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Bacterial Vaginosis: Symptoms, Causes, Treatment and Prevention

Bacterial Vaginosis: Symptoms, Causes, Treatment and Prevention
Submitted and Medically Reviewed By: Dr. Mavra Farrukh

Overview

Bacterial vaginosis is a bacterial vaginal infection common in reproductive-age women that leads to a fishy odour and vaginal irritation. It is rather embarrassing and a cause of distress. Picking up the symptoms early helps ensure prompt treatment and prevents unnecessary distress. The following article covers all you need to know about bacterial vaginosis. 

What Is Bacterial Vaginosis?

An excess of bad bacteria in the vagina can cause bacterial vaginosis. Symptoms of BV in women include “fishy” odour and vaginal irritation. It is a prevalent common cause of abnormal vaginal discharge affecting women of reproductive age. However, many women may not experience any symptoms at all. 

Bacterial Vaginosis Symptoms

According to studies, up to 84% of people with bacterial vaginosis (BV) may show no symptoms. Commonly experienced symptoms include:

  • Grey, Off-white, or green vaginal discharge.
  • Discharge that smells “fishy.”
  • “Fishy” smell is most pungent during the menstrual cycle or after sex 
  • An itchy or sore vagina(rarely).

Bacterial infection symptoms can be similar to other infections. Therefore, it’s essential to consult a doctor to determine whether you have BV or another type of vaginal infection.

How common is BV?

Bacterial vaginosis is a prevalent vaginal infection affecting women in the age group of 15-44. One in three American women is estimated to get BV, with the infection rate higher in black women.

Causes & Risk Factors

Your vagina houses multiple types of bacteria, also referred to as vaginal flora. Bacterial vaginosis (BV) occurs when some vaginal bacteria multiply and are present in excess amounts. Too much of a specific type of bacteria creates an imbalance resulting in an infection. 

Your chances of getting BV are higher if you: 

  • do not use condoms or dental dams when having sex
  • are of African American descent
  • have an intrauterine device (IUD) in place
  • use vaginal washes or douches 
  • have multiple sex partners
  • are pregnant 
Do you have vaginal discharge that smells fishy? Chat with a doctor and get treated for BV.

How to diagnose bacterial vaginosis

Your doctor will examine and take a sample of fluid/discharge from your vagina. The sample is sent to the lab for a bacterial vaginosis test. The fluid is examined under a microscope at the lab for analysis.

Bacterial Vaginosis Treatment

Your doctor will prescribe antibiotics for bacterial vaginosis. These include metronidazole or clindamycin. These medications are available in the form of a cream or gel that you insert into your vagina. They are also available in the form of pills that are taken orally.

There aren’t any over-the-counter products to treat bacterial vaginosis (BV). It is recommended to avoid using douches or products used to treat yeast infections, as they can worsen BV. Instead, consult a doctor to determine the proper treatment for you. 

Some measures that may help prevent bacterial vaginosis from worsening include:

  • eating probiotic-rich food like yogurt with live cultures or consuming probiotic supplements
  • wearing loosely fitted cotton underwear
  • practising good vaginal hygiene habits
  • switching to unscented products such as soaps and tampons 

How to Prevent Bacterial Vaginosis

It is not entirely possible to prevent bacterial vaginosis (BV). There aren’t any guaranteed ways of avoiding it. The following measures can reduce your risk of getting bacterial vaginosis:

  • Avoid douching. Douching disrupts the natural balance of bacteria in your vagina. Instead, practice healthy vaginal and genital hygiene.
  • Avoid vaginal contact with things that have been in contact with your anus. Such items, including toilet paper and sex toys, can transfer bacteria found in your stool to your vagina. Make sure to wash sexual toys after every use.
  • Limit the number of sex partners. Research indicates that your chances of getting BV increase if you have multiple sex partners.
  • Use latex condoms or dental dams while having intercourse. Although, there is no clear evidence why research indicates that sexual activity is associated with BV.
  • Wear cotton underwear. Bacteria thrive in warm and moist environments. Cotton helps prevent the entrapment of moisture.

