Bacterial Vaginosis: Causes, Symptoms and Diagnosis

bacterial vaginosis

Bacterial Vaginosis occurs due to an imbalance of bacteria in the vagina.

Usually, the vagina, like most body parts, does have good bacteria that are not harmful. However, in BV, the growth of a certain bacteria increases leading to a decrease in the acidity of the vagina therefore causing the infection.

This article would discuss the causes, symptoms, treatment and prevention of Bacterial Vaginosis.

causes of bacterial vaginosis

Causes and Risk Factors of Bacterial Vaginosis

Bacterial Vaginosis occurs due to a disturbance in the balance of many bacteria already present in the vagina, not by a single type of bacteria.

These include the lactobacillus, anaerobic bacteria, Gardnerella organism, Peptostreptococcus among others.

The excessive growth of anaerobic bacteria reduced the growth of lactobacilli and in return decreases the acidity of the vagina.

The vagina’s normal ph is around 3.8 to 4.5. If the pH crosses 4.5, the lactobacilli begin to die leading to BV.

1 in 3 women has experienced Bacterial Vaginosis once in their life. 

You have an increased risk of getting Bacterial Vaginosis BV if:

  • You are a sexually active woman. Women who are not sexually active can also get BV but it is more likely to happen to women who are currently active.
  • Having multiple sexual partners, frequently changing sexual partners, or having a new sexual partner can cause Bacterial Vaginosis.
  • You have previously contracted a Sexually transmitted infection (STI).
  • If you have an Intrauterine device (IUD)for contraception.
  • If you have been on a recent antibiotic course, it is likely to kill the good bacteria.
  • Douching or rinsing the vagina with scented soaps and vaginal deodrants. The vagina is a self-cleaning organ and it does not require douching. Using water or soaps can imbalance the pH leading to more anaerobic bacteria growth.
  • You are a smoker.
  • You lack lactobacilli in the vaginal area naturally. Since fewer lactobacilli reduce acidity then there is a greater likelihood of getting this issue.
  • You are undergoing some hormonal changes like menopause, pregnancy or puberty. During this time, the natural acidity of the vagina decreases.
  • You are recently having heavy or prolonged than usual periods.
  • Using perfumed pads, bubble baths or deodorants near the vagina

Bacterial Vaginosis is not to be confused with Urinary Tract Infection or Yeast infection.

While both of these are infections,

Urinary Tract Infection (UTI) happens when bacteria enters the urinary system from which they are supposed to be kept out.

Whereas in Bacterial Vaginosis, the already existing bacteria in the vagina are disturbed and increase the natural pH of the vagina.

bacterial vaginosis symptoms

Symptoms of Bacterial Vaginosis

From 50 to 75 percent of women may never experience any symptoms of Bacterial Vaginosis however, one prominent symptom is vaginal discharge. In fact, BV is behind the vaginal discharge many childbearing women face.

It can also happen to women in between the menstrual cycle, even before or after the period. An abnormal amount of discharge should be consulted with a doctor.

The common symptoms of BV if any include the vaginal discharge being either white or grey in color and being watery. The vaginal discharge also has a foul odor which is very strong especially after sexual intercourse.

Other less likely symptoms are itching, pain and burning around the vagina and vulva and having a strong burning sensation during urination but it does not usually cause these issues prominently.

diagnosisDiagnosis of Bacterial Vaginosis 

If you discover all these symptoms, it is better to consult the doctor soon. The doctor will probably carry out a physical examination alongside gathering your medical history.

After going through your symptoms, the doctor or nurse may wipe some discharge on a cotton bud as a sample, to check for cells infected with bacteria in the vaginal walls called the clue cells.

They may also do a pH acidity test. They may immediately check the sample on a pH paper to check for the acidity levels. If pH value increases from 4.5, that may indicate BV.

You can also do this test at home. The sample may also be sent for lab testing to have a clearer look at the cells infected with bacteria and rule out any STI’s.

In some cases, the doctors may also suggest carrying out a pelvic exam to thoroughly examine the vaginal lining and cervix.



