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Bacterial vaginosis fact sheet

What is bacterial vaginosis (BV)?

The vagina normally has a balance of mostly "good" bacteria and fewer "harmful" bacteria. Bacterial vaginosis, known as BV, develops when the balance changes. With BV, there is an increase in harmful bacteria and a decrease in good bacteria. BV is the most common vaginal infection in women of childbearing age.

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What causes BV?

Not much is known about how women get BV. Any woman can get BV. But there are certain things that can upset the normal balance of bacteria in the vagina, raising your risk of BV:

  • Having a new sex partner or multiple sex partners
  • Douching
  • Using an intrauterine device (IUD) for birth control
  • Not using a condom

BV is more common among women who are sexually active, but it is not clear how sex changes the balance of bacteria. You cannot get BV from:

  • Toilet seats
  • Bedding
  • Swimming pools
  • Touching objects around you

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What are the signs of BV?

Women with BV may have an abnormal vaginal discharge with an unpleasant odor. Some women report a strong fish-like odor, especially after sex. The discharge can be white (milky) or gray. It may also be foamy or watery. Other symptoms may include burning when urinating, itching around the outside of the vagina, and irritation. These symptoms may also be caused by another type of infection, so it is important to see a doctor. Some women with BV have no symptoms at all.

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How can I find out if I have BV?

There is a test to find out if you have BV. Your doctor takes a sample of fluid from your vagina and has it tested. Your doctor may also see signs of BV during an examination of the vagina. To help your doctor find the signs of BV or other infections:

  • Schedule the exam when you do not have your period.
  • Don't douche for at least 24 hours before seeing your doctor. Experts suggest that women do not douche at all.
  • Don't use vaginal deodorant sprays. They might cover odors that are important for diagnosis. It may also lead to irritation.
  • Don't have sex or put objects, such as a tampon, in your vagina for at least 24 hours before going to the doctor.

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How is BV treated?

BV is treated with antibiotic medicines prescribed by your doctor. Your doctor may give you either metronidazole (met-roh-NIH-duh-zohl) or clindamycin (klin-duh-MY-sin). Generally, male sex partners of women with BV don't need to be treated. However, BV can be spread to female partners. If your current partner is female, talk to her about treatment. You can get BV again even after being treated.

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Is it safe to treat pregnant women who have BV?

All pregnant women with symptoms of BV should be tested and treated if they have it. This is especially important for pregnant women who have had a premature delivery or low birth weight baby in the past. There are treatments available at any stage of your pregnancy. Be sure to talk to your doctor about what is right for you.

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Can BV cause health problems?

In most cases, BV doesn't cause any problems. But some problems can arise if BV is untreated.

  • Pregnancy problems. BV can cause premature delivery and low birth weight babies (less than five pounds).
  • PID. Pelvic inflammatory disease or PID is an infection that can affect a woman's uterus, ovaries, and fallopian tubes. Having BV increases the risk of getting PID after a surgical procedure, such as a hysterectomy or an abortion.
  • Higher risk of getting HIV and other sexually transmitted infections (STIs). Having BV can raise your risk of HIV, chlamydia, and gonorrhea. Women with HIV who get BV are also more likely to pass HIV to a sexual partner.

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How can I lower my risk of BV?

Experts are still figuring out the best way to prevent BV. But there are steps you can take to lower your risk.

  • Help keep your vaginal bacteria balanced. Wash your vagina and anus every day with mild soap. When you go to the bathroom, wipe from your vagina to your anus. Keep the area cool by wearing cotton or cotton-lined underpants. Avoid tight pants and skip the pantyhose in summer.
  • Don't douche. Douching removes some of the normal bacteria in the vagina that protects you from infection. This may raise your risk of BV. It may also make it easier to get BV again after treatment.
  • Have regular pelvic exams. Talk with your doctor about how often you need exams, as well as STI tests.
  • Finish your medicine. If you have BV, finish all the medicine your doctor gives you to treat it. Even if the symptoms go away, you still need to finish all of the medicine.

Practicing safe sex is also very important. Below are ways to help protect yourself.

  • Don't have sex. The best way to prevent any STI is to not have vaginal, oral, or anal sex.
  • Be faithful. Having sex with just one partner can also lower your risk. Be faithful to each other. That means that you only have sex with each other and no one else.
  • Use condoms. Protect yourself with a condom EVERY time you have vaginal, anal, or oral sex. Condoms should be used for any type of sex with every partner. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex, use a condom or a dental dam. A dental dam is a rubbery material that can be placed over the anus or the vagina before sexual contact.
  • Talk with your sex partner(s) about STIs and using condoms. It's up to you to make sure you are protected. Remember, it's YOUR body! For more information, call the Centers for Disease Control and Prevention at 800-232-4636.
  • Talk frankly with your doctor or nurse and your sex partner(s) about any STIs you or your partner(s) have or had. Talk about any discharge in the genital area. Try not to be embarrassed.

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More information on bacterial vaginosis

For more information about bacterial vaginosis, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

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Content last updated: July 16, 2012.

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