Bacterial vaginosis

What is bacterial vaginosis (BV)?

Bacterial vaginosis (BV) is a condition caused by changes in the amount of certain types of bacteria in your vagina. BV can develop when your vagina has more harmful bacteria than good bacteria.

Who gets BV?

BV is the most common vaginal condition in women ages 15 to 44.1 But women of any age can get it, even if they have never had sex.

You may be more at risk for BV if you:

  • Have a new sex partner
  • Have multiple sex partners
  • Douche2
  • Do not use condoms or dental dams
  • Are pregnant. BV is common during pregnancy. About 1 in 4 pregnant women get BV.3 The risk for BV is higher for pregnant women because of the hormonal changes that happen during pregnancy.
  • Are African-American. BV is twice as common in African-American women as in white women.4
  • Have an intrauterine device (IUD), especially if you also have irregular bleeding5

How do you get BV?

Researchers are still studying how women get BV. You can get BV without having sex, but BV is more common in women who are sexually active. Having a new sex partner or multiple sex partners, as well as douching, can upset the balance of good and harmful bacteria in your vagina. This raises your risk of getting BV.1

What are the symptoms of BV?

Many women have no symptoms. If you do have symptoms, they may include:

  • Unusual vaginal discharge. The discharge can be white (milky) or gray. It may also be foamy or watery. Some women report a strong fish-like odor, especially after sex.
  • Burning when urinating
  • Itching around the outside of the vagina
  • Vaginal irritation

These symptoms may be similar to vaginal yeast infections and other health problems. Only your doctor or nurse can tell you for sure whether you have BV.

What is the difference between BV and a vaginal yeast infection?

BV and vaginal yeast infections are both common causes of vaginal discharge. They have similar symptoms, so it can be hard to know if you have BV or a yeast infection. Only your doctor or nurse can tell you for sure if you have BV.

With BV, your discharge may be white or gray but may also have a fishy smell. Discharge from a yeast infection may also be white or gray but may look like cottage cheese.

How is BV diagnosed?

There are tests to find out if you have BV. Your doctor or nurse takes a sample of vaginal discharge. Your doctor or nurse may then look at the sample under a microscope, use an in-office test, or send it to a lab to check for harmful bacteria. Your doctor or nurse may also see signs of BV during an exam.

Before you see a doctor or nurse for a test:

  • Don’t douche or use vaginal deodorant sprays. They might cover odors that can help your doctor diagnose BV. They can also irritate your vagina.
  • Make an appointment for a day when you do not have your period.

How is BV treated?

BV is treated with antibiotics prescribed by your doctor.

If you get BV, your male sex partner won’t need to be treated. But, if you are female and have a female sex partner, she might also have BV. If your current partner is female, she needs to see her doctor. She may also need treatment.

It is also possible to get BV again. Learn how to lower your risk for BV.

BV and vaginal yeast infections are treated differently. BV is treated with antibiotics prescribed by your doctor. Yeast infections can be treated with over-the-counter medicines. But you cannot treat BV with over-the-counter yeast infection medicine.

What can happen if BV is not treated?

If BV is untreated, possible problems may include:6

  • Higher risk of getting STIs, including HIV. Having BV can raise your risk of getting HIVgenital herpeschlamydiapelvic inflammatory disease, and gonorrhea. Women with HIV who get BV are also more likely to pass HIV to a male sexual partner.
  • Pregnancy problems. BV can lead to premature birth or a low-birth-weight baby (smaller than 5 1/2 pounds at birth). All pregnant women with symptoms of BV should be tested and treated if they have it.

What should I do if I have BV?

BV is easy to treat. If you think you have BV:

  • See a doctor or nurseAntibiotics will treat BV.
  • Take all of your medicine. Even if symptoms go away, you need to finish all of the antibiotic.
  • Tell your sex partner(s) if she is female so she can be treated.
  • Avoid sexual contact until you finish your treatment.
  • See your doctor or nurse again if you have symptoms that don’t go away within a few days after finishing the antibiotic.

Is it safe to treat pregnant women who have BV?

Yes. The medicine used to treat BV is safe for pregnant women. All pregnant women with symptoms of BV should be tested and treated if they have it.

If you do have BV, you can be treated safely at any stage of your pregnancy. You will get the same antibiotic given to women who are not pregnant.

How can I lower my risk of BV?

Researchers do not know exactly how BV spreads. Steps that might lower your risk of BV include:

  • Keeping your vaginal bacteria balanced. Use warm water only to clean the outside of your vagina. You do not need to use soap. Even mild soap can cause irritate your vagina. Always wipe front to back from your vagina to your anus. Keep the area cool by wearing cotton or cotton-lined underpants.
  • Not douching. Douching upsets the balance of good and harmful bacteria in your vagina. This may raise your risk of BV. It may also make it easier to get BV again after treatment. Doctors do not recommend douching.
  • Not having sex. Researchers are still studying how women get BV. You can get BV without having sex, but BV is more common in women who have sex.
  • Limiting your number of sex partners. Researchers think that your risk of getting BV goes up with the number of partners you have.

How can I protect myself if I am a female and my female partner has BV?

If your partner has BV, you might be able to lower your risk by using protection during sex.

  • Use a dental dam every time you have sex. A dental dam is a thin piece of latex that is placed over the vagina before oral sex.
  • Cover sex toys with condoms before use. Remove the condom and replace it with a new one before sharing the toy with your partner.


  1. Centers for Disease Control and Prevention. (2017). Bacterial Vaginosis.
  2. Klebanoff, M.A., et al. (2010). Personal Hygienic Behaviors and Bacterial VaginosisSex Transm Dis; 37(2):94-9.
  3. Koumans, E.H., Sternberg, M., Bruce, C., McQuillan, G., Kendrick, J., Sutton, M., Markowitz, L. (2007). The Prevalence of Bacterial Vaginosis in the United States, 2001-2004; Associations with Symptoms, Sexual Behaviors, and Reproductive HealthSexually Transmitted Diseases; 34(11): 864-869.
  4. Ness, R.B., et al. (2003). Can known risk factors explain racial differences in the occurrence of bacterial vaginosis? J Natl Med Assoc; 95:201–212.
  5. Madden, T. et al. (2012). Risk of bacterial vaginosis in users of the intrauterine device: a longitudinal studySex Transm Dis; 39(3): 217-222.
  6. Centers for Disease Control and Prevention. (2015). Bacterial Vaginosis. Sexually Transmitted Diseases Treatment Guidelines, 2015.

Source: Page last updated: April 24, 2018.

December 7, 2020
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