Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age. The cause is not fully understood. BV is associated with an imbalance in the bacteria that are found in a woman’s vagina, which normally contains mostly “good” bacteria and fewer “harmful” bacteria. BV develops when there is a change in the environment of the vagina that causes an increase in harmful bacteria.

How do women get BV?

Women who have a new sex partner or who had multiple sex partners are more likely to develop BV. Women who never had sexual intercourse are rarely affected. It is not clear what role sexual activity plays in the development of BV, and there are many unanswered questions about the role that harmful bacteria play in causing BV. Women do not get BV from toilet seats, bedding, swimming pools or from touching objects around them.

What are the signs and symptoms?

Women with BV often have an abnormal vaginal discharge with an unpleasant odor. Some women report a strong fish-like odor, especially after intercourse. The discharge is usually white or gray; it can be thin. Women with BV may also have burning during urination and/or itching around the outside of the vagina. Some women have no signs or symptoms at all. BV is diagnosed by examining the vagina for signs of BV (e.g., discharge) and performing lab tests on a sample of vaginal fluid to look for bacteria associated with BV.

Who is at risk for BV?

Any woman can get BV. However, some activities or behaviors can upset the normal balance of bacteria in the vagina and put women at increased risk:

Having a new sex partner or multiple sex partners


Using an intrauterine device (IUD) for contraception

Pregnant women are at increased risk for complications of BV.

What are the complications?

In most cases, BV causes no complications. But there are some serious risks:

Pregnant women with BV more often have babies who are born early or with low birth weight.

The bacteria that causes BV can sometimes infect the uterus and fallopian tubes. This type of infection is called pelvic inflammatory disease (PID). PID can cause infertility or damage the fallopian tubes enough to increase the future risk of ectopic pregnancy or infertility.

BV can increase a woman’s susceptibility to HIV infection if she is exposed to the virus.

Having BV increases the chances that an HIV-infected woman can pass HIV to her sex partner.

BV can increase a woman’s susceptibility to other STDs such as chlamydia and gonorrhea.

Who should be treated for bacterial vaginosis?

Although BV sometimes clears up without treatment, all women with BV symptoms should be treated to avoid such complications as PID. Treatment is especially important for pregnant women. Male partners generally do not need to be treated. However, BV may spread between female sex partners.

BV is treatable with antimicrobial medicines prescribed by a health care provider. Two different medicines are recommended: metronidazole or clindamycin. BV can recur after treatment.

How can BV be prevented?

Some basic prevention steps can help reduce the risk of upsetting the natural balance in the vagina:

Use condoms during sex.

Limit the number of sex partners.

Don’t use douches, strong soaps, deodorants or sprays.

Keep your vaginal area clean and dry. Wash daily with warm water, rinse well and pat dry.

Wear cotton underwear.

Avoid tight-fitting clothing.

Wipe from front to back after a bowel movement.

Use all of the medicine prescribed for treatment of BV, even if the signs and symptoms go away.



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