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Bacterial Vaginosis – CDC Basic Fact Sheet

Bacterial vaginosis is a common, treatable, vaginal condition. BV can increase your chance of getting a sexually transmitted disease (STD) . This fact sheet answers general questions about BV.

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Bacterial vaginosis (BV) is a condition that happens when there is too much of certain bacteria in the vagina. This changes the normal balance of bacteria in the vagina.
BV is the most common vaginal condition in women ages 15-44.
Researchers do not know the cause of BV. However, we do know the condition most often occurs in those who are sexually active. BV is a result of an imbalance of “good” and “harmful” bacteria in a vagina. Douching, not using condoms , and having new or multiple sex partners can upset the normal balance of vaginal bacteria, increasing your risk for getting BV.
We also do not know how sex causes BV. There also is no research to show that treating a sex partner affects whether someone gets BV. Having BV can increase your chances of getting other STDs.
BV rarely affects those who have never had sex.
You cannot get BV from toilet seats, bedding, or swimming pools.
Healthcare providers and scientists do not completely understand how BV spreads or know how best to prevent it.
The following basic prevention steps may help lower your risk of getting BV:
Treating BV during pregnancy is very important. If you are pregnant and have BV, your baby is more likely to be born early (premature) or at a low birth weight. Low birth weight means having a baby that weighs less than 5.5 pounds at birth.
Many people with BV do not have symptoms. If you do have symptoms, you may notice:
A healthcare provider will examine your vagina for signs of discharge. They also can test a sample of vaginal fluid to determine if BV is present.
A healthcare provider can treat BV with antibiotics. If you have symptoms, you should be checked and treated by a healthcare provider. It is important to take all the medicine your provider prescribes, even if your symptoms go away. Treatment also may reduce the risk for getting other STDs. BV can return even after treatment.
Male sex partners of women with BV do not need treatment. However, BV can spread between female sex partners.
At times, BV will go away without treatment. However, treatment can help avoid the increased chance of some serious health risks associated with BV, including:
Workowski, KA, Bachmann, LH, Chang, PA, et. al. Sexually Transmitted Infections Treatment Guidelines, 2021 . MMWR Recomm Rep 2021; 70(No. 4): 1-187.
Hillier S and Holmes K. Bacterial vaginosis. In: K. Holmes, P. Sparling, P. Mardh et al (eds). Sexually Transmitted Diseases, 3rd Edition. New York: McGraw-Hill, 1999, 563-586.
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Bacterial vaginosis (BV) is a common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows, causing a bacterial imbalance. Symptoms include an off-white or grey vaginal discharge that smells “fishy.” In some women, BV goes away without treatment, in others, antibiotics successfully treat this infection.

Centers for Disease Control. Bacterial Vaginosis Fact Sheet. (https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm) Accessed 6/3/2020.
American College of Obstetricians and Gynecologists. Vaginitis. (https://www.acog.org/patient-resources/faqs/gynecologic-problems/vaginitis) Accessed 6/3/2020.
U.S. Department of Health and Human Services, Office on Women’s Health. Bacterial Vaginosis. (https://www.womenshealth.gov/a-z-topics/bacterial-vaginosis) Accessed 6/3/2020.
Centers for Disease Control and Prevention. Bacterial Vaginosis. (https://www.cdc.gov/std/bv) Accessed 6/3/2020.
Koumans EH, Sternberg M, Bruce C, McQuillan G, Kendrick, J, Sutton M, Markowitz LE. The prevalence of bacterial vaginosis in the United States, 2001–2004; Associations With Symptoms, Sexual Behaviors, and Reproductive Health. Sexually Transmitted Diseases, (https://journals.lww.com/stdjournal/Fulltext/2007/11000/The_Prevalence_of_Bacterial_Vaginosis_in_the.6.aspx) November 2007;34(11):864-9. Accessed 6/3/2020.
Kairys N, Garg M. Bacterial Vaginosis. (https://www.ncbi.nlm.nih.gov/books/NBK459216/) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Accessed 6/3/2020.
Centers for Disease Control and Prevention. Bacterial Vaginosis (BV). Statistics. (https://www.cdc.gov/std/bv/stats.htm) Accessed 6/3/2020.

