Bacterial Vaginosis (BV, aka Gardnerella)
Testing and treatment near you (Manhattan, NYC)
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Question 1

What can I expect during a BV (Bacterial vaginosis) test?

Answer

Pelvic exam

During this procedure, a health care provider visually examines the woman’s genitals and checks for the signs of pelvic infection via inserting two lubricated fingers into vagina and while pressing on the lower abdomen with the other hand (the procedure is illustrated below).

Females vaginal swab

The test should be performed by a doctor. Self-swabbing is also possible.

Cervical and/or vaginal fluid will be collected with a cotton swab (the procedure is illustrated below).

The procedure may cause mild discomfort or minor spotting afterwards.

Remember: You should not practice douching or use vaginal creams for 24 hours prior to testing.

Performance of the chlamydia swab test in females

Image source:
Chlamydia / N. Gonorrhoeae RNA, TMA - Unisex Collection | Diagnostic Laboratory of Oklahoma. https://www.dlolab.com/chlamydia-n-gonorrhoeae-rna-tma-unisex-collection.

pH test

A pH strip will be inserted, placed against the vaginal wall for a few seconds, and removed. The new color of the strip will be compared against a chart color to determine the pH level. A pH level > 4.5 suggests imbalanced vaginal flora, indicating possible BV.

Question 2

When will I know my test results?

Answer

pH test (point of care test): few minutes
Swab test: 4 business days

Question 3

What if my test is positive?

Answer

Gardnerella vaginalis (the main type of bacteria causing BV) is a curable vaginal infection. However, if a patient does not experience symptoms, she is not advised to get treatment.

According to the Centers for Disease Control and Prevention (CDC), females who test positive for Gardnerella vaginitis should be tested for other sexually transmitted infections such as HIV , Gonorrhea , Trichomoniasis ,and Chlamydia .

Question 4

How is BV treated?

Answer

Gardnerella is treated with one of the following options:

Metronidazole oral tablets (500mg) for a week (twice a day)
Intravaginal application of Metronidazole gel 0.75% for 5 days (once a day)
Intravaginal application of Clindamycin cream 2% for 1 week (every night)

It is important to abstain from alcohol during the treatment period (1 week) and for 24 hours after treatment completion. Only protected sex (use of condoms during sex) is recommended during the treatment period.

Question 5

If I tested positive, should my sex partner(s) be tested and treated?

Answer

It is not recommended to treat male partners of females diagnosed with Gardnerella vaginitis
Only female partners need to be tested for Gardnerella vaginitis because of the high prevalence of infection
Both male and female partners should undergo testing for other sexually transmitted diseases

Question 6

Should I get tested again after treatment?

Answer

After-treatment testing is recommended only for individuals who continue to experience symptoms of Gardnerella vaginitis.

Question 7

What is the probability of being infected with BV again?

Answer

About 80% of treated patients are reinfected. In 30% of cases, reinfection happens within three months of treatment completion.

Question 8

What is the recommended treatment for Gardnerella vaginitis recurrence?

Answer

For Gardnerella vaginitis recurrence, the course of therapy should be extended by an additional 3-7 days (10-14 total days of treatment).

For multiple recurrences of symptomatic Gardnerella vaginitis, one of the following is recommended:

Metronidazole oral tablets (2g) along with Fluconazole (150mg) for half a year (once a month)
Intravaginal application of Metronidazole gel 0.75% for 4-6 months (twice a week)

Question 9

What are the risk factors resulting in the harmful growth of Gardnerella vaginitis (bacteria causing BV)?

Answer

Factors that put a woman at increased risk of an overgrowth of Gardnerella are:

Frequent sexual activity
Suppressed immunity
Pregnancy
Douching
Multiple sexual partners
Sex with another female
New sexual partner
Smoking
Overweight
Low estrogen levels
Having an IUD (intrauterine contraceptive device)

Question 10

Where can I get tested for BV?

Answer

The test can be done in OB/GYN clinics, primary care offices or our specialized STD clinic.

