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Definition

Bacterial vaginosis is an infection of the vulva and vagina. It is associated with an imbalance of bacteria in the vagina.

Vagina

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Causes

A mix of good and bad bacteria is normally found in the vagina. Bacterial vaginosis occurs when there is an increase in the amount of bad bacteria. The increase in bad bacteria causes a decrease in good bacteria. This imbalance can lead to symptoms.

It is not clear exactly what causes the increase in bad bacteria.

Risk Factors

Factors that may increase your chance of bacterial vaginosis include:

  • Antibiotic use
  • Smoking
  • Douching
  • Having a new sexual partner or multiple partners
  • Having sex without a condom
  • Using an intrauterine device (IUD) for birth control

Any woman can get bacterial vaginosis, including those who have never had sex.

Symptoms

Some women with bacterial vaginosis do not have any symptoms.

Symptoms that can develop include:

  • Itching around the vagina
  • Vaginal irritation
  • Burning feeling while urinating
  • Abnormal vaginal discharge:
    • Color: white or gray
    • Consistency: thin, foamy, or watery
    • Odor: fish-like, especially after sex

There are several different conditions that can cause these symptoms. Your doctor will help you determine the cause of your symptoms.

Diagnosis

You will be asked about your symptoms, and medical and sexual history. A physical exam will be done. This will include a pelvic exam.

Fluid from your vagina may be tested to look for specific bacteria or other infectious agents.

Treatment

Bacterial vaginosis can lead to complications such as an increased risk of:

Treatment is important even if you do not have any symptoms. The main course of treatment is prescription antibiotic pills or vaginal creams. Finish all medication as prescribed by your doctor even if the symptoms have gone away. This can prevent the infection from recurring.

Avoid sexual intercourse during treatment. If you do have sexual intercourse, use condoms. Usually, male sexual partners do not need to be treated. Talk with your doctor about the best treatment plan for you.

Prevention

To help reduce your chance of bacterial vaginosis:

  • Abstain from sex or remain monogamous.
  • Use condoms when having sex.
  • Do not use douches.
  • After bowel movements, wipe from front to back, away from the vagina.

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

Office on Women's Health
http://www.womenshealth.gov

CANADIAN RESOURCES:

Sexuality and U—The Society of Obstetricians and Gynaecologists of Canada
http://www.sexualityandu.ca

Women's Health Matters
http://www.womenshealthmatters.ca

References:

2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/tg2015/default.htm. Updated October 21, 2015. Accessed December 11, 2015.

Bacterial vaginosis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm. Updated September 3, 2015. Accessed December 11, 2015.

Bacterial vaginosis. Office on Women's Health website. Available at: http://womenshealth.gov/publications/our-publications/fact-sheet/bacterial-vaginosis.html. Updated May 26, 2015. Accessed December 11, 2015..

Bacterial vaginosis (BV). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 9, 2015. Accessed December 11, 2015.

Martin HL, Nyange PM, et al. Hormonal contraception, sexually transmitted diseases, and risk of heterosexual transmission of human immunodeficiency virus type 1. J Infect Dis. 1998;178(4):1053-1059.

Martin HL, Richardson BA, et al. Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. J Infect Dis. 1999;180(6):1863-1868.

Myer L, Kuhn L, et al. Intravaginal practices, bacterial vaginosis, and women's susceptibility to HIV infection: epidemiological evidence and biological mechanisms. Lancet Infect Dis. 2005;5(12):786-794.

Taha TE, Hoover DR, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS. 1998;12(13):1699-1706.

7/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Qaseem A, Humphrey LL, Harris R, et al. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161(1):67-72.



Last reviewed December 2015 by Karli-Rae Kerrschneider, RN

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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