Bacterial vaginosis is a mild infection of the vagina caused by bacteria. Normally, there are a lot of “good” bacteria and some “bad” bacteria in the vagina. The good types help control the growth of the bad types. In women with bacterial vaginosis, the balance is upset. There are not enough good bacteria and too many bad bacteria.
Bacterial vaginosis is usually a mild problem that may go away on its own in a few days. But it can lead to more serious problems. So it’s a good idea to see your doctor and get treatment.
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.
Smoke.
Douche.
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.
The most common symptom is a smelly vaginal discharge. It may look grayish white or yellow. A sign of bacterial vaginosis can be a “fishy” smell, which may be worse after sex. About half of women who have bacterial vaginosis do not notice any symptoms.
Many things can cause abnormal vaginal discharge, including some sexually transmitted infections (STIs). See your doctor so you can be tested and get the right treatment.
Doctors diagnose bacterial vaginosis by asking about the symptoms, doing a pelvic exam, and taking a sample of the vaginal discharge. The sample can be tested to find out if you have bacterial vaginosis.
Bacterial vaginosis usually does not cause other health problems. But in some cases it can lead to serious problems.
If you have it when you are pregnant, it increases the risk ofmiscarriage, early (preterm) delivery, and uterine infection after pregnancy.
If you have it when you have a pelvic procedure such as a cesarean section, an abortion, or a hysterectomy, you are more likely to get a pelvic infection.
If you have it and you are exposed to a sexually transmitted infection (including HIV), you are more likely to catch the infection.
Symptoms
Many women with bacterial vaginosis do not have any symptoms. Bacterial vaginosis does not typically cause itching. But it does cause:
An excessive grayish white vaginal discharge, unlike normal vaginal discharge (1 out of 3 women who have bacterial vaginosis describe the discharge as yellow).1
A bothersome “fishy” odor, which is usually worse after sex (intercourse).
To treat bacterial vaginosis, your doctor may prescribe one of the following medications:
- Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine may be taken orally — as a pill that you swallow. Metronidazole is also available for use topically, as a gel that you insert into your vagina. To avoid the potential for stomach upset, abdominal pain or nausea while using this medication, avoid alcohol during treatment and for at least one day after completing treatment — check the instructions on the product.
- Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that you insert into your vagina. One effect of using clindamycin cream is that it may weaken latex condoms during treatment and for at least three days after you stop using the cream.
- Tinidazole (Tindamax). This medication is taken orally. Tinidazole has the same potential for stomach upset and nausea as oral metronidazole does, so avoid alcohol during treatment and for at least one day after completing treatment.
Generally, it’s not necessary to treat a woman’s male sexual partner, but bacterial vaginosis can spread between female sexual partners. Female partners should seek testing and, if indicated, treatment of bacterial vaginosis. It’s especially important for pregnant women with symptoms to be treated, as this may decrease the risk of premature delivery or low birth weight.
Take your medicine or use the cream or gel for as long as your doctor prescribes it — even if your symptoms go away. Stopping treatment early may increase the likelihood of recurrence.
