Bacterial vaginosis, often called BV, is a common vaginal condition that can cause changes in discharge, odor, and comfort. It happens when the normal balance of bacteria in the vagina changes.
BV is not the same as a yeast infection, and it is not a sign that someone is unclean. However, because BV symptoms can overlap with yeast infections, sexually transmitted infections, and vaginal irritation, it is important to get the right diagnosis before choosing treatment.
This guide explains the common symptoms and causes of bacterial vaginosis, how healthcare providers test for BV, available treatment options, and when it is best to schedule a consultation.
Table of Contents
- What is bacterial vaginosis?
- Common bacterial vaginosis symptoms
- What causes BV?
- Who may be more likely to develop BV?
- BV vs. yeast infection: what is the difference?
- Is bacterial vaginosis an STI?
- How is bacterial vaginosis diagnosed?
- How is BV treated?
- Why does bacterial vaginosis come back?
- When to see a healthcare provider
- Can bacterial vaginosis be prevented?
What Is Bacterial Vaginosis?
Bacterial vaginosis is a condition caused by an imbalance in the types of bacteria that normally live in the vagina. The vagina naturally contains bacteria that help maintain a healthy environment. When that balance changes, certain bacteria can become more common and lead to BV.
BV is common, and some people do not have any symptoms. Others may notice a change in vaginal discharge or a stronger-than-usual odor. Because symptoms can vary, it is possible to have BV without realizing it.
Bacterial vaginosis is different from a vaginal yeast infection. Yeast infections are caused by an overgrowth of yeast, while BV is related to a change in vaginal bacteria. These conditions require different treatment approaches.
Common Bacterial Vaginosis Symptoms
Some people with bacterial vaginosis have no symptoms. When symptoms are present, they may include:
- Thin, watery, white, gray, or slightly green vaginal discharge
- A noticeable fishy vaginal odor
- An odor that may be more noticeable after sex
- Mild vaginal itching or irritation
- Burning during urination
- Discomfort around the vaginal opening
BV does not always cause itching. In fact, intense itching, redness, swelling, and thick clumpy discharge may be more commonly associated with a yeast infection. Still, symptoms can overlap, so it is not possible to diagnose BV based on symptoms alone.
Learn more about abnormal vaginal discharge and when to seek care.
What Causes BV?
BV develops when the normal vaginal balance changes. The exact reason this happens is not always clear, and it is not caused by poor hygiene.
The vagina naturally contains many types of bacteria. Some bacteria help support a healthy vaginal environment, while others can grow in greater numbers when the balance changes. Bacterial vaginosis can occur when certain bacteria become more common than usual.
Factors that may be associated with changes in the vaginal environment include:
- Douching or washing inside the vagina
- Using scented vaginal products, sprays, wipes, or washes
- New sexual partners or multiple sexual partners
- Changes in sexual activity
- Not using barrier protection during sex
- Natural changes in the vaginal environment
BV can occur even when there is no obvious trigger. It can also happen to people who are not currently sexually active.
Who May Be More Likely to Develop BV?
Anyone with a vagina can develop bacterial vaginosis. Certain factors may be linked with a higher chance of developing BV, but having a risk factor does not mean you will get it.
- A history of bacterial vaginosis
- Douching or using products inside the vagina
- Using scented intimate-care products that cause irritation
- A new sexual partner or multiple sexual partners
- Changes in sexual activity
- Previous episodes of vaginal infections or recurring vaginal symptoms
It is important to avoid blaming yourself or a partner. BV is a common medical condition related to changes in the vaginal bacterial balance, not personal cleanliness.
BV vs. Yeast Infection: What Is the Difference?
Bacterial vaginosis and vaginal yeast infections may both cause discharge or irritation, but they are different conditions with different causes and treatments.
| Feature | Bacterial Vaginosis (BV) | Vaginal Yeast Infection |
|---|---|---|
| Typical cause | Imbalance of vaginal bacteria | Overgrowth of yeast |
| Common discharge | Thin, watery, white, gray, or slightly green | Often thick, white, and clumpy |
| Odor | May have a noticeable fishy odor | Usually does not have a strong odor |
| Itching | May be mild or absent | Often common and may be intense |
| Typical treatment | Prescription antibiotic medication | Antifungal medication |
These are common patterns, but they do not replace an evaluation. If symptoms are new, severe, recurring, or unclear, testing can help identify the cause and guide treatment.
Read more about bacterial vaginosis vs. yeast infections.
Is Bacterial Vaginosis an STI?
