Bacterial vaginosis, also known as vaginal bacteriosis is one of the most common causes of infection in the female reproductive system. Very often, this medical condition is confused with other vaginal infections like candidiasis (yeast infection) or trichomoniasis (infection caused by Trichomonas vaginalis, a parasite).

Under normal conditions a woman’s genital area has a healthy supply of naturally occurring bacterial flora that helps fend off unwanted foreign and potentially harmful bacteria. An imbalance in the number of bacteria can cause bacterial vaginosis. It’s more prevalent in women of child bearing age.


There are might not be any symptoms in mild or early cases. But moderate to severe cases might exhibit

  • Fish smelling vaginal discharge
  • Intense itchiness
  • Irritation
  • Stomach pain or cramps occasionally

Clinical significance of the infection is that it makes it more prone for other sexually transmitted diseases.


Under normal conditions the vagina is teeming with good bacteria known as the Lactobacillus, especially lactobacillus jenseni and lactobacillus crispatus. These good bacteria keep the other bacteria in check and the bad ones at bay.

  • Antibiotics – are non- discriminatory in the sense they kill both the bad as well as the good bacteria. Taking too many and strong antibiotics could lower the lactobacillus count leading onto infection with harmful bacteria.
  • Non pH friendly soaps. Under normal circumstances the pH in the vagina is acidic between 3.8 and 4.5, this is maintained by Lactobacillus. When a non pH friendly soap is used the lactobacillus are lowered in number with the harmful bacteria gaining an upper hand.


Vaginal swabs taken from the vagina are examined for

  • Loss of acidity
  • Whiff test – a fishy smell is given out by reaction with potassium hydroxide
  • Clue cells test –the swabs after treatment with sodium chloride show cells coated with bacteria under a microscope.


Antibiotics such as metronidazole or clindamycin are effective either vaginally or orally. But there is a high chance of recurrence as high as half recurring within 12 months.

The verdict is divided on the usefulness of probiotics such as yogurt.

Please consult the online doctor for bespoke, evidence based and confidential medical advice.