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Sexual Health

STIs: Bacterial Vaginosis (BV)
What is bacterial vaginosis?

Bacterial vaginosis is not officially classified as an STI because it occurs even in women who are not sexually active. It is, however, more common in women who are sexually activeand especially if multiple sex parners are involved. Bacterial vaginosis is a change in the balance of bacteria that normally resides in the vagina because of an overgrowth of one or more types of the bacteria present. BV is as common as yeast infections in women of reproductive age.

What causes bacterial vaginosis?

Bacteria is always present in the vagina, but usually there is more "good" bacteria than "harmful" bacteria. BV occurs when the amount of "harmful" bacteria increase. What causes this growth of harmful bacteria is unknown, but there are some activities that increase the risk of developing BV.

What increases the risk of developing bacterial vaginosis?

Any woman can get BV, but there are some activities that can upset the balance of bacteria in the vagina and put women at increased risk. These activities include:

  • Having a new sex partner or multiple sex partners
  • Douching
  • Using an intrauterine device (IUD) for contraception
  • Oral-to-genital sexual activity
  • Using tampons or a diaphragm
  • Gynecological surgery immediately increases the risk but does not impact long-term risk.
What are the symptoms of bacterial vaginosis?

More than half of all women with BV have no symptoms. Women with symptoms may notice:

  • Abnormal vaginal discharge (usually thick, white or gray), often with an unpleasant fishy odor
  • Itching around the outside of the vagina
  • Spotting after sex
  • Increased cramping or discomfort with sex
How is bacterial vaginosis diagnosed?

Your healthcare provider may perform a pelvic exam to take a sample of vaginal discharge for inspection under a microscope. The pH level of the discharge may be checked, or a whiff test could be performed—mixing the discharge with potassium hydroxide produces a strong fishy smell if BV is present.

How is bacterial vaginosis treated?

Although BV can sometimes clear up on its own without treatment, any woman with symptoms should visit her healthcare provider for treatment. Pregnant women especially need to receive treatment to avoid complications such as premature delivery or low birth weight.

BV is treated with oral antibiotics and/or with an antimicrobial vaginal cream prescribed by your healthcare provider.

Bacterial vaginosis can recur after treatment.

Does my partner need to be treated?

No.

Are there complications associated with bacterial vaginosis?

Women with BV are at an increased risk for developing pelvic inflammatory disease or other STIs.

Pregnant women who develop BV are at an increased risk of preterm delivery and low birth weight. There is also an increased risk of miscarriage, especially in the first trimester.

Are there special considerations for the prevention of bacterial vaginosis?

In addition to following Disease Prevention and Safer Sex tips, the following practices can help reduce the risk of developing BV:

  • Do not douche.
  • Avoid spreading bacteria from the rectum to the vagina. Wipe from back to front, away from the vagina.
  • Use a tampon or diaphragm for no longer than 8 hours.
  • Keep reusable contraceptive devices and sex toys clean and dry.
  • Use all medication as prescribed for treatment of BV, even if the symptoms go away, to prevent recurrence.