Bacterial vaginosis (BV) is a common vaginal infection and one of the most common reasons for unusual vaginal discharge.
Vaginal discharge is a normal and healthy bodily function — and your vagina’s way of staying clean, healthy, and lubricated. It’s also your body’s way of sounding the alarm when an infection is afoot.
Understanding what bacterial vaginosis discharge looks like can help you spot and manage this infection effectively. Keep reading to learn more about bacterial vaginosis, plus other causes of abnormal vaginal discharge.
What is bacterial vaginosis?
Bacterial vaginosis is a vaginal infection that occurs when there's an imbalance in the vaginal bacteria.
Typically, the vagina has a healthy mix of bacteria, predominantly Lactobacillus, which help maintain an acidic environment. However, in bacterial vaginosis, there's an overgrowth of anaerobic bacteria such as Gardnerella vaginalis and Prevotella species, which can lead to symptoms like unusual discharge and vaginal odor.
The cause of bacterial vaginosis isn't well understood, but anything that disrupts the natural balance of bacteria present in your vagina could lead to bacterial vaginosis. Research has also found that you're at an increased risk of developing it if you have unprotected sex, have new or multiple sex partners, smoke, or use douches.
What does BV discharge look like?
Bacterial vaginosis doesn’t always cause noticeable symptoms, but when it does, abnormal vaginal discharge is the main one. Discharge with bacterial vaginosis often has distinct characteristics:
- Color: gray or whitish
- Consistency: thin and watery
- Quantity: excessive, or more than usual
- Odor: a strong fishy odor that gets more noticeable after sex.
In terms of appearance, healthy vaginal discharge is typically clear or milky-white and may vary in consistency from thin and watery to thick and sticky, depending on where you are in your menstrual cycle. It's usually odorless or has a mild, slightly “earthy” smell.
While some variations in vaginal discharge are normal (such as during ovulation) any drastic changes in color, consistency, amount, or odor may indicate an infection. It's important to pay attention to your vaginal discharge and get acquainted with what “normal” looks for you. That makes it easier to spot when something isn’t quite right. Any unusual or persistent changes should warrant a visit to your healthcare provider, especially if accompanied by symptoms like itching, irritation, burning, or discomfort.
Symptoms of bacterial vaginosis
The main symptom of bacterial vaginosis is abnormal vaginal discharge. Vaginal discharge in bacterial vaginosis usually has the following characteristics:
Healthy vaginal discharge is typically clear or white with a creamy or stretchy consistency. It can have a mild odor that ranges from musky to tangy. Knowing how to spot healthy vs. abnormal vaginal discharge can help you recognize when something isn't quite right down there.
Most people don't have noticeable irritation or discomfort. If you experience any pain, burning, or vaginal itching, it may be due to another infection. (FYI, it’s possible to have more than one vaginal infection at the same time!)
Bacterial vaginosis might not always have noticeable symptoms, and sometimes they come and go so most people might not even realize they have it. The symptoms can be subtle or similar to other vaginal infections, so it can be tricky to pinpoint. Trichomoniasis, for example, can often be mistaken for bacterial vaginosis. A study found that self-diagnosis of bacterial vaginosis was only correct 56% of the time.
If you suspect you have bacterial vaginosis, see your healthcare provider. Although it’s not a serious infection, untreated BV can lead to serious complications, including infertility and pelvic inflammatory disease (PID).
To diagnose bacterial vaginosis, your doctor will perform a pelvic exam to check for symptoms of BV. They will also take a sample of vaginal fluid with a swab, and analyze it to check for BV-causing bacteria.
How to treat BV
The most common and effective treatment for bacterial vaginosis is a course of antibiotic medications prescribed by a healthcare provider. The typical antibiotics used are:
- Metronidazole
- Clindamycin
- Tinidazole
Your doctor might prescribe antibiotics in the form of a vaginal gel or suppository, or the form of an oral tablet. It's important to complete the full course of antibiotics prescribed, even if symptoms improve before finishing the medication.
Follow up with your healthcare provider if your symptoms don’t go away. They may recommend a different treatment approach or further tests to rule out other conditions.
Lifestyle adjustments can also help restore the natural balance of bacteria in the vagina and help prevent bacterial vaginosis:
- Avoid douching, as it upsets the normal balance of bacteria in your vagina
- Change your period products within the proper time frame
- Practice safe sex and use condoms or dental dams
- Cover sex toys with a condom during partnered sex, and wash them after each use
- Quit smoking.
FAQ
How do you know if you have bacterial vaginosis?
Sometimes, symptoms are enough to know if you have bacterial vaginosis. Telltale bacterial vaginosis symptoms are gray, watery vaginal discharge, and a fishy vaginal odor. That said, other infections can cause similar symptoms. And sometimes bacterial vaginosis doesn’t cause any symptoms at all. The best way to know if you have bacterial vaginosis is to see your healthcare provider or take a vaginal microbiome test.
Can BV go away on its own?
Sometimes, your body can clear up bacterial vaginosis on its own, but waiting it out isn't the best idea. Without treatment, BV increases your risk of serious health issues like STIs, infertility, pregnancy complications, and pelvic inflammatory disease (PID). It's best to see your healthcare provider and treat bacterial vaginosis if you're experiencing symptoms.
Is bacterial vaginosis an STD?
No, bacterial vaginosis is not classified as a sexually transmitted disease (STD), but it is linked to sexual activity. Bacterial vaginosis happens when there’s an imbalance in the vaginal microbiome, with a decrease in Lactobacillus (good bacteria) and an overgrowth of other types of bacteria. While you can develop BV even if you aren’t sexually active, it’s more common in those who are, especially if they have new or multiple sexual partners.
What happens if BV goes untreated?
Untreated bacterial vaginosis puts you at an increased risk of serious complications, including infertility, pelvic inflammatory disease (PID), pregnancy complications, and a higher risk of contracting sexually transmitted infections.
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