Bacterial vaginosis (BV) is a type of vaginal infection. The vagina normally contains both healthy bacteria and unhealthy bacteria. BV occurs when more unhealthy bacteria grow than healthy bacteria.
No one knows exactly what causes this to occur. BV is a common problem that can affect women and girls of all ages.
Symptoms of BV include:
- White or gray vaginal discharge that smells fishy or unpleasant
- Burning when you urinate
- Itching inside and outside the vagina
You also may not have any symptoms.
Your health care provider may do a pelvic exam to diagnose BV. Do not use tampons or have sex 24 hours before you see your provider.
- You will be asked to lie on your back with your feet in stirrups.
- The provider will insert an instrument into your vagina called a speculum. The speculum is opened slightly to hold the vagina open while your doctor examines the inside of your vagina and takes a sample of discharge with a sterile cotton swab.
- The discharge is examined under a microscope to check for signs of infection.
Treatment From Your Health Care Provider
If you have BV, your provider may prescribe:
- Antibiotic pills that you swallow
- Antibiotic creams that you insert into your vagina
Be sure you use the medicine exactly as prescribed and follow the instructions on the label. Drinking alcohol with some medicines may upset your stomach, give you strong stomach cramps, or make you sick. Do not skip a day or stop taking any medicine early, because the infection may come back.
You cannot spread BV to a male partner. But if you have a female partner, it is possible it can spread to her. She may need to be treated for BV, as well.
Self-care and Symptom Relief
To help ease vaginal irritation:
- Stay out of hot tubs or whirlpool baths.
- Wash your vagina and anus with a gentle, non-deodorant soap.
- Rinse completely and gently dry your genitals well.
- Use unscented tampons or pads.
- Wear loose-fitting clothing and cotton underwear. Avoid wearing pantyhose.
- Wipe from front to back after you use the bathroom.
Preventing Bacterial Vaginosis
You can help prevent bacterial vaginosis by:
- Not having sex.
- Limiting your number of sex partners.
- Always using a condom when you have sex.
- Not douching. Douching removes the healthy bacteria in your vagina that protect against infection.
When to Call the Doctor
Call your provider if:
- Your symptoms are not improving.
- You have pelvic pain or a fever.
Nonspecific vaginitis - aftercare; BV
Abdallah M, Augenbraun MH, McCormack WM. Vulvovaginitis and cervicitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 108.
Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.
Review Date 7/19/2021
Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.