Bacterial Vaginosis Complications

Bacterial vaginosis may clear up on its own as well, but there is a possibility that the infection can worsen without treatment. The infection is associated with poor gynecologic and obstetrics outcomes. These include preterm delivery and increased chances of infection after surgeries such as a hysterectomy. Additionally, it also increases the risk of certain complications, including:

  • contracting sexually transmitted infections (STIs)
  • contracting HIV in case of exposure 
  • premature delivery 
  • chances of developing the pelvic inflammatory disease (PID)
  • facing fertility problems due to STIs and PID
  • the decreased success rate of in vitro fertilisation (IVF) treatment

What Is Recurrent Bacterial Vaginosis?

Recurrent bacterial vaginosis results from an imbalance in the vaginal bacteria. Although bacterial vaginosis is a common condition, in some women, the condition may recur, and they may get frequent infections. Treatment for chronic bacterial vaginosis requires multiple and long-term treatments. Bacterial vaginosis is one type of vaginitis or inflammation of the vagina. 

Treating bacterial vaginosis with antibiotics wipes off the harmful bacteria, but this does not necessarily fix the underlying problem of imbalance in the vaginal flora. Resultantly, many women experience an endless cycle of BV episodes. Recurrent BV occurs when the infection isn’t fully treated, this creates an imbalance in the colonies of bacteria residing in the vagina, also known as a biofilm. Besides affecting your sex and work life, recurrent bacterial vaginosis can also lead to severe complications. Once the imbalanced vaginal microbiome is overpowered, other bacteria and viruses can multiply as the pH balance in the vagina is disturbed. Some causes attributed to this include having multiple sex partners or the inability of your body to produce the right amount of lactobacilli to keep your vagina’s pH in check. Hormonal fluctuations can also contribute to recurrent BV.

Women living with recurrent BV have a higher chance of getting STIs, including gonorrhea and chlamydia, as well as contracting and transmitting HIV. In addition, risk of developing other uterine and vaginal infections is increased as well. 

Bacterial vaginosis increases the risk of miscarriage, preterm delivery, and low birth weight during pregnancy. The burden of bacterial vaginosis is exceptionally high for women in marginalised communities. These communities comprise of African American, Hispanic, and Native American women. 

Do you have vaginal discharge that smells fishy? Chat with a doctor and get treated for BV.

Bacterial Vaginosis vs Yeast Infection

Bacterial vaginosis and yeast infections are not classified as vaginal infections that can cause vaginal discomfort and discharge. However, the following symptoms may help you differentiate yeast infection vs bacterial vaginosis: 

  • Discharge: BV’s pathognomonic sign is discharge with a “fishy” smell. Discharge caused by yeast infections doesn’t usually have an odour but appears to be like cottage cheese.
  • Vaginal irritation: Typically, BV doesn’t lead to vaginal itchiness and irritation, while yeast infections do.
  • Over-the-counter treatment: To treat bacterial vaginosis, antibiotics are required, while to treat yeast infections, over-the-counter medications work as well.

Bacterial vaginosis and yeast infections can present similar symptoms but have different causes and treatments. However, both can cause inflammation of the vagina, also referred to as vaginitis.

In order to differentiate BV or a yeast infection, your doctor may:

  • ask about your medical history and history of previous vaginal infections
  • carry out an examination to look for signs that indicate an infection and take a look at the vaginal discharge
  • collect a sample of the vaginal discharge for analysis to test for overgrowth of harmful bacteria or fungi 
  • test the pH of the vagina — a pH of 4.5 or above can be an indication of BV

Bacterial vaginosis vs UTI

Although UTIs and bacterial vaginosis are different infections, it’s possible that both can co-occur. This commonly results when Gardnerella vaginalis of BV activates dormant E. coli to cause a recurrent UTI. Furthermore, treating a UTI with antibiotics can lead to a vaginal infection. Moreover, bacterial vaginosis may predispose you to recurrent Urinary Tract Infections.

UTI symptoms mainly include a burning sensation while urinating or the urge to urinate frequently. Vaginal infections usually result in vaginal discharge, odour and itching. 

Bacterial vaginosis treatment during pregnancy

Bacterial vaginosis during pregnancy is treated with medications that are safe to use during pregnancy. However, treatment for the infection is necessary even if you have no symptoms to prevent complications. Pregnancy complications include preterm delivery or having a baby with low birth weight.  

