Bacterial Vaginosis (BV)- Causes and Treatment

What is Bacterial Vaginosis

Bacterial vaginosis (BV) is a mild infection in the vagina. It develops when there’s an imbalance between the “good” bacteria in the vagina that are helpful and the “bad” bacteria that can cause problems.

Bacterial vaginosis may cause pain, itching, and bad-smelling discharge. But most girls with BV don’t notice any symptoms and that’s not necessarily a good thing. Symptoms alert us to signs of trouble. Girls who don’t know they have BV might not get treated for it. BV may be mild, but if it isn’t treated it can lead to other problems.

BV is the most common vaginal infection affecting young women. Although it’s not considered a sexually transmitted disease (STD), the chances of developing bacterial vaginosis seem to increase with the number of sexual partners a woman has. You don’t need to be having sex to get BV, though. Girls who’ve never had sex also can get it.

Epidemiology

BV is the most common infection of the vagina in women of reproductive age. The percentage of women affected at any given time varies between 5% and 70%. BV is most common in parts of Africa, and least common in Asia and Europe. In the United States, about 30% of those between the ages of 14 and 49 are affected. Rates vary considerably between ethnic groups within a country.

Risk factors

Unprotected sexual activity with a new partner or multiple partners can increase your risk of getting bacterial vaginosis. That means sex without a condom or oral sex without a dental dam. Having a female sex partner may also increase your risk of bacterial vaginosis.

Frequent douching (using a cleanser or water to clean inside the vagina) or using medicated or perfumed soaps, shower gels or bubble baths also increase your chances of getting BV.

If you smoke you are also at increased risk of getting BV.

Causes

Not much is known about how women get BV. Any woman can get BV, but there are certain things that can upset the normal balance of bacteria in the vagina, raising your risk of BV:

  • Having a new sex partner or multiple sex partners
  • Douching
  • Using an intrauterine device (IUD) for birth control
  • Not using a condom

BV is more common among women who are sexually active, but it is not clear how sex changes the balance of bacteria. You cannot get BV from:

  • Toilet seats
  • Bedding
  • Swimming pools
  • Touching objects around you

Symptoms of bacterial vaginosis

The symptoms of BV may differ from patient to patient and according to the stage of the infection.

Vaginal Discharge

This is the most common and the first symptom to appear in infected women. The vaginal discharge ranges in consistency and color over time. It can look watery and whitish or thick and yellow. The discharge is very distinctive from normal vaginal discharge. It will also smell foul and putrid with a strong note of ammonia.

Itching

This is another common symptom of BV which occurs in most women. The patient will complain of itching in the vaginal area. This is especially experienced in the inner walls of the vagina and the clitoris. It is best to avoid scratching as much as possible. This is because scratching the area will aggravate the itching even more. It can even lead to bleeding.

Spotting

This is not seen very often but some women do complain of it. Light spotting may occur when the infection is more advanced. Bleeding may also occur when the area is irritated due to scratching or intercourse.

Discomfort

This is an obvious symptom of any infection. The patient will feel uncomfortable in the vaginal area because the skin is irritated by the bacterial activity. Some women say that they feel a peculiar discomfort while sitting or wearing very tight underclothes.

Some also say that the area feels very dry and scratchy internally. The infection may also cause slight inflammation of the vaginal walls which can cause undesirable symptoms like tenderness and sensitivity.

Discomfort during sexual intercourse

This happens because the region is already injured by the infection. Further friction due to sex will aggravate the discomfort even more. Some women find sex painful during infection while others suffer from vaginal dryness. It is usually advised to abstain from sex until the patient is completely free of infection.

Complications of Bacterial Vaginosis

Most of the time, BV goes away without any complications when properly treated. But if it’s not treated, BV can increase a girl’s chances of certain health problems:

Increased chance of getting an STD: Girls with BV are more likely to get STDs like herpes, chlamydia, gonorrhea, and HIV.

Increased chance of pregnancy complications: When BV isn’t treated; a woman may have more problems when she gets pregnant, such as premature birth, low birth weight, infection, and possibly miscarriage.

Infections like BV are one reason why girls who are having sex need to get regular gynecological checkups and STD tests. Even if a girl doesn’t know that she has an infection, doctors and nurse practitioners can diagnose and treat it to help prevent complications.

Diagnosis of bacterial infection

Your health care provider will check to see if you have at least 3 out of 4 of the following symptoms:

  • Thin white discharge
  • Clue cells
  • pH>4.5
  • Fishy odor (from discharge)

There are two tests that can help provide accurate results right away:

Vaginal pH test: The doctor will take a sample of your discharge and analyze the pH level. If it is higher than 4.5, you most likely have bacterial vaginosis.

Cotton swab sample: Your vaginal discharge will be analyzed to check if the bacterial infection is actually responsible for the symptoms because a yeast infection can have similar symptoms to bacterial vaginosis.

