7 Key Bacterial Vaginosis Symptoms Every Woman Should Know

Bacterial vaginosis (BV) is one of the most common vaginal infections affecting women of reproductive age. It occurs when there’s an imbalance in the natural bacteria found in the vagina, with harmful bacteria outnumbering the beneficial ones. While some women may not experience any noticeable signs, others can have symptoms that significantly impact their daily comfort and quality of life.

Understanding the symptoms of bacterial vaginosis is crucial for early detection and proper management. This article explores the seven key symptoms that every woman should be aware of, helping you recognize when it might be time to consult with a healthcare provider.

1. Unusual Vaginal Discharge

One of the most characteristic symptoms of bacterial vaginosis is a change in vaginal discharge. Women with BV typically notice their discharge becoming thinner and more watery than usual. The consistency differs significantly from the normal, thick white discharge that many women experience.

The BV discharge is often described as:

• Thin and watery in texture
• White or gray in color
• More abundant than normal discharge
• May appear milky or cloudy

This discharge may be more noticeable after sexual intercourse or during menstruation. The amount can vary from woman to woman, with some experiencing only a slight increase while others notice a significant change in volume.

2. Fishy Vaginal Odor

Perhaps the most distinctive and bothersome symptom of bacterial vaginosis is a strong, unpleasant fishy odor. This smell is caused by amines, which are compounds produced by the overgrowth of anaerobic bacteria in the vagina.

Key characteristics of the BV odor include:

• A distinct fishy smell that’s often described as similar to the scent of fish or ammonia
• The odor becomes more pronounced after sexual intercourse
• It may intensify during menstruation
• The smell can become stronger after washing with soap, as alkaline products can increase the release of amines

This symptom can cause significant embarrassment and anxiety for many women, affecting their confidence in social and intimate situations. It’s important to remember that this odor is a medical symptom and not a reflection of personal hygiene.

3. Vaginal Itching and Irritation

While not as common as discharge and odor, some women with bacterial vaginosis experience vaginal itching and irritation. This symptom tends to be milder compared to other vaginal infections like yeast infections, but it can still cause considerable discomfort.

The itching associated with BV may:

• Be mild to moderate in intensity
• Occur around the vaginal opening and vulva
• Come and go throughout the day
• Worsen when the area is moist or after physical activity

If you experience severe itching, this might indicate another condition occurring alongside BV or a different type of infection altogether, and you should consult with a healthcare provider for proper diagnosis.

4. Burning Sensation During Urination

Some women with bacterial vaginosis report experiencing a burning sensation when urinating. This symptom occurs when urine comes into contact with the irritated vaginal tissue affected by the bacterial imbalance.

This burning sensation is characterized by:

• A stinging or burning feeling as urine passes
• Discomfort that’s typically felt at the vaginal opening rather than internally
• Pain that occurs during urination but subsides afterward
• Increased sensitivity in the vulvar area

It’s important to note that painful urination can also be a symptom of urinary tract infections (UTIs) or other conditions. If this symptom is severe or accompanied by fever, blood in urine, or back pain, seek medical attention promptly to rule out other infections.

5. Vaginal Discomfort or Pain

Many women with bacterial vaginosis experience a general sense of discomfort in the vaginal area. This symptom can manifest in various ways and may be subtle or more pronounced depending on the severity of the infection.

Vaginal discomfort related to BV includes:

• A feeling of soreness or tenderness in the vaginal area
• Mild pain or discomfort during sexual intercourse
• A sensation of pressure or fullness in the pelvic region
• General irritation that makes you more aware of the vaginal area

This discomfort can affect daily activities and intimate relationships. While BV itself doesn’t typically cause severe pain, the persistent nature of the discomfort can impact overall wellbeing and quality of life.

6. Increased Discharge After Sexual Intercourse

Women with bacterial vaginosis often notice that their symptoms become more apparent after sexual activity. This is because the pH of semen is alkaline, which can disrupt the vaginal pH balance even further when BV is present.

Post-intercourse symptoms may include:

• A noticeable increase in the amount of discharge
• Intensification of the fishy odor
• Increased vaginal wetness or dampness
• More pronounced discomfort or irritation

Some women may only notice their BV symptoms after sexual intercourse, as this can be when the signs become most obvious. This pattern can be a helpful diagnostic clue when discussing symptoms with a healthcare provider.

7. Asymptomatic Presentation (No Visible Symptoms)

It’s crucial to understand that many women with bacterial vaginosis don’t experience any noticeable symptoms at all. Studies suggest that up to 50-75% of women with BV may be asymptomatic, meaning they have the infection without being aware of it.

Important points about asymptomatic BV:

• The infection can be present without causing any discomfort or noticeable changes
• It may be discovered during routine gynecological examinations or testing for other conditions
• Even without symptoms, BV can still increase the risk of complications such as pelvic inflammatory disease or pregnancy-related issues
• Regular gynecological check-ups are important for detecting asymptomatic infections

This highlights the importance of regular health screenings, especially for women who are pregnant, planning to become pregnant, or undergoing gynecological procedures, as asymptomatic BV can still pose health risks in these situations.

What Causes Bacterial Vaginosis?

Bacterial vaginosis occurs when there’s an imbalance in the vaginal microbiome. The vagina normally contains a mix of bacteria, with Lactobacillus species being the predominant beneficial bacteria that help maintain a healthy acidic pH. When BV develops, these beneficial bacteria decrease while harmful anaerobic bacteria multiply.

