All About Bacterial Vaginosis – Causes, Symptoms & Treatment

Unpleasant vaginal odor or a sense of imbalance? You’re not alone. Bacterial vaginosis (BV) is actually the most common cause of unusual vaginal discharge and odor in women of reproductive age. Yet many have never heard of it or they mistake it for a yeast infection. In this post, we explain what BV is, why it happens and what you can do about it with expert advice from the DeoDoc medical team.

What is Bacterial Vaginosis?

Bacterial vaginosis occurs when the natural balance of bacteria in the vagina is disrupted. In a healthy vagina, lactobacilli (good lactic acid–producing bacteria) dominate, protecting against infections and maintaining an ideal low pH. When these bacteria decrease, other (less beneficial) bacteria overgrow.

Dr. Hedieh Asadi, MD and co-founder of DeoDoc, explains: "The vaginal environment is sensitive and easily affected by external factors like menstrual blood and semen. When pH levels shift, it creates a space where harmful bacteria can replace the good lactobacilli."

How is BV different from a yeast infection?

Many women think any kind of discharge or discomfort must be a yeast infection, but BV has different characteristics:

Why do you get BV?

The exact cause of BV isn’t fully known, but several factors are known to disrupt the pH- balance:

• Semen (has a high pH and can disturb the vaginal environment)

• Menstrual blood (higher pH and can upset balance)

• Excessive washing or using high-pH intimate products

• New or multiple sexual partners

BV is not a sexually transmitted infection (STI), but it often develops after sex or hormonal changes.

Symptoms – What to look out for:

• Thin, gray-white or yellowish discharge

• Noticeable fishy odor, especially after sex

• Mild irritation or discomfort (but usually no itching)

Dr. Gunvor Ekman-Ordeberg, gynecologist, professor at Karolinska Institutet, and co-founder of DeoDoc, explains: “In bacterial vaginosis, the normal lactobacillus flora is replaced by anaerobic bacteria, which raise the pH. This change in bacterial composition causes the release of amines, giving the discharge its characteristic fishy odor.”

Treatment – What helps?

BV is typically treated with:

• Prescription antibiotics, such as metronidazole (in topical vaginal gel or oral form)

• Over-the-counter pH-balancing gels, which may work for mild cases

Avoid treating BV with antifungal medications as they do not help and can worsen the imbalance.

Prevention tips

• Don’t wash inside the vagina –  it’s self-cleansing

• Use a mild, pH-balanced intimate wash

• Avoid excessive washing, incorrectly fragranced products and harsh soaps

• Use a condom if you often experience BV after sex

• Use over-the-counter acidifying gels after your period or sex if you're prone to BV

When to seek medical care

Contact a healthcare provider if:

• You notice a strong, unpleasant vaginal odor for the first time

• You’re unsure whether it’s BV or a yeast infection

• You get recurring symptoms

• You are pregnant and notice BV symptoms

Summary

Bacterial vaginosis is common and it’s not about poor hygiene. It’s about a disruption in the natural bacterial balance of the vagina. With the right knowledge and the right products, BV can be treated and prevented effectively.