Question 11

Will health insurance cover BV testing and treatment?

Answer

Yes. Health insurance usually covers the doctor’s office visit, testing and treatment.

If you have a high deductible plan and want to know your exact contribution for the testing, please call your insurance company about your contribution for the primary care office visit and Bacterial vaginosis testing (ICD 73.88; CPT 87491 or 87591).

Question 12

What is the cost of BV testing without health insurance?

Answer

If you do not have health insurance, the cost of the office visit is $84 cash (or $90 credit) plus $60 for the BV testing. All testing is performed in certified labs.

Question 13

What are the symptoms of bacterial vaginosis (BV)?

Answer

Bacterial vaginosis (BV) is a clinical condition caused by an imbalance of “good” (mostly lactobacillus) and “bad” bacteria (various anaerobic bacteria such as Gardnerella vaginalis) in the vagina.

Those who have symptoms of BV present with thin vaginal discharge with an off-white color and fishy smell, particularly after a sexual encounter and during a menstrual period
BV alone does not cause urinary symptoms (urgency, burning sensation during urination, increased frequency). The presence of those symptoms suggests an additional infectious disease
50 to 75% of females who have BV do not have symptoms

Question 14

Is Bacterial Vaginosis considered an STD?

Answer

BV can be (and usually is) sexually transmitted but is not classified as an STD because of the lack of a single cause (only caused by sex) and absence of the disease in males.

Question 15

Can I suspect my partner of infidelity if I have BV?

Answer

No. Sexual activity, as well as many other factors (douching, pregnancy, hormone disbalance, oral contraceptive pill, etc.), can trigger Bacterial vaginosis.

Question 16

What can I do to decrease the chances of getting BV?

Answer

Avoid douching
Limit the number of sexual partners (long-term sexual partnership leads to stability and alignment of vaginal micro flora)
Practice safe sex (use condoms)

Question 17

What can I do to alleviate BV symptoms?

Answer

Most people with Bacterial vaginosis (BV) have no symptoms.

Those who have significant symptoms such as smelly discharge or itching need to be seen by a doctor.

In the meantime, the following can help with managing symptoms:

Take a shower instead of a bath
Avoid vaginal washes and deodorant. Use regular soap and water instead
Wear breathable underwear (cotton)

Question 18

What are the complications of BV?

Answer

Usually, BV causes no complications. However, in some cases it may result in:

Increased risk of contracting STIs such as HIV, herpes, chlamydia, and etc.
Obstetrics complications (preterm delivery, low birth weight newborn, or miscarage) in pregnant women
Pelvic Inflammatory Disease (PID)

Question 19

Bacterial vaginosis vs. yeast infection.

Answer

BV and yeast infection (or vulvovaginal candidiasis) have similar symptoms, and both cause vaginitis.

However, these two conditions are treated differently (yeast infection can be treated with over-the-counter medicines, while BV medications should be prescribed by your doctor).

Therefore, to have the needed treatment outcome, it is essential to distinguish between these two conditions. The main differences between the BV and yeast infection are:

BV is mainly caused by Gardnerella vaginitis, whereas the yeast infection is caused by a fungus called Candida
BV cause fishy odor from vaginal secretions, yeast infection does not cause vaginal odor
BV causes thin vaginal discharge, while the discharge of yeast infection tends to be thick (like cottage cheese)

Question 20

Where is the STDcenterNY clinic located?

Answer

Our walk-in clinic for STD testing and treatment is conveniently located on the east side of Midtown Manhattan near the Grand Central Terminal and the Main branch of the New York City public library.
Despite it being our only STD testing center, we offer health services to New Yorkers from all zip codes across all 5 NYC boroughs: Manhattan, Brooklyn, Queens, Bronx, and Staten Island
Our certified STD center offers testing services for chlamydia and other STDs (including syphilis, gonorrhea, herpes, HIV, HPV, hepatitis B, and hepatitis C), along with quality treatment and follow-up care.