Treatment and medications

To treat bacterial vaginosis, your doctor may prescribe one of the following medications:

Metronidazole (Flagyl, Metrogel-Vaginal, others): This medicine may be taken as a pill by mouth (orally). Metronidazole is also available as a topical gel that you insert into your vagina. To reduce the risk of 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. Clindamycin cream 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.

It’s generally not necessary to treat an infected woman’s male sexual partner, but bacterial vaginosis can spread between female sexual partners. Female partners should seek testing and may need treatment. It’s especially important for pregnant women with symptoms to be treated to help 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 risk of recurrence.

Prevention of BV

BV is not completely understood by scientists, and the best ways to prevent it are unknown. However, it is known that BV is associated with having a new sex partner or having multiple sex partners.

The following basic prevention steps can help reduce the risk of upsetting the natural balance of bacteria in the vagina and developing BV:

  • Be abstinent
  • Limit the number of sex partners
  • Do not douche
  • Use all of the medicine prescribed for the treatment of BV, even if the signs and symptoms go away.

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115 comments

  1. Your Namefavour Alpheaus Shagnah

    thanks for educating us, guestion, the medicine described can cure discharge?

  2. Francisca Nisha Gomes Bukkam

    cleanliness is the best way to prevent it as I do it.

  3. this has help me a lot to dig out what has been affecting my spouse, is there any mechanism to design as a cloth or pads to treatment thanks.

  4. please is it the same as gonorrhea and syphilis.

  5. please can one take all the above prescribed drugs at once?
    Or pick just one to be used

  6. I think I noticed the fishy smell discharge. and am using a vaginal inserter drug on it but the discharge are now white and smell drug-like.

  7. is it every medicine mentioned there will the person use

  8. thank you so much for this medical institution for the public to know what to do ,what not to do for you to keep yourself healthy,so I wanted to know if you 2yrs without sex is there any problems you will experience,cause I’m separated with my husband so I have less interested to man please help

  9. is Tremendous good for treating BV??

  10. thanks a lot, i am now knowledgeable.

  11. Adebowaleur Name

    if I use d inserting 1 will it cure. thanks

  12. I was diagnosed BV for the past two weeks;I have seen the gynecologist who prescribed levofloxacin and flagyl for which I took for 7 days but the problem is that I been menstruating or rather bleeding since then(non-stop) is it normal.I mean is lasting for 2 weeks now.

  13. Can’t we go to pharmacy and buy all this drugs without doctor’s knowledge

  14. when you see your circle early before the normal month those that mean the person have infection

  15. how can someone treat menstral disorder, I mean if you are to see it 28days it comes on the 25 or 26 day of it is it normal

  16. My wife has this problem and I have been finding the cause . Thanks. How can this be treated effectively?

  17. pls.be careful each medicine suppose to be take under doctors instruction thanks.

  18. Thank you for the insight

  19. can this also cause heavy Mestral pain

  20. Simon Serzio Ziazia

    With proper management it can cured well

  21. Good afternoon
    May I get the medication over the counter?

  22. Wow
    This article is very useful to me.
    Thanks to the presenters of this

  23. Ramzey Shybuttaniah

    Thanks

  24. Good afternoon,
    My spouse noticed the following symptoms yesterday and today. Itching and pain in her private part. Can it be a sign of BV??

  25. beauty Davamalar

    It is a good advise for the girls and ladies. To avoid unnecessary deseases.

  26. pls treatment for infection

  27. can i use a feminielle vaginal wash to cure vaginal odour?

  28. Angella Odjevwe

    I went into taking native medicine,and for two months I’ve been seeing my period, please what can I do or take to stop it

  29. can I use gentamycin injection to treat Bv?

  30. ls only seeing yellowish discharges and blood during sexual intercourse a sign of BV

  31. I’m having this infection for couple a months now I went to see the doctor several times nothing actually helped….what now???

  32. Please can you give out some medication for the treatment for gonorrhea because I am experiencing symptoms of gonorrhea. thank you

  33. Md.Hafizul Islam

    I think it’s overcome to success. I will pescribe now and i think the will be 100% come back. Thanks a lot everyone

  34. friends is it that dangerous to our system

  35. Augusta M Bunduka

    Thanks,a lot!! am living with BV for your concern I will start my treatment now

  36. that’s nice,I haven’t noticed any of this because I do check up Every 3month but I will still try to be careful and I also have to conduct the BV test to be sure of my self.thanks

  37. Beatrice Agyemang

    please,l have been treating bacterial vaginosis with all the medications given to me by doctors for quite long but it still reoccurs .What should l do please?

    • To prevent recurrent bacterial vaginosis please follow the following Treatment strategies:
      Antibiotics – taken either orally or vaginally until they are gone
      Lifestyle changes – including changes in diet, abstinence from sexual activity until healed, vitamin supplements, and avoiding douches and antiseptic bath products

  38. what is the treatment of BV for pregnant women?

