What Is Bacterial Vaginosis (and How to Prevent It?)

Bacterial vaginosis (BV) is the most common vaginal problem for women in their reproductive years. According to the World Health Organization (WHO), about 1 in 4 women worldwide live with BV. And while BV can come with symptoms, it can sometimes exist without any signs. Why does it matter? Bacterial vaginosis can affect your day-to-day comfort and health, and may even have an impact on fertility. Here's more about the condition and how to control it.

Just like the microbiome in your gut, your vagina has its own unique microbiome (called the urogenital microbiome, which also includes the uterus, bladder, and urethra). There’s a delicate balance that keeps things running smoothly, and when it’s disrupted, bacterial vaginosis can happen.

When you have BV, the harmful bacteria have become dominant; this imbalance is called dysbiosis and, depending on which strain of bacteria is dominant, it can cause a variety of symptoms from irritation to discharge changes. 

Exactly why this happens isn’t well understood. However, researchers agree that some behaviors, internal factors, and environmental conditions can change the number and kind of bacteria that naturally grow in the vagina. 

Bacteria can be passed between sexual partners, so even though it isn’t necessarily considered an infection, it does function similarly to one. 

No, BV is not considered an STI. It can happen in people who have never had sex and it does not involve transmitting any virus. But bacteria can be transmitted between sexual partners. A 2025 trial published in the New England Journal of Medicine found that treating the male partners of women with BV reduced recurrence. So, while BV does not carry the official STI tag (yet), sexual activity can increase your risk. 

Without a vagina, you can’t get bacterial vaginosis (so males don’t get it). But, the bacteria seen in BV can also live in the male genitals (on the penile skin and in the urethra). Which means a man can reintroduce BV-associated bacteria into a sexual partner’s vagina. Treating both partners at the same time can help stop the cycle for people with recurrent BV.

The most common symptoms of BV include a fishy-smelling vaginal discharge. Some women find the smell becomes more obvious after sex or during their period. The discharge, which is typically thin, can be grey, greenish or whitish. Another common symptoms is mild vaginal itching and irritation.

But, importantly, up to 84% of women with BV will have no symptoms at all. 

Symptoms of BV may include:

• Fishy-smelling discharge
• Thin discharge
• Abnormally colored discharge (grey, greenish, or white)
• Vaginal itching or irritation

If you have bacterial vaginosis symptoms or suspect you may have it without symptoms, it is a good idea to see a doctor. If left untreated, BV can increase the risk of other infections and create complications in pregnancy. Here are a few ways it can be treated:

Antibiotics (like the FDA-approved etronidazole and clindamycin) are the standard treatment for bacterial vaginosis and are super effective in the short term. 

But, unfortunately, BV is notorious for recurring. One study found that 50 to 80% of women experience recurrence within 12 months of completing antibiotic treatment. This is mainly because the drugs don’t replenish beneficial Lactobacillus strains after eliminating harmful bacteria.

Probiotics, unlike antibiotics, do not destroy bacteria. Rather, they help certain beneficial bacteria grow. In a recent study, researchers administered a vaginal probiotic containing multiple lactobacillius strains after a complete course of antibiotic treatment. The results showed reduced rates of BV occurrence.

Oral probiotics can also reduce the occurrence of BV. Probiotics containing lactobacillus strains (or strains that help lactobacillus like the bacillus coagulans found in the Triple Power Collagen + Probiotic) are especially helpful to promote a healthy balance of good bacteria and in recovery from BV.

For beneficial bacteria to thrive the acid-base balance in the vaginal must be optimal. In this case that means mildly acidic. Acidifying agents like boric acid help maintain the right pH for good bacteria to grow. 

Vaginally administering boric acid has been used to treat BV, at 600 mg daily for 1 to 3 weeks. However, it should be avoided during pregnancy and never taken orally—and this treatment should always be guided by a healthcare professional. 

Yes, BV can go away on its own. But there is no way to know if yours will clear without treatment. Also, since BV increases your risk of other infections and can also create complications in pregnancy, it is better to treat it rather than wait to see if it will clear on its own. If you have any BV symptoms, it is a good idea to seek medical attention.

You can reduce your BV risk in the following ways: 

Lifestyle

A recent review shows that quitting smoking, using condoms, and choosing certain hormonal contraceptives can reduce your BV risk. Research also shows that avoiding douching and skipping scented vaginal products both help keep the natural environment of the vagina stable, helping the vagina protect itself better.The less interference with the vagina’s ecosystem, the less likely you are to get BV.

Diet

Diet has a bigger effect on vaginal health than most people realize. Fermented foods like yogurt, kimchi, and kefir can introduce live lactobacillus strains through the gut and support vaginal microbiome health

Some evidence links Vitamin D deficiency with elevated BV risk, particularly among pregnant people, though the relationship is less consistent in non-pregnant populations. (Most people don't get enough Vitamin D as-is, so adding a supplement with at least 1000 IU of the vitamin can help mood, energy, and fertility—you'll find the amount in our Calcium + Magnesium + Vitamin D Boost and all our prenatal and postpartum capsules.) 

Some studies also support avoiding sugar and fat while topping up on vitamins A, C, D and E. A diet built around vegetables, whole grains, and fermented foods is a great general foundation.

Studies show BV is associated with pelvic inflammatory disease that can scar the fallopian tubes and directly reduce your ability to conceive spontaneously (i.e. at home). It also increases your risk of spontaneous abortion and preterm birth. 

The good news is that treating BV before or early in pregnancy makes a difference. WHO guidelines recommend antibiotic treatment combined with lifestyle and risk-reduction counselling.

If you’re pregnant or planning to be, talk to your doctor or midwife about any current BV symptoms or history of recurrence.

BV is one of those conditions shrouded in secrecy, despite affecting many people. The better you understand what really happens in BV, the easier it becomes to seek help, make informed choices, and take care of your body without shame or spiraling. If something feels off (even without BV symptoms), talk to a doctor and seek medical care as soon as you can.