Bacterial Vaginosis

ExitCare ImageBacterial vaginosis (BV) is a vaginal infection where the normal balance of bacteria in the vagina is disrupted. The normal balance is then replaced by an overgrowth of certain bacteria. There are several different kinds of bacteria that can cause BV. BV is the most common vaginal infection in women of childbearing age.


  • The cause of BV is not fully understood. BV develops when there is an increase or imbalance of harmful bacteria.

  • Some activities or behaviors can upset the normal balance of bacteria in the vagina and put women at increased risk including:

  • Having a new sex partner or multiple sex partners.

  • Douching.

  • Using an intrauterine device (IUD) for contraception.

  • It is not clear what role sexual activity plays in the development of BV. However, women that have never had sexual intercourse are rarely infected with BV.

Women do not get BV from toilet seats, bedding, swimming pools or from touching objects around them.


  • Grey vaginal discharge.

  • A fish-like odor with discharge, especially after sexual intercourse.

  • Itching or burning of the vagina and vulva.

  • Burning or pain with urination.

  • Some women have no signs or symptoms at all.


Your caregiver must examine the vagina for signs of BV. Your caregiver will perform lab tests and look at the sample of vaginal fluid through a microscope. They will look for bacteria and abnormal cells (clue cells), a pH test higher than 4.5, and a positive amine test all associated with BV.


  • Pelvic inflammatory disease (PID).

  • Infections following gynecology surgery.

  • Developing HIV.

  • Developing herpes virus.


Sometimes BV will clear up without treatment. However, all women with symptoms of BV should be treated to avoid complications, especially if gynecology surgery is planned. Male partners generally do not need to be treated. However, BV may spread between female sex partners so treatment is helpful in preventing a recurrence of BV.

  • BV may be treated with antibiotics. The antibiotics come in either pill or vaginal cream forms. Either can be used with nonpregnant or pregnant women, but the recommended dosages differ. These antibiotics are not harmful to the baby.

  • BV can recur after treatment. If this happens, a second round of antibiotics will often be prescribed.

  • Treatment is important for pregnant women. If not treated, BV can cause a premature delivery, especially for a pregnant woman who had a premature birth in the past. All pregnant women who have symptoms of BV should be checked and treated.

  • For chronic reoccurrence of BV, treatment with a type of prescribed gel vaginally twice a week is helpful.


  • Finish all medication as directed by your caregiver.

  • Do not have sex until treatment is completed.

  • Tell your sexual partner that you have a vaginal infection. They should see their caregiver and be treated if they have problems, such as a mild rash or itching.

  • Practice safe sex. Use condoms. Only have 1 sex partner.


Basic prevention steps can help reduce the risk of upsetting the natural balance of bacteria in the vagina and developing BV:

  • Do not have sexual intercourse (be abstinent).

  • Do not douche.

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

  • Tell your sex partner if you have BV. That way, they can be treated, if needed, to prevent reoccurrence.


  • Your symptoms are not improving after 3 days of treatment.

  • You have increased discharge, pain, or fever.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.


Division of STD Prevention (DSTDP), Centers for Disease Control and Prevention:

American Social Health Association (ASHA):