Bacterial Vaginosis: Your Guide to Causes and Cures

Content medically reviewed by Jill Steinle, MD

Bacterial vaginosis, also known as BV, is a common vaginal infection in women between ages 15 and 44. Women outside of these age ranges can also get BV.

“Around 30% of women get this condition at some point in their life,” said Dr. Jill Steinle, an OB/GYN at Essentia Health. “The symptoms can be uncomfortable, but it’s treatable. There are also things you can do to prevent getting another case of BV.”

BV isn't a yeast infection or a traditional sexually transmitted infection (STI), but it may have symptoms similar to these conditions. Understanding BV is the first step to managing or preventing it.

What Is BV?

The vagina has different types of bacteria, including good bacteria that help maintain an acidic environment that ultimately keeps the bad bacteria from thriving. An imbalance in the naturally occurring bacteria in the vagina causes bacterial vaginosis.

With BV, the good bacteria decrease, and other types of bacteria overgrow. This throws off the natural balance, leading to symptoms like itching, pain and a foul odor.

Symptoms of Bacterial Vaginosis

If you have BV, you may not have every sign of it. Some people have no symptoms at all. In fact, about half of women with BV don’t report any symptoms. If you have symptoms, you may notice –

• A fishy odor, especially after sex or during your period
• Burning during urination
• Thin, grey or white vaginal discharge
• Vaginal itching

These symptoms can be mild or very noticeable.

What Causes BV?

Experts do not know exactly what causes the imbalance that leads to BV. However, there is a strong link between certain lifestyle factors and bacterial vaginosis. While BV is not considered an STI, it is more common in people who are sexually active. It's common in people who have multiple sex partners.

Risk FactorsAnything that changes the normal environment inside the vagina can increase your risk of BV. Some common contributing factors may include –

• Douching (washing inside the vagina)
• Using certain types of intrauterine devices
• Using scented soaps, bubble baths or vaginal deodorants

Diagnosing and Treating BV

If you have signs of BV, your provider will do several tests to check for the presence of bacteria.

• Wet mount. A wet mount is one of the most common diagnostic tests. This involves taking a sample of vaginal discharge and examining it under a microscope.
• Whiff test. Your provider may also do a test that checks for odor. A whiff test mixes a vaginal sample with a chemical to see if it creates a fishy odor.
• Vaginal pH test. This test checks for high acidity, which is a strong indicator of bacterial vaginosis.

Treating BV

Even if you have mild symptoms of BV, it's important to talk to your provider to get an accurate diagnosis and prompt treatment. Having BV can increase your risk of –

• Pelvic inflammatory disease (PID), an infection of the reproductive organs
• Premature birth, if you have BV during pregnancy
• STIs, including HIV

Antibiotics are a common and effective treatment for BV. Some treatments only require a single pill. These come in the form of a pill you swallow, vaginal suppositories, or a gel that’s inserted into the vagina.

How to Prevent Bacterial Vaginosis

There’s no single action you can take to guarantee you won’t get BV. But you can lower your risk with these lifestyle habits –

• Avoid douching. The vagina cleans itself naturally. Douching washes out the good bacteria.
• Avoid scented products on or near your vagina. Don't use scented tampons, pads, bubble baths or soaps near the vagina. Instead, use plain, unscented soap only on the outside area.
• Practice safe sex. Limiting your number of sex partners and using condoms can help lower your risk, as semen can affect the balance of bacteria.

If you notice any symptoms of BV or are concerned about your vaginal health, see your provider as soon as possible.

“Don't try to treat bacterial vaginosis yourself,” Dr. Steinle said. “It’s easy to mistake BV for another infection.”Getting a proper diagnosis is key to getting the right treatment and staying healthy.

Frequently Asked Questions About Bacterial Vaginosis

Q: Is bacterial vaginosis contagious?

A: Bacterial vaginosis is not considered a contagious condition. However, BV can spread between female partners.

Q: Does bacterial vaginosis go away on its own?

A: BV may go away without treatment. However, getting treatment, even for mild cases, can lower your risk of future complications.

Q: Can men get bacterial vaginosis?

A: While men don't get BV themselves, they can be carriers of the bacteria that cause it and pass it on to their partners.

Q: Why do I keep getting bacterial vaginosis?

A: Recurring BV can happen for several reasons, including behaviors that increase the chances of getting it, such as using scented products on your vagina and not using condoms. You can also get BV multiple times if you don’t complete treatment, such as not taking the full recommended dose of antibiotics.