Bacterial Vaginosis

What Is Bacterial Vaginosis?

Bacterial vaginosis (BV) is a mild infection in the vagina. BV happens when there are more "bad" bacteria than "good" bacteria in the vagina. BV is the most common vaginal infection affecting young women.

What Are the Signs & Symptoms of Bacterial Vaginosis?

Many girls don't see any signs of BV. But those who do might notice:

• white or gray thin vaginal discharge
• a bad, fishy smell that's more noticeable during a girl's period or after sex

Itching and burning are not common signs of bacterial vaginosis. If a girl has those symptoms, the doctor will check for other conditions.

What Causes Bacterial Vaginosis?

A lot of good, healthy bacteria live in the vagina. They help protect the vagina from bad bacteria that can cause symptoms such as smelly discharge. Girls with BV have fewer good bacteria than usual, which lets more bad bacteria grow. When the normal balance of bacteria in the vagina changes, a girl can start to have symptoms of bacterial vaginosis.

Although doctors don't know for sure what causes BV, some things can make it more likely, such as:

• douching
• cigarette smoking
• new sex partners or many different sex partners (male or female). BV isn't considered a sexually transmitted disease (STD). But the chances of getting it seem to go up with the number of sexual partners a woman has.

Rarely, even girls who have never had sex can get BV. You can't get BV from things like toilet seats, sheets and towels, or swimming pools.

How Is Bacterial Vaginosis Diagnosed?

The doctor or nurse will:

• ask questions about your past health and your current symptoms
• examine you. If you have a discharge that bothers you, the doctor might do a pelvic exam to look inside the vagina.
• collect a sample of vaginal fluid with a cotton swab to test in the office or in a lab

How Is Bacterial Vaginosis Treated?

The usual treatment for BV is antibiotics. These come in two forms:

• pills to swallow
• creams or gels to put in the vagina using an applicator like a tampon

Because BV can come back, a girl may need to take more than one series of antibiotics. Even if you feel better partway through taking the antibiotics, be sure to finish the entire amount. That's the best way to kill the harmful bacteria. Some creams can weaken condoms and diaphragms (even after treatment), so ask your doctor when it’s OK to use these for birth control again.

If a girl is having sex with male partners, they don't need to be tested. If a girl is having sex with another girl, the partner also should be tested and treated if she has symptoms.

Can Bacterial Vaginosis Be Prevented?

It's not always possible to prevent BV. But you can lower your chances of getting it by:

• not douching
• not having sex or limiting the number of sex partners if you do have sex

Also, use a condom each time you have sex (vaginal, oral, or anal). This also helps protects you from getting an STD.

What Problems Can Happen?

Most of the time, BV goes away without any problems when properly treated. BV that's not treated can increase a girl's chances of having health problems such as:

• STDs like herpes, chlamydia, gonorrhea, or HIV
• problems during pregnancy, like giving birth too early or having a baby that is too small
• pelvic inflammatory disease (PID), which can make it hard or impossible to get pregnant

Infections like BV are one reason why girls who have sex need regular gyn checkups and STD tests, even if they don't have symptoms. Most girls with BV don't notice any symptoms, so they might not know they have it and might not get treated.

BV may be mild, but must be treated to prevent other problems. Doctors and nurse practitioners can diagnose and treat BV to make sure you stay healthy.