Bacterial Vaginosis:
What It Is, Why It Happens, and How to Find Relief
A change in vaginal odor or discharge can feel uncomfortable, frustrating, and even embarrassing. However, bacterial vaginosis is extremely common—and it is not a sign that you are dirty or have done something wrong.
Usually called BV, bacterial vaginosis develops when the normal balance of bacteria in the vagina changes. Some people never notice symptoms, while others experience odor, unusual discharge, irritation, or burning.
Fortunately, BV is treatable. The first step is getting the correct diagnosis, because several vaginal conditions can cause similar symptoms but require different treatments.
At MORE 901 in Memphis, Dr. Susan Lacy and her team provide respectful, judgment-free evaluation and treatment for vaginal symptoms, including new or recurrent bacterial vaginosis.
What Is Bacterial Vaginosis?
A healthy vagina naturally contains many types of bacteria. Lactobacillus bacteria usually help maintain an acidic environment that discourages the overgrowth of other organisms.
BV occurs when protective bacteria decrease and other types of bacteria become more abundant. This shift disrupts the normal vaginal microbiome and may cause odor, discharge, or irritation.
Despite the name, bacterial vaginosis is not the same as a typical infection caused by one specific bacterium. Instead, it involves an imbalance among multiple types of vaginal bacteria.
What Are the Symptoms of BV?
Many people with bacterial vaginosis do not experience noticeable symptoms. When symptoms occur, they may include:
- Thin white, gray, or slightly green vaginal discharge
- A strong or “fishy” vaginal odor
- Odor that becomes more noticeable after sex or during a period
- Vaginal irritation or itching
- Burning during urination
- Mild discomfort around the vaginal opening
BV does not usually cause intense swelling or severe itching. Those symptoms may be more consistent with a yeast infection, allergic reaction, or another condition.
Because symptoms can overlap, appearance and odor alone cannot reliably identify the cause.
Is BV the Same as a Yeast Infection?
No. BV and yeast infections are different conditions and require different treatment.
Bacterial vaginosis results from an imbalance of vaginal bacteria. A yeast infection develops when Candida yeast grows excessively.
BV is more commonly associated with thin discharge and a fishy odor. In contrast, a yeast infection often causes intense itching, redness, irritation, and thicker discharge.
However, symptoms are not always predictable. Some people have more than one condition at the same time, and sexually transmitted infections such as trichomoniasis can also cause odor or discharge.
That is why treating every vaginal symptom with an over-the-counter yeast medication may delay the correct diagnosis.
Is Bacterial Vaginosis an STI?
BV is not currently classified simply as a traditional sexually transmitted infection. It can occur without recent sexual activity, and it does not result from one single sexually transmitted organism.
However, sexual activity can influence the vaginal microbiome. BV is associated with new partners, multiple partners, female partners, inconsistent condom use, and the exchange of genital bacteria.
Recent evidence also suggests that bacteria associated with recurrent BV may be shared between sexual partners. In 2025, the American College of Obstetricians and Gynecologists updated its guidance to support considering concurrent treatment for certain male partners of adults with recurrent, symptomatic BV.
Partner treatment is not automatically necessary for every first episode. If BV keeps returning, your provider can discuss whether partner treatment should be part of your plan.
Most importantly, a BV diagnosis does not prove infidelity or reveal when or from whom the bacterial imbalance developed.
What Can Increase the Likelihood of BV?
Researchers do not fully understand why some people develop bacterial vaginosis while others do not. Several factors may disrupt vaginal bacteria or increase the likelihood of BV, including:
- A new sexual partner
- Multiple sexual partners
- Sex without condoms or barrier protection
- Douching
- Scented vaginal products
- Menstruation
- A previous history of BV
- Sexual activity involving the exchange of vaginal fluids
- Possibly using a copper IUD in some patients
BV is not caused by poor hygiene. In fact, trying to clean inside the vagina can make the imbalance worse.
The vagina is self-cleaning and does not need internal washes, deodorants, fragrances, or douches.
How Is BV Diagnosed?
Your provider will ask about your symptoms, menstrual cycle, sexual health, products you use, recent medications, and previous episodes.
Testing may involve a vaginal swab, an examination of the discharge, vaginal pH testing, microscopy, or a molecular laboratory test. Depending on your symptoms and risk factors, your provider may also recommend testing for yeast, trichomoniasis, chlamydia, gonorrhea, or other infections.
A Pap smear is not designed to diagnose BV. Although a Pap report may occasionally mention bacterial changes, symptomatic patients usually need a separate evaluation.
Accurate testing matters because medical history and symptoms alone are not always enough to distinguish BV from other causes of vaginitis.
How Is Bacterial Vaginosis Treated?
Symptomatic BV is usually treated with prescription antibiotics.
Common options include:
- Oral metronidazole
- Vaginal metronidazole gel
- Vaginal clindamycin cream
- Other prescription medications when first-line treatments are not appropriate
Your provider will recommend a treatment based on your symptoms, medical history, pregnancy status, previous response, medication tolerance, and personal preferences.
Take or use the medication exactly as prescribed, even if your symptoms improve early. Stopping treatment too soon may allow symptoms to return.
Some vaginal treatments can weaken latex condoms or diaphragms temporarily. Ask your provider or pharmacist how your medication may affect barrier protection.
Should I Avoid Sex During BV Treatment?
