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Health Issues

Bacterial Vaginosis

Bacterial vaginosis (BV) is the most common vaginal infection in sexually active teenaged girls. It appears to be caused by a bacterial imbalance or overgrowth in the vagina, resulting in an increase in harmful bacteria. The actual organism responsible for vaginosis hasn’t been clearly identified. 

BV is uncommon in sexually inexperienced females. The presence of BV in girls before puberty raises concerns about but does not prove sexual abuse

​Signs and Symptoms

In many cases, BV does not cause any signs or symptoms. At other times, BV may cause:

  • A white vaginal discharge that coats the walls of the vagina
  • Vaginal discharge with an unpleasant or fishlike odor
  • Vaginal pain or itching
  • Burning during urination

Doctors are unsure of the incubation period for bacterial vaginosis.

How Is the Diagnosis Made?

Your child’s pediatrician can make the diagnosis of BV during a physical examination by looking for the signs associated with the infection. The doctor can also order a laboratory analysis using a sample of vaginal secretions to detect bacteria associated with the infection.

If BV is diagnosed in a sexually active teenager, she should be tested for other sexually transmitted infections (STIs) such as:


Treatment is recommended for all teenaged girls and adult women who have signs and symptoms of BV. Common treatments include an oral or gel formulation of metronidazole or, in some cases, clindamycin in a cream preparation.

What Is The Prognosis?

Proper treatment can resolve a BV infection.

Teenaged girls and women with BV may have an increased risk of developing pelvic inflammatory disease (PID). If BV is present in a pregnant woman, it can increase the likelihood of premature delivery or endometriosis.


While acknowledging that the best preventive steps are unknown, the Centers for Disease Control and Prevention has noted that the risk of BV may be reduced by limiting the number of sexual partners and not using douches, which can upset the natural balance of bacteria in the vagina. It is not necessary to treat the male partner of a patient with BV.

Last Updated
Adapted from Immunizations and Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics) and updated 2012
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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