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Bacterial Vaginosis

Bacterial vaginosis is a condition caused by an overgrowth of a certain bacteria that’s normally found in the vagina. This overgrowth changes the normal balance of bacteria in the vagina and results in bad-smelling vaginal discharge.

Any woman can have bacterial vaginosis. Bacterial vaginosis is the most common vaginal condition in women of reproductive age.

What are the symptoms of bacterial vaginosis?

Many women with bacterial vaginosis have no symptoms. Symptoms, when they occur, include:

  • “Fishy-smelling” vaginal discharge

  • White or gray vaginal discharge

  • Pain, itching, or burning in the vagina

  • Itching around the outside of the vagina

Is it a yeast infection or bacterial vaginosis?

It can be hard to tell the difference between the two most common causes of vaginal discharge since both can itch, burn, and have an abnormal odor. While subtle, the differences are:

  • Smell: Bacterial vaginosis discharge has a distinct, fishy odor. Yeast infection discharge smell is mild, and well, yeasty.

  • Appearance: With bacterial vaginosis, there’s lots of thin white or grey discharge. Yeast infection discharge may also be white or grey but may look like cottage cheese.

Of course, only a trip to the doctor’s office can determine with certainty if your sniff and visual examination are correct.

How is bacterial vaginosis diagnosed?

Your healthcare provider will do an exam and take a sample of your vaginal discharge to look for the source of infection.

How is bacterial vaginosis treated?

Sometimes, bacterial vaginosis will go away on its own without treatment. Nevertheless, it should be treated if you’re pregnant or if you have symptoms. Untreated bacterial vaginosis can increase odds of a preterm delivery as well as increase the chance of getting sexually transmitted diseases and pelvic inflammatory disease.

Bacterial vaginosis is treated with medications, in either pill, gel, or cream form. The most commonly prescribed antibiotics for bacterial vaginosis are metronidazole and clindamycin.

Symptoms may go away after a few doses, but it’s important to take all the medication as prescribed to minimize the chance of the symptoms from coming back.

What are some ways to prevent bacterial vaginosis from coming back?

Even with treatment, bacterial vaginosis can recur within a year.

To prevent or minimize the chance of recurrence:

  • Use condoms during sex

  • Abstain from sex or limit the number of sexual partners

  • Do not douche

  • Wipe from front to back (vagina to anus)

  • Wear cotton or cotton-lined underwear


Kairys N, Garg M. Bacterial Vaginosis. [Updated 2020 Nov 21]. In: StatPearls

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