Bacterial Vaginosis
Female Body

Bacterial Vaginosis

Dama Awadallah Dama Awadallah

Right now, at this very moment, your body is generously hosting trillions of bacteria. In fact, we need our bacterial friends to survive and thrive. But which bacteria we welcome, and the balance between different types of bacteria is crucial to our health.

Bacterial Vaginosis is common, yet many people are embarrassed by it and often don’t seek treatment. Knowing what it is, why it happens, and what can be done about it can help motivate you or someone you know into seeking treatment and getting rid of it once and for all.  

What is Bacterial Vaginosis?

Bacterial vaginosis occurs when there is an imbalance of naturally occurring bacteria or flora. This means that there is a change in the amount of bacteria already present in the vagina [1].

The main signs of bacterial vaginosis are a fishy odour and a thin grey or white discharge. It can be more pronounced after sexual intercourse, and other symptoms might include difficulty urinating, discomfort during sex, and itchiness. However, it's also possible to have minimal or no symptoms [1].


What causes BV and is it an STI? 

Because bacterial vaginosis is caused by an overgrowth of endogenous bacteria or bacteria that already belong in the vagina. It is not considered a sexually transmitted infection or STI. Although rare, it's possible to have bacterial vaginosis without ever having sex [1].

Some risk factors include having multiple sex partners, recent antibiotic use, cigarette smoking, using an intrauterine device, and vaginal douching. For this reason, vaginal douching is discouraged. The risk of bacterial vaginosis is also increased by 60% with a partner with vagina[1].

It is not possible to get BV from bedding, toilet seats, or swimming pools [2].


What should I do if I think I have it?

If you think you might have bacterial vaginosis, it's important to see a gynaecologist. The gynaecologist will take a swab of vaginal fluid, which will be taken to a lab and observed under a microscope. A pelvic exam might be done as well to check the health of your cervix and exclude other diseases that might present similarly [1].

The reason it's important to diagnose BV is that it increases the risk of getting STIs by allowing other pathogens to infect the upper genital tract. It can also weaken your immune response by reducing the ability of your white blood cells to fight off infections. Additionally, it increases the risk of pelvic inflammatory disease, HIV, and other conditions [1].

For pregnant people, bacterial vaginosis increases the risk of preterm delivery or spontaneous abortion, so it's important to get treated even while pregnant. Luckily, the antibiotics clindamycin and metronidazole, which are used to treat bacterial vaginosis, are also safe to take during pregnancy [1].

Another reason for seeking help from a healthcare provider is that there are other diseases that may look similar to BV, such as chlamydia, gonorrhoea, or yeast infection. Because bacterial vaginosis increases the likelihood of other infections, it's possible to have more than one at the same time [1].


What does treatment look like?

While up to 30% of cases might go away without any treatment, bacterial vaginosis is generally treated with antibiotics. Two antibiotics, clindamycin or metronidazole, can be taken by mouth or applied vaginally [1].

In some cases, the first course of antibiotics may not work and might have to be repeated. The good news is that because bacterial vaginosis is not an STI, your partner does not have to be treated and there is no risk of passing on the infection to your partner [1].


What happens next?

If you were diagnosed and treated, you can prevent future incidences by reducing your risk factors, such as vaginal douching. If the antibiotics weren't successful the first time, your doctor might prescribe another round to try to get rid of it once and for all.

Many people are embarrassed by the discharge and fishy odour that often comes with bacterial vaginosis. For this reason, they might not seek help. While BV can go away on its own, the risks of having concurrent infections or developing other problems are too high to avoid going to a healthcare professional.


In conclusion

Bacterial vaginosis is the most common vaginal condition in people with uteruses between the age of 15 and 44 [2]. So if you're experiencing any symptoms, remember that you're not alone, and to get properly diagnosed and treated.


  1. Kairys N, Garg M. Bacterial Vaginosis. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: 


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