What Is Bacterial Vaginosis? BV Symptoms, Causes, and Treatment

A change in vaginal odor or discharge can leave you uncomfortable and unsure what to do next. Bacterial vaginosis, commonly called BV, is a common, treatable cause of these symptoms. Understanding the difference between BV and other vaginal conditions can help you get appropriate care instead of trying treatments that may not address the problem.

What is bacterial vaginosis?

Bacterial vaginosis occurs when the normal balance of bacteria in the vagina changes. Protective bacteria decrease while other bacteria become more abundant.

BV can develop without sexual activity, although sexual activity and douching can influence the risk. It is not a sign of poor hygiene. Washing more frequently or using vaginal cleansing products will not correct the imbalance.

What are the symptoms of BV?

Common symptoms include:

1. Thin white or gray vaginal discharge.
2. A noticeable fishy odor, sometimes stronger after sex.
3. Vaginal itching or irritation.
4. Burning during urination.

Some people with BV have no symptoms. Odor or discharge alone cannot confirm the diagnosis because several vaginal conditions can cause similar changes.

BV vs. yeast infection: What is the difference?

BV and vaginal yeast infections have different causes and require different treatments.

BV involves a bacterial imbalance. Thin discharge and a fishy odor are common.

Yeast infections involve an overgrowth of Candida fungus. More intense itching, redness, and thick white discharge are common.

These patterns offer clues, but they are not a reliable substitute for an evaluation. Over-the-counter yeast infection medicines do not treat BV.

What increases the risk of BV?

Factors associated with BV include douching, a new sexual partner, multiple partners, and not using condoms. The exact reasons some people develop BV are not fully understood. You cannot get BV from toilet seats, bedding, or swimming pools. A diagnosis also does not establish that a partner has been unfaithful.

How is BV diagnosed?

A clinician may review your symptoms, perform an examination, and test a sample of vaginal fluid. Testing can help distinguish BV from yeast infections and sexually transmitted infections. Depending on the test, the vaginal swab may be collected by a clinician or by the patient following instructions. A home vaginal pH result alone cannot confirm BV. Before your visit, note when symptoms began, whether they have happened before, and any treatments or vaginal products you have used.

How is bacterial vaginosis treated?

BV is treated with prescription antibiotics. Common options include oral metronidazole, vaginal metronidazole gel, or vaginal clindamycin cream. Your clinician selects treatment based on your medical history, allergies, pregnancy status, and preferences. Complete the prescribed course even if you start feeling better.

During treatment, follow guidance about avoiding sex or using protection. Vaginal clindamycin cream can weaken latex condoms and diaphragms during use and for five days afterward.

Why does BV keep coming back?

BV can return after successful treatment. Recurring symptoms deserve reassessment rather than repeated self-treatment.

For some patients, a clinician may recommend a longer-term treatment plan. Probiotics and vaginal cleansing products should not replace prescribed treatment.

Partner treatment is also worth discussing when BV recurs. Updated ACOG guidance recommends considering concurrent treatment for male partners of adults with recurrent, symptomatic BV. Decisions about other situations, including same-sex partners or a first episode, should be individualized with a clinician.

What if you are pregnant?

Tell your clinician if you are pregnant or could be pregnant. BV during pregnancy is associated with complications, including preterm birth, and symptomatic BV should be evaluated and treated. Your clinician can select an appropriate medication for pregnancy.

When should you seek medical care?

Arrange an evaluation if you notice new vaginal odor, unusual discharge, burning, or symptoms that persist or return after treatment. Seek prompt in-person care if you also have fever, pelvic or lower abdominal pain, or feel significantly unwell. These symptoms can indicate a condition requiring a different evaluation.

Can telehealth help with BV symptoms?

A virtual visit can be a convenient starting point for discussing vaginal symptoms and reviewing your history.

Your clinician can determine whether treatment is appropriate or whether you need vaginal testing, an examination, or other in-person care. Telehealth cannot confirm every cause of vaginal symptoms without additional testing.

Take the next step with Qare

You should feel comfortable bringing up changes in your vaginal health, even when the conversation feels personal.

Visit www.GetQare.com to explore virtual care and discuss your symptoms with a licensed healthcare provider. Prescriptions are provided when medically appropriate following an individual evaluation.

This article provides general education and does not replace individualized medical advice.