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Bacterial vaginosis (BV) is a vaginal infection caused by bacteria. It is the most common cause of abnormal vaginal discharge that occurs in reproductive-age women (women who have not gone through menopause yet).
Bacterial vaginosis may cause a "fishy" odor and cause vaginal irritation in some women. Others may not have any symptoms.
Bacterial vaginosis is associated with poor obstetrics and gynecologic outcomes such as preterm delivery, infection after surgeries such as a hysterectomy, and may make a woman more susceptible to sexually transmitted infections, especially HIV .

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
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Bacterial vaginosis (BV) is the most common vaginal problem for women ages 15 to 44. In fact, an estimated one in three American women will get BV. The rate is higher in black women.
Anyone with a vagina can get bacterial vaginosis (BV), even if you haven’t had sex. But that’s rare. It usually occurs in people who are sexually active. You may have a higher risk of getting BV if you:
Your vagina is home to multiple types of bacteria (called a microbiome), just like your digestive system. Bacterial vaginosis (BV) happens when some of the vaginal bacteria grow more quickly than others. Too much of one type of bacteria leads to an imbalance.
Bacterial vaginosis (BV) doesn’t spread from person to person, but sexual activity can increase your risk of getting the infection.
Bacterial vaginosis isn’t sexually transmitted, but it is linked with sexual activity. Researchers think that sex may change the bacterial environment in your vagina. This makes bacterial overgrowth more likely.
Up to 84% of people with bacterial vaginosis (BV) don’t have symptoms. If you do, you may have:
BV symptoms are similar to other infections. It’s important to visit your healthcare provider to determine if what you have is BV or another vaginal infection.
Both bacterial vaginosis (BV) and yeast infections are vaginal infections that increase discharge. Here’s how you can tell the difference:
During an exam, your healthcare provider takes a sample of fluid from your vagina. Healthcare providers view the fluid under a microscope, test it in the office or send it to the lab for analysis.
In one-third of cases, bacterial vaginosis (BV) resolves on its own without any medications. However, if you have symptoms, you should seek medical care. Having BV makes you prone to sexually transmitted infections and can affect pregnancy.
Your doctor will prescribe antibiotics , typically metronidazole or clindamycin . These medications come in a gel or cream you insert into your vagina. They also come in pills you can take orally.
There are no over-the-counter products to treat bacterial vaginosis (BV). Avoid using douches or products meant for yeast infections, which could make BV worse. See your healthcare provider for treatment.
Because bacterial vaginosis (BV) isn’t fully understood, there are no foolproof ways of avoiding it. These steps may reduce your risk:
Most of the time, one round of antibiotics — taken for up to seven days — eliminates the infection. About 10% to 15% of people need another round of treatment.
Yes. Up to 80% of women may get bacterial vaginosis again.
If you have bacterial vaginosis (BV), your provider can prescribe medication that’s safe to use during pregnancy. You should get treated for the infection whether or not you have symptoms. BV can cause pregnancy complications, such as early delivery or having a baby that weighs less than average.
Male partners don’t need to be treated for bacterial vaginosis (BV). If you have a female partner, she may have BV too. It’s important to let her know so she can get treatment.
Although bacterial vaginosis is a mild infection, it can make you vulnerable to more serious conditions. Don’t put off seeing your healthcare provider if you notice anything unusual. A simple course of antibiotics could set things straight.
Last reviewed by a Cleveland Clinic medical professional on 06/05/2020.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
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Have you ever thought about how when your body is healthy, you don’t even notice your vagina? But when things are a little off, it’s hard to ignore. Bacterial vaginosis is a common bacterial infection of the vagina that rarely goes unnoticed. It sometimes can be confused with a yeast infection or sexually transmitted disease, such as trichomoniasis, but it is not an STD .
With bacterial vaginosis, bacteria growth can cause uncomfortable symptoms, including a change in vaginal discharge or odor — often described as being white or gray in color and having a fish-like odor. Some women will experience inflammation and itching. However, itching is uncommon.
Low levels of the bacteria that cause bacterial vaginosis are normally found in the vagina. It becomes a problem when too much of the bacteria grow.
Several factors can make increase the number of bacteria, including:
The first instinct often is to look online for home remedies because it seems too embarrassing to seek medical care. Home remedies include a borax suppository, yogurt, garlic supplements, hydrogen peroxide or diluted tea tree oils. These treatments aren’t well-studied, so we do not recommend trying to treat bacterial vaginosis at home with them. Seeing a primary care provider or gynecologist is the best and safest option for treatment. Bacterial vaginosis is not transferrable to male partners, but is to female partners, so both females should consider being treated.
It is fairly common for bacterial vaginosis to recur. If this happens, a medical provider should be consulted for other treatment options specific to your case. Bacterial vaginosis can be uncomfortable and frustrating to deal with, which is why it’s important to seek medical care. Don’t deal with it longer than you have to.
See your primary health care provider or OB-GYN if you suspect you have bacterial vaginosis.
Carla Toft is a certified nurse-midwife OB-GYN in Eau Claire , Wisconsin.

