Bacterial vaginosis is a condition that results from an overgrowth of the bacteria that are normally present in the vagina. Many people with BV may not experience symptoms. However, those who do may notice discomfort, unusual discharge, and a strong odor.

BV is one of the most common vaginal infections in those who have hit puberty. In the United States, about 30% of females between the ages of 14 and 49 years have BV.

BV develops due to the imbalance of the bacteria that occur naturally in the vagina. Specifically, healthcare professionals associate BV with a decline in the number of Lactobacilli.

In this article, we discuss BV in more detail, including its symptoms and causes and how to treat and prevent it.

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The Centers for Disease Control and Prevention (CDC) state that many people with BV do not experience any symptoms.

However, if symptoms are present, a person may notice the following:

Color of vaginal discharge

Some people may notice changes in the appearance of their vaginal discharge.

BV can cause thin, watery vaginal discharge that is gray or white.

Vaginal odor

People may notice a strong fishy odor coming from the vagina.

The CDC note that the odor may get stronger after having sex.

Pain and itching

People may also experience pain, itching, and burning in the vaginal canal or around the outside of the vagina.

Burning sensation during urination

Some people may find that they have a burning sensation when they urinate.

BV is a result of the most common bacteria in the vagina, the Lactobacilli, becoming less predominant. However, scientists are not sure what causes this change.

It is important to note that BV is not a sexually transmitted infection (STI), even though sex can trigger it. It can also pass between females during sex.

The United Kingdom’s National Health Service (NHS) state that although a person is more likely to develop BV if they are sexually active, the condition can also affect those who have not had sex.

Other factors that may increase the chances of developing BV include:

  • having sex with a new partner
  • having an intrauterine device, or IUD
  • having recently used antibiotics
  • using perfumed products in or around the vagina
  • smoking
  • having a diet that is high in fat and low in folate, vitamin E, and calcium
  • douching
  • coming into contact with alkaline sperm
  • having unprotected sex

In some cases, BV goes away without any treatment.

However, treatment options are available when it persists.

Medical treatment

Doctors will prescribe antibiotics — usually clindamycin or metronidazole — to treat BV.

People can take these antibiotics orally in the form of a tablet or use a gel that they can apply to the vagina. These medications are also safe to use during pregnancy.

If one course of antibiotics does not treat the symptoms, or BV keeps coming back, a doctor will prescribe a second course of antibiotics.

Home remedies

Some home remedies that may help manage symptoms include:

  • bathing in apple cider vinegar and water
  • eating garlic
  • using over-the-counter pH-balancing vaginal cream
  • using fragrance-free sanitary and hygiene products
  • eating a healthful and balanced diet

It is important to seek medical treatment if BV symptoms do not improve with the use of home remedies.

A person should tell the doctor what home remedies they have used when they ask for treatment.

Learn more about alternative remedies for BV here.

Without treatment, BV can lead to an increased chance of a person getting other STIs, including HIV.

The authors of a 2020 article state that people with BV are almost twice as likely as other people to have a chlamydia or gonorrhea infection.

In addition, they note that BV increases the likelihood of HIV passing from someone with the infection to a sexual partner.

They also say that there is evidence that having BV makes it more likely that a person will experience a reactivation of the human papillomavirus, which causes genital warts, and the herpes simplex virus type 2, which is responsible for genital herpes.

During pregnancy

BV can potentially lead to complications in pregnancy.

For instance, having BV makes a pregnant person twice as likely to give birth prematurely.

They are also up to five times more likely to experience a pregnancy loss than a person without BV.

Some ways to reduce the likelihood of developing BV include:

  • refraining from douching
  • avoiding using perfumed products on or around the vagina
  • using barrier methods, which include male and female condoms and dental dams, during sexual activities
  • wearing breathable cotton underwear

Learn more about why a person should avoid douching here.

Learn more about how to clean the vagina and vulva here.

It is important to see a doctor if any symptoms of BV are present.

BV can cause many complications, and doctors can prescribe medication that prevents them.

BV can sometimes cause symptoms, including a strong fishy odor that comes from the vagina and can become stronger after sex. Other symptoms include thin, grayish-white discharge, itching, and burning during urination.

Doctors can prescribe medication to treat this condition. People can also take steps to reduce the likelihood of developing BV in the first place.