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Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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The medical history and physical examination are the first steps in helping to distinguish bacterial vaginosis from more serious conditions.

After taking a medical history, the healthcare practitioner will perform a pelvic exam. During the exam, the healthcare practitioner will observe the vaginal lining and cervix and will perform a manual examination of the ovaries and uterus. Also during the exam, the healthcare practitioner may collect samples for examination under a microscope or for culture studies to rule out the presence of sexually transmitted infections (STDs).

Examination of the discharge under the microscope can help distinguish bacterial vaginosis from yeast vaginitis (candidiasis) and trichomonas (a type of sexually transmitted infection). A sign of bacterial vaginosis under the microscope is an unusual cell referred to as a "clue cell." Women with bacterial vaginosis also have fewer of the type of normal vaginal bacteria called lactobacilli. The vaginal pH (degree of acidity or alkalinity) may also be measured, since a vaginal pH greater than 4.5 also suggests bacterial vaginosis.

A so-called "whiff test" with potassium hydroxide (KOH) liquid is sometimes performed whereby a drop of KOH testing liquid is mixed with a drop of vaginal discharge. If bacterial vaginosis is present, a fishy odor can result.

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