Bacterial Vaginosis Quiz
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Vaginal discharge
Lower abdominal pain
Yeast infection
Abnormal discharge
Painful urination
Burns when I pee
Vaginal odor
Vaginal itching
Fishy smell
Thick white discharge no smell
Irritation in vaginal area
Bad odor after period
Not seeing your symptoms? No worries!
What is Bacterial Vaginosis?
A healthy human vagina contains various types of bacteria. When the balance of bacteria is disrupted, some types can overgrow and cause symptoms. Common triggers include vaginal washing, sexual intercourse, or use of an Intrauterine Device.
Typical Symptoms of Bacterial Vaginosis
- Increased vaginal discharge that is smelly
- Increase in vaginal discharge
- Abnormal color, amount or odor of vaginal discharge
- IUCD / coil use within the last 1 year
- Soiled gential area e.g. due to diarrhea or proloned tampon use
- Mental stress and physical fatigue
- Fever
- Been sexually active with multiple partners during the past 1 month
Diagnostic Questions for Bacterial Vaginosis
Your doctor may ask these questions to check for this disease:
- Has the vaginal discharge odor worsened recently?
- Have you had more vaginal discharge lately?
- Have you noticed any changes in the color, amount, or odor of your vaginal discharge?
- Are you using an IUD (intrauterine device)?
- Have you experienced uncleanliness in the vaginal area recently?
Treatment of Bacterial Vaginosis
Antibiotic cream or tablets may be given to treat the bacterial overgrowth.
Reviewed By:
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Dec 6, 2024
Following the Medical Content Editorial Policy
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How Ubie Can Help You
With a free 3-min Bacterial Vaginosis quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.
This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
Your symptoms
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Your report
Your personal report will tell you
✔ When to see a doctor
✔︎ What causes your symptoms
✔︎ Treatment information etc.
People with similar symptoms also use Ubie's symptom checker to find possible causes
- Smelly vaginal discharge
- Lots of vaginal discharge
- Vaginal discharge odor
- Vaginal discharge changed
- There is a large amount of vaginal discharge with bad smell
- Increase in vaginal discharge
- Excessive amount of vaginal discharge
- Smelly vaginal discharge
- Increased vaginal discharge
- Excessive vaginal discharge
- White vaginal discharge
- There is an increase in vaginal discharge
- Yellow vaginal discharge
- Heavy vaginal discharge
- Abnormal vaginal discharge
See full list
User Testimonials for Bacterial Vaginosis
Female, 30s
The symptom checker helped me get a better idea of what was going on with me and eased my anxiety. Ubie even helped find me a doctor in my network, whom I'm consulting right away!
(Jun 16, 2025)
Female, 30s
Ubie let me explain all my symptoms, and it also asked questions relating to my symptoms, after which it placed all of my issues into possible conditions. Based on my symptoms, it showed me all of the possible outcomes: STD, STI and vaginal health-related, and gave me a better outlook on what I may be experiencing. Very helpful! I saw a doctor and got a diagnosis for Bacterial Vaginosis, in line with Ubie's report.
(Mar 27, 2025)
Symptoms Related to Bacterial Vaginosis
Diseases Related to Bacterial Vaginosis
FAQs
Q.
Confused by BV Symptoms? Why Your pH is Off + Medical Next Steps
A.
BV is a common, treatable imbalance where protective Lactobacillus decline and other bacteria overgrow, raising vaginal pH above 4.5 and causing thin white or gray discharge and a fishy odor, often noticed after sex; triggers include douching, new or multiple partners, unprotected sex, smoking, hormonal shifts, recent antibiotics, and sometimes IUDs. There are several factors to consider. See below for diagnosis steps, treatment options, prevention tips, and urgent signs like pelvic pain, fever, pregnancy, or recurrent symptoms that need prompt care, since untreated BV can raise the risk of STIs, PID, and pregnancy complications.
References:
* Zozaya M, Santana-Cruz I, Torres-Carrillo A, González-Pedraza Avilés A. Bacterial Vaginosis: An Overview of the Microbiome, Disease, and Diagnosis. J Clin Microbiol. 2021 Jul 20;59(8):e0108321. doi: 10.1128/JCM.01083-21. PMID: 34281358; PMCID: PMC8309191.
