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Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women. It can cause bothersome symptoms, and also increases the risk of acquiring serious sexually transmitted infections, such as HIV.

BV occurs when there is a change in the number and types of bacteria in the vagina. Lactobacilli are a type of bacteria that are normally found in the vagina. In women with BV, the number of lactobacilli is reduced. The reason for these changes is not known.

Risk factors for BV include multiple or new sexual partners, douching, and cigarette smoking. Although sexual activity can increase the risk of developing BV, BV can occur in women who have never had vaginal intercourse. BV is not thought to be a sexually transmitted infection.

Approximately 50 to 75 percent of women with BV have no symptoms. Those with symptoms often note an unpleasant, “fishy smelling” vaginal discharge that is more noticeable after sexual intercourse. Vaginal discharge that is off-white and thin may also be present.

Pain during urination or sex, vulvar itching, redness, and swelling are not typical. Occasionally, BV causes an abnormal cervical discharge and easy bleeding (such as after sexual intercourse).

The diagnosis of BV is based upon a physical examination and laboratory testing. The physical examination usually includes a pelvic examination, which allows the healthcare provider to observe and test vaginal secretions. It can be difficult to know, without an examination and testing, if vaginal discharged is caused by BV or another vaginal infection.

BV itself is not harmful, although it has been associated with some health problems.

  • Pregnant women with BV are at higher risk of preterm delivery
  • Untreated BV in a woman who undergoes hysterectomy or abortion can lead to infection of the surgical site.
  • BV increases the risk of becoming infected with and spreading HIV.
  • BV increases the risk that a woman will become infected with genital herpes, gonorrhea, or chlamydia.

Treatment of BV is usually recommended.