What is bacterial vaginosis?

Bacterial vaginosis (BV) is a widespread vaginal infection. Global statistics on BV incidence are not yet available, but it is believed to be the most common vaginal pathology in women between 15 and 44. It is twice as common as a vaginal yeast infection. This infection is not easy to treat correctly and can become recurrent or even chronic. So, it is essential to know how to recognize it and seek care as soon as possible, especially if you are pregnant.

What are the causes of bacterial vaginosis?

BV is due to an overgrowth of anaerobic bacteria naturally found in the vagina.  No specific type of anaerobic bacteria has been identified as the cause of BV. The vagina contains a balanced mix of anaerobic bacteria and a particular type of bacteria called Lactobacillus, also known as good bacteria. Lactobacillus is beneficial for our body and does not cause any infection. It protects the vagina from the growth of pathogenic microbes by acidifying the typical vaginal environment. It also helps maintain vaginal health by producing peroxide hydrogen, which has cleansing and anti-infective properties. Under certain circumstances, the Lactobacillus does not work correctly.  It leads to an overgrowth of anaerobic bacteria.

What are the risk factors of bacterial vaginosis?

The risk factors that promote the overgrowth of anaerobic bacteria are:

  • High-risk sexual behaviors such as unprotected sex and having multiple sexual partners have been shown to increase vaginal flora diversity. It leads to the proliferation of many pathogenic bacteria and a decrease in Lactobacillus (1).
  • Douching is also implicated in the onset of the BV. Douching is the practice of washing out the vagina with water or a cleansing product. As a result, it destroys Lactobacilli and destabilizes the vaginal flora. As we said earlier, The Lactobacillus, which keeps the number of bad bacteria under control, ensures the vagina’s adequate cleaning of the vagina.  It, therefore, does not need aggressive external intervention to maintain good health.  This is crucial information, which, unfortunately, is not known by everyone. Consequently, many women with good body hygiene often have frequent and recurrent vaginal infections.
  • Smoking. Some cigarettes’ chemical components can alter the vaginal flora and lead to local immunosuppression, a favorable ground for anaerobic bacteria’s overgrowth. (2)
  • Pregnancy. Up to 30% of pregnant women will experience BV during pregnancy. It is due to the hormonal change that happens during pregnancy. (3)
  • Intrauterine devices (IUDs). Studies suggest that IUD can significantly increase the risk of BV in certain women, especially when they’ve already had an underlying imbalance in their vaginal flora. (4)
  • Natural lack of lactobacilli bacteria. Some women don’t have enough Lactobacilli bacteria. Therefore, it makes them more likely to develop BV.
  • Many everyday habits can increase your risk of BV. These habits include improper perineal care, food habits, tight clothing, poor menstrual hygiene, and sedentary. (5)

Related Post: 7 Steps To Improve Your Vaginal Health

What are the symptoms of bacterial vaginosis?

You may suspect that you have contracted BV if you have the following symptoms:

  • Low abdominal pain
  • Itching in the vulva and vagina
  • Burning during urination
  • Vaginal discharge that is thin, homogeneous, grey, off-white, or green and has a foul fish-like smell, especially after having sex.

If you experience these symptoms, it is crucial to seek medical treatment.

Many women who have BV don’t have any symptoms.

How is bacterial vaginosis treated?

BV clears up sometimes on its own without treatment, but most cases will require treatment.
Several drug and substances have shown their effectiveness in the treatment of BV.

  • Metronidazole and clindamycin are two major antibiotics used in the treatment of BV (6). Metronidazole is widely used in BV treatment because it acts effectively against anaerobic bacteria while having a low action on the Lactobacillus.
  • Intravaginal administration of lactobacilli probiotics. It aims to increase the colonization of the vaginal flora by lactobacilli and prevent anaerobic bacteria’s proliferation.
  • Local application of lactic acid gel once a day also proves its effectiveness. (7) This treatment is more manageable and has fewer side effects than antibiotics.  It restores the vaginal PH and flora.

What are the complications of bacterial vaginosis?

BV usually doesn’t cause major complications. However, some cases have been linked to a higher risk of other health issues.

  • Pelvic Inflammatory Disease (PID). BV can sometimes cause PID when the infection passes through the cervix and spreads to the uterus and the fallopian tubes. PID increases the risk of infertility.
  • Preterm birth or low birth weight baby if you are pregnant.
  • Women with BV have an increased risk of contracting STDs, including HIV.
  • Having BV increases the risk of developing an infection after a hysterectomy or other surgery on your female organs.

How can you prevent bacterial vaginosis?

Here are some things you can do to lower your chances of getting BV:

  • Don’t douche.
  • Limit the number of sexual partners or abstain from intercourse to minimize your risk of a sexually transmitted infection.
  • Avoid unprotected sex.
  • Always wipe yourself from front to back after using the bathroom.
  • Use unscented tampons, pads, or other hygiene.


  1. Wessels, J. M., Lajoie, J., Vitali, D., Omollo, K., Kimani, J., Oyugi, J., Cheruiyot, J., Kimani, M., Mungai, J. N., Akolo, M., Stearns, J. C., Surette, M. G., Fowke, K. R., and Kaushic, C. Association of high-risk sexual behavior with diversity of the vaginal microbiota and abundance of Lactobacillus. PLoS ONE, 12(11), 1-23. https://doi.org/10.1371/journal.pone.0187612
  2. Ranjit, E., Raghubanshi, B. R., Maskey, S., and Parajuli, P. (2018). Prevalence of Bacterial Vaginosis and Its Association with Risk Factors among Nonpregnant Women: A Hospital Based Study. International Journal of Microbiology, 1/9. https://doi.org/10.1155/2018/8349601
  3. https://www.cdc.gov/std/bv/stats.htm
  4. https://pubmed.ncbi.nlm.nih.gov/22337109/
  5. Masoudi, M., Kopaei, M. R., Miraj, S. (2017). A comparison of the efficacy of metronidazole vaginal gel and Myrtus (Myrtus communis) extract combination and metronidazole vaginal gel alone in the treatment of recurrent bacterial vaginosis. Avicenna Journal of Phytomedicine, 7(2), 129-136.
  6. Anstey Watkins, J., Ross, J. D. C., Thandi, S., Brittain, C., Kai, J., and Griffiths, F. (2019). Acceptability of and treatment preferences for recurrent bacterial vaginosis—Topical lactic acid gel or oral metronidazole antibiotic: Qualitative findings from the VITA trial. PLoS ONE, 14(11), 1-24. https://doi.org/10.1371/journal.pone.0224964
  7. Pentikis, H. S., Adetoro, N., Kaufman, G. (2020). In vitro metabolic profile and drug-drug interaction assessment of secnidazole, a high-dose 5-nitroimidazole antibiotic for the treatment of bacterial vaginosis. Pharmacology Research and Perspectives, 8(4), 1-9. https://doi.org/10.1002/prp2.634


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Hermione M.

My name is Hermione. I am the founder of WomenH and I write about women's health, wellness, mental health, and personal growth. I created this platform to inspire women to take care of themselves mentally, physically, and emotionally to become their best selves. Thank you for stopping by.

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