Bacterial Vaginosis

It is a change in the normal bacteria of the vagina.

The exact cause of BV is unknown. There are many bacteria that live in a normal vagina. When you have BV, there are not enough “good” bacteria. This causes harmful bacteria to grow in the vagina, causing the vaginal environment to be out of balance.

Most women with BV have no symptoms at all. Sometimes a woman has more vaginal discharge than usual. The discharge might be milky with a “fishy” odor. The odor can be worse after sex. Other symptoms women may experience include itching or burning in or near the vagina.

BV is usually not serious. In some cases, however, it can cause infections in the uterus and fallopian tubes. It is important to treat BV, especially before having an IUD inserted, an abortion, or tests done on the uterine lining. BV during pregnancy may cause the baby to be born too soon.

The clinician will do a few simple tests in the clinic. Looking at the vaginal discharge under the microscope for bacteria and checking the acid level of the vagina are two tests that help the clinician decide if a woman has BV.

The clinician can prescribe an antibiotic, taken by mouth, called metronidazole or Flagyl®. There is also a vaginal cream. This medicine can cause nausea or a metal aftertaste in the mouth for some people. Take it with food. DO NOT DRINK ALCOHOL ANY TIME WHILE TAKING THIS MEDICINE. This medicine can cause severe nausea and vomiting when combined with alcohol. Either use a condom or do not have sex until you have finished taking the antibiotic. The clinician can order antibiotic vaginal creams or gels which work just as well, but the cost is higher. The side effects are less with vaginal antibiotics.

Your partner does not need to be treated because BV has not been proven to be a sexually transmitted infection.

Some women get BV again and again. It is not clear why or how this happens. These suggestions for good vaginal health may help:

• Wipe from front to back (away from the vagina) after bowel movements to avoid spreading bacteria from the rectum to the vagina.
• Keep the vulva (outside of the vagina) dry and clean.
• DO NOT DOUCHE. Douching is never a good idea, especially with BV.
• Avoid feminine hygiene sprays, harsh soaps, or soaps with lots of perfume.
• Avoid clothing that can trap moisture: pantyhose (wear pantyhose with cotton crotch) or latex exercise clothing.
• Using condoms may decrease BV recurrence for some women.

12 million women in the U.S. have no health insurance.
Of these, 8 million are employed.

Feminist Women's Health Center