• Bacterial Vaginosis (BV)
• Vaginal Changes
• Vaginal Discharge
• Infections

A Comprehensive Overview of Bacterial Vaginosis Testing

Medically reviewed and edited by Dr. Banita Sehgal

Bacterial vaginosis (BV) is one of the most common conditions affecting the vagina.

It’s estimated that around 29.2% of Americans, especially in the 14-49 age group, have experienced this bacterial infection.

Despite its prevalence, BV often goes undetected or can be mistaken for other conditions. That’s why a proper testing procedure is essential for an accurate diagnosis and for preventing other medical concerns.

LifeMD can help you better understand BV, how the testing process works, and what you can expect when you undergo a BV test.

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What is Bacterial Vaginosis?

BV is a common vaginal infection caused by an imbalance in the naturally-occurring bacteria in the vagina.

There is a delicate balance of beneficial bacteria in a healthy vagina. With a bacterial vaginosis infection, there is an overgrowth of harmful bacteria that upsets the vaginal flora.

BV can lead to uncomfortable symptoms such as abnormal vaginal discharge, itchiness, and a strong or unpleasant odor.

The exact cause of BV isn’t fully understood, but factors like sexual activity, douching, and hormonal changes contribute to its development.

How is Bacterial Vaginosis Diagnosed?

There are a few methods for diagnosing BV. Most healthcare professionals will use a combination of clinical evaluation and testing to provide the most accurate diagnosis.

Clinical evaluation

During a clinical BV evaluation, your healthcare provider will review your medical history and ask about your symptoms.

They may also perform a physical examination to determine if you have any physical signs of BV, such as redness or swelling in the vaginal area.

BV test

After a clinical evaluation, your healthcare provider will likely order a BV test. This usually involves taking a vaginal fluid sample and sending it to a laboratory.

If specific cells and bacteria are found in the samples, you’ll be diagnosed with BV.

What are the Different Types of Bacterial Vaginosis Tests?

There are a few different types of BV tests, and your doctor will recommend the one depending on your circumstances.

pH testing

BV often increases the acidity of the vagina, so a pH test can be used to determine if you have an infection.

Your healthcare provider may use a special strip or swab to collect discharge and measure the vaginal pH levels. Anything greater than 4.5 is typically associated with BV.

Whiff test

A whiff test involves adding a chemical solution to a sample of vaginal discharge. If a characteristic fishy odor is detected, it may indicate a BV infection.

This type of test can also help differentiate BV from other vaginal infections -- it’s the only one that causes such a strong smell.

Microscopic examination

A microscopic examination of a vaginal discharge sample is also often used to identify indicators of BV.

Healthcare providers primarily look for the presence of clue cells, which are vaginal cells covered with bacteria.

How Can You Prepare for a Bacterial Vaginosis Test?

Depending on your circumstances, there are a few things your doctor may recommend to help you prepare for your BV test. This usually includes:

• Avoiding vaginal products for 24 to 48 hours before the test

• Avoiding using menstruation products like tampons

• Limiting sexual activity and products that may disrupt the pH level — like lubricants

• Not scheduling a test during your menstrual period

• Informing your healthcare provider about any medications you’re taking or conditions you may have — some products and diseases require special care during the testing process

• Being honest about your symptoms in your initial consultation with your doctor

What Should You Expect on the Day of Your Test?

Although getting a BV test can seem stressful, you don’t have anything to worry about.

When you arrive at your appointment, your doctor will typically perform a clinical evaluation after asking you to remove your clothes from the waist down.

You will likely lie on an exam table and place your feet on stirrups to keep your legs up and apart from each other.

Your healthcare provider will insert a medical tool called a speculum into your vagina. The tool may be covered in lubricant to ease discomfort.

During this process, your healthcare provider will examine your vagina and determine if you have any physical signs of BV.

Once they complete this check, your doctor will insert a cotton swab into your vagina to collect a fluid sample. This sample will be sent to a lab for further testing.

What happens after your BV test?

While BV tests usually don’t cause much discomfort, it’s normal to feel a bit sore afterward. You may also experience some light bleeding.

These symptoms typically resolve on their own and don’t require you to restrict any physical activity in the days following the test.

How long does it take to get results?

Depending on the type of test you took, it can take anywhere from a few hours to a couple of days for your results to be available.

During your test, your doctor will usually inform you of the expected time to receive your results. At-home tests will have information about results on the packaging.

Are There Any Risks Involved with BV Testing?

Although BV tests typically don’t involve any risks, there are a few things to consider during and after your appointment. Here’s what you should be mindful of:

• Discomfort during your test: If you feel any excessive pain or discomfort, it's important to inform the healthcare professional performing the test.

• False negative or false positive results: While BV tests are generally accurate, there is a small chance of false results. Factors such as improper sample collection, laboratory errors, or underlying conditions can affect the accuracy of your test. If you have concerns about your results or if your symptoms persist, consult with a healthcare provider for further evaluation.

• Psychological impact: For some people, undergoing a BV test may cause anxiety or stress. If you experience emotional distress during the testing process, discussing your concerns with your healthcare provider can be helpful.

• Invasive testing: In rare cases, additional testing methods, such as endometrial biopsy or pelvic ultrasound, may be performed to rule out other potential causes of symptoms. These procedures carry their own risks and complications, which should be discussed with your healthcare provider beforehand.

If you experience any of these factors, it’s important to mention them to your doctor as soon as possible.

They can provide additional information and support to help you avoid any problems or discomfort during your BV test.

When Should I See a Doctor About BV Testing?

BV isn’t a life-threatening condition, but it can be uncomfortable to live with. That’s why you should speak with your doctor as soon as you suspect you may have an infection.

You should also speak to your healthcare provider in the following circumstances:

• Experiencing persistent symptoms such as abnormal discharge, odor, and discomfort that persists for more than a few days.

• Having recurrent BV infections within a short period of time.

• Symptoms that don’t improve with treatment may indicate that a more comprehensive testing approach is necessary to determine an effective management plan.

• If you have concerns about your general vaginal health, you should discuss this with your doctor, even if you don’t show symptoms of BV.

• Planning on getting pregnant requires a healthy vaginal environment. BV during pregnancy has also been associated with birth complications, so it’s important to talk to your doctor about lowering your risk of infection.

• Feeling uncertain about your symptoms generally requires a trip to the doctor for clarification and peace of mind.

It’s important to consult with your doctor whenever you feel unsure or concerned about your sexual health. They can offer support and recommend the appropriate management plans, if necessary.

Where Can I Learn More About BV and Similar Conditions?

If you want to learn more about BV or you’re worried about your symptoms, LifeMD can help.

A medical professional can assist you by providing information on BV and recommending further testing for a more accurate diagnosis — all from the comfort of your own home.

Make an appointment with a licensed doctor or nurse practitioner.

Dr. Banita Sehgal

Dr. Sehgal received her medical degree from Western University in Los Angeles and trained as Chief Resident at White Memorial Medical Center, also in Los Angeles. She’s been practicing medicine for 20+ years and has a specific interest in women’s health.

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