Overview of Bacterial Vaginosis

How to Prevent and Treat This Common Vaginal Infection

pigeon-toed woman
Getty/Photolibrary/Eric O'Connell. Getty/Photolibrary/Eric O'Connell

Bacterial vaginosis or vaginitis is an inflammation that occurs due to a disruption in the normal balance of bacteria in the vagina. It is the most common type of vaginal infection, affecting from 10 to 64 percent of the population at any given time. It is even more common than vaginal yeast infections.

Treatment is available that quickly cures bacterial vaginosis, but it is important to know that the treatment is different from that given for yeast infection.

If left untreated it can increase a woman's risk of pelvic inflammatory disease (PID) or endometritis cervicitis, cause pregnancy complications, lead to post-operative infections, and other health problems.

What Causes Bacterial Vaginosis?

The primary causes of bacterial vaginosis include an overgrowth of anaerobic bacteria and Gardnerella bacteria. The healthy vagina includes a small amount of these bacteria and organisms. When the vaginal balance is disrupted by the overgrowth of these bacteria, another protective bacterium, lactobacilli, is unable to adequately perform its normal function. Lactobacilli normally provide a natural disinfectant (similar to hydrogen peroxide) that helps maintain the healthy and normal balance of microorganisms in the vagina.

Other factors include hot weather, poor health, poor hygiene, use of an intrauterine device (IUD) for birth control, and routine douching.

 E. coli, which is a normal inhabitant of the rectum, can also cause bacterial vaginitis if it is spread to the vaginal area. However, you cannot get BV from toilet seats, bedding, or swimming pools, according to the CDC.

Being sexually active increases a woman's risk of bacterial vaginosis. Women who do not have sex rarely get the condition.

 It can be spread between female sex partners. A woman won't give her male sex partner an infection if she has bacterial vaginosis.

Bacterial vaginosis occurs most during the reproductive years, although women of all ages are susceptible to this infection.  The rsk of bacterial vaginosis increases with menopause and in women with diabetes, as well as with women whose resistance is lowered due to other conditions.

What Are the Symptoms of Bacterial Vaginosis?

The most obvious sign of bacterial infection is an unpleasant, foul, sometimes fishy odor. Itching and/or burning sometimes accompany bacterial infections, but not always. Many times, women are unaware they are infected until they are diagnosed during a routine pelvic exam and Pap smear.

It is important not to douche during the few days preceding a visit to your gynecologist, as douching can hide signs of infection and may make bacterial vaginosis worse.

What is the Treatment for Bacterial Vaginosis?

The good news is that treatment is relatively simple and effective once a proper diagnosis is made. Keep in mind that this is a bacterial infection, not a yeast infection, and it won't respond to over-the-counter yeast infection treatments.

It requires antibiotics prescribed by a doctor. Treatment usually consists of three to seven nights of vaginal cream. An oral antibiotic treatment is also sometimes prescribed and may be available if you request it from your physician.

Although your symptoms may disappear before you finish your medication, it's important you complete your medication exactly as directed by your physician.

A 2009 research review suggests that probiotics may be of some benefit for non-pregnant women with bacterial vaginosis. When capsules of lactobacillus were taken orally along with the antibiotic metronidazole or administered as an intravaginal capsule, it appeared to increase the effectiveness of the antibiotic.

However, the research is still thin in this area.

Preventing Vaginal Infections

  • Always wipe from front to back after bowel movements to prevent E. coli from the rectum from entering the vagina.
  • Douching is never a good idea. Douching may disrupt the fragile balance of natural organisms in the vagina, which may lead to bacterial or yeast infections and may also cause the spread of infection up into the reproductive tract, where it can do damage.
  • Keep the vaginal area clean and dry. Wash before and after sex with a gentle, non-deodorant soap and thoroughly dry the vaginal area to prevent moisture from creating a breeding ground for bacteria.
  • Avoid tight clothing and always wear white cotton underpants that help absorb moisture and allow air to circulate.
  • Avoid scented or treated toilet paper, personal hygiene products, perfumes, spermicides, and harsh soaps or detergents if the vaginal area is irritated.
  • Practice safe sex. Always use condoms to prevent STDs or other vaginal infections unless you are in a long-term monogamous relationship.
  • Diaphragms, cervical caps, and medication applicators should be thoroughly cleaned after each use.

A Word From Verywell

Remember, if you experience signs of a vaginal infection, it is important that a diagnosis is made by your physician. Most vaginal infections are not yeast infections. Self-treatment with over-the-counter remedies for yeast infection will not cure a bacterial infection and may increase your risk of complications.


Bacterial vaginosis. Womenshealth.gov. https://www.womenshealth.gov/a-z-topics/bacterial-vaginosis.

Bacterial Vaginosis - CDC Fact Sheet. CDC.gov. https://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR, 64(RR-3) (2015).

Oduyebo OO, Anorlu RI, Ogunsola FT. "The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women." Cochrane Database Syst Rev. 2009 8;(3):CD006055.