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Bacterial vaginosis

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What is bacterial vaginosis?

Bacterial vaginosis is a common vaginal infection in women. It occurs when there is an overgrowth of certain types of bacteria that are normally found in the vagina. This can result in a grey-colored vaginal discharge. Some women with bacterial vaginosis may not experience any symptoms at all.

Bacterial vaginosis is not usually a very serious condition and is generally treated with antibiotics to help restore the vaginal bacteria to healthy state.

Signs and symptoms

The main symptoms of bacterial vaginosis include:

Some women with bacterial vaginosis will not experience any symptoms at all.

Causes and risk factors

A healthy vagina is host to bacteria, especially Lactobacillus species. These bacteria produce lactic acid that keeps the vaginal area acidic, preventing other types of bacteria from growing there.

Bacterial vaginosis occurs when other types of bacteria, such as Gardnerella vaginalis, Mycoplasma hominis and Mobiluncus species, overgrow Lactobacillus.

It is not exactly clear what leads to this imbalance of bacteria in bacterial vaginosis. There are certain factors that can increase the risk of developing bacterial vaginosis, including:

Although bacterial vaginosis is more common in sexually active women and sometimes develops after having sex with a new partner, bacterial vaginosis is not classified as a sexually-transmitted infection (STI), as it is not passed on through sexual activity.

Methods for diagnosis

To work out if you have bacterial vaginosis, your doctor may ask about any symptoms and perform a physical examination. They may take a sample of the vaginal discharge and send it to a laboratory to check the number and type of bacteria present and the pH (acidity) of the discharge.

You may also be given tests to rule out other conditions that could be causing your symptoms.

A vaginal swab is used to collect a sample of discharge for analysis. 

Types of treatment

Cases of bacterial vaginosis that are do not cause any symptoms will not usually require treatment, unless there is a risk of complications from the condition.

If you have symptoms, your doctor may prescribe antibiotics, such as metronidazole, to treat the bacterial vaginosis and help restore the normal balance of bacteria in the vagina. In some cases a vaginal cream, such as clindamycin, may be prescribed. Creams are usually applied into the vagina using a device called a vaginal pessary.

Potential complications

Having bacterial vaginosis during pregnancy increases the risk of premature birth (a baby born before 37 weeks' gestation) and delivering a baby with a low birth weight. Women who have bacterial vaginosis during pregnancy can be treated with antibiotics that are safe to take during pregnancy.

Prognosis

Bacterial vaginosis is usually not a serious condition. Some mild cases may go away on their own without any treatment, or resolve after antibiotic treatment.

Unfortunately, many people who are treated for bacterial vaginosis will develop the infection again within several months of treatment, but bacterial vaginosis does not usually cause any long-term health issues.

Prevention

As the exact cause of bacterial vaginosis is not known, there is no sure way to protect yourself from getting it. You may be able to reduce the risk by avoiding:

There is currently no evidence that treating a male sexual partner reduces the chance of developing the condition again.

References

  1. Bacterial vaginosis. Better Health Channel. Accessed 1 July 2014 from link here
  2. Bacterial vaginosis - symptoms treatment and prevention?: SA Health. Accessed 1 July 2014 from link here
  3. Bacterial_Vaginosis_(BV)_a4.pdf. Accessed 1 July 2014 from link here
  4. RACGP - Bacterial vaginosis - More questions than answers. Accessed 1 July 2014 from link here
  5. Murtagh J. MD. (2011). John Murtaghs General Practice (5th Revised edition.). North Ryde N.S.W.: McGraw-Hill Medical Publishing.

10 Most frequently asked questions (FAQs)

What is bacterial vaginosis?
Bacterial vaginosis is a common vaginal infection. It occurs when there is an overgrowth of certain bacteria that are normally found in the vagina. This can result in a grey-colored vaginal discharge, although some women may not experience any symptoms.
What causes bacterial vaginosis?
Bacterial vaginosis occurs when there is an overgrowth of certain bacteria in the vagina. In particular, there is less of the normal vaginal bacteria Lactobacillus and an overgrowth of other types of bacteria, such as Gardnerella vaginalis, Mycoplasma hominis and Mobiluncus species. It is not clear exactly what leads to this imbalance of bacteria but certain factors that can increase the risk of developing bacterial vaginosis include: Douching; Cleaning the vagina with perfumed soaps and other cleansing products; Having sexual intercourse with a new partner, and; Having many sexual partners.
What are the symptoms of bacterial vaginosis?
The main symptoms of bacterial vaginosis are a greyish discharge from the vagina, and an unpleasant 'fishy' odor from the vagina. However, some women with bacterial vaginosis may not experience any symptoms at all.
Is bacterial vaginosis a sexually-transmitted infection?
Although bacterial vaginosis is more common in sexually active women and sometimes develops after having sex with a new partner, bacterial vaginosis is not classified as a sexually-transmitted infection (STI), as it is not passed on through sexual activity.
How do I know if I have bacterial vaginosis?
Bacterial vaginosis is diagnosed by a doctor, with the help of laboratory testing.
How is bacterial vaginosis diagnosed?
To work out if you have bacterial vaginosis, your doctor may ask you about your symptoms and perform a physical examination. They may take a sample of the vaginal discharge and send it to a laboratory to check the number and type of bacteria present and to measure the pH of the vaginal discharge.
How is bacterial vaginosis treated?
If symptoms are present, your doctor may prescribe antibiotics, such as metronidazole, to treat the bacterial vaginosis and help restore the normal balance of bacteria in the vagina. In some cases a vaginal cream, such as clindamycin, may be prescribed for application into the vagina, usually using a device called a pessary.
Can I prevent getting bacterial vaginosis?
As the exact cause of bacterial vaginosis is not known, there is no sure way to protect yourself from getting it. You may be able to reduce the risk of getting bacterial vaginosis by avoiding douching, not using heavily perfumed soaps and other cleansers to clean the vaginal area, and avoiding unprotected sex. There is currently no evidence that treating a male sexual partner lowers the chance of developing the condition again.
Will having bacterial vaginosis affect my pregnancy?
Having bacterial vaginosis during pregnancy increases the risk of a premature birth and delivering a baby with a low birth weight. Women who have the condition during pregnancy can be treated with specific antibiotics.
Is bacterial vaginosis serious?
Bacterial vaginosis is not usually a serious condition. Some mild cases may go away on their own without any treatment, or resolve after antibiotic treatment. It does not usually cause any lasting health issues.

Related topics

Vaginal discharge

It is normal for women to have some vaginal discharge. The appearance and amount of discharge will vary, according to factors such as ovulation, pregnancy or starting oral contraceptive medication. There are infections such as thrush, chlamydia and gonorrhoea that can also cause changes to vaginal discharge.

Vaginal itching

Vaginal itching is experienced by many women and may be accompanied by vaginal discharge. There are many causes for vaginal itching. Generally, it is easily treated.

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is the infection of a woman’s reproductive organs and surrounding pelvic tissues. It occurs most commonly when a sexually-transmitted infection spreads beyond the vagina to internal pelvic organs. This can lead to long-term complications if not recognised and treated early.

Vulvovaginitis in girls

Vulvovaginitis is the inflammation of the lining of the vagina and outer genitalia, and is a common condition in young girls. Although it can be uncomfortable and cause pain and discharge, it is usually easy to treat.

About this article

Title: Bacterial vaginosis

Author: Dr Joanne Van der Velden PhD, BSc (Hons)

First Published: 18 Sep 2014

Last reviewed: 17 Jan 2022

Category: Information on Bacterial vaginosis

Average rating: 4.7 out of 5 (1556 votes)

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