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Home > Patient & Family Resources > Health Library > Bacterial Vaginosis
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Bacterial vaginosis is an infection of the vagina that may cause a fishy-smelling discharge. It's usually a mild problem that may go away on its own in a few days. But it can lead to more serious problems. So it's a good idea to see your doctor and get treatment.
In women who have bacterial vaginosis, there aren't enough "good" bacteria and are too many "bad" bacteria in the vagina. Experts aren't sure what causes the bacteria to get out of balance. But certain things make it more likely to happen, such as douching or having a new sex partner.
The most common symptom of bacterial vaginosis is a smelly vaginal discharge. It may look grayish white or yellow. It may have a bothersome "fishy" smell, which may be worse after sex. Many women with the infection don't notice any symptoms.
Doctors diagnose bacterial vaginosis by asking about the symptoms, doing a pelvic exam, and taking a sample of the vaginal discharge. The sample can be tested to find out if you have bacterial vaginosis.
Treatment for bacterial vaginosis includes antibiotic medicine. Depending on the medicine prescribed, these may be taken either by mouth or in the vagina. Antibiotics kill the "bad" bacteria that cause symptoms. But symptoms often come back after antibiotic treatment.
Normally, there are a lot of "good" bacteria and some "bad" bacteria in the vagina. The good types help control the growth of the bad types. In women who have bacterial vaginosis, the balance is upset. There aren't enough good bacteria, and there are too many bad bacteria.
Experts aren't sure what causes the bacteria in the vagina to get out of balance. But certain things make it more likely to happen. Your risk of getting bacterial vaginosis is higher if you:
Bacterial vaginosis is more common in women who are sexually active. But women who aren't having sex can also get it.
Here are some tips to help prevent bacterial vaginosis.
Bacterial vaginosis may be passed between women during sexual contact. If you have a female sex partner, you may benefit from using protection and carefully washing shared sex toys.
It is always important to practice safer sex to prevent sexually transmitted infections, whether or not you have bacterial vaginosis. Preventing an STI is easier than treating an infection after it occurs.
Bacterial vaginosis is generally not considered a sexually transmitted infection (STI). But if you are exposed to an STI while you have bacterial vaginosis, you are more likely to get that infection.
Many women who have bacterial vaginosis don't notice any symptoms. It doesn't typically cause itching. But it does cause:
The symptoms are similar to some sexually transmitted infections (such as trichomoniasis, chlamydia, and gonorrhea) and to a vaginal yeast infection.
Bacterial vaginosis often clears up on its own. But in some women it doesn't go away on its own. And for many women it comes back after it has cleared up. Antibiotic treatment works for some women but not others.
Bacterial vaginosis usually doesn't cause other health problems. But in some cases it can lead to serious problems.
Bacterial vaginosis can be hard to distinguish from other types of vaginal infection. Consider the following if you have any signs of vaginal infection.
Call your doctor now if you:
Call your doctor for an appointment if you:
It's a good idea to contact or see your doctor about unusual vaginal symptoms.
If your symptoms are due to a sexually transmitted infection (STI) and not bacterial vaginosis, you may infect a sex partner if you delay treatment. You may also develop more serious complications of STIs such as pelvic inflammatory disease (PID).
Doctors diagnose bacterial vaginosis by asking about symptoms, doing a pelvic exam, and taking a sample of the vaginal discharge. The sample can be tested for bacterial vaginosis.
These lab tests may include:
A sample of discharge is checked for bacteria, white blood cells, and unusual cells called clue cells. These clue cells are one sign of bacterial vaginosis.
A special solution is added to a sample of discharge to see if it gives off a strong fishy odor. This odor usually means you have bacterial vaginosis.
The pH of a sample of vaginal discharge is measured. Bacterial vaginosis often causes a pH that is higher than normal.
This test looks for the genetic material (DNA) of bacterial vaginosis bacteria.
The presence of clue cells, an increased vaginal pH, and a positive whiff test are enough evidence to treat for bacterial vaginosis.
For some women, bacterial vaginosis goes away without treatment. But doctors usually prescribe an antibiotic medicine. Antibiotics kill the "bad" bacteria that cause symptoms. The medicine may be pills you swallow. Or it might be a cream or capsules that you put in your vagina. In many cases, symptoms come back after antibiotic treatment. This can be frustrating.
Bacterial vaginosis makes the reproductive tract vulnerable to infection or inflammation. So your doctor will test and treat you with antibiotics if you are:
Talk to your doctor about whether testing is right for you.
Some women have tried treating bacterial vaginosis with the probiotic Lactobacillus. This is found in foods like yogurt and in dietary supplements. But more research is needed to find out if it works to treat or prevent bacterial vaginosis. It's also not clear which type of Lactobacillus would work best.
The antibiotics metronidazole (such as Flagyl and MetroGel), clindamycin (such as Cleocin and Clindesse), and tinidazole (such as Tindamax) are used to treat bacterial vaginosis.
When thinking about treatment, ask your doctor if you should:
Current as of:
February 11, 2021
Author: Healthwise StaffMedical Review: Sarah Marshall MD - Family MedicineKathleen Romito MD - Family MedicineMartin J. Gabica MD - Family MedicineDevika Singh MD, MPH - Infectious Disease
Current as of: February 11, 2021
Author: Healthwise Staff
Medical Review:Sarah Marshall MD - Family Medicine & Kathleen Romito MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Devika Singh MD, MPH - Infectious Disease
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