* Gudiño-Salinas EA, Rojas-Rodríguez S, Moncada-Cortés B, Arévalo-Herrera M, Rodríguez-Hernández A, Guzmán-Velázquez G, Zúñiga-Cervantes E, Pérez-Rodríguez AM. Vaginal pH and Microbiome: A Clinical Approach to Diagnosis and Management of Vaginal Infections. J Clin Med. 2023 Jul 13;12(14):4658. doi: 10.3390/jcm12144658. PMID: 37510793; PMCID: PMC10383794.
* Koumans EH, Ferris D, Schwebke PJ, McClung HJ, Wagner R, Bertolli J. Update on the Treatment and Prevention of Bacterial Vaginosis. Clin Infect Dis. 2020 Sep 23;71(Supplement_2):S233-S239. doi: 10.1093/cid/ciaa747. PMID: 32964295.
* Muzny CA, Schwebke JR. Bacterial Vaginosis: A Review of the Pathogenesis, Diagnosis, and Treatment. Curr Infect Dis Rep. 2018 Jul 13;20(8):25. doi: 10.1007/s11908-018-0629-9. PMID: 30006766.
* Muzny CA, Schwebke JR. Mechanisms of Recurrent Bacterial Vaginosis. J Infect Dis. 2021 May 27;223(10):1825-1834. doi: 10.1093/infdis/jiaa640. PMID: 33179040; PMCID: PMC8154130.
Q.
Bacterial Vaginosis? Why Your Vagina Is Imbalanced & Medical Next Steps
A.
Bacterial vaginosis is an imbalance of vaginal bacteria that commonly causes thin gray or white discharge with a fishy odor and mild irritation; it is not an STI or a hygiene problem, but it should be confirmed by a clinician with pH and discharge testing and treated with antibiotics such as metronidazole or clindamycin. There are several factors to consider that can change your next steps, including pregnancy risks, higher STI and PID risk if untreated, frequent recurrences, what to avoid, and prevention strategies; see below for complete details and how to decide when to seek care now versus routine follow up.
References:
* Schwebke JR, Muzny CA. Bacterial Vaginosis: An Update on the Microbiology, Clinical Indications, and Therapeutic Implications. J Infect Dis. 2020 Jun 2;221(11):1733-1743. doi: 10.1093/infdis/jiz542. PMID: 32363080.
* Greenbaum S, Greenbaum A, Moran-Gilad J, Grossman S, Wong S, Lebovitz EE, Shlasko E, Amit S, Azab AN. The Vaginal Microbiome and Bacterial Vaginosis: An Update on Current Understanding and Future Directions. J Infect Dis. 2019 Mar 15;219(7):1001-1005. doi: 10.1093/infdis/jiy642. PMID: 30896944.
* Brotman RM, Ravel J, Karle M. Update on the screening and management of bacterial vaginosis. Curr Infect Dis Rep. 2018 Mar 8;20(2):8. doi: 10.1007/s11908-018-0612-4. PMID: 29514781.
* Mastronardi M, Cacciapuoti S, Di Domenico I, Di Domenico M, Di Domenico F. Recurrent Bacterial Vaginosis: A Review of the Current Literature. Microorganisms. 2020 Mar 27;8(4):479. doi: 10.3390/microorganisms8040479. PMID: 32247348; PMCID: PMC7238210.
* Van der Pol B, Van Kessel G, Ravel J, Fortenberry JD. Current and Emerging Therapeutic Strategies for Bacterial Vaginosis. Clin Infect Dis. 2021 Nov 16;73(10):e3783-e3792. doi: 10.1093/cid/ciaa1661. PMID: 34199988; PMCID: PMC8596667.
Q.
Is it BV? Why your pH is off and medical steps for fast relief
A.
There are several factors to consider; if your vaginal pH is above 4.5 with thin gray or white discharge and a strong fishy odor, especially after sex, it likely indicates BV, and pH can be pushed higher by semen exposure, douching, recent antibiotics, new or multiple partners, hormonal shifts, or smoking, not poor hygiene. See below to understand more. For fast relief, see a clinician for confirmation and first-line antibiotics such as metronidazole or clindamycin for 5 to 7 days, avoid alcohol with metronidazole, stop douching, use condoms temporarily, and seek urgent care for fever, severe pelvic pain, or symptoms in pregnancy; important nuances on look-alike conditions, recurrence, probiotics, and prevention are detailed below.