Your provider may recommend avoiding sexual activity until treatment is complete and symptoms have resolved. If you do have sex, consistent condom or barrier use may help reduce exposure to bacteria that can contribute to recurrence.
Sex can also irritate already sensitive tissue or make odor more noticeable.
If you have recurrent BV and an ongoing partner, discuss your sexual practices openly with your provider. These conversations help us create a more effective plan—not judge your relationships or choices.
Why Does My BV Keep Coming Back?
Recurrent BV is common and does not mean you failed treatment or did something wrong.
The vaginal microbiome can be difficult to restore and maintain. Bacteria associated with BV may form a biofilm, which can make them harder to eliminate completely. Sexual exposure, menstruation, douching, and individual differences in vaginal bacteria may also contribute.
If symptoms return, avoid repeatedly using leftover medication or assuming every episode is BV. A new evaluation can confirm the diagnosis and rule out yeast, an STI, or another cause.
Treatment for recurrent BV may involve:
- Repeating the original treatment
- Trying a different recommended medication
- Using suppressive vaginal medication for several months
- Considering a clinician-directed regimen that includes boric acid
- Discussing concurrent partner treatment when appropriate
- Testing for other infections
- Reviewing products or practices that may disrupt vaginal bacteria
The right strategy depends on how often BV returns, previous treatments, test results, pregnancy considerations, and your relationships.
Should My Partner Be Treated?
Partner recommendations depend on your situation.
Routine partner treatment may not be necessary after a single episode. However, newer guidance supports discussing concurrent treatment for certain patients with recurrent, symptomatic BV and an ongoing male sexual partner.
Treatment recommendations for partners with vaginas are less clearly established. Because BV-associated bacteria may be shared between partners, both people should seek evaluation if they have symptoms.
Do not share prescriptions or use someone else’s medication. Each person needs appropriate medical guidance and screening.
Do Probiotics Help Prevent BV?
Researchers continue to study whether oral or vaginal probiotics can help restore healthy Lactobacillus bacteria.
At this time, evidence does not support using commercially available probiotics as a replacement for recommended antibiotic treatment. Products also vary widely in bacterial strains, quality, storage, and dosing.
A probiotic may be reasonable for some patients, but “natural” does not always mean effective or risk-free. Ask your provider before inserting any probiotic or supplement into the vagina.
What About Boric Acid?
Boric acid is sometimes included in a clinician-directed treatment plan for recurrent BV. It is not usually the first treatment for a new episode, and it should not be used without appropriate guidance.
Boric acid can be dangerous if swallowed and should be stored securely away from children and pets. It may also be inappropriate during pregnancy.
Never take boric acid by mouth. If your provider recommends it, follow the exact vaginal dosing and safety instructions provided.
Can I Treat BV at Home?
There is no reliable home remedy that replaces proper diagnosis and prescription treatment for symptomatic BV.
Avoid putting vinegar, hydrogen peroxide, essential oils, yogurt, garlic, or other household substances into the vagina. These products may cause burns, irritation, allergic reactions, or further disruption of the vaginal microbiome.
To support vulvovaginal health:
- Wash the external vulva gently with water or a mild, unscented cleanser
- Avoid douching
- Skip scented sprays, wipes, powders, and deodorants
- Change out of damp clothing
- Use condoms or barriers when appropriate
- Complete all prescribed medication
- Return for evaluation if symptoms recur
You do not need to scrub, deodorize, or “detox” your vagina.
Is BV Dangerous During Pregnancy?
Symptomatic BV during pregnancy should be evaluated and treated. BV has been associated with pregnancy complications, including premature birth and low birth weight.
Contact your healthcare provider if you are pregnant and notice unusual discharge, odor, irritation, or burning. Do not use leftover antibiotics, boric acid, or over-the-counter vaginal products without medical guidance.
Your provider can recommend treatment that is appropriate for pregnancy.
When Should You Schedule an Appointment?
Make an appointment if you experience:
- A new or persistent vaginal odor
- Unusual discharge
- Vaginal itching, burning, or irritation
- Burning with urination
- Symptoms that return after treatment
- Repeated episodes of suspected BV
- Symptoms after a new sexual partner
- Concerns about possible STI exposure
- Vaginal symptoms during pregnancy
Seek prompt care if vaginal symptoms occur with fever, chills, significant pelvic or lower abdominal pain, vomiting, sores, or abnormal bleeding. These symptoms may suggest a condition other than uncomplicated BV.
You Deserve Care Without Embarrassment
Vaginal odor and discharge can be difficult to discuss, but these are routine medical concerns—not personal failures.
You do not need to apologize, feel ashamed, or try multiple products before asking for help. A proper evaluation can identify the cause and help you feel comfortable again.
At MORE 901, we provide straightforward answers, evidence-based treatment, and a respectful environment where you can talk openly about your health.
Bacterial Vaginosis Treatment in Memphis
If you are experiencing vaginal odor, unusual discharge, irritation, or recurrent BV, schedule an evaluation with Dr. Susan Lacy at MORE 901.
Call 901-701-1777 to request an appointment at our Midtown Memphis office.
Care that listens. Expertise that empowers.
This blog incorporates current guidance as of August 2026 from the CDC and ACOG, including the newer recommendation to consider concurrent partner treatment in selected cases of recurrent, symptomatic BV.
