Bacterial vaginosis: Causes & Symptoms

Bacterial vaginosis, also known as vaginal bacteriosis or bacterial vaginosis, is the most common vaginal infection among women. BV is not often a sexually transmitted infection.

The infection results in pink or grayish-brown vaginal discharge, which usually contains bacteria such as “Escherichia coli” or “Streptococcus.”

BV is due to the overgrowth of a certain type of bacteria, “Vibrio vulnificus”.

Bacterial vaginosis is typically treated with antibiotics such as clindamycin or the penicillin-based antibiotics amoxicillin or amoxicillin-sulbactam.

There is no cure for BV and the infection is usually diagnosed by a healthcare provider.


In the US, an estimated 66% of women have at least one symptom of BV. It is most often caused by bacteria (“Enterococcus faecalis”, “Escherichia coli”, “Staphylococcus aureus”) rather than a virus. Bacterial vaginosis is estimated to occur in 10%–50% of women.

In 2012, the Centers for Disease Control and Prevention estimated that 26 million American women have a symptom of bacterial vaginosis.

These may be asymptomatic, which means that they will not appear in a standard physical examination, and may cause no symptoms.

In this case, the infection may be extremely difficult to detect by physical examination.

Bacterial vaginosis symptoms

Bacterial vaginosis symptoms include excessive itching and a burning sensation during intercourse, according to Mayo Clinic. About 90 percent of women are infected with BV at some point in their lives, and up to two-thirds have no symptoms.

However, many women notice an increase in odor and discharge, itching, pain during sex or in between periods, and sometimes rash.

Bacterial vaginosis often clears up without treatment, but women with signs and symptoms should seek treatment to avoid complications.

Uncommon but potentially serious complications include:

  • an infection of the uterus that can cause high blood pressure and preterm labor
  • infection in the lungs, which can lead to pneumonia

Bacterial vaginosis Complications:

It causes an overgrowth of the vaginal microbiome that can lead to vaginal yeast infections and irritation and also causes inflammatory changes, which may be linked to bacterial vaginosis or other conditions, such as vulvodynia toxic polyps, which can grow inside the vagina or on the outside and may also cause itching and burning sensations


Certain lifestyle changes can help prevent bacterial vaginosis, including:

  • losing weight if overweight
  • taking probiotics to balance the vaginal microbiome
  • taking lactic acid-based vaginal moisturizers that help support the elasticity of the vagina
  • quitting smoking and avoiding secondhand smoke

Taking lactic acid-based vaginal moisturizers is best if they contain the active ingredient, lactic acid. Certain products contain other ingredients, which may interact with lactic acid and make the moisturizer ineffective.

Wearing comfortable clothing can also prevent vaginal irritation, which can help prevent bacterial vaginosis.


Bacterial vaginosis can cause burning, itching, and redness in the vagina. When it clears up, the vagina should return to normal. Most cases resolve with few symptoms. If bacterial vaginosis persists for more than a month or causes any problems, it may be bacterial vaginosis, prostatitis, or a cyst.

A doctor may be able to provide support and prescription medication to help manage the symptoms.

People who suspect that they have bacterial vaginosis or another condition should visit a doctor.

Bacterial vaginosis with Antibiotics

Microbial vaginosis is usually of a short duration, and there is no risk of pregnancy with the occurrence of the condition. Women in their childbearing years are usually affected by bacterial vaginosis. Bacterial vaginosis is generally treated with an antibiotic.

Diagnosis of bacterial vaginosis

Bacterial vaginosis is diagnosed based on vaginal odor, discoloration or thickening of vaginal discharge and vaginal infection with different types of bacteria.

Vaginal discharge may also have the following characteristics:

  • Feeling of tightness or burning pain when passing urine.
  • Discharge that is gray in color, stiff and stringy and non-adhesive.
  • Dark colored vaginal discharge that feels viscous or gluey and thick in consistency.
Specific bacterial testing

A vaginal swab sample may be taken by inserting the swab into the vagina and wiping it with a sterile cotton wool pad. If the swab yields a positive result for the presence of a bacterial organism, a sample of vaginal fluid is examined.