References:
* Wu S, Ma S, Li S, Hu J, Sun S, Tang H. Vaginal pH, a potential non-invasive diagnostic marker for bacterial vaginosis: a systematic review and meta-analysis. BMC Womens Health. 2022 Jul 25;22(1):298. doi: 10.1186/s12905-022-01880-w. PMID: 35883181; PMCID: PMC9313838.
* Muzny CA, Van Der Pol B. Bacterial Vaginosis: An Update on the Microbiology, Clinical Manifestations, and Therapeutic Strategies. Sex Transm Dis. 2019 Sep;46(9):590-598. doi: 10.1097/OLQ.0000000000001032. PMID: 31219661; PMCID: PMC6692131.
* O'Hanlon DE, Partner JM, Moench TR, Cone RA. The Vaginal Microbiome and pH: The War That Has Been going on for Eons. Clin Microbiol Rev. 2021 Mar 17;34(2):e00155-20. doi: 10.1128/CMR.00155-20. PMID: 33729114; PMCID: PMC8058206.
* Soro N, Vange K, Kouassi R, Koné M, Konan N. Current perspectives on the epidemiology, diagnosis, and treatment of bacterial vaginosis. Expert Rev Anti Infect Ther. 2023 Jul;21(7):727-738. doi: 10.1080/14787210.2023.2229562. PMID: 37378772.
* Machado D, Donders GGG, Currie A, Pavlidou E, Fadda M, Nardiello P, Piroddi P, Van den Bossche D, Donders R, Piroddi G, Piras B, Montanari C, Montanari S, Montanari A, Costanza S, Donders G. Bacterial Vaginosis: Beyond the Diagnosis to Management of Recurrence. J Clin Med. 2022 Jul 23;11(15):4278. doi: 10.3390/jcm11154278. PMID: 35893457; PMCID: PMC9322301.
Q.
Persistent Odor? Why Your Internal Flora is Shifting and the Medical Steps to Solve BV
A.
Persistent fishy vaginal odor, especially after sex, with thin gray or white discharge most often points to bacterial vaginosis, a common shift in vaginal bacteria when protective lactobacilli decline. Diagnosis is straightforward with pH and microscopic testing, and treatment uses prescription antibiotics like metronidazole or clindamycin, plus guidance on preventing recurrences and knowing when to seek care. There are several important factors that can change your next steps, so see below for the complete answer.
References:
* Marrazzo JM, Fiedler T, Srinivasan S, *et al*. Bacterial Vaginosis: An Update on the Microbiology, Epidemiology, and Treatment. *Clin Infect Dis*. 2019;68(Supplement_2):S105-S113. doi:10.1093/cid/ciy1120
* Muzny CA, Schwebke JR. The Vaginal Microbiota and Bacterial Vaginosis: An Update. *Microbiol Spectr*. 2023;11(1):e0084322. doi:10.1128/spectrum.00843-22
* Ma B, O'Sullivan M, Wang Y. Understanding the Vaginal Microbiome in Health and Disease. *ACS Synth Biol*. 2023;12(10):2825-2834. doi:10.1021/acssynbio.3c00249
* Muzny CA, Van Der Pol B. Recurrent bacterial vaginosis: The role of the vaginal microbiome and potential new therapies. *J Infect Dis*. 2023;227(Supplement_1):S6-S13. doi:10.1093/infdis/jiac398
* Pattison A, Muzny CA, Schwebke JR. Emerging strategies for the treatment of bacterial vaginosis. *J Infect Dis*. 2021;223(Suppl 3):S243-S251. doi:10.1093/infdis/jiaa672
Q.
Metronidazole for Women: Side Effects, BV Relief, and Your Next Steps
A.
Metronidazole is a first-line, highly effective treatment for bacterial vaginosis, with relief often starting in 2 to 3 days; complete the full course, avoid all alcohol during treatment and for 24 to 48 hours after, and expect mostly mild side effects like nausea or a metallic taste while seeking care for any severe or unusual reactions. There are several factors to consider, including oral vs gel choices, what to do if BV keeps coming back, possible yeast overgrowth, sex and partner management, pregnancy safety, drug interactions, and when to get checked; see the detailed guidance below to decide your best next steps.
