It is normal to have a variety of bacteria and a small amount of fungi in the vagina. However, some women can develop an imbalance in the bacteria in their vagina and a condition called bacterial vaginosis (BV) can develop. BV may or may not cause symptoms in every case. According to the Mayo Clinic, the following symptoms are associated with BV:

  • a thin white or green fluid that comes from the vagina
  • a fishy odour from the vagina
  • vaginal itching
  • a burning sensation while urinating

Women with these symptoms should see their doctor for an assessment. A sample of fluid from the vagina can be collected and sent to a lab for testing.

Known risk factors for BV include the following:

  • having multiple sex partners or a new sex partner
  • douching can upset the normal balance of bacteria in the vagina, but not all researchers agree about the precise role of douching on the risk of BV

BV can have serious implications for women's health, including the following:

  • an increased risk for becoming infected with sexually transmitted infections, including HIV, herpes, chlamydia and gonorrhea
  • an increased risk for developing pelvic inflammatory disease (PID)
  • an increased risk among pregnant women for giving birth prematurely

Common treatments for BV include the following:

  • metronidazole (Flagyl) tablets taken orally
  • metronidazole gel that is placed in the vagina
  • clindamycin cream that is placed in the vagina

For further information about the diagnosis and treatment of BV, see Management and Treatment of Specific Syndromes in the Canadian STI guidelines.