Treatment of Bacterial Vaginosis 

If you are experiencing no symptoms of Bacterial Vaginosis then it is possible that it may go away without seeking treatment.

However, if you have already noticed the symptoms then your doctor might recommend you some antibiotics to take as a full course of 5 to 7 days, the most common of which is Metronidazole.

Take Metronidazole tablets twice a day in 400 to 500 mg amount, or as prescribed by your doctor.

They are considered to be most effective to treat BV especially if the woman is pregnant or breastfeeding.

If tablets do not suit you then you can also choose to use Metronidazole vaginal gel inside your vagina which also happens to be equally effective as antibiotics. Other antibiotics that can be used for treatment are Clindamycin and Tinidazole.

Bacterial Vaginosis is still very likely to return after 3 to 6 months, even after getting treatment. The doctor may change the method of treatment this time from medicine to gel or vice versa but if the frequency of contracting BV persists then, treatment may be prolonged for 6 months.

While there is not much evidence that this problem can be treated by home remedies, it is thought that probiotics help. Some women do suggest that applying plain yogurt outside the vagina helps in easing it.

However, due to the lack of evidence, it is always better to consult the doctor and get proper treatment rather than trying home remedies.

Complications of Bacterial Vaginosis 

Sometimes BV may not be that critical and it can also be at times cured without much treatment. However, it can occur again if left untreated.

Even if there is a less probability, it can get dangerous for pregnant women and their babies to leave it untreated.

Some complications that can arise due to Bacterial Vaginosis during pregnancy include a preterm delivery which is a premature birth of the baby essentially leading to the baby having less weight. There can also be an inflammation of the lining of the uterus leading to postpartum endometriosis.

In extreme cases, there can be loss of the baby and tubal factor infertility when the fallopian tubes get damaged. This is termed the Pelvic Inflammatory Disease (PID).

Other complications that can occur in women are being more susceptible to catching Sexually Transmitted Infections like herpes and Sexually Transmitted Diseases. In fact, if complications arise, you are more likely to transfer HIV to your partner and also contract it.

You can also contract another bacterial infection if you are having surgery for your reproductive organs like hysterectomy while you already have BV. There is also a lesser chance of IVF being successful after you have contracted it.


It is quite possible to prevent BV and all these terrible complications from arising if you take small steps to ensure that you do not contract it.

It is not linked with hygiene but limiting the risk factors can surely help.

Bacterial Vaginosis can be prevented and controlled by:

  • Having one sexual partner and having safe sex with the use of condoms
  • Stopping douching. Using only water and mild soaps on your genitals and wiping thoroughly from the front and back after cleaning. Also not pushing water inside the vagina because it is a self-cleaning organ.
  • Showering instead of bathing in a bathtub and avoiding the use of bubble baths, bath oils, or any scented soap.
  • Making sure that you and your partner are both tested for Sexually Transmitted Diseases
  • Stopping smoking.
  • Not using very strong detergents for washing and cleaning your underwear.
  • Not using any lubricants or scented intimate hygiene products near the vagina.
  • Avoiding wearing nylon tights and thongs.
  • Washing the vulva once a day with water.

Taking these measures can reduce your chances of contracting this issue and stopping its recurrence. However, once diagnosed, it is also better to take these preventative measures so that the treatment is more effective.

bacterial vaginosis diagramConclusion 

While Bacterial Vaginosis is not that dangerous or life-threatening, the symptoms can be disturbing and can alter the quality of life. Therefore it is in your best interest to detect it as soon as possible.

Moreover, the complications can go from mild to severe (infertility, losing baby, contracting HIV), especially if left untreated.

It will not be spread through contacts like toilet seats and swimming pools but it is not sure if it can be considered contagious. It spreads through multiple partners and unbalances the bacteria but not as a contagion.

However, women whose partners are also female, can both contract it. But not to forget that women who have never had sex are also likely to get it because of douching or a lack of lactobacillus naturally around their vagina.

Therefore, to have a good quality of life, you should diagnose Bacterial Vaginosis sooner and get it treated. If it reoccurs then contact your doctor for a different and longer treatment.

After all, we all wish to live a healthy and comfortable life.


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