Treatment for bacterial vaginosis

Bacterial vaginosis can be treated with a range of antibiotics. Some antibiotics, such as:

  • Bactrim tablets
  • Doxycycline tablets
  • Azithromycin tablets

Oftentimes, a course of antibiotics is required to cure bacterial vaginosis. These may include different combinations of antibiotics, sometimes called a regimen, and this may be started in one treatment.

Often, it is necessary for an antibiotic to be taken daily for up to two months. The majority of people report a complete cure of bacterial vaginosis. However, it is important to note that bacterial vaginosis can recur following the treatment of bacterial vaginosis.

How does antibiotic treatment work?

A regimen of antibiotics can be taken daily for up to two months to cure bacterial vaginosis.

Antibiotic treatment for bacterial vaginosis can be challenging, because antibiotics can cause side effects such as diarrhea, nausea, vomiting, or an allergic reaction. This is why it is essential that the treatment is carried out under the supervision of a healthcare professional. It is also important that the bacteria causing bacterial vaginosis are eliminated from the vaginal area.

Common side effects of antibiotics include:

  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal pain
  • Vaginal rash or itching
  • Infection that spreads to other parts of the body
What are the complications of antibiotic treatment for bacterial vaginosis?

People can experience side effects of antibiotic treatment for bacterial vaginosis. Antibiotic treatment of bacterial vaginosis may cause infection that spreads to other parts of the body.

What are the complications?

Many people who take antibiotics for bacterial vaginosis have a bacterial infection called group A streptococcal pharyngitis, an infection of the throat, which can be potentially fatal.

Antibiotic-associated pelvic inflammatory disease (AIPID)

While antibiotics are sometimes used to treat bacterial vaginosis, they are not very effective at eradicating the bacteria responsible for the condition. In most cases, people develop a resistance to antibiotics that are used to treat bacterial vaginosis. AIPID is caused by the bacteria that cause bacterial vaginosis becoming resistant to antibiotics that are used to treat the infection.

AIPID is more common in women of reproductive age.

While many symptoms of AIPID are similar to symptoms of bacterial vaginosis, there are differences between the two conditions.

AIPID symptoms include:

  • pain during sex
  • pain in the vagina that does not go away
  • problems with the vagina or uterus
  • infected vaginal discharge
Menstrual or menopausal symptoms

AIPID is more common in women of reproductive age. AIPID is more common in women of reproductive age.

Women who are pregnant may experience symptoms of bacterial vaginosis, but this does not affect the vagina or uterus. Some types of yeast may develop in the vagina and rectum. Pregnancy, however, causes an increase in the bacteria of the vaginal and vulvar area that leads to some vaginal changes.

Symptoms that affect the vagina or uterus include:
  • spotting
  • pain during sex
  • unexplained discharge
  • hot flashes or night sweats

Some women also report a discharge that smells like vinegar, while others have no discharge at all. Other signs and symptoms that could indicate the presence of AIPID include:

  • pain in the vagina or rectum
  • pain during sex
  • problems with the vagina or uterus
  • discharge that smells like wine
  • vaginal itching or burning
  • fever or chills

AIPID symptoms tend to affect women of reproductive age, but the exact age that is most common is unknown.


It is possible to prevent bacterial vaginosis by avoiding infection with the types of bacteria that cause the condition.

People with a weakened immune system should take steps to avoid infections. They may want to use condoms and get tested before having intercourse. People should also avoid engaging in sexual contact if they have an infection.

Women who are using hormonal contraception and who may be allergic to some types of condoms may wish to take other precautions to prevent a breakout of the infection.

In addition, it is essential to avoid using oral contraceptives that contain oxytocin if they have been prescribed.


People with bacterial vaginosis can take steps to prevent a repeat infection.

A woman who has had a previous infection may wish to use condom in the case of another infection. This is because infections can have a long-term effect on the vaginal tissue and can reduce a woman’s fertility in the future.

The symptoms of bacterial vaginosis are not life-threatening, but they can make sex difficult and cause embarrassing situations for both partners.

Most cases of bacterial vaginosis clear up without treatment, so it is essential to speak to a doctor if symptoms do not resolve on their own.



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