Bacterial Vaginosis

When to Seek Medical Care


vaginal discharge, a visit to your healthcare practitioner is recommended so that more serious conditions can be ruled out, such as infection with chlamydia or gonorrhea. The unpleasant symptoms of bacterial vaginosis also can be effectively treated.


Exams and Tests


are the first steps in helping to distinguish bacterial vaginosis from more serious conditions.

After taking a medical history, the healthcare practitioner will perform a pelvic exam. During the exam, the healthcare practitioner will observe the vaginal lining and cervix and will perform a manual examination of the ovaries and uterus. Also during the exam, the healthcare practitioner may collect samples for examination under a microscope or for culture studies to rule out the presence of sexually transmitted infections (STDs).

Examination of the discharge under the microscope can help distinguish bacterial vaginosis from yeast vaginitis (candidiasis) andtrichomonas (a type of sexually transmitted infection). A sign of bacterial vaginosis under the microscope is an unusual cell referred to as a "clue cell." Women with bacterial vaginosis also have fewer of the type of normal vaginal bacteria called lactobacilli. The vaginal pH (degree of acidity or alkalinity) may also be measured, since a vaginal pH greater than 4.5 also suggests bacterial vaginosis.

A so-called "whiff test" with potassium hydroxide (KOH) liquid is sometimes performed whereby a drop of KOH testing liquid is mixed with a drop of vaginal discharge. If bacterial vaginosis is present, a fishy odor can result.


Bacterial Vaginosis Treatment

Self-Care at Home

of antibiotic (see below) that has been prescribed, even if the symptoms disappear. With proper treatment, the symptoms usually resolve in a few days, but it is still necessary to take the entire course of antibiotic treatment.

Medical Treatment

involves antibiotics taken either orally or applied locally to the vagina. Since bacterial vaginosis is not believed to be a sexually transmitted condition, treatment of male sex partners is typically not necessary.


of bacterial vaginosis.

  • Metronidazole (Flagyl) taken by either oral (pill) form or as a vaginal gel (Metrogel) is an effective treatment. 
  • A vaginal clindamycin cream (Cleocin) is also an effective option. 
  • Tinidazole (Tindamax) is an antibiotic that appears to have fewer side effects than metronidazole and is also effective in treating bacterial vaginosis.


Next Steps


recommended if the patient's symptoms do not resolve after antibiotic treatment or if symptoms return. Recurrent bacterial vaginosis may develop in the same woman after she has been treated, so it is important to see a healthcare practitioner if symptoms persist or recur. Up to 50% of women who are treated will develop a recurrence of symptoms in the year following treatment.


overgrowth in the vagina are unknown, it may not be always possible to prevent bacterial vaginosis. However, by decreasing certain behaviors (smoking, vaginal douching, and having multiple sex partners) a woman can reduce her chances of developing the condition.


with antibiotics. The presence of bacterial vaginosis does appear to increase a woman's risk for acquiring sexually transmitted infections(STDs), including HIV.

In pregnancy, bacterial vaginosis is associated with an increased risk of premature labor andpremature birth as well as infection of the uterus after delivery. However, studies have shown that screening and treatment of all pregnant women without symptoms for bacterial vaginosis did not reduce the incidenceof preterm delivery. So routine screening of all pregnant women is not recommended. However, certain groups of women at higher risk for preterm birth may benefit from screening even when no symptoms are present, and research is ongoing to further characterize and determine the need for screening in women at higher risk for preterm birth.

Synonyms and Keywords

bacterial vaginosis, bacterial vaginosis and 

pregnancy, recurrent bacterial vaginosis, BV

dyspareunia, vaginal infection

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