What causes Bacterial Vaginosis (BV)?

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Last updated: April 3, 2025View editorial policy

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From the Guidelines

Bacterial vaginosis (BV) is typically caused by an imbalance in the vaginal microbiome, where healthy lactobacilli bacteria decrease and harmful bacteria overgrow, and can be developed through various factors including douching, multiple sexual partners, and lack of vaginal lactobacilli, as noted in the 2002 study by the Centers for Disease Control and Prevention 1. You can develop BV through various factors including:

  • Douching
  • Multiple sexual partners
  • New sexual partners
  • Lack of condom use
  • Using scented feminine hygiene products BV is not considered a sexually transmitted infection, but sexual activity can disrupt vaginal bacterial balance, as stated in the 2002 study by the Centers for Disease Control and Prevention 1. Other risk factors include:
  • Intrauterine devices (IUDs)
  • Smoking
  • Having naturally low levels of protective lactobacilli Antibiotics, particularly broad-spectrum ones, can also disrupt vaginal flora and lead to BV, as mentioned in the 2002 study by the Centers for Disease Control and Prevention 1. Maintaining good vaginal health through avoiding douches and scented products, using condoms, limiting sexual partners, and possibly taking probiotics may help prevent BV, as suggested by the 2002 study by the Centers for Disease Control and Prevention 1. If you experience symptoms like unusual discharge, fishy odor, itching, or burning, consult a healthcare provider for proper diagnosis and treatment, which typically involves antibiotics like metronidazole or clindamycin, as recommended in the 2002 study by the Centers for Disease Control and Prevention 1.

From the Research

Causes of Bacterial Vaginosis (BV)

  • BV is characterized by a dysbiosis of the vaginal microbiota with a depletion of Lactobacillus spp. 2
  • The exact causes of BV are not fully understood, but it is associated with an imbalance of the vaginal microbiome 3

Risk Factors for BV

  • Prevalence of BV in pregnancy ranges from 7 to 30% depending on the study population and definition 2
  • BV may be associated with an increased risk of spontaneous preterm delivery (sPTD) 2, 4
  • Other risk factors for BV include sexual activity, use of intrauterine devices, and previous history of BV 5, 6

Transmission of BV

  • BV is not considered a sexually transmitted infection, but sexual activity may contribute to its development 5, 6
  • The exact mechanisms of BV transmission are not fully understood, but it is thought to involve an imbalance of the vaginal microbiome 3

Prevention of BV

  • There is no proven method for preventing BV, but maintaining a healthy vaginal microbiome may help reduce the risk of developing BV 3
  • Treatment of BV with antibiotics such as metronidazole or clindamycin may help reduce symptoms and prevent complications, but it is not a guarantee against recurrence 5, 2, 6, 4

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.

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