Bacterial Vaginosis in Women: Causes and Care

Bacterial vaginosis is a common vaginal condition that develops when certain bacteria overgrow and upset the normal balance inside the vagina.

Women ages 15 to 44 experience it most often, though it can affect anyone with a vagina. Up to 84 percent of cases produce no symptoms, yet those who notice changes typically report off-white or gray discharge that carries a fishy odor, especially after sex. The condition is not classified as a sexually transmitted infection, but sexual activity raises the chance of developing it.

Symptoms of Bacterial Vaginosis

Many women remain unaware they have bacterial vaginosis because symptoms stay mild or absent. When signs appear they include thin, watery discharge that may look white, gray, or slightly green and a noticeable fish-like smell that becomes stronger after intercourse. Some women also feel mild irritation, though itching and burning occur less often than with yeast infections.

Causes and Risk Factors

The vagina normally contains a mix of bacteria dominated by lactobacilli. Bacterial vaginosis develops when anaerobic bacteria multiply faster than the protective lactobacilli, raising vaginal pH. Researchers have not identified one single trigger, yet several behaviors increase risk. These include having a new sexual partner, multiple partners, douching, and using an intrauterine device. Pregnant women face higher rates because of hormonal shifts, and African-American women experience the condition at roughly twice the rate of white women. Our breakdown of My Poop Black While Pregnant? Causes and When to Worry covers the related details.

Why Douching Raises Risk

Douching removes beneficial bacteria and allows harmful species to flourish. Health authorities advise against the practice for this reason and because it can make symptoms harder to diagnose.

Diagnosis

A healthcare provider confirms bacterial vaginosis through a pelvic exam and laboratory tests on a vaginal fluid sample. Common tests include a wet mount viewed under a microscope, a whiff test that checks for a fishy odor when potassium hydroxide is added, and measurement of vaginal pH. Only a clinician can distinguish bacterial vaginosis from yeast infections or other causes of discharge.

Treatment Options

Prescription antibiotics such as metronidazole or clindamycin clear the overgrowth in most cases. These medicines come as oral tablets or as gels and creams inserted into the vagina. Completing the full course remains essential even when symptoms disappear early, because stopping early raises the chance of recurrence. Male partners do not require treatment, but female partners should be evaluated. Pregnant women with symptoms should receive testing and treatment because untreated bacterial vaginosis can increase the risk of preterm birth and low birth weight.

Prevention and Recurrence

No guaranteed method prevents every case, yet several habits lower risk. These include limiting the number of sexual partners, avoiding douching, wiping front to back after using the toilet, and wearing cotton underwear to keep the area dry. Women who have sex with women should inform partners if bacterial vaginosis is diagnosed so both can receive care if needed. Because the condition can return, follow-up visits are recommended if symptoms reappear within a few weeks of finishing antibiotics.

Possible Complications

Untreated bacterial vaginosis raises the chance of acquiring or transmitting certain sexually transmitted infections, including HIV, chlamydia, gonorrhea, and genital herpes. During pregnancy it is linked to premature delivery and infants born weighing less than five and a half pounds. Prompt evaluation by a clinician reduces these risks.

Information in this article comes from public health sources and medical centers. It is not a substitute for personalized care from a qualified provider.

Sources

• Bacterial Vaginosis (BV) - Arkansas Department of Health
• Bacterial vaginosis: a review of approaches to treatment and ...
• Bacterial vaginosis