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Bacterial vaginosis (BV) is a common vaginal condition among women. Despite how often it occurs, people may mistake it for a yeast infection. Some people with BV symptoms notice changes in vaginal discharge or odor, and others have no symptoms at all and learn about the condition only during a routine exam. Learning how BV develops, what signs to look for, and how health care providers manage it can help you recognize changes in your body and know when to seek an evaluation.
What Is Bacterial Vaginosis?
The vagina naturally contains a community of bacteria known as the vaginal microbiome. In a typical, balanced state, beneficial bacteria called lactobacilli are the most common. These bacteria produce lactic acid; this keeps the vaginal environment slightly acidic and limits the growth of other organisms.
BV develops when this balance shifts. The number of lactobacilli decreases, and other types of bacteria grow in greater numbers. Several factors are associated with a higher likelihood of developing BV, including:
- Having a new sexual partner or multiple sexual partners
- Douching or using scented vaginal washes
- Having a naturally low level of lactobacilli
- Smoking
BV is not classified as a sexually transmitted infection, although sexual activity may influence the vaginal microbiome. People who have never been sexually active can also develop BV.
What Are BV Symptoms?
People with BV may not experience any symptoms. Symptoms can resemble those of other conditions, such as yeast infections. A yeast infection typically causes thick, white discharge, and it is often accompanied by an odor. Because the symptoms overlap, a health care provider usually performs an exam to confirm the cause. Other BV symptoms can include:
- Thin vaginal discharge that is gray in color
- Strong, fish-like odor, which may become more noticeable after intercourse or during menstruation
- Vaginal itching or irritation
- Burning sensation during urination
During an evaluation, a provider may perform a pelvic exam and collect a small sample of vaginal fluid. The sample can be tested for pH level, and it is examined under a microscope for specific cells that indicate BV. These steps help distinguish BV from other conditions that call for different treatment.
How Is It Treated?
Health care providers commonly treat BV with prescription antibiotics. These medications are available in several forms, including oral tablets and gels or creams applied inside the vagina. Common options include metronidazole and clindamycin; your provider will recommend a medication based on your health history, symptoms, and personal preferences.
BV returns for many people months after treatment. If you experience repeated episodes, your provider may recommend a longer treatment plan or a different medication. Male sexual partners typically do not require treatment, but female partners can benefit from an evaluation. Certain habits may help support a balanced vaginal environment. These include avoiding douching, limiting the use of scented soaps and feminine products in the genital area, and using condoms.
Meet With a Gynecologist
Some providers check for BV before certain gynecologic procedures. A gynecologist is able to perform the appropriate tests, and they can recommend a treatment plan suited to your needs. If you notice unusual discharge, odor, or irritation, schedule an appointment with a gynecologist for an evaluation.
