Bacterial Vaginosis

Bacterial vaginosis is the most common cause of vaginal discharge in women of fertile age. 


Bacterial vaginosis is a condition secondary to an overgrowth of the normal vaginal bacteria. 

The risk factors for bacterial vaginosis include sexual activity and the presence of a sexually transmitted disease. 


Bacterial vaginosis may present with thin whitish gray vaginal discharge with a fishy odor. This is more prevalent after sexual intercourse. 

Some women do not exhibit symptoms. 

Depending on the bacteria involved some may have pain and burning with urination, pain with intercourse, itching or burning. 

Pregnant women with bacterial vaginosis have an increased risk of preterm delivery. There is also an increased risk of pelvic inflammatory disease in those with bacterial vaginosis. 


Due to the overlap of symptoms between bacterial vaginosis and other conditions, it is important to rule out other illnesses. 

The diagnosis of bacterial vaginosis is based on the following symptoms: fishy odor, grayish whitish thin vaginal discharge, vaginal pH >4.5, clue cells on saline wet mount testing with at least 20% epithelial cells. 


Patients who have symptoms or are getting a procedure which involves the vaginal area are recommended to get treatment. 

If there are no symptoms there is no treatment needed because most people will clear this on their own. 

Bacterial vaginosis is treated with antibiotics. 

The goal of treating bacterial vaginosis is for symptom relief, avoiding postprocedure infections and the reduction of sexually transmitted diseases. 

Approximately 30% of people have a recurrence after treatment within 3 months and up to 60% have a recurrence within 12 months. This recurrence should be treated with a different antibiotic as the initial episode.