Bacterial vaginosis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 26, 2016
StartDiseasesBacterial vaginosis

Bacterial vaginosis is a condition caused by the excessive growth of bacteria in the vagina. This disease is caused by an imbalance of good and bad bacteria within the vagina, and while the infection is usually mild, it can become more serious if left untreated.


Definition & Facts

Bacterial vaginosis is an infection in the vagina that is caused by numerous types of bacteria. A vaginal yeast infection shares similar symptoms as bacterial vaginosis. The only way to make the correct determination is to have the issue diagnosed by a doctor.

The risk of this infection increases for women that are sexually active. This infection should dissipate after a few days, even without the usage of medicine or other treatment options. There are instances where serious complications can develop.

Symptoms & Complaints

Many women won't have any symptoms after contracting the infection. Those that do, however, report an odd vaginal discharge that can be anything from white or dark gray to watery or foamy. A strong odor may also be present with this discharge particularly after having sex.

A burning sensation when urinating is a common symptom as is a general irritation in the vagina. Itching may also occur outside of the vagina. However, this symptom is rare. Symptoms of bacterial vaginosis are similar to those of a vaginal yeast infection. If these symptoms are left untreated, there is a higher risk of contracting other STIs, including chlamydia and HIV.


This disease is caused by an imbalance of flora within the vagina that exist there naturally. The vast majority of this flora, nearly 95 percent, is referred to as lactobacillus bacteria. This bacteria prevents extra growth of different organisms in the vagina. Bacterial vaginosis infection will result from instances where the lactobacillus bacteria measures well below 95 percent. This results in the spread of other, more harmful bacteria.

The cause for this imbalance is not known. There are risk factors that can contribute to the onset of this condition. The disease can be caused by anal sex, oral sex, or vaginal intercourse. Both male and female sexual partners can bring about bacterial vaginosis. Women between the ages of 15 and 44 have the highest chance of being affected by the condition. There's also a small chance that women who have never had sex will suffer from the disease.

Women that have a new sex partner or more than one sex partners have a higher risk, as do any women that don't use dental dams or condoms during sex. This disease is also twice as common among African-American women in comparison to white women. The most common risk factor is pregnancy. Almost 25 percent of pregnant women will suffer from this infection. This is due to standard hormonal changes that will occur throughout the course of pregnancy.

Diagnosis & Tests

Bacterial vaginosis can be diagnosed by a doctor through the administration of several tests. These tests will take place once a doctor or other healthcare professional takes a sample of the vaginal discharge and examines it under a microscope. To prepare for these tests, women should avoid using vaginal deodorant sprays beforehand. These sprays may cause irritation in the vagina or mask smells that could assist in the diagnosis.

The whiff test utilizes several drops of potassium hydroxide in combination with the discharge. If the test produces a very strong odor, bacterial vaginosis may be diagnosed. The vaginal wet mount test mixes the discharge with a salt solution and examines it under a microscope. If white blood cells and rare clue cells are present, the diagnosis is likely to be bacterial vaginosis.

Oligonucleotide probes are also provided to help detect certain DNA that are specific to this disease. This is the most accurate test, but is not usually administered. A women's vaginal pH levels may be checked. The disease could lead to levels higher than 4.5.

Treatment & Therapy

Bacterial vaginosis typically doesn't require treatment due to mild or non-existent symptoms. Complications can occur however, so treatment is recommended. This is especially true with pregnant women that suffer from bacterial vaginosis as complications can include a premature birth. When symptoms are present, antibiotic medications can be prescribed. These medications include metronidazole, tinidazole and clindamycin. The first two are taken orally, while the third is a cream that is placed into the vagina.

Recurrence of symptoms is common. Women that continue to suffer from the disease should contact a doctor. The doctor will likely provide a stronger treatment. One of these treatments is extended-use therapy of metronidazole. A self-help form of long-term therapy involves lactobacillus, which is meant to boost good bacteria in the vagina and can be ingested through yogurt or any food that contains lactobacilli.

Prevention & Prophylaxis

In order to assist in the prevention of bacterial vaginosis, women should not use douches. Standard bathing is all that's required to clean the vagina. Douching on a regular basis can create an imbalance among the organisms inside the vagina, increasing the risk of this disease.

Vaginal irritation should also be kept to a minimum. To do so, women should not excessively use spas and hot tubs. Soap should be rinsed from around the vagina directly after a shower. Soaps should be mild and any tampons should be non-scented. Minimizing risk of a sexually transmitted infection can also help by practicing safe sex techniques.