Is bacterial vaginosis (BV) a sexually transmitted infection (STI)?

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Last updated: April 3, 2025 • View editorial policy

From the Guidelines

Bacterial vaginosis (BV) is not considered a sexually transmitted infection (STI), although it is associated with sexual activity. BV occurs when there's an imbalance in the vaginal microbiome, specifically an overgrowth of certain bacteria like Gardnerella vaginalis while beneficial lactobacilli decrease 1, 2. The condition results from disruption to the vaginal environment, which can happen through various means including douching, using scented products, or changes in hormonal levels.

Key Points

  • BV is more common in sexually active women and can be triggered by new or multiple sexual partners, but it can also occur in women who aren't sexually active 1, 2.
  • Treatment typically involves antibiotics such as metronidazole (500mg orally twice daily for 7 days or 0.75% gel intravaginally once daily for 5 days) or clindamycin (300mg orally twice daily for 7 days or 2% cream intravaginally at bedtime for 7 days) 3.
  • While sexual partners don't generally require treatment, using condoms during treatment is recommended, and avoiding sex during treatment may help prevent reinfection or irritation.
  • BV can recur even after successful treatment, so maintaining vaginal health through avoiding douches, wearing breathable underwear, and practicing good hygiene is important for prevention.

Prevention and Recurrence

To prevent BV recurrence, it's essential to maintain good vaginal health. This includes:

  • Avoiding douches and scented products
  • Wearing breathable underwear
  • Practicing good hygiene
  • Using condoms during sexual activity to reduce the risk of disruption to the vaginal environment.

Pregnancy Considerations

In pregnant women, BV is associated with adverse pregnancy outcomes such as preterm labor and premature rupture of membranes 4. Therefore, screening and treatment of BV in pregnant women are crucial to prevent these complications. The US Preventive Services Task Force recommends screening for BV in pregnant women to prevent preterm delivery 4.

From the Research

Bacterial Vaginosis Transmission

  • The provided studies do not directly address whether bacterial vaginosis is sexually transmitted 5, 6, 7, 8, 9.
  • The studies focus on the treatment and prevention of bacterial vaginosis, as well as the restoration of the vaginal microbiota after treatment 5, 6, 7, 8, 9.
  • There is no clear evidence in the provided studies to support or refute the idea that bacterial vaginosis is sexually transmitted.

Treatment and Prevention

  • The studies suggest that various treatments, such as metronidazole, clindamycin, and probiotics, can be effective in treating bacterial vaginosis 5, 6, 7, 8, 9.
  • The use of probiotics may help to restore the vaginal microbiota and prevent recurrence of bacterial vaginosis 8, 9.
  • The studies do not provide information on the transmission of bacterial vaginosis, but rather focus on treatment and prevention strategies.

Vaginal Microbiota

  • The restoration of the vaginal microbiota after treatment for bacterial vaginosis is an important aspect of preventing recurrence 9.
  • The use of probiotics may help to maintain a healthy vaginal microbiota and prevent the overgrowth of pathogenic bacteria 9.
  • The studies suggest that the vaginal microbiota plays a crucial role in the development and recurrence of bacterial vaginosis, but do not provide information on the transmission of the condition.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treatment of bacterial vaginosis: what we have and what we miss.

Expert opinion on pharmacotherapy, 2014

Research

Continuous versus interrupted use of vaginal probiotics plus vaginal clindamycin cream for bacterial vaginosis: a randomized controlled study.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.