Bacterial Vaginosis in Teens: Symptoms, Causes, and Treatment

Bacterial vaginosis, often shortened to BV, is one of the most common vaginal conditions in teens and adults who have a vagina. It can be confusing and sometimes embarrassing to talk about, but understanding it is an important part of taking care of your sexual and reproductive health.

This guide explains BV in clear language: what it is, why it happens, how it is treated, and when to get help. It is written especially with teens in mind.

What Is Bacterial Vaginosis?

The vagina naturally contains many different types of bacteria. Some are considered “good” because they help keep the vagina healthy, and others are “bad” when they grow too much. BV happens when the balance shifts and the good bacteria are reduced, allowing other bacteria to overgrow.

BV is:

• Very common in people of reproductive age, including teens
• Not the same as a yeast infection
• Not caused by poor hygiene or anything you did “wrong”
• Linked to sexual activity, but is not considered a classic sexually transmitted infection (STI)

Some people with BV have obvious symptoms, while others do not notice anything unusual.

How a Healthy Vagina Works

To understand BV, it helps to know what normal vaginal health looks like.

• The vagina usually has mostly lactobacillus bacteria. These produce lactic acid and help keep the vaginal environment slightly acidic.
• This mildly acidic environment makes it harder for harmful bacteria to grow.
• Normal discharge can be clear or white, may change during your menstrual cycle, and usually does not have a strong, unpleasant odor.

With BV, lactobacillus levels drop and other bacteria multiply. This change in the vaginal environment is what leads to common BV symptoms.

What Causes BV in Teens?

Experts do not know one single cause, but they have identified situations that make BV more likely. These are called risk factors—they increase the chances of BV but do not guarantee that someone will get it.

Common Risk Factors

• Sexual activity (oral, vaginal, or sharing sex toys), especially with a new partner or more than one partner
• Having a partner who has a vagina
• Not using condoms or other barrier protection consistently during sex
• Douching or washing the inside of the vagina with water or products
• Using perfumed soaps, sprays, or strong cleansers on the vulva
• Smoking tobacco

BV is not spread by toilet seats, swimming pools, or casual contact.

Is BV an STI?

BV is not officially classified as a sexually transmitted infection. However:

• It is more common in sexually active people than in those who have never had sex.
• Bacteria linked with BV can move between sexual partners, especially between partners who both have vaginas.

Because BV can make it easier to get some STIs, it is still considered an important sexual health concern.

Signs and Symptoms of BV

Some teens with BV feel completely normal and have no symptoms at all. Others notice changes that can be uncomfortable or worrying.

Common Symptoms

• Change in discharge – often thin, milky, white or gray
• Strong or fishy vaginal odor, especially after sex
• Mild irritation or discomfort in the vaginal area

Less commonly, people may also notice:

• Burning when peeing
• Light itching or soreness around the vulva

Many other conditions, like yeast infections or STIs, can cause similar symptoms. That is why getting checked by a health professional is important instead of guessing.

BV vs. Yeast Infection: Key Differences

How BV Is Diagnosed

If you notice changes in your vaginal discharge, odor, or comfort, it is a good idea to talk with a doctor, nurse practitioner, or provider at a sexual health or teen clinic. They are used to discussing these issues and will not be shocked or judgmental.

What to Expect at the Visit

• The provider will ask about your symptoms, menstrual cycle, and sexual activity.
• They may do a gentle pelvic exam to look at the vulva and vagina.
• A small sample of discharge might be taken using a soft swab. This sample can be looked at under a microscope or tested in a lab.

These tests help tell BV apart from yeast infections and sexually transmitted infections, which often need different treatment.

Treatment Options for BV

BV is usually treated with antibiotic medicine. These medicines target the overgrown bacteria and help restore a healthier balance.

Common Treatments

• Oral antibiotics – usually metronidazole tablets taken for several days
• Vaginal gels or creams – such as metronidazole or clindamycin applied inside the vagina, often at bedtime

How long treatment lasts depends on the medicine, but many courses are about 5–7 days.

Important Treatment Tips

• Finish all your medicine, even if you feel better before you are done.
• Avoid having sex, or use condoms consistently, while being treated if your provider recommends it.
• Do not use tampons at the same time as vaginal creams or gels unless your provider says it is okay, because tampons can absorb the medicine.
• Do not drink alcohol while taking metronidazole unless your provider confirms it is safe; alcohol can interact with this medication.

In many cases, BV improves within a week of proper treatment, though discharge and odor may take a bit of time to completely normalize.

Can BV Come Back?

Yes. Even after successful treatment, BV can return. Studies suggest that about half of people treated for BV may have it again within a year.

If your symptoms come back:

• Make an appointment for another check-up.
• Let your provider know if you have had BV more than once; sometimes a different medicine or a longer course may be offered.

Possible Complications If BV Is Not Treated

Many teens worry mainly about symptoms like odor or discharge. But BV can also affect long-term health, especially if it is not treated.

Increased Risk of Other Infections

• The change in vaginal bacteria can make it easier to get STIs such as chlamydia, gonorrhea, herpes, and HIV if exposed.
• BV can increase the chance of developing pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, or ovaries. PID can lead to chronic pelvic pain and fertility problems later in life.

Pregnancy-Related Concerns

For people who are pregnant, untreated BV has been linked to:

• Premature birth
• Low birth weight
• Pregnancy loss in some cases

Because of this, anyone who is pregnant and has symptoms of BV should talk to a healthcare provider about testing and safe treatment.

Protecting Your Vaginal Health

There is no guaranteed way to prevent BV, but you can lower your risk and support a healthy vaginal environment.

Everyday Habits That Help

• Avoid douching – the vagina cleans itself. Douching can disrupt natural bacteria and increase BV risk.
• Use mild, fragrance-free soap on the outside (vulva) only; rinse with water and avoid scrubbing inside the vagina.
• Choose breathable cotton underwear and change out of wet swimsuits or sweaty clothes soon after activity.
• Wipe from front to back after using the toilet to reduce bacteria from the anus moving toward the vagina.

Sexual Health Choices

• Use condoms or other barrier methods correctly and consistently during vaginal, oral, or anal sex to reduce BV and STI risk.
• Limit the number of sexual partners and talk openly with partners about sexual health and testing.
• Do not share sex toys, or use a new condom on them with each partner, and clean them according to the manufacturer’s directions.

What About Probiotics?

Researchers are studying whether probiotics (like certain strains of lactobacillus in pills or vaginal products) might help prevent or treat BV, but there is not yet enough strong evidence to recommend them as a replacement for antibiotics. Always talk to a healthcare provider before using any over-the-counter or alternative treatments for vaginal symptoms.

When to See a Healthcare Provider

It is a good idea to seek medical advice if:

• You notice a strong vaginal odor that is new or bothers you.
• Your discharge changes in color, amount, or consistency and does not go back to normal.
• You have burning when you pee, pelvic pain, or pain during sex.
• You are pregnant and have any unusual discharge or odor.
• You have been treated for BV but your symptoms return.

Going for care is about protecting your health, not about being judged. Health professionals are trained to be confidential and respectful.

Talking About BV and Your Health

It can feel uncomfortable to bring up vaginal symptoms, even with a doctor or parent. But asking questions and getting help when you need it is a sign of maturity and self-care.

Tips for Starting the Conversation

• Write down your symptoms and how long you have noticed them.
• If you feel shy, you can start with: “I have noticed some changes in my discharge and I am worried something might be wrong.”
• Let your provider know if you are sexually active so they can recommend the right tests and advice.
• Ask any questions you have about periods, discharge, sex, or protection—nothing is “too small” to ask.

Frequently Asked Questions About BV