What is Bacterial Vaginosis?
Bacterial Vaginosis also known as anaerobic vaginosis, nonspecific vaginitis, Corynebacterium vaginalis, Haemophilus vaginalis, Gardnerella vaginalis or anaerobic colpitis. It is a common vaginal disease affecting women aged 15-44 however aetiology of the infection is not fully comprehended. 
Nature of the disease
The vaginal infection is basically caused by imbalance of bacterial microflora. Anaerobic bacteria and some other types of bacterial agents like Gardnerella vaginalis, Mobiluncus species, Peptostreptococcus species Mycoplasma hominis or ureaplasmas reproduce rapidly and vaginal pH increases above 4,5 followed by destruction of Lactobacilli. Some Lactobacillus species produce hydrogen peroxide which is toxic to organisms without relevant enzymes. Therefore reduced amount of Lactobacilli and increased concentration of other bacterial species is supposed to cause the malady. Apart from this, Lactobacilli metabolize glycogen to maintain acidic environment. Lactobacilli serve as a disinfectant supporting proper amount of vaginal microorganisms and maintaining relatively constant conditions in the vaginal environment. The bacteria associated with bacterial vaginosis may use amino acids as carbon source. Therefore women suffering from the disease show lower concentration of amino acids and dipeptides along with appearing amino acid catabolites in their metabolic profiles. 
Causes of bacterial vaginosis
Usage of medicated soaps, oral antibiotics, intra uterine devices, douching, cigarette smoking or detergents increases probability of contracting the disease. Many sex partners also make bacterial vaginosis more likely although it is not any sexually transmitted disease. Factors altering the vaginal pH like e.g. douching or alkaline semen increase probability of the infection due to disruption of the vaginal environment. Something as innocent as tight clothing or damp swimsuit also may trigger the bacterial imbalance in vagina. Obviously bad diet and poor personal hygiene can cause infection too. 
Complications associated with Bacterial Vaginosis
Bacterial vaginosis is considered to be a mild infection notwithstanding if left untreated it leads to more complications with sexual organs. The bacteria can make its way up towards fallopian tubes or uterus causing pelvic inflammatory disease, cervical cancer, abnormal bleeding, endometritis and even infertility. Bacterial vaginosis is not considered to be any dangerous illness however it increases the risk of preterm birth, spontaneous abortion, post cesarean wound infections, postpartum endometritis, amniotic fluid infection or premature rupture of membranes in case of pregnant women or even miscarriage [3,4]. Women suffering from bacterial vaginosis are more likely to catch any other infections or sexually transmitted diseases including AIDS, especially while undergoing gynecologic procedures or surgery.
How to recognize the symptoms of Bacterial Vaginosis? [1,2]
Bacterial Vaginosis turns out to be asymptomatic in many cases. However it is relatively easy to identify the malady by the below mentioned symptoms:
Vaginal discharge: White or grey homogeneous fluid adhering to the vaginal wall. It occurs when naturally living bacteria in the vaginal area grow excessively.
Vaginal odor: The vagina becomes more alkaline and the discharge may smell of fish due to high concentration of volatilized amines. The fishy odor often becomes stronger with higher pH which might increase even up to 7.
Vulvar pruritus: Itching in the vaginal area also may occur although they are not common symptoms. Some women may feel either pain or burning during urination.
Clue cells from vaginal epithelium which are covered by the excess bacteria – most often Gardnerella vaginalis, but also fusobacteria, mobiluncus, cocci etc. They can be detected by a microscopic examination.
Presence of short coccobacilli and mild nuclear enlargement.
Gram staining can be clinically used to determine concentration of Gram-positive and Gram-negative bacteria.
Can Bacterial Vaginosis be mistaken for other conditions?
The symptoms are similar to other maladies like gonorrhea, chlamydia, trichomoniasis etc. Therefore bacterial vaginosis can be easily misdiagnosed.
May Bacterial Vaginosis be recurrent?
Conventional treatment by antibiotics or antifungals often fails because they disturb the natural balance of vaginal bacteria so it may even lead to worse Bacterial Vaginosis. Bacterial vaginosis may turn out to be unusually persistent infection and even after short-term successful antibiotics treatment it may keep coming back. It happens because the drugs solely clear up symptoms but don’t fix the underlying bacterial imbalance which is supposed to be the most probable cause of bacterial vaginosis. Therefore it is essential not only to apply natural healing home remedies but also to alter your lifestyle in order to get rid of bacterial vaginosis for good. 
 Centers for Disease Control and Prevention (CDC). Bacterial vaginosis – CDC fact sheet. Retrieved from www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm
 Kumar N, Behera B, Sagiri SS, et al. Bacterial vaginosis: Etiology and modalities of treatment—A brief note. Journal of Pharmacy and Bioallied Sciences. 2011;3(4):496–503.
 Shimaoka M, Yo Y, Doh K, et al. Association between preterm delivery and bacterial vaginosis with or without treatment. Scientific Reports. 2019;9:509.
 Isik G, Demirezen S, Dönmez HG, Beksaç MS. Bacterial vaginosis in association with spontaneous abortion and recurrent pregnancy losses. Journal of Cytology. 2016;33(3):135–40.
 Wilson J. Managing recurrent bacterial vaginosis. Sexually Transmitted Infections. 2004;80:8-11.