Bacterial vaginosis (BV), also known as vaginal bacteriosis is the most common cause of vaginal infection for women of childbearing age. Although it frequently develops after sexual intercourse with a new partner, bacterial vaginosis is not considered as an STI (sexually transmitted infection). BV is more common in women with multiple partners.
Bacterial vaginosis – not to be confused with candidiasis (yeast infection) or Trichomonas vaginalis (trichomoniasis) which are not caused by bacteria – is caused by an imbalance of naturally occurring bacterial flora (the usual bacteria found in a woman’s vagina). Smoking and the use of some hygiene products are linked to a higher risk of developing BV.
Experts are not sure what causes the bacteria in the vagina to get out of balance. But certain things make it more likely to happen. Your risk of getting bacterial vaginosis is higher if you:
- Have more than one sex partner or have a new sex partner.
You may be able to avoid bacterial vaginosis if you limit your number of sex partners and don’t douche or smoke. Bacterial vaginosis is more common in women who are sexually active. But it is probably not something you catch from another person.
What are the signs and symptoms of bacterial vaginosis?
Women with BV may have an abnormal vaginal discharge with an unpleasant odor. Some women report a strong fish-like odor, especially after intercourse. Discharge, if present, is usually white or gray; it can be thin. Women with BV may also have burning during urination or itching around the outside of the vagina, or both. However, most women with BV report no signs or symptoms at all.
What is the treatment for bacterial vaginosis?
While up to 1/3 of cases of bacterial vaginosis may resolve on their own, it is recommended that medical treatment be given if symptoms are present or during pregnancy to avoid the development of complications. Antibiotics are the recommended treatment for bacterial vaginosis. A few antibiotic remedies are routinely used. Metronidazole (Flagyl) taken by either oral (pill) form or by vaginal metronidazole gel (Metrogel) is an effective cure. Also available is the vaginal clindamycin cream (Cleocin). The oral metronidazole can cause some minor but unpleasant side effects, but is believed to be the most effective treatment. The gels do not typically cause side effects, although yeast vaginitis can occur as a side effect of the medication.
Complications of BV
Generally, bacterial vaginosis doesn’t cause complications. But under certain circumstances, having bacterial vaginosis may lead to:
- Preterm birth. In pregnant women, bacterial vaginosis is linked to premature deliveries and low birth weight babies.
- Sexually transmitted infections. Having bacterial vaginosis makes women more susceptible to sexually transmitted infections, such as HIV, herpes simplex virus, chlamydia or gonorrhea. If you have HIV, bacterial vaginosis increases the odds that you’ll pass the virus on to your partner.
- Infection risk after gynecologic surgery. Having bacterial vaginosis may be associated with a greater chance of developing a post-surgical infection after procedures such as hysterectomy or dilation and curettage (D&C).
- Pelvic inflammatory disease (PID). Bacterial vaginosis can sometimes cause PID, an infection of the uterus and the fallopian tubes that can increase the risk of infertility.