Is bacterial vaginosis an std?

Bacterial vaginosis is not classified as a sexually transmitted disease. However, it is linked with sexual activity. Many researchers suggest that sex can change the bacterial environment of your vagina and resultantly trigger BV. 

When to Consult a Doctor

Untreated Bacterial vaginosis can lead to severe conditions. If something does smell fishy, trust your instinct. A fishy vaginal odour can indicate BV. Connect with our online doctor at Your Doctors Online to get treatment for bacterial vaginosis immediately. 

Do you have vaginal discharge that smells fishy? Chat with a doctor and get treated for BV.

FAQs About Bacterial Vaginosis Answered by Your Doctors Online Team

How do you know if you have bacterial vaginosis?

Bacterial vaginosis presents unusual greyish-white or thin, watery vaginal discharge with a strong fishy smell. The smell is prominent, particularly after intercourse. 

How can you get bacterial vaginosis?

Your vagina houses multiple types of bacteria, also referred to as vaginal flora. Bacterial vaginosis (BV) occurs when some vaginal bacteria multiply and are present in excess amounts. Too much of a specific type of bacteria creates an imbalance resulting in an infection. 

Will BV go away on its own?

In some cases, bacterial vaginosis (BV) resolves on its own. However, treatment is essential to avoid complications if you have an infection. 

I’m pregnant. How does BV affect my baby?

Pregnancy complications include preterm delivery or having a baby that is born with low birth weight. In addition, treatment for the infection is necessary to prevent complications.

What happens if BV is left untreated?

Untreated infections can increase your chances of:
contracting sexually transmitted infections (STIs)
contracting HIV in case of exposure 
premature delivery 
chances of developing the pelvic inflammatory disease (PID)
facing fertility problems due to STIs and PID
the decreased success rate of in vitro fertilisation (IVF) treatment

How long does bacterial vaginosis last?

It is possible that a mild infection can clear up in a few days. Although BV is treated with antibiotics, the infections resolve with treatment. 

What is the most common cause of BV?

Gardnerella vaginalis is a common type of bacteria in the vagina that can lead to BV. Anything that alters your vaginal pH balance can mess with bacteria levels and cause an infection. For example, douching or using vaginal sprays or products can result in BV.

What if BV doesn’t go away with antibiotics?

A repeat course of antibiotics or a prolonged treatment is usually required in case of recurrent bacterial vaginosis. 

How to get rid of bacterial vaginosis?

Your doctor will prescribe antibiotics for bacterial vaginosis. These include metronidazole or clindamycin. These medications are available in the form of a cream or gel that you insert into your vagina. They are also available in the form of pills that are taken orally.

Can men get bacterial vaginosis?

Males do not get bacterial vaginosis. However, they can carry the bacteria that causes BV and trigger an infection in a woman. Therefore, male partners of women diagnosed with BV do not require treatment.

Can bacterial vaginosis cause bleeding?

Bacterial vaginosis does not usually cause bleeding, but it is possible. Some women have reported mild spotting while having BV. Although bacterial vaginosis does not cause heavy bleeding, it is often more present and noticeable during your period.

Can you go to urgent care for bacterial vaginosis?

Depending on your symptoms or inability to get in with your primary care physician, it is best to seek urgent care for treatment if you have signs and require treatment for BV. 

Is bacterial vaginosis a yeast infection?

Bacterial vaginosis is a bacterial vaginal infection, whereas a yeast infection is a fungal infection. 

Can BV cause sores?

Bacterial vaginosis does not cause sore formation. Genital sores are commonly caused by STDs such as herpes or syphilis. Although, itching and irritation caused by the infection may result in minor cuts from scratching.

Can yeast infections turn into BV?

No, these are separate infections. A woman can have more than one infection at the same time. 

Can BV cause infertility?

Some complications of untreated BV include fertility problems that may result from STIs or PID(pelvic inflammatory disease). In addition, getting BV can also decrease the success rate of in vitro fertilisation (IVF) treatment. 

Doctors Treating this Issue
dr asim cheema

Dr. Asim Cheema

Internal Medicine

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