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Bacterial vaginosis
Also known as BV
Bacterial vaginosis is a bacterial infection caused by a change in the normal balance of vaginal bacteria.
QUICK FACTS
BV is a common bacterial infection of the vagina
BV-causing bacteria can also be carried on the penis
BV-bacteria can be transmitted during sexual activity
Condoms reduce the risk of BV
BV often causes a vaginal discharge or unpleasant odour, but may cause no symptoms
BV is usually treated with antibiotic tablets or intravaginal antibiotic cream
Treating regular sexual partners who have a penis, at the same time as the person with BV is receiving treatment,
improves BV cure
What is this?
Healthy vaginas are protected by bacteria called lactobacilli that work to maintain an acidic pH in the vagina, prevent harmful bacteria
from causing genital infections, and support healthy pregnancies.
Bacterial vaginosis (BV) develops when vaginal lactobacilli are replaced by BV-causing bacteria, which disturb the healthy vaginal
environment.
BV affects up to 1 in 3 people with a vagina. BV may cause an unpleasant vaginal odour, vaginal discharge, or sometimes can cause
no symptoms at all.
Once the healthy vaginal environment is disturbed by BV-causing bacteria, the vagina becomes more vulnerable to other sexually
transmitted infections and complications.
How do you get it?
BV infections usually only affect people who are sexually active. BV-causing bacteria can be transmitted through sexual contact.
Importantly, BV-causing bacteria can be carried on the penis, specifically on the penile skin and inside the urethra (the tube that urine
and semen exit through). During penile-vaginal sex these bacteria can be transmitted from the penis to the vagina where they can
cause a BV infection.
There is also evidence that BV-causing bacteria can be exchanged during sex between partners where both have a vagina.
Certain practices are associated with an increased risk of developing BV, including:
having a new sexual partner
having unprotected penile-vaginal sex (sex without a condom)
having a sexual partner with a vagina
vaginal douching (washing inside the vagina with water, soap, “feminine wash”, etc.)
having an intrauterine device (IUD), particularly a copper IUD
Page updated 03 November 2025
In addition, people who have a regular or ongoing sexual partner are more likely to get BV back again after treatment.
What are the symptoms?
If you have BV, you may experience:
strong or unpleasant vaginal odour (sometimes described as a “fishy” odour)
increase or change in vaginal discharge (thin consistency, white/grey)
vaginal discomfort
no symptoms at all
BV-causing bacteria do not usually cause symptoms in or on the penis; however, some people notice an unpleasant odour on their
penis (sometimes described as a “fishy” odour).
How do you test for it?
Vaginal BV infections are diagnosed by a physical examination followed by laboratory testing.
Tests to detect BV-causing bacteria on the penis are not currently available.
How is it treated?
BV is usually treated with an oral antibiotic or an intravaginal antibiotic cream for 5-7 days.
Due to the sexual transmissibility of BV, it can be helpful to involve regular sexual partners in treatment. Giving BV antibiotics to
regular sex partners aims to treat and eliminate any BV-bacteria they may be carrying, which reduces the risk of reinfection. This
strategy is most effective when both partners start and finish their antibiotics at the same time.
BV partner treatment is now available at the Melbourne Sexual Health Centre.
For regular sexual partners with a penis:
Antibiotic treatment for partners with a penis is recommended. Treatment is an oral antibiotic tablet and a topical antibiotic
cream. This requires a doctor’s prescription. No testing or symptoms for the partner with a penis are needed to access
treatment.
For regular sexual partners with a vagina:
Antibiotic treatment is available following testing and confirmation of a BV diagnosis.
More information about partner treatment can be found here: Bacterial vaginosis general information
Talk to a healthcare professional to discuss the best treatment option for you.
Are there any complications if not treated?
BV is a common and treatable infection and many people with BV do not suffer from any long-term complications.
If you have a vagina and uterus:
BV can increase your risk of other sexually transmissible infections, including chlamydia, gonorrhoea and HIV.
BV can increase the risk of pelvic inflammatory disease (PID), a condition that can cause pelvic pain and may lead to
complications including infertility.
During pregnancy, BV has been linked to complications such as miscarriage, premature delivery and low birth weight of
infants.
Is it likely to come back after treatment?
People who have an untreated regular sex partner are at higher risk for recurrent BV infections. A major reason for this is the carriage
of BV-bacteria on the genitals of untreated partners, which gets transmitted back into the vagina during sex and causes reinfection. A
recent clinical trial in monogamous couples where one partner has a penis has shown that partner treatment significantly improves
long-term BV cure and reduces BV recurrence. Further research investigating the benefits of partner treatment in LGBTQIA+ couples
is now underway.
A longer course of vaginal antibiotics, a combined treatment of oral and intravaginal antibiotics, or the addition of boric acid
suppositories may also improve cure for persistent BV infections.
If your symptoms come back after treatment, see your doctor to discuss the best option for you.
How can I protect myself?
Use barrier protection such as a condom (or dental dam) during sex.
Avoid douching or using any water, soaps or “feminine washes” inside the vagina. These are harmful to the “good” bacteria (known as
lactobacilli) that protect the vagina.
Let them know
When you've been diagnosed with an STI like this, all of your sexual partners from the last few months should be checked by a
doctor.
It is very important that all your sex partners (regular and casual) are checked because if STIs are not treated they may cause
serious problems later on.
If you have difficulty telling your partners, you can use Let Them Know for sample conversations, emails, text messages and
letters you can send to your partners either personally or anonymously.
Where can I get help?
Visit a sexual health service near you
Visit your local doctor
Visit your local community health centre
DISCLAIMER
This fact sheet provides general sexual health information and is not intended to replace the need for a consultation with your
doctor.
If you have concerns about your health, you should seek advice from your doctor.
If you require urgent care, you should go to your nearest Emergency Department or call 000.