While the exact cause of this imbalance isn’t fully understood, several factors can increase the risk of developing BV:

• Sexual activity: Having new or multiple sexual partners, though BV is not classified as a sexually transmitted infection
• Douching: Vaginal douching disrupts the natural bacterial balance and increases BV risk significantly
• Natural lack of lactobacilli: Some women naturally have fewer beneficial Lactobacillus bacteria in their vagina
• Smoking: Cigarette smoking has been linked to an increased risk of developing BV
• Intrauterine devices (IUDs): Some studies suggest IUD use may be associated with BV
• Antibiotic use: Taking antibiotics for other infections can disrupt vaginal bacteria balance
• Hormonal changes: Fluctuations in hormones during menstruation or pregnancy can affect vaginal pH
• Use of scented products: Perfumed soaps, bubble baths, and vaginal deodorants can irritate the vagina and disrupt its natural balance

It’s important to note that BV can affect any woman, and having BV doesn’t reflect on personal hygiene. In fact, excessive cleaning of the vaginal area can actually increase the risk of developing this condition.

Prevention Strategies

While it’s not always possible to prevent bacterial vaginosis, especially if you’re prone to recurrent infections, there are several steps you can take to reduce your risk and maintain a healthy vaginal environment:

• Avoid douching: This is the single most important preventive measure. Douching disrupts the natural balance of bacteria and can push harmful bacteria higher into the reproductive tract
• Practice safe sex: Using condoms can help reduce the risk of BV, especially when having sex with new partners
• Limit sexual partners: Having fewer sexual partners may reduce your risk of developing BV
• Use mild, unscented products: Choose gentle, fragrance-free soaps for external cleaning and avoid scented tampons, pads, or vaginal sprays
• Wear breathable underwear: Cotton underwear allows for better air circulation and helps keep the vaginal area dry
• Avoid tight clothing: Tight pants or synthetic fabrics can trap moisture and create an environment where harmful bacteria thrive
• Wipe front to back: After using the toilet, always wipe from front to back to prevent bacteria from the anal area spreading to the vagina
• Quit smoking: If you smoke, quitting can reduce your risk of BV and improve overall health
• Maintain a healthy lifestyle: A balanced diet, adequate sleep, and stress management can support your immune system and overall vaginal health
• Consider probiotics: Some research suggests that probiotics containing Lactobacillus strains may help maintain vaginal health, though more research is needed

Remember that even with the best preventive measures, some women may still develop BV due to factors beyond their control. If you experience symptoms or have recurrent infections, consult with a healthcare provider to discuss your individual situation and additional preventive strategies.

Frequently Asked Questions

Is bacterial vaginosis a sexually transmitted infection?

No, bacterial vaginosis is not classified as a sexually transmitted infection (STI). However, it is associated with sexual activity and having new or multiple sexual partners can increase your risk. BV results from an imbalance of naturally occurring bacteria in the vagina rather than from a pathogen passed between partners. Women who have never been sexually active can also develop BV.

Can bacterial vaginosis go away on its own?

In some cases, mild bacterial vaginosis may resolve without treatment. However, this is not guaranteed, and leaving BV untreated can increase the risk of complications such as pelvic inflammatory disease, increased susceptibility to STIs, and pregnancy complications. If you suspect you have BV, it’s best to consult a healthcare provider for proper diagnosis and guidance.

How is bacterial vaginosis different from a yeast infection?

BV and yeast infections have different causes and symptoms. Bacterial vaginosis is caused by an overgrowth of bacteria and typically produces thin, grayish discharge with a fishy odor. Yeast infections are caused by fungal overgrowth and usually cause thick, white, cottage cheese-like discharge, intense itching, and no odor. A healthcare provider can perform tests to accurately distinguish between these conditions.

Can men get bacterial vaginosis?

Men cannot get bacterial vaginosis as they don’t have a vagina. However, the bacteria associated with BV may affect the male urogenital tract in some cases, though this is less common and not well understood. If a male partner experiences unusual symptoms, he should consult with a healthcare provider.

Why does bacterial vaginosis keep coming back?

Recurrent BV is a common problem, with many women experiencing multiple episodes. The reasons aren’t fully understood, but may include incomplete treatment, re-exposure to risk factors, difficulty in re-establishing a healthy balance of vaginal bacteria, or having a naturally low level of protective Lactobacillus bacteria. If you experience recurrent BV, discuss this with your healthcare provider who may recommend different management strategies.

Can I have sex if I have bacterial vaginosis?

While having sex with BV is not dangerous, it may worsen symptoms and could potentially pass the bacteria to partners. Additionally, BV increases susceptibility to other sexually transmitted infections. It’s generally advisable to complete treatment and wait until symptoms resolve before resuming sexual activity. Using condoms may help reduce recurrence risk. Discuss this with your healthcare provider and communicate openly with your partner.

Does bacterial vaginosis affect pregnancy?

Yes, bacterial vaginosis during pregnancy can increase the risk of complications including premature birth, low birth weight, and premature rupture of membranes. Pregnant women who suspect they have BV should seek medical attention promptly. Some healthcare providers routinely screen pregnant women who have a history of preterm delivery for BV.

How long does bacterial vaginosis last?

Without treatment, BV can persist for weeks, months, or even longer. With appropriate treatment, symptoms typically improve within a few days, though it’s important to complete the full course as directed by your healthcare provider. However, recurrence is common, with some women experiencing multiple episodes throughout their lives.

References:

• Centers for Disease Control and Prevention (CDC) – Bacterial Vaginosis
• Mayo Clinic – Bacterial Vaginosis
• NHS – Bacterial Vaginosis
• American College of Obstetricians and Gynecologists (ACOG) – Vaginitis
• National Center for Biotechnology Information – Bacterial Vaginosis