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What Is Bacterial Vaginosis?

This vaginal infection is frequently seen in pregnant women.

Bacterial vaginosis is a common vaginal infection that can be caused by a bacterial imbalance in the vagina or transmitted through sexual contact.

It’s the most common type of vaginal infection in American women.

And it’s surprisingly prevalent among pregnant women: Sixteen percent of expectant mothers in the United States have bacterial vaginosis.

Causes of Bacterial Vaginosis

Bacteria naturally occur in the vagina, but there are both “good” and “bad” types of bacteria.

There’s a careful balance between the good and bad bacteria that live in the vagina, and when that balance is disrupted, bacterial vaginosis can occur.

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What causes this bacterial imbalance isn’t exactly known, but there seems to be some evidence that it can be a sexually transmitted disease.

“We know that women who have multiple sexual partners or women who have a new sexual partner are at a higher risk of getting bacterial vaginosis,” says Jennifer A. Shuford, MD, MPH, director of applied science at the Medical Institute for Sexual Health in Austin, Texas.

“Male sexual partners of these women carry these bacteria in the penis, so there is evidence of sexual exchange.”

But, says Dr. Shuford, sexual contact is not the only method of infection. “Women who have had no sexual contact their whole lives can still get bacterial vaginosis.”

Bacterial Vaginosis Symptoms

Some women have bacterial vaginosis and don’t have any symptoms.

But when symptoms do appear, they may include:

  • Vaginal discharge that may be white or gray in color
  • Discharge with a strong, foul odor
  • Vaginal odor that is particularly strong, with a fishy smell after sex
  • Vaginal itching
  • Painful or burning urination
  • Risk Factors and Complications

Having sex with someone who has bacterial vaginosis, as well as having multiple sex partners or a new sex partner, can put you at risk for the infection, says Shuford.

Douching can also increase the risk, as it disrupts the balance of bacteria in the vagina.

The complications and health risks of bacterial vaginosis can be serious if the infection isn’t treated.

Untreated vaginosis can lead to:

  • Pelvic inflammatory disease (PID):
    PID is an inflammation of the female reproductive system, including the uterus, fallopian tubes, and even the ovaries.
    Shuford notes that PID can lead to a number of complications, including infertility and ectopic pregnancy.
  • Pregnancy complications:
    Pregnant women with bacterial vaginosis may be at a higher risk for having low-birth-weight babies, says Shuford, as well as premature rupture of the membranes (your water breaks too early).
  • Greater risk of other sexually transmitted infection:
    Women who have bacterial vaginosis are at greater risk of getting HIV, gonorrhea, and chlamydia.
  • Increased risk of postsurgical infection:
    Women who have bacterial vaginosis may be more likely to develop an infection after surgeries affecting the reproductive system, such as a hysterectomy or an abortion.

Bacterial Vaginosis Treatment

Bacterial vaginosis is easily diagnosed using a sample of vaginal fluid and is treated with a simple round of antibiotics.

Antibiotics may be given orally or in the form of a topical cream or ointment inserted in the vagina, notes Shuford.

Bacterial vaginosis can recur, even after antibiotic treatment. It’s important to make sure you take all of the antibiotics as prescribed.

Treatment of male sexual partners is generally not recommended.


Bacterial vaginosis can’t always be prevented, but you can reduce your risk of getting the infection and spreading it by being in a monogamous relationship, as well as by using condoms.

  • Avoid douching to help keep bacteria balanced in the vagina and reduce the risk of bacterial vaginosis.
  • Good hygiene, too, can help prevent bacterial vaginosis.
  • Wash the anus and vagina every day, and wipe from front to back after urination or defecation.
  • Wear cotton underwear and pants that fit loosely in the crotch to allow airflow and prevent moist conditions, which can encourage infection.

Bacterial vaginosis is a very common infection, but some simple preventive steps can help reduce your risk.

And women who do experience symptoms should remember to seek treatment right away to prevent unnecessary health problems caused by untreated bacterial vaginosis.

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