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What is Bacterial Vaginosis? Signs, Symptoms, Treatments and More

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What is Bacterial Vaginosis? Signs, Symptoms, Treatments and More

writtenByWritten by: Sofie Wise
Sofie Wise

Sofie Wise

Sofie hopes to create a more sustainable healthcare system by empowering people to make conscious health decisions. Her interests include cooking, reading, being outdoors and painting.

Read more posts by this author.

June 25, 2018 Read Time - 12 minutes

Learn what the signs and symptoms of bacterial vaginosis are and how to get proper treatment

What is Bacterial Vaginosis?

There are different kinds of bacteria or microflora living in your vagina, both good and bad. Bacterial vaginosis, or BV, is caused when there is an overgrowth of bad bacteria. This upset of the natural pH balance in your vagina can cause an infection.

The vagina is usually mildly acidic and contains a “good bacteria” called lactobacillus that helps keep your vagina’s environment in a healthy balance. Normally, the pH factor in your lady parts would be between 3.8 and 4.2. But if the level of lactobacillus drops, the “bad bacteria” starts to grow. It the pH factor goes over 4.5, this means that there is too much alkaline, and this can contribute to an infection like bacterial vaginosis.

Women in the age group of 15 to 44 are the most likely to get bacterial vaginosis, but it can affect a woman of any age. In fact, it is the most common infection of women in this age group.

You do not have to be sexually active to get bacterial vaginosis and you may not even know you have it because it doesn’t always present with symptoms. According to some studies, up to 84% of women don’t report any symptoms.

If you do have symptoms it might be confusing to know whether it is a yeast infection or something else. It may be embarrassing to seek treatment, but there are some risk factors involved, especially if you are trying to get pregnant or already are pregnant.

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Causes of Bacterial Vaginosis

While researchers do not completely understand the specific cause of bacterial vaginosis, there are certain scenarios which lead to a higher incidence of getting this infection. We do know that bacterial vaginosis includes an abnormal response to the changes in the pH balance of the vagina and there are several ways to upset this natural balance.

Some risk factors may include:

  • Having several sexual partners
  • Having a past history of a sexually transmitted disease
  • Using lubricants that contain perfume during intercourse
  • Smoking – Some studies have shown that there is an increased risk of getting BV if you smoke because it increases the bacteriophage amounts of lactobacillus.
  • Douching
  • Heavy or unusually long periods
  • Hormonal changes
  • Wearing tights or a thong for long periods of time
  • Using sex toys
  • Taking antibiotics

BV can also affect your unborn baby if you are pregnant. You may have a slightly higher risk of developing complications such as a preterm birth, early labor, or postpartum endometritis.
If you had a baby that was born with a low birth weight or was premature before the 37th week, it is possible that you may have had BV and should consider asking your doctor about getting tested.

You may have less success with fertility treatments like in vitro fertilization (IVF) if you have had prior bacterial vaginosis infections. BV can be more common in women with fertility issues. However, this doesn’t necessarily mean that you will have infertility if you have had BV before. See you doctor to discuss your best treatment options.
It would not be unusual to think that just keeping yourself clean by douching would prevent BV. However, this isn’t the case. Cleaning products like bubble baths, scented soaps, douches, and vaginal deodorants all upset the delicate chemical balance of vaginal bacteria.

Symptoms of Bacterial Vaginosis

You may have BV if you have the following symptoms:

  • Burning while urinating
  • Itchiness around the vagina
  • Thin discharge that is white-gray, green, or white
  • Strong odor that smells like fish, especially after sex
  • Vaginal discharge that may be more noticeable after sex
  • Discharge that is heaviest just after your menstruation cycle
  • Pain with sexual intercourse – This is rare, but BV sometimes can cause pain or a dull, low pain in your stomach during intercourse
  • Pain with urination – This is also rare but can be a symptom among some women.

Some of the same risk factors that can cause bacterial vaginitis can also cause more complicated conditions such as a uterine infection, pelvic inflammatory disease (PID), an ovarian infection, or a fallopian tube infection.

Is bacterial vaginosis an STD?

