Bacterial Vaginosis

Causes

The exact cause of this overgrowth is not known. It is more common in women who have had sex with more than one person. It is more common in women who use vaginal douches or feminine hygiene products that disrupt the normal bacterial balance in the vagina. Since the causes of BV are not known, there is not a specific way to prevent it.

Products that interfere with your vagina’s natural bacteria balance can cause the bacteria to grow irregularly. These products include douches (genital cleansing products) or certain soap products. It is best to avoid using these products. If you do use soap, stay away from products that are scented or colored. Instead, use a mild unscented soap.

Symptoms

Women with BV report a fishy-smelling discharge (fluid) that is white to gray in color. The odor may seem worse around the time of your period, or after having sex. You may notice other symptoms such as itchiness or redness in the genital area. You may have pain when having sex.

Diagnosis

To diagnose BV your doctor will need to test the vaginal discharge. The doctor will use a swab to take a sample the discharge. During the exam the doctor will first examine the outside of the genitalia (the vulva). The doctor may insert the swab into the vagina.  

Sometimes it is necessary to insert a speculum into the vagina. A speculum is a tool that gently moves the walls of the vagina apart. This allows the doctor to get a better look inside.   

A swab of the discharge is sent to the lab. It may be looked at under a microscope in the office. This helps the doctor determine if you have BV or any other vaginal infection.  

Risks

Bacterial Vaginosis may increase your risk of having a pre-term delivery (a baby born too early).

BV can also increase your chances of getting an infection called Pelvic Inflammatory Disease (PID). This is an infection of the uterus, fallopian tubes, or ovaries. These are internal organs that you cannot see. PID can:

• Cause chronic pelvic pain (pain in the lower belly area)
• Cause difficulty getting pregnant later in life
• Increase the risk of having a pregnancy in the fallopian tubes (ectopic pregnancy)

Getting treatment for BV lowers your risk of getting PID.

Treatment

If you have BV your doctor may prescribe either a cream or gel to insert into the vagina. Or your doctor may prescribe oral (taken by mouth) antibiotics. 

• If you are given a cream to use, do not use tampons. Tampons can absorb the medicine. This makes the treatment less effective.   
• If your doctor prescribes antibiotics, be sure to take ALL of the medicine as instructed. This is important for the treatment to work properly.
• DO NOT drink alcohol if you are being treated for BV. This may cause side effects like nausea and vomiting. 
• It is best to not have sex until after you have finished all of your medicine.

When to Contact the Doctor

Though BV can be treated, it may come back again. If you experience symptoms again, contact your health care provider.

Call the doctor if:

• You have increase in pain or discomfort
• You have increase in discharge
• Symptoms get worse while you are on prescribed medicine
• BV symptoms come back after you have finished the medicine

Helping Hands Patient Education Materials

Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.

HH-I-409 5/16 Copyright 2016, Nationwide Children's Hospital