It’s a fact that 50-75% of women who have BV don’t have any symptoms but those who do often complain of a fishy smelling vaginal odor and a thin, grayish-white vaginal discharge. The discharge may be light or heavy. The odor may get worse around the time of menstruation or after unprotected sexual intercourse. When semen (male sperm) mixes with vaginal secretions, the odor becomes stronger. Less common symptoms include: vaginal itchiness, redness, and pain with intercourse.
Your health care provider may notice vaginal discharge or odor during your routine pelvic exam and do a test of the vaginal fluid to see if you have BV or any other vaginal infections. If you do have BV, your health care provider will give you a prescription to treat it.
Here how is bacterial vaginosis (BV) diagnosed
The only way to diagnose BV is by an exam by your health care provider (HCP) and testing the vaginal discharge. Your HCP will use a cotton swab to take a sample of your vaginal discharge. He/she can then measure the acidity of the discharge with pH paper. If your vagina is less acidic than it should be (pH of more than 4.5), this may be a sign that you may have bacterial vaginosis.
Your HCP can look at the sample under a microscope. If the normal bacteria (lactobacilli) are not there but many “clue” cells (cells from the vaginal lining that are coated with bacteria) are present, then you likely have bacterial vaginosis. Your health care provider will check to see if you have at least 3 out of 4 of the following symptoms:
- Thin white discharge
- Clue cells
- Fishy odor (from discharge)
- There are also special office tests that can help make the diagnosis.
How is bacterial vaginosis (BV) treated
If you have bacterial vaginosis, your health care provider will likely either give you a prescription for a cream or gel that you put into your vagina with an applicator or a prescription for pills that you take by mouth. You should let your HCP know about any other medications that you are taking. If you use a vaginal cream or gel, you should NOT use tampons during the treatment because it will absorb the medication and make it less effective.
Metronidazole or clindamycin are two antibiotics used to treat bacterial vaginosis. Both medications are effective, but you need to make sure that you take ALL of the medicine for it to work. Many women choose the vaginal gel because the pills can cause nausea and a metal taste in your mouth. Others prefer the oral medication because they don’t want to insert a cream in the vagina. Both help treat BV.
- You should not use douches or vaginal deodorant sprays. Although they may help cover up the odor, they will not cure the infection, and they might make your infection worse.
- Condoms may help to lessen the chance of getting BV if you are sexually active because the semen doesn’t change the bacteria in the vagina. Even though BV is more common in young women who have sexual intercourse with many partners, treatment of a male partner does not prevent future BV infections.
Can I get bacterial vaginosis again
Unfortunately, bacterial vaginosis often comes back, even if you take all of your medication and follow the advice from your health care provider (HCP). If your symptoms come back, see your HCP. You may need to be treated for a longer period of time.