Exams and Tests

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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