Although bacterial vaginosis is not an STD, having this infection can make it easier for you to a get a sexually transmitted disease like gonorrhea, herpes, or chlamydia. Likewise, if you have autoimmune issues like HIV, having bacterial vaginosis increases the chances of passing HIV on to your partner.

It is not possible for a woman to get BV from intercourse with a male partner. However, for reasons that aren’t clear, it is more likely to develop bacterial vaginosis after a new change in sexual partners. It may be possible that having a new male partner or multiple male partners upsets the pH balance of good and bad bacteria in the vagina.

A woman who has a female sexual partner can pass this condition on to her. This is because the anaerobic bacteria on a woman’s body that has bacterial vaginosis may overwhelm the pH balance of the lactobacilli of her partner.

Can men get bacterial vaginosis?

No. As this infection is unique to a woman’s vagina, men cannot get bacterial vaginosis. There is no equivalent place on a man’s body for organisms like lactobacilli and anaerobic bacteria to attempt to create a balanced acidic environment.

If you have a male sexual partner and you think you have bacterial vaginosis, there is no need for your partner to seek medical treatment. However, if your partner is a woman, she may want to consider treatment from a medical professional particularly if your BV is recurring or chronic.

How to get rid of bacterial vaginosis

If you have any of the above symptoms or you feel like something just isn’t right, the first step is to seek professional medical help. Check with your primary care doctor or your gynecologist and make an appointment.

Your doctor will ask you about your symptoms, the length of your discomfort, and do a vaginal examination if they deem it necessary. They may also take a sample of the discharge by using a cotton swab and check this sample under a microscope to determine what kind of bacteria it is.

A sample of your vaginal discharge may also rule out any other potential medical issues with similar symptoms like a yeast infection or a sexually transmitted disease such as trichomoniasis or gonorrhea. If you are in a stable relationship, your doctor may diagnose BV simply because of your symptoms, usually by the appearance and strong, fishy odor of your discharge.

Your doctor may want to take a test of the acid level in your vagina with some pH paper. You may also consider buying a kit from your local pharmacy and doing this test at home. If your pH level is over 4.5, it is likely that you have BV and will be given a dose of antibiotics.

Your medical professional may also want to take a swab of the discharge from your vagina and send your sample to the lab to rule out other sources of infection.

Home remedies for bacterial vaginosis

Bacterial vaginosis natural treatment is one possible way to treat your condition. Some remedies may be more effective than others, but the idea here is to restore the natural pH balance of the bacteria in your vagina.

Although these natural remedies may not be as likely to be effective against the infection, many do not have the side effects that prescriptions medications may cause.

  • Yogurt – Yogurt is a natural probiotic with lots of healthy bacteria. Eating yogurt can help boost your immune system and keep the bad bacteria away. In addition, applying a coat of live, plain yogurt to the outside of the vagina on a daily basis may help to alleviate symptoms. You may also consider applying a small amount of yogurt on a tampon and inserting it into the vagina before bedtime.
  • Lactobacillus tablets or suppositories – Studies on use of lactobacilli are mixed for treatment of BV.
  • Probiotics – Some studies suggest that taking a daily dose of probiotics for at least two months may have a favorable benefit in promoting a healthy bacterial balance in the vagina and help treat and prevent bacterial vaginosis.
  • Acetic or lactic acid gel – Lactic acid gels promote the growth of lactobacilli and help to prevent the growth of anaerobic bacteria by keeping the vaginal pH balance at less than 4.5.
  • Garlic – The use of garlic has long been used for medicinal purposes because of its strong antibacterial properties. Taking a daily garlic supplement may be helpful in preventing BV.
  • Hydrogen Peroxide – Using one ounce of hydrogen peroxide each day for a week has been shown to help reduce vaginal itching and irritation that can be symptoms of BV. Its low cost and few side effects may be a beneficial natural alternative to traditional Western medicine.
  • Tea Tree Oil – Tea tree oil has strong antifungal and antibacterial properties that can be diluted with essential oils such as coconut, olive, or almond. Simply mix five to ten drops of tea tree oil and mix with one ounce of the carrier oil of your choice. It is advisable to not use tea tree oil by itself as it can burn sensitive skin.
    Some women may have an allergic reaction to tea tree oil. Consider testing a small amount of diluted oil on your arm to make sure that there is no reaction after 24 to 48 hours.