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Normally, when bacteria are spoken about in relation to health it’s presented as a negative thing. From a young age, it’s likely you were told to avoid germs as much as you can. Our relationship with bacteria is pretty complicated. However, when it comes to gut and vaginal health it’s of paramount importance. A delicate mix of ‘friendly’ bacteria live in your body and some make up your vaginal microbiome. When it’s disturbed it can cause some pretty serious irritation. So, what is bacterial vaginosis , and what causes it? Getting accustomed to what is ‘normal’ for you could help you identify when your vaginal flora is out of balance.
Bacterial vaginosis is a disturbance of the bacteria in your vagina. The mix of bacteria in your vagina can help you stay healthy and well. Bacterial vaginosis may occur when your vagina has more harmful bacteria than good bacteria. The vaginal microbiome was first identified by German gynecologist Albert Döderlein in 1892 and is considered to be fundamental for your overall health.
Both anaerobic bacteria and lactobacilli are bacterias that thrive in your vaginal flora. Anaerobic bacteria grow without air and when they increase in number and lactobacilli deplete it can make the vagina less acidic. While you may not have considered the pH of your vagina before, a healthy pH for a vagina is 3.8 to 4.5. If the vaginal pH rises above this anaerobic bacteria continue to thrive and lactobacilli decrease. This imbalance of bacteria can cause conditions like bacterial vaginosis.
Speaking to Shape, Dr. Kameelah Phillips, M.D. , a board-certified obstetrician-gynecologist, and founder of Calla Women's Health said, "Lactobacilli produces lactic acid, which helps maintain the acidic environment in the vagina. Low levels of lactobacilli, and therefore lactic acid too, allow the overgrowth of bacteria that cause BV and its associated symptoms.”
A change in your body can be incredibly scary but bacterial vaginosis is really easily treated and is believed to be incredibly common. It’s estimated that one in three people have BV at some time in their lives and it’s most common in people aged 15 to 44. While some people experience no symptoms, BV can manifest as an unusual discharge which is cloudy and white or grey. It could also be unusually watery or have a fishy smell. You may also experience itching or irritation and burning when you urinate. Symptoms of BV and yeast infections can be very similar and you should see a clinician if you notice any changes in your body or the way you’re feeling.
Your natural reaction may be to think that you need to change your hygiene routine to prevent BV and that might be the case but BV isn’t caused by not washing enough. In fact, using harsh or perfumed products or too much washing can cause BV. Similarly, antibiotics can kill the good bacteria in your vagina causing BV. Sex can upset the balance of bacteria but it’s not a sexually transmitted disease. Hormone changes can also lead to imbalances that cause BV. It’s been found that when people enter puberty or menopause the pH levels of their vagina can change.
If you’re worried that you’re suffering from BV your doctor can take a sample of your discharge and run a test. It’s treated with antibiotics and as it’s not an STD your partner won’t need to be tested or treated. While symptoms may be similar, you can’t treat BV with over the counter medication for yeast infections.
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