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Gynecology

Bacterial Vaginosis

  1. What is bacterial vaginosis?
  2. What are the symptoms?
  3. How can it be treated?
  4. How can it be prevented?
  5. Can it be transmitted sexually?
  6. Does bacterial vaginosis have any long-term effects if it is not treated?

What is bacterial vaginosis?

Bacterial vaginosis is the most common cause of vaginal irritation, itching, and discharge, and is sometimes referred to as Gardnerella; Gardnerella is really just one of the normal vaginal bacteria found in excess during bacterial vaginosis. The vagina has several different types of bacteria present in balanced amounts. Typically, the vagina has a predominance of Lactobacilli which keep the vaginal environment acidic. When this balance is disrupted by too much of one type, women experience vaginal itching, discharge, or redness. Any condition that changes the environment of the vagina (the vaginal pH or acidity) could lead to this imbalance, such as vaginal creams, douching, hygiene products, lubricants, soaps, or certain types of condoms. Oral sex may also cause a change in the vaginal environment, possibly leading to bacterial vaginosis. Most cases of bacterial vaginosis occur in women who are sexually active, but women who are not having sex can also have it. Bacterial vaginosis is the most common cause of vaginal irritation, itching, and discharge...Sometimes referred to as Gardnerella...it's really just one of the normal vaginal bacteria found in excess during bacterial vaginosis

What are the symptoms?

The most common symptom is abnormal vaginal discharge. This may be grey or yellowish in color, and has a fishy odor. You may also experience vaginal itching and burning (often because of vaginitis or other infections that can accompany bacterial vaginosis). However, nearly 50% of women who are diagnosed with bacterial vaginosis at a clinic visit may not have noticed any symptoms. The symptoms are often confused with other vaginal infections, such as yeast infections. If you have tried to treat vaginal discomfort with yeast infection medicated creams and it hasn't worked, it is possible you have bacterial vaginosis, NOT a yeast infection. Make an appointment with your health care provider if you are not sure. Symptoms
  • Abnormal discharge -may be grey or yellowish in color, with a fishy odor.
  • Vaginal itching and burning
  • Nearly 50% of women may not have noticed any symptoms

How can it be treated?

It can be treated with antibiotics in pill or cream form. The most common treatment prescribed is metronidazole. This is applied vaginally twice a day for five days. You should not drink alcohol while taking metronidazole. If it does not clear up within a few days of treatment, or you continue to get bacterial vaginosis, other conditions of the vagina (such as a yeast infection or cervical infection) should be ruled out as a cause.

How can it be prevented?

Although not considered a sexually transmitted infection, there is some evidence that condom use helps prevent recurrence. You should avoid douching or using other feminine hygiene products that may lead to an increase in incidence of bacterial vaginosis.

Can it be transmitted sexually?

It is possible that bacterial vaginosis can be spread sexually, probably through vaginal intercourse. Currently, the role of sexual activity in bacterial vaginosis is not known. Your partner should not need to be treated, unless you have a case of bacterial vaginosis that is not responding to antibiotics. In these cases, it may be helpful to treat your partner.

Does bacterial vaginosis have any long-term effects if it is not treated?

Researchers are currently investigating a possible connection between bacterial vaginosis and pelvic infections that can sometimes result in infertility and tubal (ectopic) pregnancies. Research also suggests that pregnant women with bacterial vaginosis have a greater chance of delivering premature and low-birth-weight babies.

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Last Reviewed: Sep 28, 2009

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated