Bacterial Vaginosis

By OBOS Common Medical Conditions Contributors |

Bacterial vaginosis (BV) is a type of vaginal infection that is caused by a disturbance of the ecology of the vagina. Bacterial vaginosis results from an overgrowth of certain microorganisms (possibly including mycoplasmas, gardnerella, and anaerobic bacteria).

Many women with BV are unaware that they have it. Some practitioners believe it can be caused by routine douching; it may also be triggered by infections, including sexually transmitted infections. The symptoms can be confused with those of trich, though the discharge tends to be creamy white or grayish and is especially foul-smelling (some call it “fishy”), especially after intercourse. It sometimes comes and goes, getting better after a period and worse again as a woman’s cycle progresses.

Medical Treatments for BV

Medication treatment is usually either metronidazole or clindamycin, taken orally or vaginally for five to seven days. Single-dose oral metronidazole may also be effective but less so (cure rates range from 40 to 60 percent). Metronidazole is sometimes used first, because it spares the lactobacilli in your vagina and is less likely to trigger a yeast infection. Vaginal treatment avoids systemic side effects but is more expensive than the five-to-seven-day pill regimens.

Some women will have another BV outbreak within nine months of initial treatment. Long-term condom use may help to prevent recurrent infection. Women with BV have more frequent infections following gynecologic surgery, and some studies suggest that BV increases the risk of giving birth prematurely if you have it during pregnancy.


Self-help treatments include general vaginitis prevention measures and taking extra vitamins B and C. You can help prevent recurrences by minimizing the use of tampons, avoiding douching, and using condoms (to offset the alkaline effect of semen). Alternative treatments may provide temporary relief but not an actual cure. Vaginal and oral use of yogurt doesn’t help with BV.