Bacterial Vaginosis (BV): Symptoms, Causes, Diagnosis


It’s normal for the vagina to have bacteria, and that is in part what keeps a healthy balance and pH. However, when there is an imbalance, the vagina can become inflamed. It’s estimated that one in three women will be diagnosed with bacterial vaginosis (BV) at some point in their lifetimes; however, many women either mistake symptoms for other problems or ignore the symptoms entirely, which could be harmful. Read on to learn about what bacterial vaginosis is, what causes it, and what treatments are available. 

What Is Bacterial Vaginosis (BV)?

Bacterial vaginosis is also referred to as vaginitis. It is an overgrowth of specific bacteria that causes the vagina to become inflamed, typically causing vaginal discharge. BV was once referred to as Gardnerella vaginitis because it was thought that Gardnerella, a type of vaginal bacteria, was the primary cause of BV. However, doctors now know that several different types of bacteria cause vaginitis, so the name of the bacterial was dropped. Other common types of bacteria that can cause BV include Lactobacillus, Bacteroides, Peptostreptococcus, Fusobacterium, and Eubacterium, among others. At any given time, there are bacteria found in the vagina. However, there are “good” bacteria and “bad” bacteria. Even so, “bad” bacteria resides in the vagina also. B occurs when there is an imbalance that causes more “bad” bacteria than “good.” Doctors aren’t fully sure what causes BV but can point to a few contributing factors that may play a role. Women in their reproductive years (15 to 44) contract bacterial vaginosis more commonly, but it can happen to women of any age. 

The most prominent symptom of BV is vaginal discharge. Because every woman is different, there’s no typical amount of discharge that’s associated with BV. Women are advised to notice if they’re having more vaginal discharge than usual. Also, women with bacterial vaginosis may notice a foul smell or a “fishy” odor. This is another hallmark symptom of BV. Other symptoms of BV may include:

  • Burning during urination
  • Vaginal itching
  • Pain during sexual intercourse

Let your healthcare provider know right away if you have these symptoms along with fever, or if you’ve tried over-the-counter treatments for yeast infection, and you still have symptoms. Often, BV can be mistaken for other conditions, such as yeast infections or sexually transmitted diseases, such as chlamydia. Often, BV (or STDs) do not have any symptoms at all, so it’s imperative always to make a yearly gynecological appointment.

How Do You Get BV?

Doctors aren’t completely sure why some women get bacterial vaginosis and others don’t. African American women have a higher risk of contracting BV, but it can occur in women of any ethnicity. Pregnant women are also much more likely to be diagnosed with BV. This is because of all the vaginal changes that occur during pregnancy, and it makes BV more likely. Beyond that, several other risk factors can contribute to an imbalance in the vagina:

  • Women who smoke are more likely to be diagnosed with BV.
  • BV is more common in women who have an intrauterine device (IUD). 
  • Douching is strongly correlated with a high BV risk.
  • Women taking antibiotics are more prone to BV.
  • Having unprotected sex or having several sex partners is tied to BV (however, you cannot “catch” BV from having sex alone).

Women are strongly advised not to use douches, as douching (with or without perfumes) can upset the bacterial balance in the vagina. Having unprotected sex with new partners or with multiple partners is also associated with BV. It is wise to use condoms and dental dams at all times. 

How Is BV Diagnosed?

BV is diagnosed by your doctor, either your general practitioner or your gynecologist. It is preferred, however, to see your gynecologist for BV or any other infection that involves the vagina or reproductive system. Most likely, your doctor will take a sample of your vaginal discharge with a swab and examine it under a microscope to pinpoint the type or types of bacteria involved. However, because BV is a common problem, a doctor may also be able to see signs of it during an exam. Your doctor may also ask questions about your recent sexual history, such as if you have a new partner or have had multiple partners. 

How Is BV Treated?

Bacterial vaginosis is treated with antibiotics, which your doctor will prescribe. The most common type of medicine used to treat BV is metronidazole. BV is different than a yeast infection (even though it shares some of the same symptoms), and over-the-counter yeast infection creams will not cure BV. Because bacterial vaginosis is not a sexually transmitted infection, you don’t need to inform your male partner about the condition, because men cannot contract bacterial vaginosis. However, if you have a female partner, it’s possible that she may also BV and should be tested. It is possible to have recurrent bouts of vaginitis, so it’s best to practice safe sex and also lower risks in other ways to prevent getting BV again.

What Can Happen if BV Is Not Treated?

It is somewhat rare that untreated BV can lead to complications and other problems, but it is possible, so treating BV swiftly is a priority. The most serious complication BV can lead to pelvic inflammatory disease (PID). This goes beyond a vaginal infection and involves infection of the uterus and fallopian tubes. PID can lead to serious complications such as infertility. 

If you are pregnant and have bacterial vaginosis, which is quite common, leaving it untreated can lead to preterm birth and low birth weight. If you suspect you have BV, notify your obstetrician immediately. 

Untreated BV can also raise your risk of contracting certain sexually transmitted infections, such as chlamydia and gonorrhea. Doctors are not sure why this correlation exists. A woman with BV is also more likely to contract herpes simplex virus or HIV. Having BV also increases the odds that a woman with a sexually transmitted infection will pass it on to her partner. 

Bacterial vaginosis also increases the risk of gynecological surgery complications post-surgery. This includes surgery such as dilation and curettage (D&C) or hysterectomy. 

How Can I Lower My Risk of BV?

An excellent way to lower your risk of BV is always to practice safe sex, particularly if you have multiple partners. Minimizing vaginal irritation is also a priority. Using deodorant, perfumed soaps and body wash can contribute to having bacterial vaginosis. Doctors and researchers also warn against douching. It’s simply not necessary to “cleanse” the vagina, as it regulates itself. If you have a foul or fishy odor, douching is absolutely not recommended. It will only cover up an odor for a short period of time before it returns, as it’s indicative of a problem, such as BV. In fact, if you have BV or another type of vaginal infection, douching can help the bad bacteria travel to the uterus and fallopian tubes, which can, in turn, cause pelvic inflammatory disease and infertility. To clean the vagina, shower daily with a non-irritant soap or body wash. 

If you need more information about bacterial vaginosis (BV) or you need to be seen by a physician, request an appointment at The Woman’s Clinic today. We offer a full range of obstetric and gynecological services and have two office locations for your convenience.

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