What is bacterial vaginosis?
- What it is
- An imbalance of vaginal bacteria
- Is it an STI?
- No, but it's linked to sexual activity
- Symptoms
- Many people have none
- Treatment
- Prescription antibiotic pills, gel or cream
A healthy vagina is dominated by protective bacteria called lactobacilli. BV develops when they decrease and other bacteria overgrow, changing the vagina's normal balance.
BV is not a sexually transmitted infection, but it is linked to sexual activity and rarely affects people who have never had sex. It isn't caused by poor hygiene. In fact, douching makes it more likely.
Treating BV matters. Untreated, it raises the risk of getting STIs, including HIV, and during pregnancy it's linked to early delivery and low birth weight.
BV symptoms
Many people with BV notice nothing. When symptoms happen, they can include:
- Thin white or gray discharge
- A fishy odor, often stronger after sex or during your period
- Vaginal itching or irritation
- Burning when you urinate
If you're pregnant
BV during pregnancy is linked to premature birth and low birth weight. If you notice new discharge or odor, contact your prenatal care provider rather than starting an online visit.
BV, yeast infection or trichomoniasis?
These three are the most common causes of vaginal symptoms, and they need different treatments:
| Feature | BV | Yeast infection | Trichomoniasis |
|---|---|---|---|
| Discharge | Thin, white or gray | Thick, white, clumpy | Frothy, yellow-green |
| Odor | Fishy, often worse after sex | Little or none | Often unpleasant |
| Itching | Mild or none | Often intense | Common |
| Treatment | Antibiotics | Antifungal medicine | Antibiotics for you and your partners |
NoteSymptoms overlap and people often guess wrong, so describe everything in your visit. Your provider may recommend a test if the picture isn't clear.
What makes BV more likely
Experts don't fully understand what causes BV, but these factors are linked to it:
- New or multiple partners
- Changes in sexual partners can shift vaginal bacteria.
- Douching
- Washes away protective bacteria and disrupts the natural balance.
- Condomless sex
- Semen and partner bacteria can alter vaginal pH.
- Female partners
- BV can pass between female sexual partners.
How BV is diagnosed
In a clinic, BV is confirmed by examining a sample of vaginal discharge: checking its pH, looking at it under a microscope or sending it for a lab test.
In an online visit, your provider relies on your symptoms and history. If you've had BV before and your symptoms are the same, that's often enough to decide on treatment. Otherwise, testing may be recommended.
Treating BV
BV is treated with prescription antibiotics, taken as pills or applied inside the vagina. All the recommended options work well. The choice depends on your preference, side effects and medical history.
Other treatment options may be used. Some vaginal creams can weaken latex condoms and diaphragms for several days after use. A follow-up test isn't needed if your symptoms clear.
During and after treatment
- Finish the full course, even if symptoms improve quickly
- Avoid sex, or use condoms, until treatment is finished
- Skip douching and scented vaginal products
- Contact a provider if symptoms don't clear, or come back
Is an online BV visit right for you?
Online care is often a good fit if you:
- Have symptoms that match a past BV diagnosis
- Are not pregnant
- Have no pelvic pain, fever or unusual bleeding
- Want a private, convenient visit
Testing or in-person care is better if you:
- Are pregnant
- Have pelvic pain, fever or bleeding between periods
- Might have been exposed to an STI
- Have BV that keeps returning after treatment
How PulseCareMD can help with BV
A PulseCareMD visit lets you talk through intimate symptoms privately with a licensed provider. Your visit fee covers the consultation.
Describe your symptoms
Answer private questions about discharge, odor, your history and any chance of pregnancy.
A provider reviews it
A licensed provider checks whether your discharge and odor fit BV or point to another cause. Many visits are reviewed within 2–3 hours.
Get your care plan
Your provider will explain your treatment plan, or give advice on testing.
Lowering your chances of BV
How best to prevent BV isn't fully understood, but these steps may help:
Don't douche
Let the vagina's natural bacteria do their job.
Use condoms
Correct, consistent condom use is linked to less BV.
Limit new partners
Fewer partner changes means fewer disruptions to vaginal bacteria.
Talk to a provider about recurrence
If BV keeps returning, longer suppressive treatment may be an option, and research suggests treating male partners may help.
Frequently asked questions
When to get prompt care
Seek in-person care right away if you have:
- Fever with pelvic or lower abdominal pain
- Severe abdominal pain
- Heavy or unexpected vaginal bleeding
- Vaginal symptoms with pain or bleeding during pregnancy