While bacterial vaginosis is especially common among patients attending STD clinics, some experts believe this may occur because BV might enhance the transmittal of STDs rather than because BV itself is transmitted by sexual contact. While sexual activity may increase the likelihood of developing BV, the condition has also been found in sexually inexperienced and monogamous women. A few studies have also correlated BV with increased douching, an increased number of sexual partners and use of intrauterine devices. The outward signs of BV may include an unpleasant vaginal odor in varying degrees and an excessive white or gray vaginal discharge with a milk-like consistency that can stain undergarments. Vaginal itching or burning are also sometimes present.
Women often report that the odor is particularly embarrassing after sexual intercourse.
When semen mixes with vaginal secretions, it lowers the acidity level to make the odor particularly strong. Odor may also be more apparent around the time of menses. Other signs of BV can be determined only through an examination by a health care professional. Potassium hydroxide may also be added to a vaginal discharge sample to enhance and help detect any fishy or foul odor. It has been estimated that up to 40 percent of women with BV may experience no outward symptoms or discomfort at all, although this perception may be due to lack of communication by patients.