Bacterial vaginosis (BV) is an infection that occurs when some normal bacteria that live in the vagina overgrow and cause a bacterial imbalance.¹

Many people with bacterial vaginosis display no symptoms. Signs and symptoms to watch for include:²

• Thin, vaginal discharge that may be gray, white or green

• Foul-smelling, "fishy" vaginal odor

• Vaginal itching

• Burning during urination

Bacterial vaginosis may cause light bleeding or spotting, but it is not a primary side effect.³

Up to 84% of people with bacterial vaginosis don’t have symptoms, but if they do appear, symptoms would include a “fishy” odor or vaginal discharge that is gray, white or green.⁴

BV occurs when the vaginal bacteria, called the vaginal flora, is unbalanced. There are good bacteria called lactobacilli and bad bacteria called anaerobes. When the level of anaerobes becomes too high, it causes BV.

The true cause of this unbalance is often unclear, but there are some risk factors that can increase the chances of BV. These include:

• Having a new sex partner or multiple partners: The risk of BV is higher if both sexual partners are female.

• Douching: The vagina is self-cleaning and does not need harsh chemicals or douche products. These can cause an imbalance in the vaginal flora.

• Natural lack of lactobacilli bacteria: Some women naturally don’t produce enough lactobacilli and are more likely to develop BV.⁵

Bacterial vaginosis (BV) is not officially classified as a sexually transmitted infection (STI), but it is associated with sexual activity in some cases. Researchers do not fully understand exactly how BV spreads, but it occurs more often in people who are sexually active.⁶

If you have BV, you should wait until the infection clears and all symptoms are gone to have sex. Although BV is technically not sexually transmitted infection because it can develop in people who do not have sex, it can still be transferred by sexual activity in some cases.⁷

There are a few differences between BV and a yeast infection, including:⁸

• BV is caused by a bacterial imbalance. A yeast infection is a fungal infection.

• BV causes a “fishy” smelling discharge that can be gray, white or green. Discharge from a yeast infection does not usually smell strong and resembles cottage cheese.

• BV requires a prescription antibiotic for treatment. Yeast infections can be treated with over-the-counter antifungal medications.

You can have BV and a yeast infection at the same time. Learn more about the differences between the two on our blog.

There are a few differences between BV and a UTI, including:

• BV is a vaginal infection caused by an imbalance of bacteria in the vagina. A UTI is an infection in the urinary tract, usually caused by bacteria entering the urethra or bladder.

• BV often causes a “fishy” smelling discharge that can be gray, white or green. UTIs do not typically cause vaginal discharge but may cause cloudy or strong-smelling urine.

• BV symptoms can include vaginal irritation and burning. UTI symptoms more commonly include frequent urination, urgency, and pain or burning during urination.

• BV requires prescription antibiotics for treatment. UTIs are also typically treated with prescription antibiotics, but the medications used may differ.^9,10
  

BV is not an STD or an STI because it can develop in people who do not have sex. However, it can be transmitted between people through sexual contact if one of them has BV or has recently come into contact with someone who has BV.¹¹

With prescribed antibiotics, BV will usually resolve in about one week. Approximately 10% to 15% of the population will require two rounds of antibiotics.¹²

In rare cases, BV can resolve on its own. However, BV can increase the risk of STIs and can cause complications in pregnancy, so it’s best to seek treatment as soon as possible.¹³

Pinpointing the cause of recurring BV can be tough. There have been some connections between recurring BV and certain factors, including:¹⁴

• Repeated sexual contact with a person who has BV, especially unprotected

• Copper IUDs

• Douching

• Scented products like perfumes, pads or tampons

Left untreated, BV can lead to:¹⁵

• Complications during pregnancy, including premature birth.

• Sexually transmitted infections (STIs) such as chlamydia and gonorrhea. If you have HIV and develop BV, you’re at higher risk for passing HIV to your partner.

• Pelvic inflammatory disease (PID), an infection of the reproductive organs that can lead to difficulties getting pregnant.
  

Untreated BV can increase risk for sexually transmitted infections (STIs) or cause pelvic inflammatory disease (PID), both of which can lead to difficulties getting pregnant.¹⁶

No, BV does not delay your period.¹⁷

No, men and those assigned male at birth cannot contract BV. However, a man can spread BV from one partner to another.¹⁸

There is no way to prevent BV. You can decrease your risk by following a few rules, including:¹⁹

• Avoid douching

• Avoid vaginal contact with anything that has touched your or your partner’s anus

• Limit your number of sex partners

• Use latex condoms for penetrative sex or dental dams for oral sex

• Wear cotton or cotton-lined underwear to wick away bacteria-causing moisture

Ask your care provider about drinking alcohol while treating BV, as it may interfere with your medication.²⁰

1. Cleveland Clinic

2. Mayo Clinic

3. Mayo Clinic

4. Cleveland Clinic

5. Mayo Clinic

6. Centers for Disease Control and Prevention

7. National Health Service

8. Cleveland Clinic

9. Mayo Clinic

10. Cleveland Clinic

11. Cleveland Clinic

12. Cleveland Clinic

13. Cleveland Clinic

14. Mayo Clinic

15. Cleveland Clinic

16. Cleveland Clinic

17. National Library of Medicine

18. Cleveland Clinic

19. Mayo Clinic

20. New York State Department of Health

The only clinically proven way to get rid of BV is with prescription antibiotic treatment like metronidazole tablets, metronidazole 0.75% gel or clindamycin from a medical provider.²¹

There are no proven over-the-counter treatments for BV.²²

If you have BV while pregnant, your healthcare provider can prescribe medication that’s safe to use. It is very important to seek treatment even if you don’t have symptoms because BV can lead to pregnancy complications such as premature birth or low birth weight.²³

Treatment for BV requires a prescription and you can get prescription medications shipped directly to your home by telehealth providers like RedBox Rx. Start a quick online assessment for BV and one of our U.S. licensed medical providers will determine if medication is right for you.

No, antibiotics that treat BV require a prescription.²⁴

No, home remedies such as boric acid, use of probiotics or garlic supplements do not cure BV. Treatment with antibiotics is required.²⁵

No, it typically takes antibiotic treatments up to one week to treat BV.²⁶

Antibiotics are prescribed to treat BV. Some of the most commonly prescribed include:²⁷

• Metronidazole tablets (Flagyl®)

• Metronidazole 0.75% gel

• Clindamycin (Cleocin®)

It typically takes antibiotic treatments up to one week to treat BV.²⁸

The typical course of treatment for chronic or recurring BV is to extend antibiotic use for up to three to six months.²⁹

RedBox Rx offers BV treatment starting with a $39 online consult. If prescribed, medication starts at $25 per treatment.

Side effects are rare, but 10% or less of women experience:³⁰

• A vaginal yeast infection

• Metallic taste in the mouth

• Nausea

• Vomiting

You should avoid having sex while on antibiotic treatment for BV. After treatment is over, wait to have sex until all symptoms have cleared.³¹

Yes, RedBox Rx has prescription treatment options for BV online. Start an affordable and easy online assessment and a U.S. licensed provider will determine if medication is right for you.

21. Mayo Clinic

22. Cleveland Clinic

23. Cleveland Clinic

24. Cleveland Clinic

25. Medical News Today

26. Cleveland Clinic

27. Mayo Clinic

28. Cleveland Clinic

29. National Library of Medicine

30. National Library of Medicine

31. Mayo Clinic

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