Bacterial vaginosis is not usually classified as a sexually transmitted infection. However, sexual activity can be associated with changes in the vaginal environment that may increase the likelihood of BV for some people.
Because BV symptoms can be similar to symptoms of some sexually transmitted infections, it is important not to assume the cause of odor, discharge, itching, or burning. Testing may be recommended based on your symptoms, sexual history, and possible exposure to an STI.
If you have a new sexual partner, multiple partners, possible STI exposure, pelvic pain, sores, unusual bleeding, or symptoms that do not improve, speak with a healthcare provider about appropriate testing.
How Is Bacterial Vaginosis Diagnosed?
A healthcare provider may diagnose BV by asking about your symptoms, reviewing your medical and sexual health history, and examining the vaginal area when appropriate. Testing often involves collecting a sample of vaginal discharge.
The sample may be evaluated in the office or sent for laboratory testing. Testing can help identify BV and rule out other conditions that may cause similar symptoms, including yeast infections, trichomoniasis, other sexually transmitted infections, and vaginal irritation.
Getting tested can be especially helpful if:
- This is your first episode of unusual vaginal discharge or odor
- You are unsure whether symptoms are caused by BV or a yeast infection
- You are pregnant
- Your symptoms are severe, persistent, or recurring
- You have possible exposure to a sexually transmitted infection
- You have used over-the-counter treatment without improvement
How Is BV Treated?
When bacterial vaginosis causes symptoms, treatment is typically provided with prescription antibiotic medication. Depending on your needs, treatment may be taken by mouth or used in the vagina as a cream or gel.
The best treatment option depends on your symptoms, medical history, allergies, pregnancy status, other medications, and whether BV has occurred before. A healthcare provider can recommend the appropriate option and explain how to use it correctly.
It is important to complete treatment exactly as directed, even if symptoms improve before the medication is finished. Using incomplete treatment or using medication that was prescribed for a previous episode may not address the current cause of symptoms.
Over-the-counter antifungal products used for yeast infections do not treat bacterial vaginosis. If you are not sure what is causing your symptoms, it is best to seek evaluation before self-treating.
Why Does Bacterial Vaginosis Come Back?
Bacterial vaginosis can recur after treatment. A recurrence does not mean you did anything wrong or that treatment failed because of poor hygiene. BV can return because the balance of vaginal bacteria may change again over time.
If you have repeated BV symptoms, it is important to schedule a consultation. A healthcare provider may recommend testing to confirm the cause, review possible contributing factors, discuss your treatment history, and create a personalized plan.
Do not assume every future episode of odor or discharge is BV. Yeast infections, sexually transmitted infections, irritation, and other conditions can cause similar symptoms and may need different treatment.
When to See a Healthcare Provider
Schedule a consultation if you have vaginal odor, unusual discharge, burning, irritation, or symptoms that are new or different for you. Medical evaluation is especially important when you are unsure whether symptoms are caused by BV, a yeast infection, or another condition.
Seek medical care promptly if you have:
- Pelvic pain, lower abdominal pain, or severe vaginal pain
- Fever, chills, nausea, or vomiting
- Vaginal sores, blisters, a rash, or significant swelling
- Unexpected vaginal bleeding or bleeding after sex
- Possible exposure to a sexually transmitted infection
- Symptoms during pregnancy
- Burning with urination or other urinary symptoms
- Symptoms that continue, worsen, or return after treatment
Prompt evaluation can help identify the cause of your symptoms and make sure you receive treatment that fits your needs.
Can Bacterial Vaginosis Be Prevented?
BV cannot always be prevented, but certain habits may help reduce irritation and support a healthy vaginal environment.
- Avoid douching or washing inside the vagina.
- Use gentle, unscented products on the outside of the genital area.
- Avoid scented sprays, wipes, washes, pads, and other intimate products if they cause irritation.
- Change out of wet swimsuits and sweaty workout clothes when practical.
- Wear breathable underwear and avoid staying in tight, damp clothing for extended periods.
- Use condoms as part of a broader sexual-health plan.
- Consider STI testing when recommended based on your sexual health needs.
- Schedule an evaluation for recurring symptoms instead of repeatedly self-treating.
Get Confidential Care for BV Symptoms
Bacterial vaginosis is common and treatable, but the right treatment begins with identifying the cause of your symptoms. Vaginal odor, discharge, irritation, and burning can also be related to yeast infections, sexually transmitted infections, hormonal changes, or product irritation.
Clínica Cabrera provides confidential, personalized care for vaginal symptoms. Schedule a consultation to discuss your concerns, explore testing when appropriate, and receive treatment guidance tailored to your needs.
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