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Am Fam Physician. 2004;69(9):2193

What is bacterial vaginosis?

Bacterial vaginosis is a mild infection of the vagina caused by a kind of bacteria. The vagina normally contains “good” bacteria and other kinds of bacteria called anaerobes (say: ann-air-robes). Too many anaerobes can cause an infection. No one knows why anaerobes sometimes overgrow and cause this infection.

How do I know if I have bacterial vaginosis?

You may notice a discharge from your vagina. The discharge may be clear or colored. It may be very light or heavy. It may have a fishy smell, especially after you have intercourse. Some women have bacterial vaginosis without any symptoms.

How can my doctor tell if I have bacterial vaginosis?

Your doctor will look into your vagina and use a cotton swab to get a sample of the discharge. This sample will be tested.

If this is an infection, did I catch it from someone?

No. Although bacterial vaginosis is more common in women who are sexually active, it also occurs in women who are not sexually active. Your sex partner usually will not have to be treated.

Do I have to be treated?

Yes. If the infection is not treated, the bacteria may spread into your uterus or fallopian tubes and cause a more serious infection. Treatment is especially important in women who are pregnant.

How is bacterial vaginosis treated?

There are several ways to treat this infection. The most common medicines for bacterial vaginosis are metronidazole (brand name: Flagyl) and clindamycin. Your doctor may give you pills to take by mouth, or a cream or gel to put in your vagina. It is important to use your medicine exactly the way your doctor tells you.

If your doctor prescribes metronidazole, do not drink any alcohol while taking the medicine or for 72 hours afterward. Drinking even small amounts of alcohol when taking metronidazole can cause nausea and vomiting. Clindamycin vaginal cream can cause latex condoms and diaphragms to break. Be sure to tell your doctor about any other medicines you are taking.

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