bacterial vaginosis

Bacterial Vaginosis Complete Guide for Women

Bacterial vaginosis bv is a prevalent illness that affects many young women. Unbalanced populations of common vaginal microorganisms result in bacterial vaginosis bv. A healthy vagina is a home to both helpful and harmful microorganisms. The beneficial bacteria are typically able to keep the bad ones at bay.

Still, sometimes this vaginal bacteria balance can change due to several reasons, including hormones, poor hygiene, multiple sex partners, etc. It's most likely to affect those with new sex partners or those who do not use protection during sex.

As it is called for short, BV can cause abnormal vaginal discharge and odor and may also be associated with itching and burning of the vagina. The symptoms can come and go over time. Still, if you experience any of them, you should contact your doctor as they could indicate more serious problems such as pelvic inflammatory disease (PID).

What is bacterial vaginosis?

bacterial vaginosis

Bacterial vaginosis bv is a bacterial infection of the cervix that occurs when there is a change in the natural balance of vaginal bacteria, upsetting the delicate balance. Bacterial vaginosis is usually associated with active sex activity. However, researchers are still unsure of the association between BV and sex. 

Vaginal bacteria are found in women's reproductive systems who have not yet reached menopause. That includes women aged 15 to 44 (childbearing age). In America, BV affects one out of every three women, with the percentages being higher among black women.

Bacterial vaginosis isn't considered a danger, but if you're pregnant or trying to get pregnant, it can cause serious issues. Furthermore, bacterial vaginosis can cause various gynecologic complications. That includes early labor, pelvic inflammatory disease, and operative complications. Having an imbalance of microbiome increases the chance of developing STDs, including HIV.

Bacterial Vaginosis Symptoms

Symptoms of bacterial vaginosis in women

The vagina contains healthy microorganisms known as (microbiome) that aid in maintaining the vagina's natural balance. On the other hand, overgrowth of these bacteria causes an imbalance, resulting in a variety of symptoms. They are as follows:

  • An itchy, painful or sore vagina
  • Fishlike odor, especially after sex or during the menstrual cycle
  • Burning sensation after you pee
  • Thin gray, green, or white vaginal discharge 

Bacterial vaginosis has symptoms similar to other sexually transmitted diseases, such as yeast infections. As a result, if you encounter the symptoms listed above, do not rush to the pharmacy for over-the-counter remedies. Rather, seek the assistance of a medical practitioner to help you determine the cause of the illness.

NB: A vaginal discharge is not always caused by BV. Thrush (an excess of yeast candida in the bowel) and sexually transmitted diseases such as chlamydia are two causes of vaginal discharge. Thrush generates a thick white discharge, which causes discomfort and itching around the vagina and vulva.

In most cases, however, those with bacterial vaginosis do not show any signs or symptoms; thus easy to overlook the symptoms.

Bacterial Vaginosis Causes: What are the main causes of BV?

Doctor explains cause of bacterial vaginosis to patient

The fundamental cause of vaginosis is an imbalance in the vagina between beneficial bacteria (lactobacilli) and harmful bacteria (anaerobes). When healthy bacteria outnumber bad bacteria, the natural balance of microorganisms in the vagina is disrupted, resulting in bacterial vaginosis. 

However, the experts are still puzzled about what causes the vaginal imbalance. Bacterial vaginosis is not an STI; however, it can readily be activated by sex. This indicates that having sexual contact with an infected person will result in BV transmission. BV thus reduces the vagina's natural fight against infections as the vagina becomes more acidic.

Other causes of bacterial vaginosis include:

  • Smoking
  • Frequent bubble baths using scented soaps
  • Prolonged menstruation cycles
  • Frequent change in sexual partners
  • Sexually active
  • Past encounter with an STI
  • Hormonal changes of menopause, pregnancy, or puberty
  • Prolonged use of antibiotics.
  • Use of sex toys
  • Wearing nylon tights or thongs.
  • Swimming in public pools
  • Sitting on public toilets


Bacterial Vaginosis Discharge Diagnosis

patient consulting with doctor

To be diagnosed, a healthcare professional will analyze your bacterial vaginosis discharge. It is also possible for your healthcare provider to test a sample of your vaginal fluid for BV under a microscope and send it to the lab for analysis. The medical examiner will also:

  • Perform a complete physical examination
  • Do an exam on your pelvis
  • Ask you about your medical history
  • Take your vaginal discharge to test the vaginas acidic level or its PH  

How Do Yeast Infections Differ from Bacterial Vaginosis (Bv)?

yeast infection and bacterial vaginosis in woman

Both are vaginal infections that cause a disruption of the natural bacteria in the vagina. Here's how you can tell them apart.

Bacterial vaginosis Discharge - the primary sign of BV is the "fishy smell," while the bacterial vaginosis discharge from a yeast infection is like that of cottage cheese and not strong.

Vaginal irritation - yeast infection causes uncomfortable itching and soreness in the vagina and vulva, while the BV doesn't cause any vagina irritation.

Over-the-counter medication - for BV treatment, you will need to see a medical practitioner to get antibiotics, while you can treat yourself with medicine from a chemist for yeast infection.

Bacterial Vaginosis Treatment

yogurt for bacterial vaginosis treatment therapy

There are several treatments for BV, including avoiding some practices to avoid triggering an infection. Treatment for bacterial vaginosis include: 

Antibiotics for Bacterial Vaginosis

Oral antibiotics are the primary treatment choice for pregnant women suffering from BV infection. The doctor may prescribe antibiotics, such as tinidazole, metronidazole, or clindamycin. These pills can be taken orally or administered vaginally.

It takes 5 to 7 days for the drug to take effect. To avoid a recurrence of the infection, doctors advise you to take all the medication even if the symptoms have subsided entirely.

