Bacterial Vaginosis Quick Overview
- Bacterial vaginosis is also known
as nonspecific vaginitis. It results from an imbalance or overgrowth of
bacteria normally present in the vagina, in contrast to an infection with
- Gardnerella are one type of
bacteria that have been implicated in the development of bacterial vaginosis.
- Symptoms of bacterial vaginosis
include vaginal discharge and odor.
- Antibiotics, either taken orally
or applied to the vagina, are the treatment of choice for bacterial
- Having multiple sex partners is a
risk factor for developing bacterial vaginosis, although it is not
considered to be a
sexually-transmitted disease since it does occur in
- There are no effective home
remedies to treat bacterial vaginosis, but the condition sometimes goes away
on its own.
What is bacterial vaginosis?
Bacterial vaginosis is a vaginal condition that results from an overgrowth of
normal bacteria in the vagina. The condition
was formerly referred to as Gardnerella vaginitis, after the bacteria that were believed to cause the
condition. However, since there are a number of species of bacteria that
naturally live in the vagina and can grow to excess or imbalance to cause the condition, the
name bacterial vaginosis is the preferred term. As a result of overgrowth of
certain bacteria, a vaginal discharge may result.
What causes bacterial vaginosis?
The reasons for overgrowth of certain types of bacteria in the vagina or an
imbalance in the growth of these bacteria are not fully understood. However,
certain factors can increase a woman's risk of developing bacterial vaginosis,
- having multiple sex partners,
- having a female sex partner, and
Vaginal douching also may increase the risk of developing bacterial vaginosis.
While the condition is more common in women with multiple sex partners, it is
not believed to be contagious or entirely related to sexual activity since it is
the result of overgrowth or imbalance in the bacteria normally present in the
vagina. Moreover, women who have not had sexual activity can develop bacterial
What are the symptoms of bacterial vaginosis?
Vaginal discharge, often with a foul-smelling odor, is
typically the only symptom of bacterial vaginosis. The discharge has been
described a thin and gray to white in color. It is difficult to determine how
much discharge represents an abnormal amount, since all women can have varying amounts of vaginal discharge.
In general, any discharge that is in excess of normal for a particular woman can
be regarded as abnormal. Many women with bacterial vaginosis have no symptoms at
What kind of doctor treats bacterial vagniosis?
Gynecologists typically treat bacterial vaginosis, although primary care providers also may treat the condition.
When should you seek medical care if you think you may have bacterial vaginosis?
If you experience an unusual or excessive vaginal
discharge, a visit to your health-care professional is recommended so that more
serious conditions can be ruled out, such as infection with
gonorrhea. The unpleasant
symptoms of bacterial vaginosis also can be effectively treated.
How is bacterial vaginosis diagnosed?
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 health-care
professional will perform a pelvic exam. During the exam, the health-care
professional will observe the vaginal lining and cervix and will perform a manual examination of the ovaries and uterus. Also during the exam, the
health-care professional may collect samples for examination under a microscope or for other 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.
Yeast Infection and Bacterial Vaginosis Symptoms
Up to 75% of women will experience an inflammatory condition of the
vagina at some point in
their lives. Medically known as vaginitis, inflammation in the vaginal area is a
common condition resulting from multiple causes. Two of the most common causes
of vaginitis are yeast infection and bacterial vaginosis.
What is the medical treatment for bacterial vaginosis
Medical treatment for bacterial vaginosis involves antibiotics taken either
orally or applied locally to the vagina. Since bacterial vaginosis is not
believed to be a sexually transmitted condition, treatment of male sex partners
is typically not necessary.
Medications that cure bacterial vaginosis (antibiotics)
Several antibiotics are effective in the treatment of bacterial vaginosis.
- Metronidazole (Flagyl) taken by either oral (pill) form or as a
(Metrogel) is an effective treatment.
- A vaginal clindamycin cream (Cleocin) is
also an effective option.
- Tinidazole (Tindamax) is an antibiotic that appears to have fewer
side effects than metronidazole and is also effective in treating bacterial
Do I need to follow-up with my doctor after having bacterial vaginosis?
A return visit to a health-care professional is
recommended if the patient's symptoms do not resolve after antibiotic treatment or if
symptoms return. Recurrent bacterial vaginosis may develop in the same woman
after she has been treated, so it is important to see a health-care professional if symptoms persist or recur. Up to 50% of women who are treated
will develop a recurrence of symptoms
in the year following treatment.
Can bacterial vaginosis be prevented?
Because the exact reasons for bacterial overgrowth in the vagina are unknown,
it may not be always possible to prevent bacterial vaginosis. However, by
decreasing certain behaviors (smoking, vaginal douching, and having multiple sex
partners) a woman can reduce her chances of developing the condition.
What is the outlook for a woman with bacterial vaginosis?
Bacterial vaginosis can be effectively treated with antibiotics. The presence
of bacterial vaginosis does appear to increase a woman's risk for acquiring
sexually transmitted infections
(STDs), including HIV.
In pregnancy, bacterial vaginosis is associated with an
increased risk of premature labor and premature birth as
well as infection of the uterus after delivery. However, studies have shown that
screening and treatment of all
pregnant women without symptoms for bacterial vaginosis did not reduce the
incidence of preterm delivery. So routine screening of all pregnant women is not
recommended. However, certain groups of women at higher risk for preterm birth
may benefit from screening even when no symptoms are present, and research is
ongoing to further characterize and determine the need for screening in women at
higher risk for preterm birth.