Bacterial Vaginosis Diagnosis

Bacterial vaginosis diagnosis is not a simple diagnosis. BV is a common cause of vaginitis. You may have a clue you have it because you have suspicious vaginal discharge or an itchy vagina, or you may not know at all. To read more about the symptoms and dangers, especially the dangers in pregnancy, go here.

BV needs to be diagnosed by a healthcare practitioner because it is only one of several causes of vaginitis, and without an accurate diagnosis, there's no way to know how to treat it or if you are having your condition treated correctly. If you self-medicate vaginitis without knowing exactly what you have, the results can be devastating.

This website is all about being healthy, especially with probiotics, but in order to be healthy, you have to know what is causing you to be unhealthy. No guess-timating!!!

So... please, don't try to self-diagnose.

 What Do Providers Look for in Bacterial Vaginosis Diagnosis?

Bacterial vaginosis diagnosis can be done in different ways. Some medical practices will do a preliminary screening for it under a microscope. They take a sample (or swab) of the vaginal fluid and look for 3 of the 4 following indicators:

  1. A pH greater than 4.5
  2. The presence of vaginal cells with a thick coating of bacteria on them so that the borders of the cells are not seen
  3. A milky, homogeneous (meaning it's the same throughout) vaginal discharge
  4. And the release of a fishy odor after the addition of 10% potassium hydroxide to the vaginal fluid.

The gold standard of diagnosis is to take a swab from the vagina and send it to a qualified laboratory for analysis and Nugent scoring. The swab is rolled on a glass slide, heat fixed, Gram stained, and then evaluated by a trained examiner under a microscope under oil immersion and one thousand-times magnification for: large Gram-positive rods indicating Lactobacillus-like bacteria, small Gram-variable rods indicating Gardnerella vaginalis-type bacteria, small Gram-negative rods indicating Bacteroides species, curved Gram-variable rods signifying Mobiluncus species and Gram-positive cocci (spheres).

A Nugent score of 0-3 is considered to be normal, 4-6 is considered to be intermediate, and 7-10 is a positive diagnosis of bacterial vaginosis. An intermediate score means that either the condition will correct itself (in about 30% of cases) or it will develop into BV ( in 32% of the cases).

If you are diagnosed with an intermediate case of BV, you and your doctor have to decide if you should be treated or not.

Treatment of Bacterial Vaginosis

Bacterial vaginosis does not always have a 100% cure rate in studies, but to learn about treatment options, see Treatment of Bacterial Vaginosis, starting with conventional treatments. To go to the use of probiotics for BV, go here.


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