Fast Five Quiz: Vaginal Health

Michel E. Rivlin, MD


October 01, 2021

Bacterial vaginosis is caused by overgrowth of normal vaginal flora. Vaginal odor is the most common symptom and often the first symptom. Odor may be recognized only after sexual intercourse. The alkalinity of semen may cause a release of volatile amines from the vaginal discharge and cause a fishy odor. Increased vaginal discharge is typically mild to moderate. Vulvar irritation is less common. Dysuria or dyspareunia occur rarely.

Ask patients about risk factors that may predispose them to developing bacterial vaginosis. Predisposing factors include:

  • Recent antibiotic use

  • Decreased estrogen production

  • Smoking

  • Douching

  • Use of an intrauterine device (IUD)

  • Sexual activity that could lead to transmission, as evidenced by a patient having a new sexual partner, more sexual partners in the month preceding the onset of symptoms, or having more lifetime sexual partners

The use of public pools or toilet seats is not a significant risk factor for bacterial vaginosis. Hypertension has also not been linked to increased risk. Hormonal contraception is associated with a decreased risk.

Read more about bacterial vaginosis.


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