BV is the most common cause of fishy odor and unusual vaginal discharge in women. Its etiology is associated with a change in vaginal ecology. Normal flora Lactobacilli bacteria is outnumbered with an overgrowth of anaerobic bacteria including Gardnerella vaginalis due to...

Bacterial vaginosis results from overgrowth of one of several bacteria naturally found in your vagina. Usually, “good” bacteria (lactobacilli) outnumber “bad” bacteria (anaerobes). But if there are too many anaerobic bacteria, they upset the natural balance of microorganisms in your vagina and cause bacterial vaginosis.

bacterial vaginosis

Who can get bacterial vaginosis (BV)?

Study shows ladies at the bearing age are susceptible to BV but that does not mean other ages cant get it. It is also more evident in black women that white ones. Therefore any woman 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:
  • Pregnancy– Due to increase foetal waste excretion. However expectant mothers are advised to do routine ANC visits.
  • Unprotected sexual activity– Lack of using a condom makes a woman susceptible to BV. Contraction with sex fluids and semen alter the pH of vagina and even risks contraction of STI.
  • Intrauterine device (IUD).- Believed to alter vaginal pH due to their contraceptive mechanism therefore giving room for the “unwanted” bacteria to grow.
  • Having new or multiple sex partners.– The frequency of contamination with altering vaginal physiological environment and increased chances of oral sexual activities.
  • Having a female sex partner– Lesbians and bisexuals are more susceptible compared to women who engage in sex with men obligatory
  • Douching– The practice of rinsing out your vagina with water or a cleansing agent (douching) upsets the natural balance of your vagina. This can lead to an overgrowth of anaerobic bacteria, and cause bacterial vaginosis. Since the vagina is self-cleaning, douching isn’t necessary.
  • Natural lack of lactobacilli bacteria. If your natural vaginal environment doesn’t produce enough of the good lactobacilli bacteria, you’re more likely to develop bacterial vaginosis.

Symptoms of bacterial vaginosis (BV)

Up to 60 % of people with bacterial vaginosis (BV) don’t have symptoms. If you do, you may have:

  • Off-white, grey or greenish color vaginal discharge (fluid).
  • Discharge that smells “fishy.”
  • “Fishy” smell that is strongest after sex or during the menstrual cycle. Smell more worse after sex due to release of amines by alkaline semen.
  • Rarely, an itchy or sore vagina.

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. It may be misdiagnosed of yeast infection.

Diagnostic difference between Bacterial vaginosis (BV) and a Yeast infection?

Both bacterial vaginosis (BV) and yeast infections are vaginal infections that increase discharge. Here’s how you can tell the difference:

  • Discharge: The cardinal sign of BV is discharge with a “fishy” smell. Discharge from yeast infections doesn’t usually have a strong smell but may look like cottage cheese.
  • Vaginal irritation: Typically, BV doesn’t cause vaginal irritation or itchiness. Yeast infections do.
  • Over-the-counter treatment: You can treat yeast infections with over-the-counter medications. You’ll need to see your healthcare provider to get antibiotics for BV.


Bacterial vaginosis doesn’t generally cause complications. Sometimes, having bacterial vaginosis may lead to:

  • Preterm birth. In pregnant women, bacterial vaginosis is linked to premature deliveries and low birth weight babies.
  • Sexually transmitted infections. Having bacterial vaginosis makes women more susceptible to sexually transmitted infections, such as HIV, herpes simplex virus, chlamydia or gonorrhea. If you have HIV, bacterial vaginosis increases the odds that you’ll pass the virus on to your partner.
  • Infection risk after gynecologic surgery. Having bacterial vaginosis may increase the risk of developing a post-surgical infection after procedures such as hysterectomy or dilation and curettage (D&C).
  • Pelvic inflammatory disease (PID). Bacterial vaginosis can sometimes cause PID, an infection of the uterus and the fallopian tubes that can increase the risk of infertility.
— Isaac Ogutu, on AfyaStoryline Weekly Editions E28

Bacterial vaginosis (BV) is the most common cause of “fishy” odor and unusual vaginal discharge in women especially under 44 years. Its etiology is associated with a change in vaginal ecology.

1. How is normal flora Lactobacilli outnumbred by Anaerobic bacteria including G. vaginalis.

2. How is BV clinically different from yeast infection by Candida albicans.

3. Risk factors, complications and management of BV

— Isaac Ogutu, on AfyaStoryline Weekly Editions E28


Treatment and Prevention

Bacterial vaginosis doesn’t necessarily have to be treated if there are no symptoms. If you have symptoms, especially if you are pregnant, it’s important you get treatment to avoid complications. Ladies may also opt to use probiotic kinds of yoghurt. Good for restoring vaginal health.

Treatment is with antibiotics. They may be given as oral tablets, or a vaginal antibiotic cream or gel. This includes but not limited to:

  • Metronidazole “flagyl” 400mg for adult
  • Tinidazole 2g
  • Secnidazole

(Please follow your healthcare provider prescription STRICTLY.)

Unfortunately, BV often comes back. So, you may need more than one course of treatment. It’s not normally necessary to treat sexual partners, but it is possible to spread bacterial vaginosis between female sexual partners. In addtion to that, avoid:

  • Douching
  • Multiple sex partners
  • Unprotected sexual activity

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