References:
* Workowski KA, Bachmann LR, Chan PA, Johnston CM, Muzny CA, Reno H, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1. PMID: 34292926; PMCID: PMC8344968.
* Saini S, Gupta S, Chander J, Gupta N. Recurrent Bacterial Vaginosis: An Overview of the Etiology, Risk Factors, and Strategies for Management. Cureus. 2023 Jul 19;15(7):e42152. doi: 10.7759/cureus.42152. PMID: 37593257; PMCID: PMC10437434.
* Muzny CA, Schwebke JR. New Insights Into the Pathogenesis of Bacterial Vaginosis: An Update on Its Therapy. Clin Infect Dis. 2020 Feb 28;70(5):953-960. doi: 10.1093/cid/ciz053. PMID: 31050731.
* Loughran-Faber KL, Slayton EE, Taggart EA, Miller E, Jhaveri M, Ndirangu S, et al. Side effects from intravaginal versus oral metronidazole for bacterial vaginosis in women who use alcohol: A secondary analysis from a randomized controlled trial. J Am Coll Health. 2023 Oct 12:1-7. doi: 10.1080/07448481.2023.2268798. Epub ahead of print. PMID: 37824128.
* Bilardi JE, De Guingand DL, Temple-Smith M, McNamee K, Chen M, Fairley CK, et al. The "why" and "why not" of adherence to bacterial vaginosis treatments: a qualitative study. BMC Womens Health. 2016 Oct 27;16(1):65. doi: 10.1186/s12905-016-0447-0. PMID: 27788647; PMCID: PMC5084323.
Q.
Chronic Yeast Infections: A Woman's Guide to Real Relief
A.
Chronic vaginal yeast infections usually mean 4 or more episodes a year or symptoms that return soon after treatment, and real relief comes from confirming the diagnosis, ruling out look-alikes like bacterial vaginosis, addressing triggers such as antibiotics, hormones, diabetes, immune stress, tight clothing, or non-albicans yeast, and using tailored induction plus maintenance therapy with supportive habits; see below for details that can change your next steps. There are several factors to consider. See below for how to get the right tests, the differences in treatment when pregnant or postmenopausal, guidance on sex and partners, warning signs that need urgent care, and practical lifestyle tips that help prevent recurrences.
References:
* Rosati D, Van der Velden L, Donders G, Bekkers R, Sen A, Mylotte JM. Recurrent vulvovaginal candidiasis: current management and future perspectives. Clin Microbiol Infect. 2021 Jun;27(6):829-840. doi: 10.1016/j.cmi.2021.03.033. Epub 2021 Apr 13. PMID: 33862215.
* Hassan S, Akilanda S, Amsden JR, Johnson MR, Brubaker D, Johnson BJ, Johnson SR. Recurrent Vulvovaginal Candidiasis: An Overview of Pathogenesis, Diagnosis, and Management. J Fungi (Basel). 2022 Oct 24;8(11):1098. doi: 10.3390/jof8111098. PMID: 36294713; PMCID: PMC9692482.
* de Sessa C, de Placido S, Masciullo A, Pirozzi G, D'Auria M, Di Spiezio Sardo A, Zullo F. Updates in the treatment of vulvovaginal candidiasis. F1000Res. 2021 Jul 15;10:656. doi: 10.12688/f1000research.51000.1. PMID: 34295462; PMCID: PMC8290333.
* Rosati D, Van der Velden L, Donders G, Bekkers R, Mylotte JM, Sen A. Updates on the treatment of non-albicans Candida vulvovaginitis. Expert Rev Anti Infect Ther. 2021 Aug;19(8):1021-1029. doi: 10.1080/14787210.2021.1942004. Epub 2021 Jun 23. PMID: 34161962.
* Blostein F, Levin-Sparenberg E, Dearing D, Nejat S, Lee J, Tamma P, Kim Y. Recurrent vulvovaginal candidiasis: novel therapeutic approaches. Future Microbiol. 2020 Mar;15:193-201. doi: 10.2217/fmb-2019-0268. Epub 2020 Feb 4. PMID: 32019445; PMCID: PMC7111267.
