Bacterial Vaginosis: Causes, Symptoms, and Treatment

Published: 10:16AM 15 May 2023

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Jayti Shah

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Bacterial vaginosis (BV) is a common yet often misunderstood condition affecting millions of women worldwide each year. Despite its prevalence, it is frequently misdiagnosed or overlooked due to its somewhat elusive symptoms and the lack of public awareness surrounding it. By understanding its causes, symptoms, and potential treatment options, we can better manage and prevent this condition.

What is Bacterial Vaginosis?

BV is a condition that occurs when there's an imbalance in the normal bacteria in the vagina. Specifically, it happens when the levels of 'good' bacteria, known as lactobacilli, are reduced and 'bad' bacteria, such as Gardnerella vaginalis, take over. It's important to understand that BV is not a sexually transmitted infection (STI), but it can increase the risk of getting an STI.

Causes of Bacterial Vaginosis

While the exact cause of BV is not entirely understood, certain factors are known to increase the risk of developing this condition:

  1. Douching: Douching disrupts the natural balance of bacteria in the vagina, which can lead to BV. A study published in the journal Obstetrics & Gynecology found a significant association between douching and BV.
  2. Having a new or multiple sexual partners: Although BV isn't an STI, it's more common among women who have a new or multiple sexual partners. A study in the American Journal of Obstetrics & Gynecology reported a higher risk of BV in women with a higher number of lifetime sexual partners.
  3. Lack of condom use: Unprotected sexual activity can change the bacterial balance within the vagina, increasing the risk of BV. A research study found that consistent condom use was associated with lower BV recurrence.

Symptoms of Bacterial Vaginosis

BV often goes unnoticed as it can sometimes cause no symptoms. However, when symptoms do occur, they may include:

  1. Vaginal discharge: This is often thin and greyish white. The volume of discharge can also increase after sex.
  2. Fishy smelling vaginal odor: This is usually more noticeable after sex.
  3. Vaginal itching or burning: Some women with BV experience a slight burning sensation during urination or itching around the outside of the vagina.

Not every woman with BV experiences these symptoms, and some may confuse them with other vaginal infections, like yeast infections, further highlighting the importance of accurate diagnosis and treatment.

Treatment of Bacterial Vaginosis

The primary goal of BV treatment is to restore the normal balance of bacteria in the vagina. This typically involves:

  1. Antibiotic treatment: Clinicians commonly prescribe antibiotics such as metronidazole or clindamycin. A review published in the Cochrane Database of Systematic Reviews found that these antibiotics are effective at treating BV.
  2. Probiotics: Some research suggests that probiotics, particularly those containing Lactobacillus strains, may help restore the normal vaginal flora and prevent BV recurrence. A study in the Journal of Applied Microbiology found that oral and vaginal probiotics reduced BV recurrence rates.
  3. Lifestyle modifications: Avoiding douching, limiting the number of sexual partners, and using condoms can help prevent BV recurrence.
Bacterial Vaginosis (Image courtesy - iStock photo)


Bacterial vaginosis is a common but often misunderstood condition. While it can sometimes cause no symptoms, it's essential to recognize possible signs such as vaginal discharge, a fishy odor, and itching or burning. Understanding the causes and risk factors, such as douching and unprotected sex, is crucial in preventing and managing BV.

Jayti Shah is a Clinical Nutritionist with a master's degree in Clinical Nutrition and Dietetics. She is a member of the Indian Dietetic Association (IDA). Over the last 9 years, she has helped 400 clients in their clinical and weight loss journeys. She works with SocialBoat as a nutrition consultant.

At SocialBoat, we offer custom diet plans and guided workouts to help you achieve your goals in a 360-degree approach. Our gamified experience ensures that you don’t find workouts boring and we reward you for being consistent with your efforts.

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  1. Ravel, J., Gajer, P., Abdo, Z., Schneider, G. M., Koenig, S. S., McCulle, S. L., ... & Forney, L. J. (2011). Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences, 108(Supplement 1), 4680-4687. Link
  2. Ness, R. B., Hillier, S., Richter, H. E., Soper, D. E., Stamm, C., McGregor, J., ... & Sweet, R. L. (2003). Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina. Obstetrics & Gynecology, 102(4), 765-772. Link
  3. Fethers, K. A., Fairley, C. K., Hocking, J. S., Gurrin, L. C., & Bradshaw, C. S. (2008). Sexual risk factors and bacterial vaginosis: a systematic review and meta-analysis. Clinical Infectious Diseases, 47(11), 1426-1435. Link
  4. Gallo, M. F., Warner, L., Macaluso, M., Stone, K. M., Brill, I., Fleenor, M. E., ... & Hook, E. W. (2012). Risk factors for incident and recurrent bacterial vaginosis among young women: a prospective cohort study. American Journal of Obstetrics & Gynecology, 207(2), 120-e1. Link
  5. Oduyebo, O. O., Anorlu, R. I., & Ogunsola, F. T. (2009). The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women. Cochrane Database of Systematic Reviews, (3). Link

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