    • Treatment is highly recommended to avoid any chance of preterm labor.
      There are various treatments which include:
      Oral medications – Clindamycin 300 mg or Metronidazole 500 mg twice daily for 7 days
      Topical medications – Clindamycin 5 g or Metronidazole at bedtime for 5 days (This treatment may give symptomatic relief, but it is insufficient in preventing pregnancy complications

  39. ALFREDO SAMUEL.

    My Question is that I am a girl of (12) entering (13) by August this year is it possible for me to treat it in this age And is it possible for me to have my MENSTURATING.
    THANKS…..

  40. Were can I get cream to use inside mu vigina or tablet cz now my vigina is itching

  41. pls is it possible for yeast infection to migrate to stapphlycocuss

  42. thanks for your help through my phone now I can help my friend in this article

  43. can a man contact Bacterial Vaginosis infection?

    • Men can’t get BV because the penis doesn’t have the same delicate balance of bacteria. In addition, bacterial vaginosis doesn’t spread like a sexually transmitted infection (STI).

  44. What if you are the BV signs and symptoms,you have been tested but the result was negative

  45. I have vdrl in my blood test… does my partner too have vdrl?

  46. what is the word dourche meaning?

    • A douche is a device used to introduce a stream of water into the body for medical or hygienic reasons, or the stream of water itself. Douche usually refers to vaginal irrigation, the rinsing of the vagina, but it can also refer to the rinsing of any body cavity.

  47. Your Name Belinda

    please is there any prescribe medicine again

  48. Can we have sex with my wife wen are on drugs for Bv?

  49. Can all the medicine be taken together

  50. i have burning problem in vegina and sometimes it increases after sex what should i do?

  51. Orekoya Oluwabunmi

    I have been having this viginal problem for the past 16years and I have been treating it but it will go and come back, But the discharge that is coming out now is yellowish and smell also it scratches and very painful. which list of drugs can I use thanks.??????????

  52. can I use Zithromax and doxycycline to treat BV

  53. It’s hot when itchy and sollowm areas very painful when u touch it I because very tried I have been using so may drugs

  54. how many pills of metronidazole should I use

    • IV:
      -Loading dose: 15 mg/kg IV once infused over 1 hour
      -Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
      -Maximum dose: 4 g per day
      -Duration of therapy: 7 to 10 days

      ORAL:
      Immediate-release Capsules and Tablets: 7.5 mg/kg orally every 6 hours
      -Maximum dose: 4 g per day
      -Duration of therapy: 7 to 10 days

  55. please when I wanted to have sex with my partner I always feel pain please is it normal at times I bleed to please am I ok

  56. Avaala Awinemah Mary

    I’m taking the metronidazole.
    But any time l finish taking it l feel like vomiting or if it is time for me to take the drug and l haven’t taken it l feel like vomiting too so what is it again please.

  57. thank you for your treatment. I was sufering about its. you are useful to me

  58. please which of the drugs can cure the fishy Smell

    • A commonly prescribed antibiotic for vaginitis is metronidazole (Flagyl) tablets or a cream or gel such as clindamycin (Cleocin) that you apply to your vagina. Follow all your doctor’s instructions for taking these medications.

  59. Lucy NkemYour Name

    what dosage of metanidazol can be taken each day to treat bacterial vaginosis

    • Nonpregnant women:
      500 mg PO BID x 7 days, OR
      2 g PO qDay single dose, OR
      Extended-release: 750 mg PO qDay x 7 days
      Pregnant women:
      500 mg PO BID x 7 days, OR
      250 mg PO TID x 7 days

  60. my wife is to infected what should I do plz? problems with sex during the intercourse

  61. Hope the cream and gel will not have any side effects

  62. please what if the discharge does not have a fishy odour but smells like starch or cassava dough.
    thanks

  63. pls I have being treating this thing now for some years and no changings pls what can I do. this discharging of a thing

  64. really helpful to me
    thanks so much for this opportunity,am really grateful and I really enjoyed using this app

  65. BV (bacteria vaginosis) should be treated as an STI. Males do contract the infection from their female partners. Both partners can suffer from and carry these signs tiny rash-like bumps all over the face, the females a fishy odor and the males a sour moldy musty smell behind the head of the penis, both sexes can experience UTI symptoms and can contract a UTI along with BV, extreme tiredness, foggy brain, constipation, constantly dry ashy lips and dehydration. The Male should be treated as well.

  66. BV are tiny bacterial parasites that feed off of good bacteria and body fluids. It is very necessary that males get treated for BV. If not the male will pass this on to whomever or if monogamous will give it right back to their partner. For a Male the parasites live inside the head of the penis at first and for both sexes the parasite multiplies and travels through out the body infesting it. MALES SHOULD ALWAYS BE TREATED IF THEY ARE HAVING SEX WITH A FEMALE WHO HAS BV.

  67. Males cannot be treated with Flagyl. Males should be treated with something stronger AND Metronidazole gel covering their penis with it after a bath pushing a good bit of the gel into the hole of their penis. Females should be treated with the Metronidazole pills or 500mg of Clindamycin. Please people believe what I’m telling you. Although it can pop up out of nowhere in females, females will pass it on through sex to males and it’s a never ending battle if the Male does not get treated.

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