Bacterial Vaginosis – Symptoms and Causes

ByJanis Updated

Overview

Bacterial vaginosis (BV) occurs when the normal balance of bacteria in the vagina gets disrupted. This imbalance can lead to discomfort and pain in the vaginal area. Normally, a healthy mix of bacteria helps maintain vaginal health.

BV can affect women of all ages but appears most frequently during reproductive years. Hormonal fluctuations during this period create conditions where certain bacteria may overgrow.

Risk factors include:

  • Sexual activity (though BV is not considered a sexually transmitted infection)
  • Unprotected sexual intercourse
  • Douching

While BV is more common among sexually active individuals, researchers haven’t fully determined why this connection exists. The condition represents a shift in the vaginal microbiome rather than an infection from outside sources.

Signs and Symptoms

People with bacterial vaginosis may notice several changes in their vaginal health. These can include thin discharge that appears gray, white, or green in color.

Many also report a strong, unpleasant odor, often described as “fishy.” Some experience itching in the vaginal area or a burning sensation when urinating.

Many people who have bacterial vaginosis don’t have any symptoms at all.

When to Contact a Healthcare Provider

Make an appointment with your healthcare provider if:

  • Your vaginal discharge has an unusual smell and causes discomfort
  • You’ve had vaginal infections before, but this discharge seems different
  • You have a new sexual partner or multiple partners
  • You tried treating what you thought was a yeast infection, but still have symptoms

These situations warrant professional attention because some symptoms can overlap with sexually transmitted infections. A healthcare provider can properly diagnose your condition and recommend appropriate treatment.

What Causes It

Bacterial vaginosis happens when the balance of bacteria in the vagina is disrupted. In a healthy vagina, “good” bacteria called lactobacilli usually outnumber “bad” bacteria known as anaerobes. This balance helps maintain vaginal health.

When too many anaerobes grow, they upset this delicate balance. The natural protective environment of the vagina changes, allowing harmful bacteria to multiply. The overgrowth of these anaerobes leads to the symptoms associated with bacterial vaginosis.

Risk Factors

Several factors can increase the chance of getting bacterial vaginosis:

  • Multiple or new sexual partners – Occurs more frequently in people with multiple sexual partners or who have recently acquired new sexual partners. This condition is also more common when both partners are female.

  • Douching practices – The vagina has a remarkable ability to maintain its cleanliness on its own. Using water or other products to rinse inside the vagina disrupts its healthy bacterial balance.

    • This can allow harmful anaerobic bacteria to grow excessively, leading to BV.

  • Low levels of lactobacilli – Some people naturally have fewer lactobacilli bacteria in their vaginas. This makes them more likely to develop bacterial vaginosis.

Complications

Bacterial vaginosis (BV) often resolves without major issues, but several potential complications can occur in some cases:

Higher STI Risk

People with BV have an increased chance of contracting sexually transmitted infections, including:

  • HIV
  • Herpes simplex virus
  • Chlamydia
  • Gonorrhea

Those who already have HIV and develop BV face a higher risk of transmitting the virus to sexual partners.

Surgical Infection Concerns

BV can raise the risk of developing infections following gynecological procedures like:

  • Hysterectomy
  • Dilation and curettage (D&C)

Pelvic Inflammatory Disease

In some cases, BV may lead to pelvic inflammatory disease (PID). This serious condition affects the uterus and fallopian tubes and can increase the chance of fertility problems.

Pregnancy Complications

Research has suggested potential connections between BV and pregnancy issues such as preterm birth and low birth weight. Recent studies indicate these risks might stem from other factors, like previous early deliveries.

However, experts agree that pregnant women showing BV symptoms should get tested. If BV is confirmed, healthcare providers can determine appropriate treatment options.

Prevention

To prevent bacterial vaginosis, avoid using scented products around your genital area. Scented soaps can irritate vaginal tissues, so wash with warm water only. Also, choose unscented tampons and pads to minimize irritation.

  • Never douche. This practice disrupts normal vaginal bacteria and may worsen infections rather than helping. Your vagina naturally cleans itself, so douching is unnecessary and potentially harmful.
  • Practice safe sex by using latex condoms or dental dams. Always clean sex toys thoroughly before and after use. Consider limiting sexual partners, as this can reduce your risk of bacterial vaginosis and other infections.

Tips for Prevention:

  • Use only warm water for cleaning
  • Choose unscented personal care products
  • Avoid douching completely
  • Use protection during sexual activity
  • Clean sex toys properly

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Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.