The most common vaginal infection in women of reproductive age, caused by disruption of normal vaginal flora with overgrowth of anaerobic bacteria. Not sexually transmitted but associated with sexual activity. Increases risk of STI acquisition, pelvic inflammatory disease, and pregnancy complications.

• 1Amsel criteria (3 of 4: thin discharge, clue cells, pH >4.5, fishy odor)
• 2Nugent score (Gram stain scoring)
• 3Vaginal pH testing
• 4Wet mount microscopy
• 5DNA probe tests
• 6Culture (limited utility)

Bacterial vaginosis responds to antibiotics in 70-90% of cases within 1 week. Recurrence is common, affecting 50-80% within 12 months. Chronic or recurrent BV significantly impacts quality of life. Treatment during pregnancy reduces preterm birth risk. Asymptomatic BV often does not require treatment except before gynecologic procedures or during pregnancy. Long-term complications can include increased HIV susceptibility and pelvic inflammatory disease.

• Avoiding vaginal douching
• Limiting number of sexual partners
• Using condoms consistently
• Probiotic supplementation
• Stopping smoking
• Maintaining vaginal health with appropriate hygiene