Bacterial vaginosis is a common vaginal infection that occurs when some of the bacteria normally inhabiting the vagina overgrow, causing a bacterial imbalance. Bacterial vaginosis is a vaginal infection caused by an overgrowth of bacteria. Every healthy vagina contains bacteria. Normally these bacteria balance each other out. Sometimes the “bad” bacteria grow too much and overpower the “good” bacteria. This disrupts the balance in the vagina and leads to bacterial vaginosis. Bacterial vaginosis can cause vaginal discharge to smell “fishy”. It can also cause vaginal irritation in some women. Others may have no symptoms at all. Bacterial vaginosis is the most common vaginal problem in women of reproductive age, ages 15 to 44. In fact, about 35% of women develop bacterial vaginosis at some point in their lives. It usually occurs in women who are sexually active. It rarely happens when sex isn’t done. Some women may naturally produce too much of the bacteria, which causes a bacterial imbalance. The risks of developing bacterial vaginosis increase in: Pregnancy; Sexual intercourse without protection; Presence of intrauterine pessaries; Multiple sexual partners; Taking antibiotics. Up to 84% of women with bacterial vaginosis have no symptoms. If they do develop, they can be: Almost white, gray or greenish vaginal discharge; Vaginal discharge with a fishy smell, especially after sex; Vaginal itching or irritation; Burning sensation during micturition. The symptoms of bacterial vaginosis are similar to other infections. It is important to visit an obstetrician-gynecologist and make the correct diagnosis when any symptoms or discomfort appear on the genital side. The vagina is home to multiple types of bacteria (called the microbiome). A change in the balance of bacteria causes vaginosis. Specifically, bacterial vaginosis occurs when “bad” bacteria (anaerobes) grow faster than “good” bacteria (lactobacilli). Too much of one type of bacteria leads to an imbalance. Anything that changes the natural chemistry of the vagina can affect the bacteria in the vagina. This is why certain activities, such as douching or unprotected sex, can lead to the development of bacterial vaginosis. Women cannot develop bacterial vaginosis from hot tubs, swimming pools, or toilet seats. Bacterial vaginosis is not spread from person to person, but sexual activity can increase the risk of infection. Bacterial vaginosis is not sexually transmitted, but is associated with sexual activity. Researchers believe that sex can change the bacterial environment in the vagina. This makes bacterial overgrowth more likely. What is the difference between bacterial vaginosis and a yeast infection? Both bacterial vaginosis and yeast infections are vaginal infections that increase the amount of vaginal discharge.The hallmark of bacterial vaginosis is a fishy-smelling discharge. Discharge from yeast infections usually does not have a strong smell, but it can look like cottage cheese. Bacterial vaginosis usually does not cause vaginal irritation or itching. In contrast, yeast infections are characterized by itching and vaginal irritation. References: 1. Centers for Disease Control and Prevention. Bacterial Vaginosis – CDC Basic Fact Sheet. (https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm) 2. Kairys N, Garg M. Bacterial Vaginosis. (https://www.ncbi.nlm.nih.gov/books/NBK459216/) 2022 Jul 4. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jan-. 3. March of Dimes. Bacterial vaginosis and pregnancy. (https://www.marchofdimes.org/find-support/topics/pregnancy/bacterial-vaginosis-and-pregnancy) 4. Office on Women’s Health. Bacterial vaginosis. (https://www.womenshealth.gov/az-topics/bacterial-vaginosis) 5. Planned Parenthood. What is bacterial vaginosis? (https://www.plannedparenthood.org/learn/health-and-wellness/vaginitis/what-bacterial-vaginosis)