Bacterial vaginosis

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It is an infection of the vagina caused by a large number of bacteria that change the usual balance of the vaginal bacterial flora.

It is more frequent in women between 15 and 45 years of age.

There is no clear cause for it to appear, although there have been described favoring factors: having a new sexual partner, multiple sexual partners, vaginal douching, etc.

It is not considered a sexually transmitted disease.

In many cases, the affected woman has no symptoms. When it does manifest itself in the form of a whitish or gray vaginal discharge, with a very unpleasant fishy odor. The fishy odor increases after sexual intercourse. It may be accompanied by itching in the genital area and a burning sensation during urination.

It is diagnosed by clinical history and gynecological examination, where a sample of vaginal secretions will be collected for laboratory analysis.

Treatment is based on the administration of antibiotics orally or in the form of vaginal gel. It is not necessary to treat the asymptomatic sexual partner.

It is not considered a medical emergency, but it is highly recommended to consult a gynecologist once it is suspected.

Bibliographic references
  1. Jack D Sobel. Bacterial vaginosis. UpToDate Aug 28, 2015.
  2. Vodstrcil LA, Walker SM, Hocking JS, et al. Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clin Infect Dis 2015; 60:1042.
  3. Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64:1.
  4. Bradshaw CS, Walker SM, Vodstrcil LA, et al. The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: the WOW Health Study. J Infect Dis 2014; 209:1562.
  5. Bradshaw CS, Vodstrcil LA, Hocking JS, et al. Recurrence of bacterial vaginosis is significantly associated with posttreatment sexual activities and hormonal contraceptive use. Clin Infect Dis 2013; 56:777.
  6. Jeanne M Marrazzo, King K Holmes. Vaginosis bacteriana. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición. 874:875
  7. Coudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol. 2020 Feb;245:143-148. doi: 10.1016/j.ejogrb.2019.12.035. Epub 2019 Dec 24. PMID: 31901667; PMCID: PMC6989391.
  8. Reiter S, Kellogg Spadt S. Bacterial vaginosis: a primer for clinicians. Postgrad Med. 2019 Jan;131(1):8-18. doi: 10.1080/00325481.2019.1546534. Epub 2018 Nov 30. PMID: 30424704.
  9. Van Schalkwyk J, Yudin MH; INFECTIOUS DISEASE COMMITTEE. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. J Obstet Gynaecol Can. 2015 Mar;37(3):266-274. doi: 10.1016/S1701-2163(15)30316-9. PMID: 26001874.
Author
Dr. Josep Estadella
Copyright
© TeckelMedical 2026

Symptoms

    Greyish vaginal discharge


    Foul-smelling vaginal discharge


    Discomfort when urinating


    Vaginal discharge


    Vaginal pain

Symptoms to watch out for

Severe belly pain
High fever (102.2 ºF or more)
Discharge of whitish fluid (pus)

Self-care

Consult with your primary care physician regarding the prescription of antibiotics.
Avoid sexual intercourse and, if you do have sex, use barrier methods such as condoms.
Reduce alcohol consumption.