Bacterial Vaginosis

Bacterial vaginosis is an infection that occurs when the normal balance of bacteria in the vagina changes. This change is caused by an overgrowth of certain bacteria in the vagina. Bacterial vaginosis is the most common vaginal infection among females aged 15 to 44 years.

This condition increases the risk of sexually transmitted infections (STIs). Treatment can help reduce this risk. Treatment is very important for pregnant women because this condition can cause babies to be born early (prematurely) or at a low birth weight.

What are the causes?

This condition is caused by an increase in harmful bacteria that are normally present in small amounts in the vagina. However, the exact reason this condition develops is not known.

You cannot get bacterial vaginosis from toilet seats, bedding, swimming pools, or contact with objects around you.

What increases the risk?

• Having a new sexual partner or multiple sexual partners, or having unprotected sex.
• Douching.
• Having an intrauterine device (IUD).
• Smoking.
• Abusing drugs and alcohol. This may lead to riskier sexual behavior.
• Taking certain antibiotic medicines.
• Being pregnant.

What are the signs or symptoms?

• Gray or white vaginal discharge. The discharge can be watery or foamy.
• A fish-like odor with discharge, especially after sex or during menstruation.
• Itching in and around the vagina.
• Burning or pain with urination.

How is this diagnosed?

• Your medical history.
• A physical exam of the vagina.
• Checking a sample of vaginal fluid for harmful bacteria or abnormal cells.

How is this treated?

This condition is treated with antibiotic medicines. These may be given as a pill, a vaginal cream, or a medicine that is put into the vagina (suppository). If the condition comes back after treatment, a second round of antibiotics may be needed.

Follow these instructions at home:

Medicines

• Take or apply over-the-counter and prescription medicines only as told by your health care provider.
• Take or apply your antibiotic medicine as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.

General instructions

• If you have a female sexual partner, tell her that you have a vaginal infection. She should follow up with her health care provider. If you have a male sexual partner, he does not need treatment.
• Avoid sexual activity until you finish treatment.
• Drink enough fluid to keep your urine pale yellow.
• Keep the area around your vagina and rectum clean.
  • Wash the area daily with warm water.
  • Wipe yourself from front to back after using the toilet.
• If you are breastfeeding, talk to your health care provider about continuing breastfeeding during treatment.
• Keep all follow-up visits. This is important.

How is this prevented?

Self-care

• Do not douche.
• Wash the outside of your vagina with warm water only.
• Wear cotton or cotton-lined underwear.
• Avoid wearing tight pants and pantyhose, especially during the summer.

Safe sex

• Use protection when having sex. This includes:
  • Using condoms.
  • Using dental dams. This is a thin layer of a material made of latex or polyurethane that protects the mouth during oral sex.
• Limit the number of sexual partners. To help prevent bacterial vaginosis, it is best to have sex with just one partner (monogamous relationship).
• Make sure you and your sexual partner are tested for STIs.

Drugs and alcohol

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
• Do not use drugs.
• Do not drink alcohol if:
  • Your health care provider tells you not to do this.
  • You are pregnant, may be pregnant, or are planning to become pregnant.
• If you drink alcohol:
  • Limit how much you have to 0–1 drink a day.
  • Be aware of how much alcohol is in your drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).

Where to find more information

• Centers for Disease Control and Prevention: www.cdc.gov
• American Sexual Health Association (ASHA): www.ashastd.org
• U.S. Department of Health and Human Services, Office on Women's Health: www.womenshealth.gov

Contact a health care provider if:

• Your symptoms do not improve, even after treatment.
• You have more discharge or pain when urinating.
• You have a fever or chills.
• You have pain in your abdomen or pelvis.
• You have pain during sex.
• You have vaginal bleeding between menstrual periods.

Summary

• Bacterial vaginosis is a vaginal infection that occurs when the normal balance of bacteria in the vagina changes. It results from an overgrowth of certain bacteria.
• This condition increases the risk of sexually transmitted infections (STIs). Getting treated can help reduce this risk.
• Treatment is very important for pregnant women because this condition can cause babies to be born early (prematurely) or at low birth weight.
• This condition is treated with antibiotic medicines. These may be given as a pill, a vaginal cream, or a medicine that is put into the vagina (suppository).