Bacterial Vaginosis

Infection, Women's Health and Childbirth

Bacterial vaginosis (BV) is a common vaginal infection (bacterial) that has affected 21.2 million women in the United States alone at least once in their lifetime. Your vagina has high numbers of healthy bacteria known as, lactobacilli. There is also a small number of anaerobic bacteria. When the natural balance between these bacteria is disturbed, BV may result. The overgrowth of anaerobic bacteria causes vaginal inflammation and uncomfortable symptoms, including itching and burning when urinating. BV is not a sexually transmitted disease; however, since bacterial infections can be passed from one partner to the next, you should refrain from having sex while infected.

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BV does not always have symptoms, so many women do not even know they have it. Sometimes the symptoms mimic a yeast infection. One important distinction between BV and a yeast infection is that yeast infections cause itching in the vaginal area while bacterial vaginosis does not. The symptoms of bacterial vaginosis are:

  • White/grey, or yellowish discharge
  • Foul, often fishy, odor
  • Burning when urinating
  • Itching on the outside of the vagina

Risk Factors

  • Antibiotics
  • Smoking cigarettes
  • Intrauterine devices
  • Multiple sex partners
  • Douching
  • Use of scented feminine products


Your healthcare provider will ask about your past medical history, including if you’ve had previous vaginal infections or sexually transmitted infections. Next, he or she will give you a pelvic exam to check for signs of infection and if the infection has spread to other pelvic organs. Lab tests will be taken to check for overgrowth of anaerobic bacteria and the pH of your vagina.


Antibiotics (e.g., metronidazole; clindamycin; tinidazole). This is the most commonly used treatment for BV as it reduces the number of anaerobic bacteria.  Metronidazole and tinidazole are usually taken orally (metronidazole also comes in topical gel form). Oral antibiotics may cause stomach upset and nausea so alcohol should be avoided. Clindamycin is a cream that is inserted into the vagina. The cream may weaken latex condoms for at least three days after you stop using the cream.

Probiotics. Research has shown that adding lactobacillus along with antibiotics may increase the effectiveness of the antibiotics by helping to restore the natural balance of bacteria in the vagina. Women who took lactobacillus orally and intravaginally showed lower rates of recurring infection and improved symptoms.

Alternative Treatments and Home Remedies

Apple cider vinegar. When you do take a bath, try using 1 cup of apple cider vinegar into your bath water and soak for 15 minutes. This can help kill bacteria and balance vaginal pH.

Yogurt. Make yogurt a regular part of your diet. It contains healthy probiotics that help balance your body’s bacteria.

Garlic. Garlic is a powerful natural antibiotic. Try eating one clove daily.

Fenugreek tea. Take one teaspoon of fenugreek seeds and soak them in water overnight. The next day, drink the water first thing in the morning before eating. Fenugreek is thought to help with a lot of different reproductive concerns in women.

Lifestyle Changes

Certain things we do may contribute to changes in that vaginal flora that cause BV. Here are some lifestyle tips that can help prevent BV.

Do not douche. Cleaning your vagina kills off the good bacteria that you need to keep bacterial levels in check.

Avoid too many baths. Baths are great but taking them often can lead to BV. This is especially true with little girls taking too many bubble baths. Do not use anything in your bathwater.

Change out of your swimsuit after swimming. Keeping a wet swimsuit on can lead to bacterial growth.

Increase water intake. Water can help balance the pH levels and flush out any infection.

Clean before and after sex. This means you and your partner. Otherwise, you may force bacteria into the vagina during sex.

Wear cotton panties. Cotton underwear reduce moisture and increase air flow, helping to keep the area dry.

Wipe front to back. Especially after a bowel movement. Otherwise, you may inadvertently wipe bacteria from your anus into your vagina.


Amaya‐Guio J., Viveros‐Carreño D. A., Sierra‐Barrios E. M., Martinez‐Velasquez M. Y., Grillo‐Ardila C. F. (2016). Antibiotic treatment for the sexual partners of women with bacterial vaginosis. Cochrane Database of Systematic Reviews, 10. Retrieved from

CDC. (2020, February 10). Bacterial vaginosis – CDC fact sheet. Retrieved from Centers for Disease Control and Prevention:

CDC. (2015, July 4). 2015 Sexually transmitted diseases treatment guidelines – Bacterial vaginosis. Retrieved from Centers for Disease Control and Prevention:

Hainer, G. L., and Gibson, M. V. (2011, April 01). Vaginitis: Diagnosis and treatment. American Family Physician, 83(7). Retrieved from American Academy of Family Physicians:

Mayo Clinic. (2019, May 9). Bacterial vaginosis – Symptoms & causes. Retrieved from Mayo Clinic:

Oduyebo, O. O., Anorlu, R. I., Ogunsola, F. T. (2009, July 08). The effects of antimicrobial therapy on bacterial vaginosis in non‐pregnant women. Cochrane Database of Systematic Reviews. Retrieved from Cochrane Library:

Spiegel, C. A. (1991, October). Bacterial vaginosis. Clinical Microbiology Reviews. (pp. 485-502). Retrieved from American Society for Microbiology:


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