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Bacterial Vaginosis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment & Prevention

| Reviewed By Dr. Arya Krishnan

Bacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina. Your vagina contains different kinds of bacteria, which are kept in a balance and when this balance is disturbed, you develop bacterial vaginosis.


A common condition, bacterial vaginosis can lead to complications and increase your risk of sexually transmitted infections (STIs). Women who are in their reproductive years are a higher risk of developing bacterial vaginosis [1] [2] .


Causes Of Bacterial Vaginosis

The condition develops from an overgrowth of one of several bacteria naturally found in your vagina. The exact cause of bacterial vaginosis is not understood but certain factors such as unprotected sex can increase the risk [3] .

Women who are not sexually active develop bacterial vaginosis in very rare cases.

Symptoms Of Bacterial Vaginosis

Mostly, the condition does not develop any specific signs usually. However, some of the reported signs of the condition are as follows [4] :

  • Vaginal itching and pain
  • Burning during urination
  • Fishy vaginal odour
  • Thin, grey, white or green vaginal discharge

Risk Factors Of Bacterial Vaginosis

  • Having multiple sex partners or a new sex partner
  • Homosexual intercourse [5]
  • Douching
  • Natural lack of lactobacilli bacteria
  • Not using condoms or dental dams when having sex
  • Having an intrauterine device (IUD)
  • Pregnancy

Complications Of Bacterial Vaginosis

  • Pelvic inflammatory disease (PID)
  • Infection risk after gynaecological surgery
  • Sexually transmitted infections such as HIV, herpes simplex virus, chlamydia or gonorrhoea
  • Preterm birth [6]

Diagnosis Of Bacterial Vaginosis

For examining and understanding the condition, the doctor will begin by asking questions about your medical history (previous vaginal infections or sexually transmitted infections).

A pelvic exam will be performed to visually examine your vagina for signs of infection [7] [8] .

A sample of vaginal secretions will be taken to check for an overgrowth of anaerobic bacteria in your vaginal flora.

Apart from that, your vaginal pH will be tested, to check the acidity of your vagina by placing a pH test strip in your vagina.

Treatment For Bacterial Vaginosis

Cases of bacterial vaginosis without any symptoms are the ones that does not require any treatment. In other cases, prescription antibiotics, such as clindamycin and metronidazole will be prescribed by the doctor [9] .

Take your medicine or use the cream or gel for as long as your doctor prescribes it - even if your symptoms go away because stopping the treatment abruptly can increase the risk of recurrence.

Prevention Of Bacterial Vaginosis

Through the following measures, you can prevent yourself from contracting the infection [10] :

  • Don't douche
  • Minimize vaginal irritation
  • Practise safe sex (use a male latex condom, limit your number of sex partners or abstain from intercourse)
  • Eat probiotic-containing foods, such as yoghurt with live and active culture
  • Wear loose-fitting, breathable cotton underwear
  • Use unscented soaps and unscented tampons
  • Practice healthy vaginal hygiene habits

FAQS On Bacterial Vaginosis

Q. Can I have sex if I have BV?

A.Although it is not impossible, sexual intercourse can be painful and uncomfortable. It is best to give your vagina a bit of rest while its pH resets.

Q. Can BV harm the baby during delivery?

A.Yes. Having bacterial vaginosis can increase your baby's risk for premature birth and low birth weight.

Q. Can sperm cause BV?

A.Yes, because exposure to semen can alter the pH of the vagina and lead to BV.

Q. Can BV cause miscarriage?

A.It can increase the risk of late miscarriage.

Q. Is bacterial vaginosis painful?

A.It can be uncomfortable and cause itching but is not painful and most people do not even realise that they have BV.

View Article References  
  1. [1]   Onderdonk, A. B., Delaney, M. L., & Fichorova, R. N. (2016). The human microbiome during bacterial vaginosis. Clinical microbiology reviews, 29(2), 223-238.
  2. [2]   Plummer, E. L., Garland, S. M., Bradshaw, C. S., Law, M. G., Vodstrcil, L. A., Hocking, J. S., ... & Tabrizi, S. N. (2017). Molecular diagnosis of bacterial vaginosis: Does adjustment for total bacterial load or human cellular content improve diagnostic performance?. Journal of microbiological methods, 133, 66-68.
  3. [3]   Srinivasan, S., Morgan, M. T., Fiedler, T. L., Djukovic, D., Hoffman, N. G., Raftery, D., ... & Fredricks, D. N. (2015). Metabolic signatures of bacterial vaginosis. MBio, 6(2), e00204-15.
  4. [4]   Paavonen, J., & Brunham, R. C. (2018). Bacterial vaginosis and desquamative inflammatory vaginitis. New England Journal of Medicine, 379(23), 2246-2254.
  5. [5]   Zozaya, M., Ferris, M. J., Siren, J. D., Lillis, R., Myers, L., Nsuami, M. J., ... & Martin, D. H. (2016). Bacterial communities in penile skin, male urethra, and vaginas of heterosexual couples with and without bacterial vaginosis. Microbiome, 4(1), 16.
  6. [6]   Verstraelen, H., & Swidsinski, A. (2019). The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment. Current Opinion in Infectious Diseases, 32(1), 38-42.
  7. [7]   Nasioudis, D., Linhares, I. M., Ledger, W. J., & Witkin, S. S. (2017). Bacterial vaginosis: a critical analysis of current knowledge. BJOG: An International Journal of Obstetrics & Gynaecology, 124(1), 61-69.
  8. [8]   King, C. P., Goldberg, H. R., Jain, L., Allen, L., Aggarwal, A., & Spitzer, R. (2017). Bacterial Vaginosis in the Pregnant Adolescent Population: Screening and Treatment in a Dedicated Adolescent Prenatal Program. Journal of Pediatric and Adolescent Gynecology, 30(2), 303.
  9. [9]   Machado, D., Castro, J., Palmeira-de-Oliveira, A., Martinez-de-Oliveira, J., & Cerca, N. (2016). Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions. Frontiers in microbiology, 6, 1528.
  10. [10]   Van Schalkwyk, J., Yudin, M. H., Allen, V., Bouchard, C., Boucher, M., Boucoiran, I., ... & Murphy, K. (2015). Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. Journal of Obstetrics and Gynaecology Canada, 37(3), 266-274.
Arya Krishnan General Medicine

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