Q.
Yeast Infections After 65: Addressing Post-Menopausal Risks
A.
After 65, yeast infections can still be common due to lower estrogen, shifts in vaginal bacteria, certain medications, diabetes, and age related immune changes; symptoms may be drier or milder and can mimic BV or vaginal atrophy, so getting the right diagnosis matters. There are several factors to consider; see below for guidance on accurate testing, safe treatment options like antifungals and when vaginal estrogen may help, prevention steps, and red flags that mean you should speak to a doctor.
References:
* Sobel JD. Vulvovaginal Candidiasis: Epidemiology, Diagnosis, and Management. J Fungi (Basel). 2021 Jul 26;7(8):602. doi: 10.3390/jof7080602. PMID: 34436154; PMCID: PMC8398030.
* Ma S, Liang S, Cui B, Li J, Wang B, Li Y, Yang H. Vaginal microbiome and its association with vulvovaginal candidiasis. Microorganisms. 2021 Nov 22;9(11):2381. doi: 10.3390/microorganisms9112381. PMID: 34835492; PMCID: PMC8619623.
* Palacios S, Mejía A, Noguera M. Genitourinary syndrome of menopause: an update. Climacteric. 2019 Jun;22(3):241-249. doi: 10.1080/13697137.2019.1574972. Epub 2019 Mar 26. PMID: 30913959.
* Sobel JD. Recurrent Vulvovaginal Candidiasis. Clin Infect Dis. 2016 Oct 15;63 Suppl 1:S109-12. doi: 10.1093/cid/ciw482. PMID: 27698246; PMCID: PMC4999146.
* Pappas PG, Sobel JD. Management of Vulvovaginal Candidiasis. Obstet Gynecol Clin North Am. 2015 Dec;42(4):619-35. doi: 10.1016/j.ogc.2015.07.009. PMID: 26546115.
Q.
Why can antibiotics cause yeast infections?
A.
Antibiotics can cause yeast infections because they kill both bad and good bacteria, which can upset the balance and allow yeast to grow. See below to understand more.
References:
Spinillo A, Capuzzo E, Acciano S, De Santolo A, & Zara F. (1999). Effect of antibiotic use on the prevalence of symptomatic .... American journal of obstetrics and gynecology, 9914570.
https://pubmed.ncbi.nlm.nih.gov/9914570/
Drummond RA, Desai JV, Ricotta EE, Swamydas M, Deming C, Conlan S, et al. (2022). Long-term antibiotic exposure promotes mortality after .... Cell host & microbe, 35568028.
https://pubmed.ncbi.nlm.nih.gov/35568028/
Samonis G, Gikas A, Anaissie EJ, Vrenzos G, Maraki S, Tselentis Y, & Bodey GP. (1993). Prospective evaluation of effects of broad-spectrum .... Antimicrobial agents and chemotherapy, 8431017.
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Bagnall P, Rizzolo D. Bacterial vaginosis: A practical review. JAAPA. 2017 Dec;30(12):15-21. doi: 10.1097/01.JAA.0000526770.60197.fa. PMID: 29135564.
https://journals.lww.com/jaapa/Fulltext/2017/12000/Bacterial_vaginosis__A_practical_review.3.aspxCoudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol. 2020 Feb;245:143-148. doi: 10.1016/j.ejogrb.2019.12.035. Epub 2019 Dec 24. PMID: 31901667; PMCID: PMC6989391.
https://www.ejog.org/article/S0301-2115(19)30602-5/fulltextSoper DE. Bacterial vaginosis and surgical site infections. Am J Obstet Gynecol. 2020 Mar;222(3):219-223. doi: 10.1016/j.ajog.2019.09.002. Epub 2019 Sep 6. PMID: 31499057.
https://www.ajog.org/article/S0002-9378(19)31107-X/fulltextOnderdonk AB, Delaney ML, Fichorova RN. The Human Microbiome during Bacterial Vaginosis. Clin Microbiol Rev. 2016 Apr;29(2):223-38. doi: 10.1128/CMR.00075-15. PMID: 26864580; PMCID: PMC4786887.
https://journals.asm.org/doi/10.1128/CMR.00075-15