Vaginitis

Bacterial Vaginosis

Ambulatory Care,Emergency Medicine,Genitourinary,Pediatric

Written by the doctors and editors at UpToDate
What is bacterial vaginosis? — Bacterial vaginosis is an infection in the vagina that can cause bad-smelling vaginal discharge. "Vaginal discharge" is the term doctors and nurses use to describe any fluid that comes out of the vagina (figure 1). Normally, women have a small amount of vaginal discharge each day. But women with bacterial vaginosis can have a lot of vaginal discharge, or vaginal discharge that smells bad.
Bacterial vaginosis is caused by certain bacteria (germs). The vagina normally has different types of bacteria in it. When the amounts or the types of bacteria change, an infection can happen.
Women do not catch bacterial vaginosis from having sex with men. But women who have bacterial vaginosis have a higher chance of catching other infections from their partner during sex. Women who have sex with other women might pass bacterial vaginosis on to their sex partners.
What are the symptoms of bacterial vaginosis? — Many women with bacterial vaginosis have no symptoms. When women have symptoms, they often have a "fishy-smelling" vaginal discharge that they might notice more after sex. The discharge is watery and off-white or gray. Women may also notice a burning feeling in the vagina.
Is there a test for bacterial vaginosis? — Yes. Your doctor or nurse will do an exam. He or she will also take a sample of your vaginal discharge, and do lab tests on the sample to look for an infection.
How is bacterial vaginosis treated? — Bacterial vaginosis is treated with medicine. The 2 medicines most often used are:
Metronidazole
Clindamycin
Both of these medicines come in different forms. They can come as a pill or as a gel or cream that a woman puts inside her vagina. Most women have fewer side effects when they use the gel or cream treatment. But you and your doctor or nurse will decide which medicine and which form is right for you.
It is important that you take all of the medicine your doctor or nurse prescribes, even if your symptoms go away after a few doses. Taking all of your medicine can help prevent the symptoms from coming back.
Does my sex partner need to be treated if I have bacterial vaginosis? — It depends. If your sex partner is a man, he does not need to be treated if you have bacterial vaginosis. But if you have sex with other women, you should tell any partners about your bacterial vaginosis. That way they can be treated if they also get symptoms.
What happens if my symptoms come back? — If your symptoms come back, let your doctor or nurse know. You might need treatment with more medicine.
Some women get bacterial vaginosis over and over again. These women might take medicine for 3 to 6 months to try to prevent future infections.
What if I am pregnant and have symptoms of bacterial vaginosis? — If you are pregnant and have symptoms of bacterial vaginosis, tell your doctor or nurse. You might need treatment with medicine.
Can bacterial vaginosis be prevented? — Sometimes. You can help prevent bacterial vaginosis by:
Not douching (douching is when a woman puts a liquid inside her vagina to rinse it out)
Using condoms when you have sex
Not smoking
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15592 Version 8.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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