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Patient education: Bacterial vaginosis (The Basics)

Patient education: Bacterial vaginosis (The Basics)

What is bacterial vaginosis? — Bacterial vaginosis, or "BV," is an infection in the vagina that can cause bad-smelling vaginal discharge. "Vaginal discharge" means fluid that comes out of the vagina (figure 1). Some amount of vaginal discharge is normal. But people with BV can have a lot of vaginal discharge, or vaginal discharge that smells bad.

BV is caused by certain bacteria (germs). The vagina normally has different types of bacteria in it. But when the amounts or the types of bacteria change, an infection can happen.

BV usually affects people who are, or have been, sexually active. Your risk of getting it increases if you have a new sex partner or more than 1 partner. This is true whether your partners are male or female.

If you have BV, you have a higher chance of catching other infections that are spread through sex. You can lower this risk by using condoms when you have sex.

What are the symptoms of BV? — Some people with BV have no symptoms. When symptoms do happen, they often include a "fishy-smelling" vaginal discharge. The discharge is watery and off-white or gray. The smell might be more noticeable:

During your period

After sex with a male partner – This happens when semen (the fluid that is released during sex) mixes with your vaginal fluids.

You might also notice a burning feeling in your vagina.

Is there a test for BV? — Yes. Your doctor or nurse will do an exam. They will also take a sample of your vaginal discharge, and do lab tests to look for an infection.

How is BV treated? — BV is treated with antibiotics. The medicines most often used are:

Metronidazole

Clindamycin

Tinidazole

Secnidazole

Some are pills you swallow. Others are a gel or cream you put inside your vagina. Some people have fewer side effects when they use the gel or cream. Other people prefer not to put medicine in the vagina. You and your doctor or nurse will decide which medicine is right for you.

It is important that you take all of the medicine your doctor or nurse prescribes, even if your symptoms go away after a few doses. Taking all of your medicine can help prevent the symptoms from coming back.

Do my sex partners need to be treated if I have BV? — It depends:

If your sex partner does not have a vagina, they do not need to be treated if you have BV.

If your partner does have a vagina, tell them about your BV. That way, they can be treated if they also start to have symptoms.

What if my symptoms come back? — Once you have had BV, it can come back, even if you are not having sex. If your symptoms come back, tell your doctor or nurse. You should be checked again and might need treatment with more medicine.

Some people get BV over and over again. If this happens to you, your doctor might suggest taking medicine for several months, or adding another medicine for a few weeks. This might help prevent future infections.

What if I am pregnant and have symptoms of BV? — Tell your doctor or nurse. They will check for this infection and others.

If you have BV and are pregnant, the infection is treated with pills. Treatment is important, because BV might increase the risk of premature or "preterm" birth.

Can BV be prevented? — Sometimes. You can help lower the risk of BV by using condoms when you have sex.

You can also avoid things that increase the risk of BV. For example:

Avoid douching (putting liquid inside your vagina to rinse it out).

Do not smoke. Try to quit if you already smoke.

Avoid sharing sex toys, and clean toys between uses.

When should I call the doctor? — Call your doctor or nurse for advice if:

Your vaginal discharge comes back or gets worse.

You have severe belly pain.

You have pain, itching, or burning in or around your vagina.

You have a fever of 100.4°F (38°C) or higher.

You have vaginal bleeding not related to your period.

You have pain with sex.

More on this topic

Patient education: Vaginal discharge (The Basics)
Patient education: Vulvovaginal yeast infection (The Basics)
Patient education: Vaginitis in adults (The Basics)
Patient education: Chlamydia and gonorrhea (The Basics)
Patient education: HIV/AIDS (The Basics)
Patient education: How to use vaginal medicines (The Basics)

Patient education: Bacterial vaginosis (Beyond the Basics)
Patient education: Vaginal discharge in adult women (Beyond the Basics)
Patient education: Vaginal yeast infection (Beyond the Basics)
Patient education: Chlamydia (Beyond the Basics)
Patient education: Gonorrhea (Beyond the Basics)
Patient education: Symptoms of HIV (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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