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BCM - Baylor College of Medicine

Giving life to possible

Obstetrics and Gynecology

Recurrent Bacterial Vaginosis

Recurrent bacterial vaginosis is an imbalance of the vaginal bacteria normally present in the vagina. Bacterial vaginosis is a common condition and treatment is available; however, in some women the condition may recur or even become chronic, requiring multiple and sometimes long-term treatments. Bacterial vaginosis is one type of vaginitis, or inflammation of the vagina.

What causes recurrent bacterial vaginosis?

Bacterial vaginosis occurs when an overgrowth of bacteria normally present in the vagina upsets the natural balance of "good" and harmful bacteria that live in the vagina.

What are the symptoms of recurrent bacterial vaginosis?

Symptoms may include:

  • Strong fishy or unpleasant vaginal odor, which may be stronger after sex or menstruating
  • Increase in vaginal discharge (about 50 percent of the time)
  • Vaginal discharge that is thin in consistency and milky white or gray
  • Vaginal itching, burning or pain when urinating

In many cases, women with bacterial vaginosis have no symptoms and only discover the condition through a routine pelvic exam.

How is recurrent bacterial vaginosis diagnosed?

Diagnosis starts with a thorough medical history and detailed discussion of your symptoms. A pelvic exam will be conducted to evaluate the appearance of the vaginal lining and cervix. A sample of vaginal discharge will also be taken and tested to determine if you have bacterial vaginosis. In addition, a "whiff test" may be performed in which potassium hydroxide is combined with a vaginal discharge sample to see if a specific fishy odor results.

How is recurrent bacterial vaginosis treated?

Bacterial vaginosis poses several risks, including increased risk of acquiring pelvic inflammation diseases and HIV, increased risk of infection following surgery, and pregnancy complications. Treatment strategies include:

  • Antibiotics - taken either orally or vaginally until they are gone
  • Lifestyle changes - including changes in diet, abstinence from sexual activity until healed, vitamin supplements, and avoiding douches and antiseptic bath products

If symptoms reappear, your doctor may prescribe extended antibiotic treatment in addition to other therapies.

How can recurrent bacterial vaginosis be prevented?

Steps that may be taken to help reduce the risk of recurrent bacterial vaginosis include:

  • Limit the number of sex partners
  • Avoid douching
  • Use all of the medication prescribed for treatment of bacterial vaginosis, even after the signs and symptoms are gone