Metronidazole tablets

These antibiotic tablets are the best in clearing BV. After taking the pills, some people may experience numerous severe effects, including vomiting and metallic taste. Therefore, always read the instructions on the leaflet to understand the full impact of the metronidazole tablets. 

Tinidazole tablets

These are the alternative tablets for those who are not tolerant of metronidazole. Like metronidazole, you have to take 2g once for two days or 1g for five days.

Metronidazole gel and clindamycin vaginal creams 

These are administered inside the vagina. However, vaginal creams can weaken the latex condoms and diaphragms, therefore not suitable to use condoms for protection during this period. Other oral antibiotics for treating BV include clindamycin tablets or tinidazole tablets.

Other treatment alternatives for treating bacterial vaginosis is Flower Power, a vegan vaginal suppository specially designed to help naturally restore your vagina's self-cleansing powers.

FlowerPower contains boric acid, an oceanic mineral that has been used for hundreds of years for its acidic, antiviral and antifungal properties.


Although there is not enough proof to suggest that yogurt can treat Bv fully, most women have acknowledged that things settle faster after using yogurt to treat vaginosis. Some women use plain live yogurt by applying a thin coat on the outside of the vagina daily. Others use tampons for internal use before going to bed.

Astodrimer Sodium Gel

Research conducted in 2019 showed that Astodrimer sodium gel provided relief for women with bacterial vaginosis BV. This new kind of treatment for BV should be used for seven days non-stop for better results. You can get it online as Betafem® BV gel. 

It works by creating a physical barrier that repels bacteria from sticking onto the vaginal wall. Most users agree that it works at the same pace as traditional antibiotics.

Vaginal Acetic and Lactic Acid

The goal of acetic and lactic acid gels is to keep the vaginal pH below 4.5, increase lactobacilli growth, and prevent anaerobic bacteria growth. 

According to certain research, long-term usage of vaginal acidifiers of this sort lowers BV recurrences. Other research, however, reveals that, while this therapy is safe, it is ineffective.

Lactobacillus tablets

Some health food stores sell Lactobacillus suppositories and oral pills for BV treatment. Probiotics that are ingested orally are thought to make their way to the vaginal area via the bowel. Some evidence shows that it can help in BV treatment and prevention. 

Some studies imply that therapy should last at least two months. Other research hasn't shown an obvious benefit. Overall, experts believe insufficient evidence to recommend the above alternative therapies.

An obvious option would be to administer intravaginal lactobacillus therapy; after all, why not place the appropriate bacteria in their natural habitat? 

The findings of investigations on vaginal lactobacilli therapies are equally inconsistent, with some studies showing that this treatment is successful and others showing that this treatment also isn't.

Bacterial Vaginosis Risk Factors

bacterial vaginosis risk

BV and Other Infections

If you have intercourse with someone HIV-positive, untreated BV may increase your chance of contracting the virus. This is likely due to the vaginal acidity's protective effect against STIs.

Having HIV and BV combined raises your risk of passing on the virus. Untreated BV may increase the chance of developing Pelvic Inflammatory Disease (PID) by a small chance.


Women who are having difficulty conceiving are more likely to have BV. Also, Low IVF success rates are common among BV-affected women with IVF. 

To determine if certain women were more prone than others to develop BV, the studies that showed these effects looked at women who had been diagnosed as having reproductive issues.

Because of this, it does not indicate that you will have reproductive issues if you are BV positive: More than one in three females of reproductive age have some form of BV, yet the necessity for IVF due to fertility issues is exceedingly rare. 

Thus, the odds of BV influencing your ability to conceive are quite minimal. However, It's still important to contact a doctor if you're hoping to get pregnant soon and you suspect you may have BV.

BV and Surgery

Untreated BV increases the risk of a womb infection following surgical procedures, such as hysterectomy. Most often, if not always, you'll be offered BV therapy.


Pregnancy may be affected by bacterial vaginosis bv. Some pregnancy-related issues may arise if untreated BV is left untreated throughout pregnancy, including:

  • Preterm birth
  • Miscarriage
  • Postpartum endometriosis
  • Early labor
  • Having an underweight baby. 

Therefore, doctors frequently provide medication if you have BV throughout your pregnancy. Ensure you seek medical attention if you experience an unexpected or foul discharge throughout your pregnancy.

Will BV go away on its own?

bacterial vaginosis in women

BV will clear up within a few weeks in many women without treatment. A common home remedy is to add some natural live yogurt with live cultures into your diet. If taken daily, this can help re-establish the proper balance of good and bad bacteria in your vagina.

Although bacterial vaginosis bv isn't life-threatening, the Cleveland Clinic says it can put you at risk for more serious illnesses. Therefore, consult a medical practitioner and get things sorted out.

Some women are known to have recurring episodes of BV, but it is a one-time occurrence for others. Some people experience more than one bout of the condition, while others never get it again remains unclear.


You may need to have several vaginal swabs taken if you have persistent BV (meaning that it doesn't go away with the first therapy you attempt). Women who have bacterial vaginosis bv infections usually get better after a few days of metronidazole pills, but they still carry the infection and pass it on to others.

If you've never taken metronidazole before, your doctor would likely recommend a seven-day course.

Using metronidazole gel twice weekly for up to six months is an option as well. Doctors may advise you to remove your intrauterine contraceptive device IUCD if you have a recurrent bacterial vaginosis bv infection that does not respond to therapy. There is some evidence that IUCDs may play a role in the recurrence of the illness.

Treatment for both you and your same-sex partner is likely to help avoid persistence and recurrence if you both have persistent BV and your partner does not have symptoms.

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