Bacterial vaginosis (BV) is the most common vaginal infection in women. According to the Centers for Disease Control and Prevention (CDC), the condition affects nearly 30% of women between 15 and 44 years old. However, BV disproportionately impacts Black women, who have an estimated infection rate of more than 50%.
BV occurs when there’s an overgrowth of bacteria, according to the Mayo Clinic, which throws off the natural pH balance of the vagina.
What causes bacterial vaginosis? Bacterial vaginosis is most often caused by an overgrowth of a common type of bacteria called gardnerella vaginalis. Certain risk factors, such as douching, can disrupt the balance of “good” and “bad” bacteria in the vagina, leading to this overgrowth.
BV can happen to anyone with a vagina, even if you’re not sexually active. However, occurrence in those who are not sexually active is rare.
You’re at higher risk for getting BV if you’re pregnant; have a new sex partner, a female sex partner or multiple sex partners; don’t use condoms or dental dams; use douches; or have an intrauterine device (IUD).
There is no foolproof way of avoiding bacterial vaginosis. But you can reduce your risk by not douching, limiting sex partners, using latex condoms or dental dams and wearing cotton or cotton-lined underwear.
What are the symptoms? Dr. Jennifer Wider tells Yahoo Life, “Sometimes there are no symptoms, but if there are, the most common include an off-white, gray or greenish, watery vaginal discharge [and] a ‘fishy’ odor that can be strongest during the period or after sex. A less common symptom is itchiness or soreness.”
Dr. Kecia Gaither, director of perinatal services at NYC Health + Hospitals/Lincoln in the Bronx points out to Yahoo Life that some people think bacterial vaginosis is a sexually transmitted infection, “hence the stigma,” she says. “But it is not.”
However, BV can increase your risk of getting a sexually transmitted infection, such as chlamydia or gonorrhea, according to the CDC. That, in turn, can lead to pelvic inflammatory disease. Having BV when you’re pregnant also increases the risk of preterm birth (before 37 weeks of pregnancy).
BV is sometimes mistaken for other conditions like a non-viral STI called trichomoniasis, as well as other bacterial infections including chlamydia and gonorrhea.
According to Cleveland Clinic, the most common mix-up occurs between bacterial vaginosis and yeast infections because both are bacterial infections that cause increased discharge. However, there are notable differences between the two infections: discharge with bacterial vaginosis has a fishy smell and is watery in consistency, while discharge from a yeast infection is thick and white with a cottage cheese-like appearance and there isn’t a strong odor.
Typically, BV doesn’t cause irritation or itchiness, but a yeast infection will. Finally, yeast infections can be treated with over-the counter-medications or with an antifungal medication, while you will need prescription antibiotics for bacterial vaginosis.
How do you treat bacterial vaginosis? The good news is that bacterial vaginosis is curable. The infection is diagnosed through a sample of vaginal fluid taken through a gynecological exam and sent to a lab. After diagnosis, treatment usually involves a seven-day course of antibiotics. Gaither explains that “multiple therapeutic medications have been utilized for treatment like metronidazole, clindamycin and tinidazole.”
However, not finishing the full course of antibiotics can trigger a relapse, according to the U.S. Department of Health and Human Services. Also, in a small percentage of cases, people may need a second treatment. Unfortunately, research shows that BV has a high rate of recurrence — a 2021 study found that BV will recur within six months in more than 50% of cases.
Bacterial vaginosis is thankfully considered a mild infection, but it can make you susceptible to more serious health conditions. If you experience any of the symptoms, don’t delay seeing your medical provider.