Another method of using tea tree oil is by soaking a tampon with a diluted mix combined with a carrier oil such as coconut oil. Insert the tampon into your vagina only for up to an hour and then remove it. Do not sleep with the tampon in place.

  • Cotton Underwear – To help prevent a bacterial vaginal infection or help treat a current condition, consider using breathable cotton underwear and limit the use of wearing tight pants. Some types of underwear that are made from materials such as spandex are not breathable and can trap moisture.
  • Boric Acid – Some doctors suggest that the use of a boric acid vaginal suppository is helpful to bring back the pH levels back to normal levels. Use a suppository every night for seven to fourteen days to clear up a BV infection. For women with recurrent infections, it may be advisable to use the boric acid vaginal suppository once or twice a week for three to four months.

Bacterial vaginosis may go away on its own or with the aid of a home remedy. If the symptoms don’t go away, it may be advisable to seek out the help of a medical professional such as your gynecologist to get a proper diagnosis and treatment.

Bacterial vaginosis treatment over the counter

Metronidazole tablets

Oral antibiotics are usually the first line of treatment for a BV infection. Your doctor may give you a course of metronidazole tablets as an antibiotic prescription. In many cases, this will clear up an infection of bacterial vaginosis.

A common dose of metronidazole is usually 400 mg to 500 mg twice a day for five to seven days. It is important to not miss any pills and complete the prescription as recommended by your physician.

Some side effects of metronidazole may include nausea, vomiting, or a metallic taste in your mouth after taking the pill. It may help to take this medication with food to alleviate the side effects. Do not drink alcohol while taking this medication or for 48 hours after finishing a course. It may cause nausea, vomiting, flushed skin, and an increased pulse rate.

Metronidazole vaginal gel

If you have experienced prior adverse side effects of metronidazole tablets, your doctor may prescribe a vaginal gel instead. Metronidazole gel or clindamycin vaginal cream can be inserted into the vagina and it is thought to be just as effective as taking the pill version of this medication. As with the pill, do not drink alcohol during the course or for at least 48 hours after finishing this medication.

Tinidazole tablets

If you are allergic to metronidazole or have had an adverse reaction, you may be prescribed tinidazole as an alternative antibiotic treatment. A common course prescribed is 1 g once a day for five days or 2 g once a day for two days. This medication is not recommended if you are pregnant.

If you have had recurrent bacterial infections, you doctor may want to take further tests to check for other possible infections. If you use a contraceptive device like an intrauterine contraceptive device (IUCD), your doctor may consider asking you to discontinue the use of your IUD until your condition can be resolved. There is some evidence that the use of an IUD can contribute to the overgrowth of vaginal bacteria that causes BV.

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.


How do you keep from getting bacterial vaginosis?

  • Safe Sex – Using condoms can help prevent your risk of getting an infection like bacterial vaginosis. Use a condom every time you have sex, especially when you have a new sexual partner. Having multiple sexual partners can increase your risk of infections and sexually transmitted diseases. Consider putting a condom on your partner’s penis before he touches your mouth, anus, or vagina.
  • Practice Healthy Hygiene – Keep your sex toys and vibrators clean by washing them after every use. Wipe yourself from front to back after you use the bathroom. This keeps contamination from your rectum getting into the sensitive areas of your vagina.

Practicing good hygiene will help prevent you from getting an infection. When you clean your genital area, only use water. Do not use soap, a douche, or other vaginal cleansers. Consider limiting your use of baths and take a shower instead. If you are on your period, change your tampon several times a day.

  • Get tested for STDs – If you are sexually active, consider seeing your doctor regularly to get tested for any sexually transmitted diseases, limit sex partners, and ask your sex partners to get tested too.

Think you may have the symptoms of bacterial vaginosis? Book an appointment with a PlushCare doctor and get treatment today.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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