Published on Aug 08, 2023 | 5:16 PM
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Bacterial vaginosis (BV) is a common vaginal condition caused by an imbalance of the natural bacteria that normally live in the vagina. It occurs when “good” lactobacilli decrease and other bacteria overgrow. BV is not considered a classic sexually transmitted infection, but sexual activity can increase the risk of developing it.
BV is most common in people of reproductive age and can recur even after treatment. While it is often mild, untreated BV can increase the risk of other infections and pregnancy complications.
Some people with BV have no symptoms at all. When symptoms are present, they are usually related to changes in vaginal discharge.
Common symptoms include:
Thin, gray or white vaginal discharge
Strong “fishy” vaginal odor, often more noticeable after sex
Vaginal itching or irritation
Burning with urination
BV does not usually cause vaginal pain or inflammation, which helps distinguish it from other vaginal infections.
BV develops when the normal vaginal bacterial balance is disrupted. Factors that increase risk include having new or multiple sexual partners, douching, and using certain vaginal products that alter vaginal pH.
BV can occur in people who are not sexually active, and it is not caused by poor hygiene.
BV is diagnosed based on symptoms, vaginal examination, and laboratory testing.
Diagnosis may include:
Vaginal pH testing
Microscopic examination of vaginal discharge
Laboratory testing when needed
Accurate diagnosis is important because BV symptoms can overlap with yeast infections and sexually transmitted infections.
BV is treated with prescription antibiotics, most commonly metronidazole or clindamycin. Treatment may be given as oral medication or vaginal therapy, depending on the situation.
It is important to:
Take the medication exactly as prescribed
Avoid alcohol when using certain medications
Complete the full course of treatment
Symptoms often improve within a few days, but recurrence is common.
Untreated BV can increase the risk of:
Sexually transmitted infections, including HIV
Pelvic inflammatory disease
Pregnancy complications such as preterm birth
Because of these risks, treatment is recommended even when symptoms are mild.
There is no guaranteed way to prevent BV, but risk may be reduced by avoiding douching, limiting vaginal products, and using condoms consistently.
Some people experience recurrent BV and may require additional management strategies.
CallOnDoc offers confidential, convenient care for bacterial vaginosis through telehealth.
With a virtual visit, you can discuss symptoms with a licensed provider, receive an accurate diagnosis, and get prescription treatment when appropriate — all without an in-person visit.
Healthcare that fits your life — not your calendar.
updated 1/26/2026 Shelly House, FNP, is a Family Nurse Practitioner and Call-On-Doc’s trusted medical education voice. With extensive experience in telehealth and patient-centered care, Ms. House is dedicated to making complex health topics simple and accessible. Through evidence-based content, provider collaboration, and a passion for empowering patients, her mission is to break down barriers to healthcare by delivering clear, compassionate, and practical medical guidance.
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