Vaginal Health: Bacterial Vaginosis

Bacterial vaginosis (BV) is a common gynecologic infection that impacts 1 in 3 women. Also known as vaginal bacteriosis, BV is the most common cause of vaginal infection for women of childbearing age.

Although it frequently develops after sexual intercourse with a new partner, BV is not considered a sexually transmitted infection (STI). A woman who has never had sexual intercourse can have it because an imbalance in vaginal bacteria can lead to bacterial vaginosis.

What are the Symptoms of BV?

Most women with BV have no symptoms. If symptoms occur, they include vaginal discharge, burning, and itching.

Vaginal discharge may:

  • Be watery and thin
  • Be gray or white in color
  • Have a strong and unpleasant smell, often described as fishy

Less commonly, there may be:      

  • A burning sensation during urination
  • Itching around the outside of the vagina

What Causes BV?

BV is caused by an imbalance of naturally occurring bacterial flora, the usual bacteria found in a woman's vagina. It should not be confused with candidiasis, a yeast infection, or Trichomonas vaginalis (T. vaginalis), or trichomoniasis, also known as trich. These are not caused by bacteria.

The Centers for Disease Control and Prevention (CDC) estimate that 29.2 percent of American women aged 14-49 experience BV, but 84 percent of them report no symptoms. Doctors say treatment is not required if a woman has BV but no symptoms. Sometimes BV can appear and disappear for no apparent reason.

We know that bacterial vaginosis is linked to an imbalance in the bacteria that are normally found in a female's vagina, but why this imbalance occurs is unclear. All parts of the body have bacteria, but some are beneficial while others are harmful. When there are too many harmful bacteria, problems can arise.

The vagina contains mostly "good" bacteria and some harmful bacteria. BV occurs when the harmful bacteria outgrow the good bacteria. A female's vagina should contain bacteria called lactobacilli. These bacteria produce lactic acid, making the vagina slightly acidic. This prevents other bacteria from growing there.

Lower levels of lactobacilli may cause the vagina to become less acidic. If the vagina is not as acidic as it should be, this can give other bacteria the chance to grow and thrive. However, exactly how these harmful bacteria are linked with BV is not known.

Any woman can develop BV, but some behaviors or activities can increase the risk.

These include:

  • Douching, or using water or a medicated solution to clean the vagina
  • Having a bath with antiseptic liquids
  • Having a new sex partner
  • Having multiple sex partners
  • Using perfumed bubble baths, vaginal deodorants, and some scented soaps
  • Smoking
  • Washing underwear with strong detergents

BV cannot be caught from toilet seats, bedding, swimming pools, or touching objects.

How is BV Diagnosed and Treated?


Any woman with an abnormal vaginal discharge should see their doctor as soon as possible. A doctor can diagnose BV and rule out other infections, such as gonorrhea or trich.

If you have any questions or concerns about vaginal health, don't hesitate to talk to any of our doctors about it. We are here to help!