV is not clear. Douching may lead to it. Having sex with a new partner or more than one partner makes it more likely.

Symptoms of bacterial vaginosis

Symptoms of BV vary for each person. Some people have few symptoms or none at all. If symptoms are present, they can include:

• Thin, milky white or gray or sometimes green discharge

• Unpleasant “fishy” odor

• Irritation, itching, and burning at opening of vagina. This may mean it's caused by more than one type of bacteria.

• Burning or irritation with sex or when you pee. This may mean it's caused by more than one type of bacteria.

Diagnosing bacterial vaginosis

Your healthcare provider will ask about your symptoms and health history. They will also do a pelvic exam. This is an exam of your vagina and cervix. They may take a sample of vaginal fluid or discharge. This sample is checked for signs of BV.

Treating bacterial vaginosis

BV is often treated with antibiotics. They may be given as a pill you take by mouth or as a vaginal cream. To use these medicines:

• Be sure to take all of your medicine, even if your symptoms go away.

• If you’re taking antibiotic pills, don't drink alcohol until you’re finished with all of your medicine.

• If you’re using vaginal cream, apply it as directed. Be aware that the cream may make condoms and diaphragms less effective.

• Call your healthcare provider if symptoms don't go away within 4 days of starting treatment. Also call if you have a reaction to the medicine.

Why treatment matters

BV should be treated even if you have no symptoms or your symptoms are mild. Untreated BV can lead to health problems such as:

• Increased risk for preterm delivery if you’re pregnant

• Increased risk for complications after surgery on the reproductive organs

• Possible increased risk for pelvic inflammatory disease (PID)